Helping stroke survivors recover communication skills

November 29, 2000

CLEVELAND -- Imagine being suddenly trapped in a foreign country without any knowledge of the written or spoken word. Something like that happened to Grover Shellko on June 1, 1999. He had a stroke.

In the aftermath of the damage to parts of the left hemisphere of his brain -- the section that controls speech and language -- he says he could only utter sounds instead of words. Suddenly the world he and his family knew changed. He had to relearn what had come naturally to him for more than five decades.

Lyn Turkstra, assistant professor of communication sciences at Case Western Reserve University, often uses the analogy of being in a foreign country when describing what aphasics experience. "You would be able to speak clearly, but would not be understood," she says. "Stroke patients can also recognize symbols, such as a Red Cross for a hospital but may not be able to say the words."

Shellko and five other individuals meet weekly in a special aphasia communication therapy group where everyday conversations are used to improve their language skills. Aphasia is an acquired language impairment due to a neurological event that causes one to lose part of their ability to understand and use language.

When the words do not come, they learn how to use gestures, draw pictures, and use symbols to communicate ideas and reconnect to the speaking world.

The Cleveland Speech and Hearing Center (CHSC) and CWRU's Department of Communication Sciences have established two therapy groups and are looking to expand the numbers they help. The groups meet Wednesday afternoons at CHSC, 11206 Euclid Avenue. The groups are geared toward placing individuals with similar language needs together.

The groups meet under the direction of Angela Hein, a CWRU graduate student in the communication sciences doctoral program. She facilitates conversations among the participants, who are working to overcome language difficulties which they have faced for up to 20 years as a result of neurological damage.

Discussions center around current and social events in their lives, says Turkstra. She initiated the idea for the groups after observing how effective similar therapy groups were at the University of Arizona, where she was a faculty member before coming to CWRU. She approached Michelle Burnett, director of speech-language pathology at the Cleveland Hearing and Speech Center, and they launched their first group in January.

Using conversational therapy techniques developed by the Pat Arato Aphasia Clinic in Toronto, the group's interaction becomes a vehicle to improve language skills, relearn how to communicate with families or friends, and use strategies which the individual's speech therapist suggest to trigger the recall of words and language. According Turkstra, an example of that strategy can be writing the first letter of the word to help stimulate recall.

The therapy group also provides an informal support network which allows the stroke survivors and their families to exchange information about how to cope in the recovery stage.

Turkstra, who has seen many people significantly improve their communication skills through this type of group, says it takes a tremendous amount of courage for individuals to make an effort to talk. Many times, speech is the last skill recovered after the stroke.

She also notes that many times stroke survivors can sing songs without any difficulty, drive a car, or do other tasks, but are mistaken as drunk or unintelligent because of the slurred speech and word errors. In the aphasia group, participants can share ways they have personally coped in these situations.

Elizabeth Calabro, who continues to regain her language skills after two brain surgeries two years ago, encourages Shellko to talk and praises him for his recovery, patting his hand. She says the way she regained her language skills was to become active at church, which forced her to talk and engage in conversations with families and acquaintances.

"She's a fighter," says Frank Calabro, who has watched his wife start over, relearning everything from the alphabet to putting words together in a sentence.

Case Western Reserve University

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