A stroke is a medical condition in which poor blood flow to the brain results in cell death and brain damage. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding.

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A stroke can result in speech, language and/or swallowing difficulties.

• Aphasia is the term used to describe a language impairment after stroke. It can affect speaking, understanding spoken language, reading and writing. 

• Dysarthria is the term used to describe slurred speech or unclear articulation of speech. 

• Dysphagia or swallowing difficulties can range from mild to severe. Some people with dysphagia have problems swallowing certain foods or liquids, while others can't swallow at all. 

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Following an initial assessment, an individualised therapy plan is made for people with aphasia, dysarthria and/or dysphagia. 

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One to one and group therapy is available at the Aptus Speech Clinic for people with aphasia. 

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Traumatic Brain Injury (TBI) is an injury to the brain caused by a trauma to the head. There are different causes, including road traffic accidents, assaults, falls and accidents at home or at work.

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A TBI can result in communication and/or swallowing difficulties:

• Cognitive-communication disorder: After a TBI the person may have problems with communication due to an underlying  cognitive deficit (e.g. attention, memory, planning, slowed processing) rather than a primary language or speech deficit.

• Aphasia: Injury to language centres of the brain leads to a condition called aphasia. There are different levels of impairment ranging from mild to severe. Reading, writing, speaking and the understanding of language may be impaired. 

• Dysarthria occurs when there is damage to parts of the nervous system involved in the control of muscles used for speech. It results in reduced control and clarity of speech.

• Dysphagia or swallowing difficulties can range from mild to severe after a TBI. 

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Every person who has had a TBI will have different needs. An individualised therapy plan is made following an assessment. 

Parkinson's disease (PD) is a long-term degenerative disorder of the central nervous system that results in slowness of movement and difficulty walking. Speech/voice and the ability to swallow are also often affected as the disease progresses.

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Intensive speech therapy is recommended for individuals with Parkinson's Disease who present with unclear speech and reduced conversational volume. Lee Silverman Voice Therapy and Speak Out are evidence-based treatment approaches. 

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Compensatory tools can benefit individuals with more severe speech/voice difficulties. These may include voice amplifiers, text to speech apps. 

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Assessment of swallowing and reviews are important due to the risk of aspiration and chest infections. Swallowing rehabilitation exercises may be introduced following assessment. Expiratory muscles strength training may also be of benefit. 

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Motor Neurone Disease (MND) is a progressive neurological condition. It attacks the motor neurones, or nerves, in the brain and spinal cord. Gradually messages stop reaching the muscles, which leads to weakness and wasting. MND can affect walking, speaking, swallowing and breathing.

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Speech therapy does offer a cure or quick fix for speech/voice problems in MND.  However, strategies can be introduced to make speech clearer. Speech will gradually deteriorate and the person may eventually lose their voice. This is why voice banking at diagnosis is advised.

 

Regular swallowing reviews are also recommended to ensure swallowing safety. Expiratory muscles strength training may be of benefit.  

A brain tumour is a growth of cells multiplying in an abnormal, uncontrollable way in the brain.

 

Some people with brain tumour will experience communication difficulties. It depends largely on where the tumour is in the brain.  Brain surgery can also cause communication difficulties. 

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There is a range of communication difficulties that can occur including

• Aphasia

• Cognitive-Communication Difficulties

• Dysarthria

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Following assessment, an individualised therapy plan is made. This may include impairment-based therapy, compensatory strategies, family and carer training on strategies to support communication. 

Dementia is an umbrella term for a range of conditions that cause damage to the brain. Memory, thinking, language and the ability to carry out everyday tasks can all be affected. There are many conditions which cause Dementia including Alzheimer’s, Vascular Dementia, Dementia with Lewy bodies and Frontotemporal Dementia.

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Communication and swallowing are often affected as the disease progresses. 

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Speech Therapists can carry out a language assessment to determine if areas of language have been affected. They can advise family members and carers on how to support the person's communication. In the earlier stages, they may be able to introduce strategies that the person can use themselves to support their communication. 

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Speech Therapists can also assess swallowing and provide advice on diet and fluid modifications as well as techniques to support the person .