This situation is familiar to many people recovering from stroke or TBI- they aren’t ‘back to normal’ yet, but for some reason therapy is ending. How disappointing! Even though you may still want or need therapy, sometimes insurance just won’t keep paying- or maybe your progress has stalled and it makes sense to take a break for a while.
But here’s the great part. You can keep working! If you are reading this while you are still getting speech therapy, ASK your speech therapist to make you some homework sheets or recommend some Apps for when you discharge. Tactus Therapy apps are fantastic and I use them all day in my private practice and with my Intensive Comprehensive Aphasia Program clients.
If you are looking for free options (who doesn’t love free) then you should check out Lingraphica’s Talk Path Therapy app/website and aphasiatherapyonline.com. Other great resources are teacher supply stores and the Dollar Tree- they have workbooks for grammar and vocabulary that are inexpensive (and math, and science, etc). In my experience, the Dollar Tree usually just has workbooks for lower level skills while the teacher supply store has challenging workbooks on many topics for any level- some that even I wouldn’t be able to do!
So let’s say you’ve tried to copy what your speech therapist was doing, and you feel like you have mastered it. For example, in therapy you may have worked on naming pictures of things (to improve semantic skills). Now what? Where can you go from here? That is always on my mind as a speech therapist. What can we do next that will challenge my client, or will solidify past learning, or make their communication as functional as possible. (Functional just means how useful something is in the real world).
So, if you’ve gotten good at naming, then you can start describing those items (Semantic Feature Analysis). Let’s take a picture of a frog- you would say ‘frog’, then we would add a challenge by asking you to describe more things about the frog. Where can you find a frog? What color is a frog? What does a frog look like? What category does a frog belong in? What other things might be in that category too? Then another challenge you can add is using that word to make a short sentence- even if it just sounds like “This is a frog” or “I see a frog” or “I want a frog”. That alone can be extremely challenging especially if you also have Apraxia of Speech (difficulty planning the mouth movements that create the sounds that make speech). After you’ve conquered nouns, start working on verbs! Verb Network Strengthening Treatment (VNeST) is all about building up your ability to use verbs effectively. Verbs are necessary in effective communication.
Another thing to keep in mind is the 'cuing hierarchy'. Tactus Therapy does a great job of describing it here. When you are struggling to find the words, have your family or friend follow the cuing hierarchy to help you get to the word. Tactus therapy apps have this cuing already set up so you can do it in the app without anyone helping you.
Final thoughts-
1. Remember to go slow, really take your time with each exercise to allow your brain time to learn. It’s natural to want to be in a hurry to get better, but if you hurry you will skip some important steps in your recovery.
2. You can add complexity to anything. If one task has gotten too easy, add something else to it that makes it harder. That can look like adding more words, or even just adding distractions to your environment while you are trying to complete the tasks.
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