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Friday, April 13, 2012

ST: Back On Board

Bob had his third appointment with the new Speech Therapist this week, you know the one who told me Bob was "functional" and didn't need speech therapy. Well, she must've went home and thought about it after our little "talk" and she arrived on Wednesday with a totally new attitude. I guess it pays to put one's foot down, occasionally.

She actually brought in some worksheets for me. She said she had looked for Level 2 Guides that I asked for, couldn't find them, but would keep looking. She gave me some ideas on how to work on this without the guides, if she can't find them. Then, she ran Bob through a list of words trying to figure out his main articulation problems. She also tried a bit of Melodic Intonation Therapy on him. (This therapy is a sort of tapping out a rhythm while speaking a difficult word or sentence.) I asked her if she would continue to work on the Melodic Intonation Therapy with him as it seemed to be helping him when she tried it and she agreed start that therapy next week.

She also gave me a helpful tip to try with Bob when he perseverates, i.e. gets stuck on a word or phrase and keeps repeating it.  Which is to touch him, physically, on the hand and arm. A physical sensation or movement, she said, should distract him and "unstick" his brain. She also said a kiss would work as well.

I told her if I kissed Bob every time he perseverates, he'd start doing it on purpose! ha!

But I couldn't believe this was the same ST, a complete turn-around from Bob's last appointment. It really does pay to be a bitch, sometimes! ha!

Anyway, I guess we'll keep this ST for now. I do like this Melodic Intonation Therapy idea. It's always good to try something new and Bob does love to sing. And he does have an articulation problem, mainly because his mouth and tongue are still weak and/or partially paralyzed.

7 comments:

Anonymous said...

I suspect I wouldn't want to be on the receiving end of one of your "talks"....:>). I bet if you like the Melodic Intonation Therapy for Bob, Bob will like it too. Have a great weekend. Hugs, Dan

an SLP said...

It's good that your SLP is getting on board with providing treatment, but it is still concerning that she initially dismissed Bob as not being in need of services because he can communicate if he's too hot or whatever.

Melodic Intonation Therapy sounds like a good approach to try with Bob, especially if he enjoys singing. Does he sound clearer or have an easier time producing words when he sings compared to when he speaks? There are also treatments that focus on drawing that Bob may enjoy. While drawing is sometimes used as a compensatory mechanism for people with aphasia, so that they have an alternate means of communicating, there is some preliminary evidence that it could help spoken word retrieval.

For a case study in which drawing was used as a component of therapy, see http://www.asha.org/Events/convention/handouts/2009/2359_Stark_Jacqueline/

You mentioned that Bob's tongue and mouth are weak. You probably know this, but this is called dysarthria and is a separate problem from the aphasia. (See http://www.asha.org/public/speech/disorders/dysarthria/ for some reliable basic info.) It might be worthwhile to have an SLP do an oral mechanism examination to evaluate the strength, range of motion, and sensitivity of Bob's tongue, lips, soft palate, etc. Bob may well have had this done already, especially since he has swallowing issues.

Linda said...

Maybe, it pays to be a bit of a bitch, but I can't help thinking that Bob's own response about what to do at the bank indicated he means business too! (Actually as opposed to threatening it showed her a bit of the real clever Bob hiding inside his head).

It sounds like the ST is making a real effort now so that is fantastic.

It must be nice for you to be getting some fresh ideas to try, and having a team and not being all alone in trying to figure out what therapy to do next must feel very good too.

I just feel so happy for the two of you right now.

oc1dean said...

Diane, just for grins ask about swearing. A survivor I know has no problem in quickly swearing. Is there a separate location for swearing as there is for singing?
Dean

Linda said...

Dean.. I am swearing a lot more.. (daughters have complained that it is a bad change) I thought it was frustration but maybe it is just that part of my brain kicking in!

Diane said...

Bob has no problem in the swearing department! ha ha!
The other day he actually yelled "F--- You!" at some poor fellow walking past the house.

I nearly died!

metalgirl162002 said...

I've heard that singing is easier for a lot of people with speech impediments and the like, so hopefully this will work for you!