Thursday, April 3, 2008

What was wrong with the speech therapy at the hospital?

Now that I have 20/20 hindsight, I can clearly see what was wrong with the 5 days of speech therapy at the hospital: The sounds! For 5 days I tried the sounds: A, E, I,O, U. In other words the vowels. But given that half of my face and tongue was paralyzed, I couldn’t pucker my lips to produce the sounds O and U, I couldn’t use chin and cheek muscles to produce the E sound, and I couldn’t use my tongue inside to produce the A sound. So all I was left with was an unrecognizable “I” sound like “It”. Whatever the therapist would point at I would always say “I”. But when I left the hospital, I was given the homework of working on: P,B,F,V, none of which required any vowels. I could bring my lips together to be able to eat, so I could at least utter P and F.
So we began with those sounds. “Bring your lips together. Now blow hard!” That was the “P” sound. “Feel how my vocal chords are vibrating. Feel it? OK, now you should do the same. OK now it gets complicated a bit. When at the same time you utter the “P” sound, if you make your vocal chords vibrate or hum you will have “B”.Wonderful!” Now “F”. Place your lower lips so that it touches your upper teeth. Now blow air out. If you can vibrate your vocal chords again while saying “F” then you will produce the sound “V”.
Mehmet and I would sit opposite to each other and say “pen” over and over again. Then mom would take over and put her index finger slightly into her mouth close her lips around her finger, urging me to do the same. “Now hold it, hold it. After I close my lips around it I will take my finger out. It will leave your lips in an O shape. You should do the same but not let you lips slacken, and then hum.” When I hummed, out came the sound “O”, because my lips were still forming an O. I was so delighted. From now on when I couldn’t think of how to form an “O” I could always put a finger into my mouth, take it out, and then say “O”.
We worked that weekend very hard. Whenever I wasn’t eating or sleeping, we worked.
On the aphasia front (putting concepts into words) there was also homework to be done. My caregivers (mom and Mehmet) were to draw some pictures with simple sound, then point them to me and ask me to say it, when that failed they would say it and then ask me to say it. Then they would ask me to write it, when that failed they would write it themselves and ask me to copy it down. So they drew “water” (in Turkish “su”), medication (meds), fork, sun, pen, paper, bed, table, up, down, left, right, book, ball, hand, moon, moon, bell, boot, head, lamp, home, salt, milk, food… I could understand all their drawings that was an achievement by itself. But I couldn’t come up with words. After several times they said it I could say something similar – maybe. They would say “fork” after some time I could say “fo” etc.


The Aphasia Decoder.... said...

It's a long road back, isn't it.

The Bee Folks - Lori Titus said...

My husband went to a speech therapist soon after his stroke, and she triede the entire A,E,I,O,U thing with him. Didn't work, not at that time. He couldn't hear the difference in sounds, nonetheless figure out how to force his mouth to make the correct movements.

Now, three years later, that sort of exercise helps. He can hear the difference now, at least when he is awake and not under stress. He can watch someone else make the sound, and try to imitate the mouth movements. He still doesn't always get it correct (ie, "teeth" comes out as "teets"), but he understands what is going on now.

Don't give up on the A,E,I,O,U thing. It might not be right for you now, but try again in a few months, or a year or two.