What does Speech and Language Therapy for neuro-rehab involve?
Speech and language therapy aims to help people with communication difficulty and improve their physical ability, including drinking, eating and swallowing through various assessments and support by professionals. Whereas neurorehabilitation aims to aid people with complex neurological conditions arising from problems associated with the central nervous system, namely the brain or spinal cord (INPA 2020). SLT with neuro- rehab combines these definitions with the center goal of supporting and improving communication, playing a crucial role in the aftermath and recovery of a neurobiological injury. Common neurological conditions treated in neurorehabilitation include; vascular disorders (such as a stroke), infections (such as meningitis), trauma (such as brain or spinal cord injury), structural or neuromuscular disorder (such as Bell’s palsy), episodic disorders (such as headaches) and degenerative disorders (such as Parkinson disease) (John Hopkins Medicine). Speech and language therapists address key areas such as speech, language, communication and swallowing (dysphagia) therapy to assist and improve the quality of life of these patients.
The Personalized Path to Progress
In order to achieve this patient specific recovery, speech and language therapists use thorough assessments and set particular goals. Specialist neurological speech and language therapist Trudi Jenkins explains this holistic approach and how assessments are conducted to match the needs of individuals. Stage one includes the initial assessment to evaluate communication and swallowing abilities, assessing speech production, language comprehension and expression, cognitive-communication skills, voice and oral motor function. Jenkins then explains the diagnosis process, stage two, where she will consider the location and type of brain injury and its impact on communication functions. The final stage of assessment is the treatment plan, consulted alongside a multi-disciplinary team, with the end goal of offering the best suited treatment plan and development strategies for the future (Jenkins 2023). Goal setting is also vital for individuals undergoing neurorehabilitation with the aim of progress, and with the knowledgeable and originative recommendations from speech and language therapists this is highly effective. For example, SLTs may use the SMART framework for approaching goal setting with individuals; specific, measurable, achievable, relevant and timed (Cognivate 2021). This approach allows them to cover the activity chosen within this goal, how to measure the progress of it, whether it is realistic and relevant and specifically in terms of a certain timeframe to see results of this achievement. This comprehensive and personalized pathway to progress given by SLT professionals allows for success and sense of achievement for many people, ultimately improving mental and physical health of individuals.
Tools of the Trade: Techniques of SLT in Neuro-Rehab
There is a plethora of therapeutic approaches conducted by speech and language therapist experts within neuro- rehab, such as aphasia therapy, swallowing therapy, cognitive-communication therapy, apraxia and dysarthria therapy. More specifically, the SLT website provides an array of techniques and treatments they use as experts within certain aspects of neurorehabilitation. For instance, speech and language therapy for neuro-rehab, specifically for an individual with problems caused by a traumatic brain injury, can involve a total communication approach, augmentative and alternative communication approaches, eating, drinking and swallowing management and compensatory strategies. These are common techniques across many neurological problems, however these are not limited, such as for individuals with dyspraxia which also may include voice therapy, articulation therapy, oral- motor exercises, breathing exercises alongside the aforementioned therapy approaches (SLT).
The Multidisciplinary Magic of Neuro-Rehab
Neurorehabilitation not only widely benefits from speech and language therapy, but is supported and combines many allied healthcare professionals, such as physiotherapists, occupational therapists, psychologists, and neurologists. This integrated multidisciplinary input is vital for the intervention, goal setting and achieving, patient centered process of neuro- rehab. In order to successfully address the many problems inherent in chronic neurological disease within the evaluation of the rehabilitation program (Freeman et al 1996). Family and caregiver involvement also have key roles within neuro-rehab, providing personal support and attainment of all goals set by professionals. The individualization of interventions and early engagement of family in the rehabilitation process can also assist in maintaining these family and spousal relationships (Keegan 2021).
Beyond Words: Inspiring Journeys of SLT Success
Elysium Healthcare shares the inspiring story of Nora, a patient undergoing neurorehabilitation after suffering a lifechanging incident which left her unable to communicate (Elysium Healthcare). By use of speech and language therapy, Nora began comprehensive therapy, alongside her family and staff, and experienced questionnaires and meetings to tailor this journey to her specific needs. By use of a communication and environmental device, which included features such as tracking eye- gaze and head switching, the SLTs also began intensive verbal communication, voice and swallowing rehabilitation for Nora. Only a year later, Nora was verbally communicating with comprehensible speech and achieved a soft diet with her progression in swallowing. This improvement in quality of life and success through speech and language approaches within neurorehabilitation evidences the importance and inextricable link between the two.
Pathways to Progress: Where to Begin Your Journey with SLT
Speech and language therapy plays an imperative role within neuro-rehab, aiding and improving an individual who suffers from a neurological condition to be able to communicate again, swallow, and eat. Ultimately improving an individual's quality of life by increasing their independence and confidence, and establishes a crucial community sense of participation, through support and multi-disciplinary means, in order to succeed in their own environments. There are various ways to begin your journey with SLT, including asking your GP, checking online and contacting speech and language organizations.
References
Cognivate. (2021). Goal setting and action plans in neurorehabilitation. Cognivate Rehab. https://www.cognivaterehab.com/goal-setting-in-neurorehabilitation/#:~:text=Goal%20setting%20is%20a%20vital,about%20your%20ambitions%20and%20priorities.
Elysium Healthcare. (N/A). From ITU and tracheostomy, to regaining communication: Nora’s inspiring neurorehabilitation journey. https://www.elysiumhealthcare.co.uk/from-itu-and-tracheostomy-to-regaining-communication/
Freeman JA, Hobart JC, Thompson AJ. Outcomes-based research in neurorehabilitation: the need for multidisciplinary team involvement. Disabil Rehabil. 1996 Feb;18(2):106-10. doi: 10.3109/09638289609166025. PMID: 8869513.
INPA (2020). What is neuro- rehab? Independant Neurorehabilitation Providers Alliance. https://in-pa.org.uk/neuro-rehab/what-is-neurorehabilitation/
Jenkins, T. [Richardson Care]. (2023, October 2). Speech and language therapy at Richardson Care [Video]. YouTube. https://www.youtube.com/watch?v=E1_gcMeOzro&t=2s
John Hopkins Medicine (N/A). Neurological Rehabilitation. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/neurological-rehabilitation#:~:text=Trauma%2C%20such%20as%20brain%20and,and%20myasthenia%20gravis%2C%20among%20others
Keegan, Marie (2021). Exploring Therapists’ Perceptions of Facilitating Family Involvement in Neurorehabilitation: A Qualitative Study. Royal College of Surgeons in Ireland. Thesis. https://doi.org/10.25419/rcsi.14915211.v1
SLT. (N/A). Neurological Problems. https://www.slt.co.uk/conditions/neurological-problems/dyspraxia/