The Speech Therapist

When 15 years old, C.B. was diagnosed with a brain tumour and as a result of surgery was left with Cerebellar Mutism, with speech appearing at times. After a recent vaccination he developed Bell’s Palsy that weakened the facial muscles. As a result, swallowing is also affected and breathing very shallow. He is on O2 support for 4 or more hours per day. He has 24-hour care from nurses and knowledgeable people. We started some resistance exercises to activate some facial muscles involved in speech, swallowing and chewing. I referred him to have a wheelchair assessment. Now he is in optimal position to support therapy. Involuntary movements are less and his head and body are better supported for breathing, speech and swallowing. He started the use of a little device to improve breathing against resistance and very recently started to whisper some words on days that he has sufficient breath to support him. C.B. embarked on a program to use a switch that is mounted on his wheelchair or bed that he is able to consistently and reliably touch with his right hand when asked yes/no questions. Currently the family is working on personalising a communication book to assist him with more communicative efforts. Long term, we are planning for him to be able to chew and swallow food safely, however, in the meantime he is able to drink moderately thickened drinks. He is enjoying tasting different types of his favourite foods to prevent a decrease in taste and smell sensations, while he is not yet able to eat safely. While his breath is too weak to support speech, he will also trial devices that enhance or amplify his whispers, so he is able to speak when he can in a more independent way.

A very vibrant, well-qualified nurse, woke up one morning after surgery, without any speech or understanding, due to secondary complications that caused a stroke. She had difficulty in planning how to say the words (apraxia), but at the same time also lost a lot of language (aphasia). In therapy she worked very hard to regain some sounds, then words and eventually 3-words in a row to form short sentences. Now, after more than two years, she can express some independent 5- to 6-word sentences. There are times when she still has difficulty with planning the words and that may leave everyone a bit frustrated, because a precious communication moment was lost. She does not show much interest in writing, despite the fact that she has learned to spell easier words. It is not her preference to rely on writing for communication or using an augmentative approach (device that talks on her behalf, using pictures). Despite some health set-backs, she is motivated to improve her communication with a very supportive husband.

“You’re very good! That’s it!! We’ve been to two of you before, and… you’re just very good! You’re doing so much more with R – looking at all aspects, his language, his swallowing. He doesn’t cough on the thickened drinks you got him. He is still quiet when we have visitors, because his speech is still mucked up when there is pressure – then something totally different comes out.”

“The first time you came to see me, I felt relieved. Why didn’t I have this in my life before?” D.B.’s mum: “All his siblings are saying they can understand him better. Also his airways are less compromised and the extra nutrition and calories in the thickened drinks make a significant difference in keeping his weight up. There is less coughing and they taste amazing! His lips can do all kinds of voluntary movements that he was not able to perform previously, like saying the /b/-sounds in words more pronounced.”

“We never anticipated a wheelchair to make such a difference! We are so grateful to you for the new wheelchair. We didn’t realise what a difference it would make to C. It has a great headrest - thanks to you! He is already, after 3 days, holding his head much better, even when not in it, and turns his head to the right spontaneously now, which he couldn’t do before. We really appreciate your help. Thank you for seeing the big picture! We’re so lucky to have you on his team!”

Aniki Heydenrych

Aniki specialises in:

Therapy Treatments

Parkinson's Disease

Cerebral Palsy

Teletherapy

Traumatic Brain Injury

Stroke

Dysphagia

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