Stroke Program - Speech-Language Pathology Department
The Speech-Language Pathology Department at Rusk Institute of Rehabilitation Medicine serves the Tisch Hospital, New York University Medical Center’s Comprehensive Stroke Care Program. The Speech-Language Pathology (SLP) staff provide a continuity of care from the hospital where acute medical needs are addressed, to the inpatient rehabilitation Stroke Unit at Rusk Institute of Rehabilitation Medicine. Following discharge from the stroke inpatient program, an outpatient program can be arranged with the same speech language pathologist who was involved in the inpatient treatment program. The series of seamless transitions from one level of service to the next is the asset of the program.
A change in speech often announces the presence of a stroke. The change in speech can be so slight as to be barely noticeable by the person or communication partner, or so severe that the person is totally unable to communicate. The Speech-Language Pathologist is trained to diagnose the patient’s communication disability and evaluate its impact on everyday functioning. Usually this is done within the first day or two after admission. It is important for the speech-language pathologist to determine the type of speech-language pathology and the level of severity to help plan for the rehabilitation needs of the patient and to assist the staff in understanding how to communicate with the patient with a communication problem.
Different types of communication problems may be present in persons who have had a stroke. Some patients have aphasia, which is a language disorder. Persons with aphasia not only have difficulty speaking, but may also have difficulty understanding spoken language, reading, writing and using numbers. Other patients have difficulty moving the muscles that produce speech, a disorder called dysarthria. Their major difficulty is with the strength and/or coordination of the muscles of the lips, tongue of larynx (voice box). A third type of communication disorder is that resulting from an underlying thought process, for example, difficulty concentrating, remembering, or reasoning. This difficulty is called a cognitive-communication disorder.
Treatment is geared to address the different communication problems. Patients who have aphasia receive treatment geared to restore vocabulary or problems understanding spoken and written language. When the aphasia is severe, the SLP works with the family or caregivers in finding techniques that support and facilitate communication in any avenue. The psychosocial issues encountered by these patients are addressed in group settings as well as individual sessions. The program for patients with dysarthria addresses muscle weakness and coordination of the processes of producing speech. The impact of dysarthria on the intelligibility of speech is a focus of the program. Patients with cognitive-communication disorders receive a program that targets the effects of the cognitive problem on speaking and understanding spoken and written language. Stroke patients may have one of these problems or a combination of two or three different disorders.
Patient and family education about the communication disorder is a critical part of the rehabilitation program. Patients and families are educated about the disorders, which are frequently the most devastating aspect of stroke. They are provided individual instruction and guidance regarding how to maximize communication. Information about access to Speech-Language Pathology and related services geared to patients with communication difficulties is provided to the stroke patient and his/her family.
Additional information about the Speech-Language Pathology department.
Information about the Aphasia Collection at the Patient and Family Resource Center, NYUMC can be obtained by e-mailing pfrc@library.med.nyu.edu.
