COMMUNICATION - ADULTS

For many people who have suffered from a stroke or an acquired brain injury, problems using language can result. Difficulties understanding what other people are saying or not being able to find the words to express their thoughts and feelings can have a huge impact on daily life. It can lead to feelings of loss, embarrassment and frustration. 

Aphasia is the clinical term for difficulties using and understanding language to communicate effectively. It can sometimes come on suddenly (like after a stroke) or it can develop gradually, getting worse over time, for example in brain cancer or dementia.

Speech Pathologists are trained in assessment and intervention to help people with Aphasia communicate. Sometimes the focus of therapy will be lots of practice using certain language functions, like finding the right words, making sentences, reading or writing. Other times, we may train people with aphasia and their caregivers to use technologies that can help when talking is no longer possible - like a 'talking tablet' or picture based communication systems. 

Adults with disabilities may also experience difficulties using language for a range of reasons. Speech Pathologists work with individuals to set goals and achieve them! For example, somebody who loves going to the movies may want to be able to buy their ticket (and their popcorn) independently, without relying on anybody else. They may want to be able to explain to somebody on the phone that they have a communication disability and tell that person how they can help. Or perhaps they want to be able to stand up for themselves in the workplace, but lack the confidence to have 'difficult conversations'. Speech Pathology input helps people communicate with confidence.  

There are many reasons somebody might experience changes to their speech that make it sound slurred or unclear. 

For example, in Parkinson's disease there are progressive changes to the brain affecting muscles and organs used for speech. These changes affect the person's ability to speak loudly and clearly.

After a stroke, damage to brain pathways can also affect the muscles used for speech, or it can make speech hard to control. Some people might speak extremely slowly and softly, while others may have rushed or jerky sounding speech. Speech Pathologists are experts in figuring out what is going wrong in the 'brain-speech' pathways and can develop interventions for rehabilitation.

In a life-long disability like Cerebral Palsy, people may have difficulty speaking clearly due to excessive or low muscle tone or difficulties taking control of their body movements - including those for speech. 

Understandably, it can be frustrating to know exactly what you want to say, only to be misunderstood by others. Speech Pathologists work with people with speech challenges to overcome these barriers and/or find ways around them. 

Some of the example goals of a person with speech difficulty might be: get up at a family function and make a speech using a communication device; make a phone call to a loved one overseas; train family or carers to use a communication device so the person with a speech disorder can participate. 

Some Speech Pathology interventions work best when they are delivered intensively - lots of sessions over a set period of time. Be sure to discuss timing of interventions with your Speechie so you can fit it into your life and get the best possible outcomes. 

Cognitive skills are thinking skills underlying our abilities to plan, organise, remember and process information. These skills are closely connected to our ability to communicate effectively.  With normal ageing come changes to our memory, attention and word finding abilities. 

For people with dementia or some lifelong disabilities, these challenges can get progressively worse. Speech Pathologists like to start working with people with cognitive-communication changes early on, so we can support you and advocate for you as your way of communicating changes. 

Taking an individualised approach, we work with people with cognitive-communication changes to achieve their goals. Example goals might be:

to get back to work after a brain injury - to organise appointments, keep on top of emails and plan weekly or daily tasks; to stay engaged in preferred activities like reading magazines, talking with friends at a craft workshop each week; being able to remember the names and faces of familiar people in my family or in my neighbourhood. 

Some adults seek support with communicating in social settings - this might include work, family or social group activities. Your Speech Pathologist will work with you to identify goals and plan therapy to reach them. Sometimes, social communication (also known as pragmatics) highlights differences in the ways people think, experience the world and communicate. Speech Pathologists respect that all ways of communicating are valid and there is no right or wrong way. Sometimes the best approach is working with individuals and their family members, work colleagues etc. to ensure peoples' communication differences are understood.

Augmentative and Alternative Communication is the name for any form of communication strategy or technique involving the use of systems such as pictures, spelling, text to speech or more complex technology like eye-gaze computers. For those who cannot communicate verbally using speech or for people with limited language abilities, there are many options for communicating effectively. Speech Pathologists are experts in supporting people to select and use the right AAC to suit their communication needs and individual skills.