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Stroke Smart Magazine

Fall 2010

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Aphasia Recovery
Survivors Take Charge of Their Own Recovery

By Lori Bartels-Tobin, PHD, CCC-SLP

Aphasia is an impairment of language. Stroke survivors with aphasia might be unable to use and comprehend words, but aphasia does not affect intelligence. It is a common problem for many stroke survivors and might make it hard to:

  • Talk
  • Understand what other people say
  • Read
  • Write
  • Use numbers and do calculations

No two people experience aphasia the same way. Some people have different symptoms than others. Some have mild problems, while others experience more severe issues.

I am often asked to recommend a center or colleague to provide speech therapy services. Before I recommend where to go or who to see, I like to introduce the idea that a survivor can continue to make progress even years after a stroke. Research shows that patients make more lasting and quicker progress when their goals are relevant to them. Personalized, functional activities could include:

  • Learning how to order at a restaurant.
  • Writing personal information.
Using a variety of ways to communicate with family — speech, writing, reading, gestures, etc.
Using new strategies and technology to read the newspaper.

Frequently the person living with aphasia receives various therapies immediately following the stroke. At some point insurance reimbursement decreases or ceases and therapy stops. The patient might be told that he or she has reached a plateau. Many patients and families might not have been educated about recovery from aphasia and do not realize that they can continue rehabilitation on their own.

Studies in neuroimaging have shown that the “spontaneous recovery period” can last up to two years after a stroke. This means that the most gains are made within the first two years. However, research also shows that patients can continue to make gains after two years, as long as they keep working on it.

Gains might not be as fast or as large as the initial improvements, but they can definitely add up. At The Aphasia Center at Steps Forward, we have seen improvements in people who have been living with aphasia for as long as 20 years.

The key is to keep going to therapy and to keep teaching oneself. After all, if brains could not change, no one would ever learn anything. Humans continue to learn throughout life because of neuroplasticity. Loosely translated, this means the brain has the ability to change and form new connections — the ability to adapt and learn. Because people are able to learn new things after brain damage, stroke survivors can continue to improve speech, language, memory, arm strength and walking, among other activities.

So, regardless of what patients are told when discharged from therapy, they can continue to improve. And they are in charge of how aggressively they pursue change. Stroke survivors should become familiar with their insurance coverage benefits for speech therapy. Some companies might renew the number of sessions each calendar year. Do not let anyone claim that stroke survivors cannot get better. Become empowered. Be insistent. It might take more time and effort, but it can be done. Get started now.

Aphasia Resources

  • National Aphasia Association at aphasia.org or 800-922-4622.
  • Local colleges might have a speech-language training program with a clinic. Students learning to become speech pathologists perform the services under the supervision of licensed speech pathologists. Servics are often free or low cost per semester.
  • Some rehabilitation centers or hospitals have a sliding-fee scale for treatment.


Lori Bartels-Tobin, PhD, CCC-SLP is the CEO of The Aphasia Center at Steps Forward in St. Petersburg, Florida. The center conducts aphasia research and offers intensive aphasia and stroke rehabilitation. It also provides support groups, return-to-work programs and community activities. She can be reached at dr.lbtobin@gmail.com.


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National Stroke Association’s mission is to reduce the incidence and impact of stroke by developing compelling education and programs focused on prevention, treatment, rehabilitation and support for all impacted by stroke.

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