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Like most people, Debbie Bowland didn't think twice about her ability to have everyday conversations with family and friends. But after a paralyzing stroke more than a year ago, the 59-year-old suddenly found she could no longer speak or read.
Bowland suffers from aphasia, a life-long language disorder resulting from traumatic brain injury. Strokes are common culprits, but brain tumors, severe head trauma and infection can also be to blame. The injury disrupts the brain's ability to translate thoughts into words and understand spoken or written words.
But thanks to an innovative program at the University of Michigan, Bowland says she's found her voice again.
The U-M's Residential Aphasia Program is the only program in the country that provides patients with an intensive, six-week regimen including 15 hours of individual therapy, five hours of group therapy and three hours of computer-assisted training each week.
"Like Debbie, many people come to us with few or no strategies for communication," says Joanne Marttila Pierson, Ph.D., C.C.C.-S.L.P., associate director of the University Center for the Development of Language and Literacy. "They, along with their spouse or caregiver, are often very frustrated because they've been given little hope from others, including health care professionals.
"Within a week of entering our program, people are already changing their communicative abilities," Pierson continues.
"The intensive therapy really helped me," says Bowland. "When I came in, I could not talk or read. And when I got out, I could talk and read a little bit, and it was glorious."
According to Pierson, data demonstrate that 95 percent of U-M's patients show measurable gains on their communication goals, even if it's been many years since their brain injury.
This is a laudable accomplishment considering the complexity of the communication process. "The entire brain is involved," explains Elaine Ledwon-Robinson, M.S., C.C.C., B.C.-N.C.D., a speech pathologist and director of the U-M Health System's Speech-Language Pathology program. "But different areas of the brain have different responsibilities and contributions to effective communication.
"In most people, damage to the dominant left hemisphere of the brain can impact their ability to understand and use language. Damage to the right hemisphere can make it difficult to understand the important emotional content of language," Ledwon-Robinson says.
The U-M program follows two broad schools of thought for treating aphasia: using intensive therapy to help the brain reorganize itself after traumatic injury and offering training to help the individual learn techniques to compensate for language problems.
Individual therapy focuses on the rehabilitation of speaking, listening, reading and writing, as well as associated problems such as memory deficits. Therapists help patients recover specific functions or work with them to develop other ways to compensate, such as gesturing or drawing.
Personalized computer training also helps patients by improving attention and comprehension skills, written and oral expression, speech and voice production, problem solving and vocational skills.
"We know that really stimulating the brain and practicing very intensely at a baseline level and then increasing the level of difficulty progressively is very valuable," says Ledwon-Robinson.
Small group therapy sessions offer patients the opportunity to apply their developing communication skills in a conversational setting that's mediated by a therapist.
Ledwon-Robinson stresses that being with other people who are experiencing similar kinds of challenges has a significant psychological benefit for her patients. "It's very important that people understand they're not alone and that they see how others are coping with these challenges."
Debbie Bowland agrees. "My friends here are so important to me. Sometimes they are the only people who understand.
"Every single day it gets easier," she says.
Facts about Aphasia:-Term comes from Greek word meaning "without speech"-An estimated 100,000 individuals acquire aphasia each year-1 million American currently suffer from aphasia-About 25 percent to 40 percent of stroke survivors acquire aphasia
For more information, visit the following web sites:
U-M Health Topics A -- Z: Aphasiahttp://www.med.umich.edu/1libr/aha/umaphasia.htm
U-M Residential Aphasia Programhttp://www.umich.edu/~comdis/services/residential-program.html
NINDS Aphasia Information Pagehttp://www.ninds.nih.gov/health_and_medical/disorders/aphasia.htm
National Aphasia Associationhttp://www.aphasia.org
Aphasia Hope Foundationhttp://www.aphasiahope.org
American Speech-Language-Hearing Associationhttp://www.asha.org/index.cfm
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