Speech Language Pathologist and Stroke Patients: Hemisphere Specific Evaluatiuons

1 Apr

A Cardio Vascular Accident (CVA), also known as a stroke, is a devastating  event for all the people it affects. Almost immediately post occurrence, a speech language pathologist is called to do a swallow assessment to check for dysphagia, a common condition that affects swallowing and eating safety. Individuals diagnosed with dysphagia need to be closely monitored so they do not develop aspiration pneumonia. The Speech Therapist is also called on to do language and cognitive assessments  to determine the presence of Aphasia, a stroke-related cognitive-linguistic disorder. Usually a battery of normed assessments are administered in order to diagnose a patient with Aphasia and proceed with treatment during regular speech therapy sessions. But what if the CVA occurred in the right hemisphere of the cortex, the side that is void of the language centers? This is often a perplexing event for speech therapists. While there are norm-referenced Aphasia Batteries to choose from,such assessments for Right Hemisphere Brain Damage (RHD) do not exist.

RHD is not Aphasia but it can have language-related symptoms.Studies show that the right hemisphere of the cortex is made up of more white matter than the predominately gray left hemisphere. This indicates that there are several neuro-interconnections, many of which are hypothesized to connect the right hemisphere to language regions located in the left hemisphere, so certain linguistic deficits will present themselves in a person with RHD. Speech Therapists should look for impaired word retrieval , figurative language skills, and pragmatic/conversational language skills. Sequencing and breaking down tasks may also be difficult for a person with RHD. These deficits can be determined through qualitative and informal tasks such as discussing a popular movie, using sequencing cards, and telling jokes. Reduced affect and awareness of affect is another symptom of this disorder. Poor planning and attention may also be evident.

Right Hemisphere Brain Damage can have significant effects on a person’s “personality” and it can be extremely difficult for his/her loved ones. It is important to diagnose it using a conglomerate of qualitative assessment tools and begin speech therapy right away to reestablish damaged/lost neurological connections.

Through The Years Speech Therapy has experience with RHD, Aphasia, Dysphagia, and other stroke-related speech-language disorders that afflict adults.



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