Aphasia program helps stroke patients improve communication

Language is not only David McClure’s livelihood, but also a point of pride. When a stroke impacted his ability to communicate, McClure admits he went to a dark place emotionally. A unique aphasia program at Northwestern Medicine Marianjoy Rehabilitation Hospital in Wheaton, Illinois is helping the Versailles, Ohio writer regain his sense of identity.

In January McClure had a stroke while on the job at MidMark Corporation. Fortunately, a coworker quickly called 9-1-1. However, even with the rapid treatment, the temporary lack of blood flow to the part of his brain responsible for speech caused permanent damage. He was diagnosed with Broca’s aphasia, a language disorder in which patients can often understand speech and know what they want to say but have trouble finding and fluently speaking the right words.

“This was tragic for me. My thoughts exist but words fail me. They didn’t use to. I spoke well and often eloquently. It was part of who I was,” said McClure.

McClure attended outpatient speech therapy but felt he only regained about 20% of the language ability he needed to return to work and a full life. His sister, an occupational therapist at Northwestern Medicine Marianjoy Rehabilitation Hospital, encouraged him to enroll in the hospital’s Intensive Comprehensive Aphasia Program (ICAP).

“Research shows that intensive speech therapy can help people with aphasia improve their language abilities. ICAP is designed to maximize on neuroplasticity by providing therapy at a high dosage and frequency to make the most progress possible in a relatively short amount of time,” said Michelle Armour, MS, CCC-SLP, program lead clinician of the Northwestern Medicine Aphasia Center at Marianjoy Rehabilitation Hospital.

Neuroplasticity is the ability of the nervous system to reorganize its structure, functions or connections after injuries, such as a stroke or traumatic brain injury. These reorganized pathways and new connections move functions from a damaged area of the brain to other undamaged areas.

“There are ten principles of neuroplasticity that have been found to drive positive change. A few of those include ‘use it or lose’, repetition and intensity,” said Armour.

Full-time ICAP participants undergo six hours of therapy four days a week for four weeks. A part-time option offers four hours of therapy each day. ICAP sessions include individual therapy, group therapy, social participation, and a dyad (one therapist and two clients).

In one-on-one sessions speech therapist Clare Goodman taught McClure strategies to overcome what he calls “the cobwebs in my brain.” One technique involves picturing the word and associated words in a ring around it.

“Before I was always stuck. It is like a Chinese finger trap. I would get locked. This program taught me to relax, release and think about the periphery of my thoughts,” said McClure. “I can sometimes get back to the word, or at least say something close enough to get my point across.”

McClure especially enjoyed the group sessions where Armour would lead the group in conversations with various topics to reflect meaningful interactions.

“The fire inside is to have conversation,” said McClure. “If you sat in solitude or just watched but didn’t engage, it wouldn’t clear the cobwebs. To converse intentionally and in a guided fashion is essential.”

McClure received homework at the end of each day that was personalized to help him focus on speaking and writing. Now he can write sentences with coherent structure and think while writing.

“What has happened here is breathtaking,” said McClure. “My family came to visit after not seeing me for several weeks and they were aghast at how fluently I was speaking. The fluency is the biggest difference for me. I was very choppy when I arrived. My vocabulary is coming back from the precipice.”

While at Marianjoy, McClure also completed the Driver Rehabilitation Program to ensure he can drive safely following his stroke. He was able to regain strength, flexibility and balance by working out with personal trainers at Marianjoy’s Health and Fitness Center.

“My husband is a person who relies on his intellect in all his relationships. Although still intact, his struggle with aphasia seemed to make him feel like a lesser version of himself,” said Michelle McClure, David’s wife. “He leaves the ICAP with tools, resources and renewed confidence. As his wife, I benefited from the meetings that centered on the participants’ care. I feel supported, not only with the knowledge of how to help my husband, but also as a caregiver to help myself.”

McClure hopes to return to his job at Midmark, where he writes technical manuals and user guides for healthcare equipment. He says he isn’t yet back to the level he needs to explain complicated material, but he knows he is on his way.

“I missed feeling like I was able to think things through correctly, precisely, intelligently. It hurt my heart to not be who I was, but I’m getting to show myself again thanks to what they have done here,” said McClure.

Now back at home in Ohio, McClure will continue services through the Northwestern Medicine Aphasia Center at Marianjoy virtually. He hopes to shine a light on aphasia, which he describes as a quiet disorder that not enough people understand. According to the National Aphasia Association, nearly 2 million people in the USA have aphasia. About one third of strokes result in aphasia.

“There are so many people with aphasia who can’t say what they want to say,” said McClure. “The more we talk about aphasia, the better.”

To learn more about the Northwestern Medicine Aphasia Center at Marianjoy, visit nm.org/aphasiarehab.