“How long should speech therapy be after a stroke?”

The length of time a patient attends speech therapy after a stroke varies widely, influenced by factors such as the severity of speech or language difficulties, areas affected (like aphasia, apraxia, or dysarthria), individual progress, and personal goals. However, your concerns about your grandfather’s therapy suggest it may be beneficial to explore different therapy approaches and potentially seek a therapist whose methods align more closely with his needs and goals.

If you're considering finding a new therapist, whether in a hospital setting or private practice, here are some questions that can help determine their approach:

1. How would you describe your overall approach to therapy? Do you focus more on specific impairments or the patient's participation in daily life?
2. Can you explain how you set therapy goals? Are they based on standardized assessments or tailored to individual life goals?
3. Do you incorporate real-life scenarios and activities into your therapy sessions?
4. What is the role of family and caregivers in your therapy process?
5. How do you adapt your therapy if a patient’s goals or circumstances change?

These questions can help you understand whether the SLP practices a traditional, impairment-based approach or a more holistic method like the Life Participation Approach to Aphasia (LPAA).

Regarding therapy settings:

- Hospital-based clinics often lean towards an impairment-based approach, especially soon after a stroke. This focus is driven by the immediate need to address specific impairments following a medical event.

- Private Practice therapists might be more inclined towards diverse approaches, including LPAA. They usually have greater flexibility to tailor therapy to individual lifestyles and personal goals, as they operate with fewer constraints than larger healthcare institutions.

Considering these points, talking with your grandfather and his current therapist about his therapy is crucial. Understanding his views and reassessing his goals might also help determine the best path forward. If he feels that his current therapy isn't aligned with his personal objectives or interests, exploring other therapists, especially those in private practice who might employ LPAA, could be a beneficial next step. This approach focuses on enabling patients to participate in life activities that are meaningful to them, which might resonate more with your grandfather’s needs and motivations.

The length of therapy is dependent upon the severity of the speech issues. Insurance often limits the number of visits, but your speech therapist should be able to recommend a course of treatment including their estimate of when therapy should be discontinued. I specialize in pediatric therapy so a therapist who specializes in stroke might have a more definitive answer.

I have had patients for up to 3 years post CVA. As long as progress and improvements are noticed therapy is warranted. Sometimes patients will get burn-out and need to take a break from direct therapy and that is okay. The patient's engagement is key to success, so if he feels it is no longer needed, progress may slow. I would recommend a private practice that can be more flexible with scheduling so he can take breaks from therapy without being discharged and forgotten about.

Hi! Thanks for reaching out to me with your question. That is a tricky question to answer, as there could be a lot of factors influencing the answer. In general, if the person is still making progress towards their goals, it would be indicative that they should continue as they are benefiting from the treatment and regaining independence and quality of life. If they are not making gains, it's important to examine why they aren't. Some factors that influence this are; motivation of the client, the connection they have with their therapist, the type of therapy being provided, the possibility that they need a break before resuming therapy. Sometimes people just want to get back to their lives and leave the illness in the past. Psychological counseling is an important part of Stroke management, as up to 80% of stroke sufferers experience depression which can impact their ability to recover. I hope this information is helpful, and that your family member continues to recover! If you're interested in services, and live in NC, NJ or FL, please reach out to my office for further details. All the best, Kim Baradei Owner/SLP Elevate Speech Services 908-892-3492 elevatespeechservices.com

It really depends on his deficits. Some strokes can make patients unaware that they need therapy. Also, the type of therapy he is receiving may be too simple or not engaging enough so that he feels it's needed.

Each patient has a different amount of speech therapy following a stroke depending on their individual needs. If the SLP you are seeing believes your grandfather could still benefit, I would strongly suggest continuing therapy.

Every brain is different and there are different types of strokes. Depending on the location of the stroke, and the motivation of the participant, the recovery time can vary. If your grandfather desires to stop, see if he will consider going a few more weeks and being trained to use a home speech therapy application or program that you as a family could continue to do with him. My favorite application to recommend to patients returning home is> https://tactustherapy.com/home-use/ ---check out the website and see how there are soooo many exercises he could continue to practice and use. I also like the Bungalow Software. He can practice problem solving, reading comprehension, verbal expression, etc. whichever areas he feels he needs the most enhancement.

It depends on the type of stroke, but typically you'll see the most spontaneous recovery between 3-6 months; after that, the recovery can slow or plateau. I recommend going to speech therapy for at least a year after a stroke if the stroke was severe.

Every case is different. The length of speech therapy depends on a multitude of things. Is your grandfather happy? Is he struggling? Strokes take a lot out of a person. If he feels successful enough, maybe he doesn’t need it. And was he discharged? Sometimes insurance only covers a certain amount of sessions.