74-year-old John Rush is trying to find the word for a type of fruit pictured on a card in front of him. He can’t see it, but other participants in this group therapy session are giving him hints: they’re small, round, you can put them in pies…
It’s on the tip of his tongue.
“Gosh, I have some at home,” he laughs, to a roomful of encouraging smiles.
After a few more minutes, and a clue—a friend named Barry—he gets it.
Rush, of Manchester, is one of seven people who have experienced a stroke and are participating in a six-week long “Aphasia Boot Camp” at Fontbonne University in St. Louis. The group meets four times a week for one hour, and then breaks into individual therapy sessions with graduate students.
Aphasia is a symptom, not a disease. Often occurring after a stroke or a brain injury, aphasia means the patient has difficulty understanding or expressing language. As many as one million Americans live with some form of aphasia, according to the National Institutes for Health, and a growing body of research suggests that continued speech therapy can help people recover some of their communication skills. But options for therapy can be limited, even if a patient has health insurance.
“The thought used to be, and still is prevalent among third party payers, that once a person plateaus and makes little to very slow progress, they’re not going to pay for therapy… they think it’s not worth it,” said Carmen Russell, who directs the program at Fontbonne. “The current findings are this intensive therapy is very powerful to break through that.”
University-based programs can be a way around the constraints of what can and can’t be covered by insurance. Fontbonne’s annual Aphasia Boot Camp is grant-funded and staffed by graduate students. There is no charge to participate, but space is limited.
Jennifer Kerr, a communication sciences and disorders professor for Missouri State University, said the benefits of group therapy cannot be underestimated.
“Therapy should be viewed as medicine, it is medicinal for folks. When therapy is removed, they do regress,” Kerr said.
“Bar none, the thing [patients] say is that they didn’t feel they were getting truly better until they met other people who were going through the same thing.”
Roxana Botezatu, who directs the Bilingualism and Aphasia Laboratory at the University of Missouri in Columbia, pointed to iPad apps and computer software programs that can help patients to practice individually. But she said the most important thing is to keep connections strong between family and friends.
“One of the biggest mistakes one can do is to limit social interaction. It’s crucial to maintain social ties, and to educate family and friends about the deficit but also the strengths… that can be built upon in the process of recovery,” Botezatu said.
Randy Miller, 53, commutes from Arnold to participate in the program at Fontbonne. He speaks haltingly but with intention—closing his eyes and breathing deeply to focus when he loses a word. Sometimes, he’ll take a pen and write it down.
“Practice, practice, practice. I’ll tell ya,” Miller said.
Miller, a father of two, worked in information systems for Graybar and volunteered for the Robert L. Reed Tap Heritage Institute before he experienced a stroke two years ago. He uses an iPad to pull up an interview he gave for a talk show on St. Louis Public Radio back in 2013.
“I know what’s good, right there,” he said, gesturing to the iPad. “Now it’s okay, but still—it’s hard.”
Follow Durrie on Twitter: @durrieB.
Note: An earlier version of this story misspelled Dr. Botezatu's last name.