Please and Thank you

As speech language pathologists, we work with the delayed, the disordered and the demented. People not only depend on us to make sense of things, they rely on us to make those things better. We have to be creative, funny, sensitive, smart, punctual, firm, empathetic, crafty, motivating and composed, all while being charming and professional. But wait, there's more...we need to focus on function.

Working primarily with adults, I have long maintained that we should be gearing our therapy to give our patients words that are functional. Let's imagine, a 72 year old man has had a stroke. Expressive aphasia and word retrieval difficulties have wiped out most of his vocabulary and the deficits are severe. His wife is in a panic and the number one goal is to "Get him to say something. Anything! I don't care!"  Where should we begin?

Theory tells us that we should start with automatic speech sequences, including numbers, letters, days of the week, months of the year, etc. Reciting these sequences typically enables patients to produce recognizable words... a relief to everyone involved. But what next?  I don't know about you, but this scenario makes be want to roll up my sleeves, grab a box of flashcards and get to work!

Because the patient is not 3 years old , I'll likely skip over the category of colors. Because his impairment is severe, I'll pass on the categories people and places. Typically, I go straight for the category of objects. This seems to be a great starting point because we can get the most bang for our buck:  successful productions during therapy yield successful interactions in daily life. As a result, I begin the process of assisting with language recovery by targeting everyday labels for things that will actually make a difference:  remote control, pillow, water, etc.  Along the way, however, I believe we should never forget to incorporate the basics:  hello,  goodbye, please, thank you and I love you.

When a brain is changed because of a stroke, a person is changed and relationships are inevitably affected. Devastation can be wide spread and frustration related to communication breakdown can be crippling. Do your part as a speech therapist to return some sense of normalcy to the lives of those you work with by incorporating functional words and phrases just as soon as possible.

This week, encourage your patients to greet you when you arrive, carefully consider your stimulus items and create opportunities for the expression of gratitude and love to spouses, family members and caregivers. It won't be long before your actions and your choices make a difference in the lives of others.


"Gratitude can change common days into thanksgivings, turn routine jobs into joy and turn ordinary opportunities into blessings."   William Arthur Ward