What I mean to say is…


By Philip Fine

A new pilot project at the School of Communication Sciences & Disorders (SCSD) has students listening closely to people whose words don’t come easily. The Adult Outpatient Teaching Clinic pairs student therapists with clients experiencing language impairments as the result of a stroke.

Clinic founder and director Lauren Tittley, BSc’06, sees a dual purpose in the project: “There was a void in the community that we wanted to fill; also students were always looking for more opportunities to work with people with acquired communication disorders.”

John Korb and Enza Barbieri are among the first to avail themselves of these new services. Both attend conversation groups held elsewhere, but the SCSD clinic offers them individualized attention and extra encouragement.

Stroke survivor John Korb works with graduate student Kristine Pennell to prepare a presentation on his family history. Photo: Owen Egan/Joni Dufour

On the day that Medicine Focus visits the clinic, Korb, who experienced a stroke in 2010, is preparing a short genealogy presentation with the help of graduate student Kristine Pennell. He is trying to pronounce the title “Korb Family History.” Sometimes, ‘family’ comes out as “flamily” and ‘history’ as “chistory.” After practising with Pennell, Korb nails it: “Korb Family History.” They record it. Korb sees this as a temporary victory. He knows that words that he can enunciate one moment may elude him the next. In an expression of frustration, he waves his hands on either side of his head, making the sound of a car racing by. He has difficulty verbalizing more than a few words at a time and often abandons sentences halfway through, relying instead on a chorus of “Oh yeah”s and “That’s right”s.

Meanwhile, Barbieri is working with another graduate student, Johanna Gruber, BSc’15, on a presentation on tole painting, a folk art used to decorate tin and wooden household items, which she has been practicing for 20 years. She had to relearn the craft after her stroke. It was 2014 when the stroke hit Barbieri at the bank where she was working as a mortgage broker, taking most of her speech and leaving the right side of her body immobilized. To tell us the ages of her two daughters, she needs first to count every number up to 11 and then 14. She has regained some of her lost independence, though. She announces that today, she drove herself to the clinic from her home in Laval, thanks to an adapted vehicle.

Pennell and Gruber elicit a few words from their clients and then ask questions before interpreting their words back to them. The students write phrases onto a notepad with a Sharpie and have their clients type their complete thoughts on an iPad. After a few minutes of back and forth and flipping through an art catalogue, Gruber figures out that Barbieri is looking for the term ‘brush stroke.’ The ever-enthusiastic Barbieri flashes the thumbs-up sign in response.

Clinics of this kind are rare. In Quebec, private therapy is usually the only option for people dealing with long-term language problems after stroke. The public system normally covers speech pathology costs for the first year following the event. While this is a critical time for recovery, those who don’t continue speech therapy past the first year are missing out on an opportunity, according to Tittley. “What we found is that if people can have access to therapy, they can make progress even several years down the road,” she says.

The clinic, in its initial iteration, is open only two days a week. Tittley is seeking permanent approval and trying to secure research funding, which would allow the school to offer a range of services not currently available anywhere in Central Canada.

In the meantime, the first batch of clients prepare to give their final presentations to family and friends. After, the clinic will close its doors until its next session, when Sharpies, notepads and iPads will once again bring submerged words to the surface.

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