Restoring Speech and Swallowing
Through rehabilitation, it is possible to regain skills diminished by your brain tumor diagnosis or course of treatment. Speech pathology and related exercises can help you with any deficits you may be facing and support you in regaining function in areas such as speech and swallowing. If you continue with your exercises, you will gradually see progress.
Language disorders caused by your brain tumor or possibly by treatments such as surgery, radiation, or medication are called aphasia. There are two types: expressive aphasia, affecting your ability to express yourself and receptive aphasia, affecting your ability to comprehend others.
With both kinds, it may be necessary find new ways to compensate for certain communication difficulties and there are many ways to do so; for example, writing down what you want to say, asking people to speak more slowly or using computers and other technology to help you communicate. It is important to start therapy as soon as possible to learn these techniques and optimize your opportunity for language improvement.
Identifying types of communication and swallowing difficulties
When you are diagnosed with a brain tumor, you may have a number of problems with speech and swallowing, and their intensity can range from mild to severe. Among the challenges you may face are:
- Challenges in expression. In this case, you'll have difficulty finding words to express thoughts, naming objects or putting sounds together to make words. Your words might come out as grunts or other forms of unintelligible speech.
- Challenges with reception. It may be hard for you to answer questions, follow the thread of a conversation or understand what others are saying.
- Specific speech impairments. You may have a speech disorder called dysarthria, caused by difficulty with coordination, strength, or the range of movements necessary for speech. Your speech may sound slurred, very soft or “like it is coming through your nose.” Or you may have apraxia, which can sound like a stutter, and occurs when it is difficult to begin, sequence, or coordinate the complex movements needed to speak.
- Cognitive deficits. You could experience a difficulty with attention, orientation, memory, problem solving, reasoning, judgment, thought organization or slow thought processing. Difficulty with aspects of cognition affects your ability to communicate.
- Swallowing difficulties. You may have trouble chewing or may experience choking, making it difficult to get the nutrition you need. Depending on your condition, food may get stuck in your throat or enter your lung passages, which could lead to pneumonia.
Going in for Tests
Your deficits can be diagnosed and treated by speech-language pathologists, also called speech therapists. Your initial visit will involve an interview and tests. It may help bring your caregiver to assist in providing information about you.
Physical examinations may include an evaluation of your face, mouth and tongue movements and, if you have swallowing problems, a video fluoroscopy or modified barium swallow study.
You will also be given a series of spoken tests, such as naming common objects, engaging in a conversation, understanding and using words and answering questions about something you just read or heard. You might also answer yes-no questions, respond to open-ended questions, tell a story or explain a joke or phrase.
Your therapist will review test results with you, lay out your challenges with communication or swallowing and recommend treatments for you.
In your treatments, you will be performing a select group of exercises that meet your specific needs. For example, you may start exercises to increase lip and tongue movement, improve your listening skills or help you find the right words to express your thoughts. In each session, the aim will be to build on your last success. For example, you might begin with simple tasks, such as naming an object, and move to more complicated challenges like explaining the purpose of an object.
You may be placed into groups of people with similar deficits and work on communication skills in the group setting. Your therapy group might even make outings to apply your newly regained verbal skills, such as going into a restaurant and ordering from a menu.
Therapy for Improved Swallowing
Your therapy for swallowing will also be tailor-made for your specific condition. For example, if your problem is that you delay swallowing, you may learn certain compensating exercises with the help of your speech therapist. And if you cannot move your tongue, you may practice tongue exercises or learn to position food in the mouth differently.
Positioning your food differently to aid in swallowing is an example of learning new techniques to compensate for lost skills, which can be applied to a wide variety of disabilities. If you have speech difficulties, for example, you might learn to use gestures, drawings or flash cards. If you have organizational deficits, you might learn to take notes. And if you have trouble remembering things, you can rely more on calendars or day planners. With these new skills and techniques in place, you can practice at home to keep on improving.