Teaching NOT Just Therapy

Introduction

If you have read the section within this website titled, 'Aphasia after Stroke', you will have read the following:

"I believe that stroke survivors with aphasia should have access to teaching and learning NOT just therapy. Chris is taught through a basic learning process that is repeated, once learnt, the words / actions/ understanding and comprehension move from his short term memory to his long term memory where it can be stored and reused."

These are my own views; you may have a different one.

There are several reasons why the NHS is unable to deliver long term stroke support to survivors and money is the main one, with the NHS 'lottery post code' being another. I believe that the therapy provided is not the only factor that should be considered to support all concerned, as stated above, and in particular for stroke survivors with aphasia (like Chris) an education process should be offered.

Learning processes

You will know that our brains are defined by areas and that these areas control different parts of the body. I do not intend to write in depth about how our brains function and/ or use complicated correct academic and neuropsychological terms. However, I can offer a simpler version of the cognitive (learning) processes of the brain to aid an understanding of how we learn. For example, as young children (you may recall) we are taught the alphabet and times tables. Depending on your age you may recall learning your times tables at school through singing them. Others will recall learning their times tables through another process that may be reading them from a list then writing them down. This process would be classed as 'repetitive learning', which stimulates parts of the brain to learn.

We all have what is called a 'preferred learning' style, that is, we may learn better if we learn in a preferred way, an example of this is when a person may learn better when learning to make a cake through someone showing them how to measure the ingredients then following the process set out by that person (this would be a practical learner). We may prefer to be able to read the recipe for ourselves (this would be a visual learner), or we may prefer to have the recipe read out to us to follow (this would be an auditory learner). Most of us use all three to a certain extent to learn a given task. All these processes are connected to different parts of our brain. Once a task is learnt we then need to practice that task (repetitive). You may recall something you have read once in a book or on a website but not quite understood, so, you read it again, slower and with a focus on the words. This is in-depth learning and is supported through our memories. We re-call what we have learnt through the use of both our short and long term memory.

A stroke survivor (like Chris) has lost the link between his memory (what he has learnt) and his processing (cognitive) part of the left side of his brain. Therapy has an important part to play in assessing where the 'link' has broken down. However, therapy is not teaching or education, as it is classed as a, 'treatment or remedy' (English Thesaurus) and has its origins within health.

Whereas, teaching is classed as, 'instruction, coaching or training' (English Thesaurus) and has its origin in education.

If, we were to add both together (therapy and teaching) surely we would be offering the best available way forward for the stroke survivor and their carers/ families?

Re-learning what the stroke survivor knew before

It is very important for the stroke survivor with aphasia to be part of the process at all stages, this is known as an 'active learner', in other words they take part in their learning. If the teaching is aimed at a specific area of the brain and the approach taken is tailored to individual needs, taking into account the individual person's impairment and limited understanding the learning process should take place. Of-course this takes time and all involved need to exercise patience's.

Learning should be tailored to interests and daily practical needs for the individual and should involve family and carers as they have a major part to play in the success of this process.

Two year study into speech and aphasia

Chris has acted as my 'single case study' since his stroke in late 2007. We have worked together to design and manage a teaching and learning process that is easy to understand and use. He is very active and involved in the development of new ideas and management of those ideas. His progress for the first 12 months after his stroke is followed within my book, 'All For Chris' and shows development of speech, handwriting and reading, along with understanding the basics like the alphabet and recognition of words. We sing the words he wants to learn first, for example his name. After a while we slow down the singing to speech. Chris is encouraged to watch the shape my mouth takes (a form of lip reading) and to copy the shape. He is also encouraged to look at other people's months when they are speaking to him.

Chris has gained more confidence within himself than before we started to work on his speech, everything he was told he would not be able to do, in fact he can do.

Please do not give up, with patience it can work, the trick is to find the right path for your partner/loved one and follow it.

Janet

Other Resources

Total CPD Ltd. offers structured courses for Continual Professional Development (CPD) and includes an interesting one on the subject of Stroke (www.cpd-istotalcpdltd.co.uk).

Supporting Stroke is a UK based independent help and resource website for stroke