From the Guidelines
Approximately 21-40% of stroke patients require speech therapy assessment within the first 3 months after a stroke, with the most recent evidence suggesting that aggressive management of aphasia through therapy can improve both language and broader recovery. This assessment should be conducted as early as possible, ideally within the first week following the stroke, as part of a comprehensive rehabilitation program 1. Speech therapy evaluation is essential for patients who exhibit any signs of aphasia (language impairment), dysarthria (speech motor impairment), apraxia of speech (difficulty planning speech movements), or dysphagia (swallowing difficulties). The high percentage reflects the common occurrence of communication and swallowing disorders after stroke, which can significantly impact recovery and quality of life. Early identification and intervention for these disorders can improve outcomes by taking advantage of the heightened neuroplasticity that occurs in the early post-stroke period. The assessment typically involves standardized testing of language comprehension, expression, speech production, and swallowing function, which helps determine the specific type and severity of impairment and guides the development of an individualized treatment plan. Key aspects of speech therapy assessment and intervention include:
- Facilitating recovery from communication difficulties
- Assisting patients in developing strategies to compensate for communication disorders
- Counseling and educating people in the patient’s environment to facilitate communication and decrease isolation 1.
From the Research
Percentage of Patients Requiring Speech Therapy Assessment
- Approximately one third of people who have a stroke experience aphasia, which affects some or all language modalities: expression and understanding of speech, reading, and writing 2, 3.
- The exact percentage of patients who require speech therapy assessment in the first 3 months after a stroke is not directly stated in the provided evidence.
- However, studies suggest that early detection of communication impairment post stroke is an important prognostic indicator and promotes the use of individualized treatment protocols 4.
- A survey of speech and language pathologists found that over 70% of participants assessed language and 80% assessed speech using their own clinical assessments in acute settings following stroke 4.
- There is some evidence to guide clinicians in aphasia management, but less in other disabilities of speech and cognitive functioning, highlighting the need for a coordinated approach to developing and testing interventions for all communication disabilities 5.
Timing of Speech and Language Therapy
- Although an early start of treatment is advocated in clinical practice, evidence for "The earlier, the better" in aphasia rehabilitation is weak 6.
- The optimal timing of speech and language therapy for aphasia after stroke is still unclear, and more evidence is needed to determine the best approach 6.
- A scoping review found that management of communication disability in the first 90 days after stroke predominantly focused on communication-related body functions and structures, with less evidence addressing environmental factors, activities and participation, and personal factors 5.