Question
I am seeing a 15 yr old girl in my school who suffered from a road traffic accident 10 years ago. She underwent medical treatment for the same but no speech therapy. She has hemiparalysis on the right side of her body, intentional tremors in the left side
Answer
First, let me say that it is surprising to learn that she was not provided speech therapy initially after the accident as it is during this period that allows for the greatest amount of spontaneous recovery (up to 18 months post trauma). I cannot emphasize enough the importance of immediate intervention when it comes to patients with treatable neuropathologies. However, I would suggest that given the amount of time post onset, the amount of time you have spent working with her, and her lack of progress, it seems that the goal of being verbal is probably not realistic. I would move to an AAC approach in order to establish some form of basic communication, where her wants and needs can be expressed (based on the information provided, I am unsure how she is currently expressing wants and needs). It is important to note that I would consult with specialist team in this area as her hemiparesis and intentional tremor may pose problems activating different types of AAC devices or even pointing to simple picture boards.
Dr. Amy Ogburn Yeager is an assistant professor at Auburn University Montgomery and is on the Advisory Board for SpeechPathology.com. Currently, she resides in Montgomery, Alabama and can be reached at ayeager@mail.aum.edu.
Amy Ogburn Yeager, Ph.D
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