Julia Zabihach, MA, CCC-SLP-CBIS
Like her colleagues, Julia is a fan of Augmentative Alternative Communication devices, and of the Tobii Dynavox products in particular. She explained the benefit of utilizing it with a patient with severe apraxia as a result of a stroke. (Apraxia is difficulty motor planning speech messages from the brain to the mouth).
Julia says patients are appropriate for the AAC if they “are relatively good at understanding language, can follow directions, and have the visual ability to discriminate pictures. It is also helpful if the patient can read words and has simple spelling skills. Most importantly they need to show the motivation and the intent to communicate.” While an AAC device may not improve the impairment, “it allows patients to communicate.”
Julia, who is a Certified Brain Injury Specialist (CBIS) also describes some excellent success she has had recently with two brain-injured patients. She started to work with the first patient when he was an inpatient. “He was not eating, had a trach, was non-verbal, and couldn’t follow a command. He was discharged from inpatient rehab, and went on to the Day Rehab program. I treated him through that phase and now he is finishing with me as an outpatient. He is walking and talking and performing high level cognitive activities. He is doing so well that next he will be referred to the Division of Vocational Rehabilitation for job placement.”
Another patient needed a great deal of cognitive therapy. “I worked with him on divided and selective attention. To do that, I gave him a task and then interrupted, for example with music. Then I offered compensatory strategies, like saying ‘I can’t talk to you right now, I have to concentrate.’ ”
“Brain injured patients don’t always realize the difficulties they are having, particularly with thinking skills. We work with them to build awareness of their deficits and to offer strategies for managing successfully.”