Ah, the myth of the plateau. Progress is important in the recovery. It helps to motivate the client and their families, and is required for insurance companies to consider continuing coverage of therapy. However, plateaus are temporary. They are often a sign that you need to change up your therapy a bit, or do something different. Aphasia recovery is not a fast progress.
You CAN continue to make progress in aphasia recovery, even years after a stroke. If your progress has slowed, there are things you can try:
Change up your program. Try different tasks, different modalities - if you were focused on auditory comprehension, work on reading. Working on writing? Switch to verbal. Work with your therapist to find another approach to target your goals.
Check your level of motivation and practice. Are you practicing daily? Ask your therapist to adjust the tasks in your home practice program. Is depression a factor? Depression commonly occurs with people with aphasia and can significantly limit progress. If feeling down is a concern, talk to your doctor about options.
Consider changing your therapist. All therapists approach their practice a little differently. We all have different personalities, experience, expertise, and time. Sometimes a different approach is beneficial to break through that plateau. It's okay to change your therapist because your recovery isn't about your therapist. It's about you.
Remember: It is okay to take a break from therapy and be done for awhile. Practice your home program. With the right supports, participating in life is the best therapy there is. Your daily activities can provide consistent functional practice.
Sometimes, insurance decides when you are done. Insurance often covers as long as there’s a medical need and there is progress. Are you able to effectively communicate your medical wants/needs? If you have a stomach ache or feel dizzy, can you communicate that? Can you communicate if you think you are having a heart attack? Insurance may no longer cover your therapy if you hit your benefit cap, they may decide it’s no longer medically necessary, or that your progress isn’t fast enough to warrant paying for therapy. Or you may be done when you reach your goals. If you pay for therapy privately, then you can continue as long as you and your SLP agree you are progressing until you reach your goals.
Speaking of which, what are your goals? How will you know if you’ve met your goals? Ask yourself:
For some people, they want to be able to participate in card club or read a story to their grandchild. You may just want to be able to order your own cup of coffee just how you like it. You may want to be able to debate politics with friends. Other people want to be just like they were before their stroke. Some people want to be better than they were before their stroke.
All of these are valid goals.
Your SLP can help you identify your goals, how to use your strengths, and create a plan to help you to reach them.
Learn more about aphasia.
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