Speech and Language Therapy Case Study

Speech and Language Therapy is one of the types of therapy provided by our Multi-Disciplinary Team for people who have acquired brain injuries. As well as helping with communication difficulties, our Speech and Language Therapist treats Dysphagia, or swallowing difficulties, to improve the individual’s well-being and quality of life, as well as reducing the risk of choking.

Mr P
Mr P had a traumatic brain injury following a motorbike accident. He sustained multiple contusions affecting bilateral frontal lobes and the right temporal lobe. He also had acute subdural haematoma and traumatic subarachnoid haemorrhage. He had previously been in a hospital neurological rehabilitation unit and came to The Richardson Partnership for Care 15 months after sustaining his brain injury.

Mr P had multiple impairments as a result of his brain injury, including cognitive difficulties such as problems with memory, attention and orientation, as well as cognitive communication difficulties and swallowing problems.

Dysphagia
Mr P had Dysphagia, or swallowing difficulties, due to nerve damage affecting tongue function. This meant that he had reduced ability to chew; when he swallowed the muscle movement in the tongue and pharynx was poor and sometimes poorly coordinated. There was also a delay in closing his airway and allowing the food to pass into the oesophagus. This meant that he frequently coughed and choked when eating and drinking.

He was taking thickened fluids from a specially adapted cup and puree diet that required no chewing. He did not enjoy the food.

Therapy programme
Mr P’s cognitive and language difficulties meant that we were limited in the therapy we could use. It had to be functional and highly motivating.

Mr P worked with a Speech and Language Therapist who devised a specific programme for him. This was combined with daily practice, supported by dedicated care staff.

We worked on his chewing skills using a variety of food types. This increased the intensity at which the muscles were working during the swallow. This programme was a form of progressive muscle training which enabled Mr P to improve the function of his eating and swallowing.

Alongside this we changed the specially adapted cup for a bottle with a sports top lid. This was more ‘normal’ and didn’t draw attention to his difficulties. It also limited the amount of fluid he could get at any one time (as opposed to an open cup).  We changed the thickened fluids to normal fluids, which he could manage because his muscle strength and swallowing coordination had improved through the therapy offered, and also because the smaller volumes were administered with a better head position.

Positive outcome
Mr P progressed well, and within a period of three months he was able to eat a normal diet, enjoying trips out to restaurants with his family.

Please note that we do not reveal the names of our service users in order to protect their privacy.

One thought on “Speech and Language Therapy Case Study

  1. It is most heartening to read of this successful outcome. My son is at present in a rehab unit at Homerton University Hospital. He is not speaking and on a soft diet due to his unsafe swallow. He was in the Royal London in Whitechapel for 2 months before being moved to Homerton. He sustained a hypoxic brain injury 5 months ago.
    He is being transferred in April to somewhere like the Richardson Partnership, and we hope to visit your centre. Maybe this would be the right place for him. An application has gone in for CHC.

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