The Road Back: Speech Pathologists on the Front Line
Approximately five million people in this country live with TBI
Since the January 8 shootings in Tucsan people across the country, and even around the world, have followed and cheered on the seemingly remarkable progress of Arizona Congresswoman Gabrielle Giffords.
|Travis Threats, Ph.D.|
In just over a month, Giffords went from intensive care to rehab to asking for toast for breakfast. Now it's reported that she has been able to mouth the words to songs and spoke several words on the phone to her brother-in-law serving on the international space station.
But what does it take to rebuild the skills used to speak and communicate? The skills most take for granted until a stroke or a critical injury such as Giffords suffered changes life unexpectedly.
Travis Threats, Ph.D., CCP-SLP, chair of Saint Louis University's department of communications sciences and disorders, shares how speech pathologists work with patients to develop the most effective therapies to relearn what has been lost. Some key elements include:
- Collaboration with other professionals about a comprehensive plan for assessment and intervention
- Discussion with the patient and family members about their concerns and hopes
- Development of a therapy plan to address the patient's ability to reintegrate back into their lives, while realizing the possible limitations
Threats, a fellow with the American Speech-Language-Hearing Association (ASHA) and veteran in the field of speech pathology, says persons with gunshot wounds to the head can have varied difficulties depending on how the bullet entered the head and where (and if) the bullet exits the head.
"Most people die from this assault because of bleeding in the brain which within the skull can quickly crush the brain," Threats said. "Representative Giffords had the best available emergency care which saved her life."
Threats adds that it is not possible to predict what Giffords' ultimate cognitive and communication status will be or whether she will be able or even desire to go back to Congress.
"The most important thing is that she regains the communication skills necessary to successfully and joyfully interact with those around her. Communication is the way we stay connected to others, which for humans is as crucial as food and water."
A patient of Threats who suffered a gunshot wound brain injury once told him, "The doctors saved my life, but my therapists convinced me I had a life worth saving."
Facts about Traumatic Brain Injury (TBI)
- According to the Mayo Clinic website: "Traumatic brain injury is damage to the brain as the result of an injury. Traumatic brain injury usually results from a violent blow or jolt to the head that causes the brain to collide with the inside of the skull. An object penetrating the skull, such as a bullet or shattered piece of skull, also can cause traumatic brain injury."
- In the United States, 1.5 million children and adults suffer from traumatic brain injury each year
- It is estimated that $48 billion is spent in the U.S. on acute medical and rehabilitation services for persons with TBI
- Approximately five million people in this country live with TBI
- Causes of TBI include motor vehicle accidents, falls, and gunshot wounds
- Ten percent of TBI's are caused by assaults
- Each year in the United States, there are about 35,000 persons with nonfatal gunshots wounds, but most gunshot wounds are fatal
- A gunshot to the head produces specific localized damage to the brain and the impairments depend on where in the brain the bullet hits
- Much of one's language abilities are in the left half of the brain
- Improvement for persons with TBI can continue well past one year after injury
About Travis Threats: Dr.Threats has worked extensively with the World Health Organization since 1999 in developing systems to improve the life functioning of persons with disabilities. He has been an invited keynote speaker in Canada, Chile, Australia, New Zealand, Greece and Slovenia. His area of interest is in researching and designing interventions for persons with acquired cognitive and communication disorders.
More than 50 of Threats' works have appeared in noted publications and books. He also was a recipient of the 2010 Excellence in Health Care award, which is given annually by the St. Louis American to eight health professionals for outstanding service to the St. Louis community