​My Mom was moved to a medical floor where she was evaluated by Speech, Occupational, and Physical Therapy. On the first day, she had difficulty speaking, swallowing, holding utensils in her right hand, and moving her right leg. However, my Mom’s cognition appeared to be relatively intact.  She was worried about missing appointments and other obligations.  She knew her whole week’s commitments.  I breathed a sigh of relief, but was still concerned about the other deficits.
On day 2, I arrived at the hospital early and was thrilled to find that Mom was able to hold a fork in her right hand and feed herself!  When she smiled at me it was more symmetrical and her facial droop was better!  AND her word finding was much improved!  Spontaneous recovery!  The brain was figuring out ways to do the things that the damaged parts of the brain used to do!
Neuroplasticity is the brain’s ability to reorganize and compensate for the damaged part(s) of the brain. My Mom’s brain was figuring out how to get back to normal.  People who “exercise” their brain tend to use their whole brain which increases neural connections.  My Mom “exercised” her brain more than the average person.  At 83, she plays in several bridge groups, reads the newspaper and books daily, is involved in church groups, volunteers at a food bank, is in a book club that has facilitators from universities, organizes a scholarship committee, and plays “Words with Friends” daily.
My Mom was moved to the Acute Rehab Department at UH Parma Medical Center where I used to work.  She received incredible intensive therapy from some of the best therapists I know. Daily improvement continued!
It is now 8 days post stroke. My Mom’s speech is only mildly slurred.  Aphasia (word finding) and dysphagia (swallowing) are completely resolved.  Her right-side weakness is continuing to improve.  Her cognition is intact. And after only 4 days of Acute Rehab, she is being released to home (with supervision) tomorrow!  My Mom is remarkable, but she still has work to do. 
Why did my Mom make such a fast and incredible recovery? She called me at the first sign of a stroke, within minutes. She had medical and therapeutic interventions beginning the first day. AND she exercised her brain daily. Neuroplasticity ROCKS!  

Last Tuesday morning, I saw on my phone that my Mom was calling and I answered. What I heard will forever be ingrained in my memory.  My Mom’s voice, usually strong and articulate, was out of control with crying and no discernable words with the exception of one.  “Stroke”. 
As a Speech Language Pathologist with experience in stroke rehab, I immediately knew she was having a stroke and could die or be severely impaired. I rushed to the hospital where my Mom was taken by ambulance.  She was conscious and oriented, but communication was difficult for her.
In the ER, it was obvious to me that my Mom was suffering from Aphasia and Dysarthria.  She also had right side weakness that affected her face, hand, and leg.
Aphasia is a communication disorder, typically caused by damage to the left side of the brain which contains the “language center”. It usually impacts the individual’s ability to express themselves verbally and in some cases, writing.  In my Mom’s case, she knew what she wanted to say but she couldn’t “get it out”.  She tried to say “heart” and instead said “house”.  
Dysarthria is a motor speech disorder also caused by damage to the brain.   It affects the muscles used for speech (tongue, lips) resulting in slurred or choppy speech. Her mouth drooped on the right side, her smile was asymmetrical, and her tongue deviated to the right when she stuck it out.  Her right hand and leg were also weak.  My Mom also demonstrated difficulty eating and swallowing (Dysphagia).
Finally, we received the results of the MRI which revealed, not one, but two strokes.  One on each side of ther brain. In a single moment, I went from being a Speech Language Pathologist to being the daughter of a stroke victim who just wanted her Mom to be ok.  Both the therapist and the daughter were terrified…but knew what the next steps would be. (to be continued)

I am from Cleveland and have lived here for my entire life.  And I’ve ALWAYS been proud of my city.  Winning teams are exciting, but they don’t increase my pride in Cleveland.  I love Cleveland for so many reasons that don’t even include sports. And I love our teams whether or not they bring home a championship.  Maybe I’m an optimist, or maybe I just root for the underdog!

I work with children who may seem like the “underdog”.  Speech and language skills that many of us acquired naturally, require direct teaching and practice for these children.  These skills are critical for the child’s success in communication, but they need extra “training”.  These children may seem less capable then their peers.

Some children are just naturally talented at something.  My oldest daughter was naturally talented at softball from an early age.  My other two daughters were naturally talented at dance.  However, they all were exposed to both activities and worked hard under the guidance of a coach or dance teacher to overcome their lack of “natural talent”.

When the Cleveland Indian pitchers had to bat in Chicago this week, I was struck by how nervous they appeared. Hitting is not their natural talent and therefore they may lack confidence in their ability. When Kluber got an RBI single, the joy in his smile was undeniable.  Imagine how empowering it is for a child to use newly acquired communication skills to express their wants, needs, emotions…to say “I love you” for the first time.
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The world loves stories of underdogs “winning”.  I am fortunate to spend my days making this happen for my clients, who in my eyes are ALL champions!

I recently watched a webinar regarding ethics in Speech Language Pathology.  The lecturer, who had a fabulous Irish accent, discussed what makes a Speech Language Pathologist clinically competent or even an “expert”.  Is it how many letters she has after her name?  (I am using female pronouns for the sake of simplicity.  I apologize to males in my field.) Is it how many articles she has published?  Is it her tenured position at a prestigious university? 
Of course the answer is no.  What makes a therapist competent is her continual quest for learning and researching.  She needs to be able to draw upon her knowledge and experience when making a clinical decision about a client.  AND she needs to be able to to combine her knowledge, clinical judgment, with the family members’ insight and desires when developing a therapy plan. 
Parents and clients are the greatest source of information, the TRUE EXPERTS, and they should feel involved and valued.  If parents feel bullied or discounted, therapy will not be effective.  Child first, family first…that is the philosophy at Reaching New Heights.  

Parents, especially those paying out of pocket, don’t want to watch their child play for a 45 minute Speech Language Therapy session.  What are we paying for?
I will tell you exactly what you are paying for.  Children who have speech and language deficits – especially young children – have a hard time attending to “drill and kill” trials for 45 minutes.  Heck – even 15 minutes!  I know that it LOOKS more like therapy, but truly, it is not motivating nor does research support generalization of skills learned in discrete trials.
If a child is to learn to use verbal communication to express his/her wants or needs, it needs to happen in an activity that is natural and motivating so that the experience is meaningful and applicable to real life situations.  If a child is to learn to improve the way they say words, it is more impactful if they are met with the real life effects of their inaccuracies.  If they want to say “blocks” to play with blocks, but they say “ba”, they don’t get the blocks. The child will be more motivated to repair the communication breakdown if the payout is getting what they want!
A therapy session should be a balance of play, drills, and reinforcement for success.