Beyond the Months of the Year Sometimes finding the passion in reading is the key to progress for older adult patients. First Person/Last Page
First Person/Last Page  |   June 01, 2014
Beyond the Months of the Year
Author Notes
  • Betty Trembly, MS, CCC-SLP, is a clinician for Salter Healthcare in Woburn and Winchester, Mass. She is an affiliate of ASHA Special Interest Group 13, Swallowing and Swallowing Disorders.
    Betty Trembly, MS, CCC-SLP, is a clinician for Salter Healthcare in Woburn and Winchester, Mass. She is an affiliate of ASHA Special Interest Group 13, Swallowing and Swallowing Disorders.×
Article Information
Special Populations / Older Adults & Aging / Normal Language Processing / First Person/Last Page
First Person/Last Page   |   June 01, 2014
Beyond the Months of the Year
The ASHA Leader, June 2014, Vol. 19, 72. doi:10.1044/leader.FPLP.19062014.72
The ASHA Leader, June 2014, Vol. 19, 72. doi:10.1044/leader.FPLP.19062014.72

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Ellen Rollins (left), who died earlier this year, reads poetry and other literature during aphasia treatment with SLP Betty Trembly.
Our adult patients—those who suffer from strokes, Parkinson’s disease and other neurogenic diseases—have long rehab trajectories. The weeks of treatment filled with reciting or reading the days of the week or the months of the year, the Pledge of Allegiance, or nursery rhymes can become tiresome.
As they work on automatized sequences, visual scanning, verbal fluency or vocal intensity, adult patients often want something deeper, something personally meaningful to read or recite. Here are some of my favorites.
After a right cerebral vascular accident, Mary was distressed that she could no longer recite the prayers she had known since she was a child. She was motivated to read her beloved prayers, and as she did, her speech became more fluent and her decoding more accurate. From there we moved on to Robert Frost’s “Stopping By Woods on a Snowy Evening.” She delighted in Jacqueline Bouvier Kennedy’s poem “Sea Joy,” and she shared her memories of the beach. She was happy as she made plans with her son to visit the ocean in her wheelchair. Mary decided that she wanted to work on her writing because “Jackie Kennedy inspired me to write thoughts down.”
Bea, whose stroke left her with word-finding impairment, wanted to share in the reading of Scripture, which led to favorite poems, which eventually led to a facility-wide poetry reading in which Bea haltingly, but clearly, read a favorite—although she still had trouble reciting the alphabet.
There also was a non-religious environmental lawyer with Parkinson’s disease who surprised staff with his strong vocal projection of Hamlet’s soliloquy. Vocal intensity improved with the deep breathing associated with laughter as he read aloud Billy Collins’ “Another Reason Why I Don’t Keep a Gun in the House” (the first line of the poem reads “The neighbors’ dog will not stop barking”).
Finally, there was Ellen, who came to me for treatment for dysarthria and aphasia after weeks in a rehabilitation hospital. Reciting the days of the week was not motivating. She wanted Elizabeth Barrett Browning’s “How Do I Love Thee? Let Me Count the Ways.” She successfully read an abbreviated version of this poem to her husband in a phone message. Later, when her husband was away on business and he sent her a dozen roses, she coquettishly announced to the other ladies in the dining room, “From my lover!”
Ellen moved from the love images of Browning to the anger and despair of Langston Hughes and Maya Angelou. Then one day she told the anguished story of the day she suffered her devastating stroke, told with tears and a poet’s rhythmic language. I wrote down her words:
I’m a Vital Human Being
My mother said,
“You are a vital human being.”
We might have said,
“I hate my life.”
My mother always said,
“You’ll be fine.”
My son said,
“Are you all right?”
He thought I was going to die.
I feel guilty—he saw
The doctor said,
“We almost lost you.”
I am a vital human being.
Ellen, who died earlier this year, read her poem to her husband, her sister, her son. The poem did for her family what no amount of practice of the months of the year could do—it opened emotions and tears and conversations. “We made peace,” Ellen said.
June 26, 2014
Maureen McCarron
Kudos to Betty!
For many years I used recorded books (of age-appropriate literature) with school age students for the same reason: the "same-old" exercises for listening comprehension were just awful & boring! Your story in the Leader has inspired me to re-visit my use of literature with my adult patients struggling with post-stroke recovery and PD.
June 26, 2014
Shirley Morganstein
Throw away the calendars
Betty's focus on the passion of the individuals she treats is the hallmark of what I consider good therapy. There is no human being, no matter how severe the speech-language impairment, who cannot be touched by the introduction of pictures or words that are part of the core humanity with which we all operate in the world. As far as I'm concerned, the only value in recitation of automatics is as a "starter" for the motor that is speech production, usually in the mute individual. Once voice and imitation is achieved, throw away the calendars, the numbers, and whatever else is in your file cabinets and shelving units. I once did a whole week of therapy based on the passion of an individual with aphasia for "environmental services," based on his trade magazines. I learned a lot about garbage. And he had a blast teaching me about his work of 45 years.
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June 2014
Volume 19, Issue 6