A home-based method of stroke therapy may help patients regain lost speech.
by Violet Snow
Barbara Schacker was 13 when her father, Vernon Keller Dean, suffered a stroke that rendered him unable to speak or understand speech, a condition called global aphasia. However, Dean recovered his speech nine years later—through a brain training system devised by his daughter.
Schacker, now 61 and a resident of Woodstock, New York, has continued to develop her system, which she calls the Sensory Trigger Method (STM). In severe cases of stroke damage, “restoration of speech often takes up to two years, but insurance companies expect results from speech therapy after six months. As a result, many people never recover their speech,” she says. That’s what happened to Schacker’s father. She says that STM increases the chances of recovery for stroke patients by allowing speech recovery to continue long after visits to a professional stop.
As a school librarian, Schacker learned that young children use both sides of their brains for speech, but as they get older, only the dominant side—the left side of the brain for right-handed people—remains the “active speech center.” Schacker also found research showing that the brain can create new learning pathways after injury. She theorized that using his non-dominant left hand could stimulate the right side of her father’s brain, where latent language skills could be reactivated.
Adapting techniques that had helped children with learning and speech disabilities, Schacker encouraged Dean to do exercises combining touch, sight and the sound of commonly used words. For example, she had him arrange cards with pictures and words printed on them to make meaningful sequences that later became “sentences.”
After 18 months, Dean said his first spontaneous word while watching a TV program on Mars exploration. “He drew the solar system, he drew Mars, and he said, ‘Mars,’” she recalls. “One by one, the words started coming back.”
Inspired to help others, Schacker designed the first talking software program for speech therapy in 1988. An informal study, led by Larry Bowles, CCC-SLP, of the University of California at Davis Medical Center, applied the program to five people who “had plateaued and were not expected to recover speech. He found that every single person improved,” Schacker says.
Since then, Schacker’s work has gained some recognition. In 1991, her program was tested by Johns Hopkins University and chosen from among 2,000 entries to receive an award for technology designed to improve the lives of people with disabilities. Schacker is now trying to find funding for a formal study.
“We have two speech centers and we need to learn how to take advantage of that,” explains Schacker. “If you’re not using the undamaged side of the brain, it’s like trying to drive a car with a flat tire—but you have a spare in the trunk. Current brain studies have shown that if you practice a new skill or activity that involves your senses or your body movements—like using your other hand to touch, trace, draw or write—intensively for six to eight weeks, your brain actually grows new connections.”
The concepts underlying STM are starting to be accepted by mainstream speech therapists and neurologists as a basis for speech recovery, but the methods are still controversial.
“The right hemisphere does seem to have some basic communication potential,” says Brenda Wilson, PhD, a speech-language pathologist at Eastern Illinois University in Charleston. “But using the left hand to establish a pathway is a new claim. We would need specific research to isolate that technique from more traditional components of the program to say if it really works.” Neurologist Randall Wright, MD, director of the Conroe Regional Stroke Center in Woodland, Texas, is somewhat familiar with STM. “I think it’s helpful, although it’s not a miracle,” he says.
In spring 2008 tragedy struck Schacker’s world again: Her husband, Michael, suffered brain damage after seven hours of surgery for a torn aorta. The operation saved his life but left the author and environmental activist with severe aphasia. “When he came out of the coma,” she says, “I started working with him immediately, holding his left hand and talking to him. I even put little pieces of tape on the fingertips of his left hand so when I wasn’t there, his fingertips would be stimulated.”
Schacker trained Michael’s caregivers in simple STM techniques. One nurse was astounded when Michael, who was unresponsive to a question asked from across the room, nodded appropriately if the nurse asked the same question while holding his left hand.
As Schacker worked alongside a speech therapist, Michael began to recover one word at a time. She recalls, “It was great to see firsthand how my method supports speech therapy and doesn’t conflict with it.” She feels conventional speech therapy helped Michael recover some comprehension and articulation, but his biggest leaps toward spontaneous fluency came after speech therapy had ended.
Stephen Larsen, PhD, works with people who have central nervous system problems at Stone Mountain Center in New Paltz, New York. Using LENS neurofeedback therapy—applying electromagnetic frequencies to the scalp to enhance brain wave activity—he has helped Michael to begin walking again. Schacker finds walking extremely helpful in stimulating language recovery.
Larsen comments, “I have seen first-hand the extraordinary effectiveness of the Sensory Trigger Method on Barbara’s husband, Michael. I have also found this method complements beautifully other therapies that we provide for brain recovery.”
More than two years after the initial trauma, Michael was able to talk in short sentences. The couple hopes for his full recovery. (To learn more, see www.strokefamily.org.)