Hey Ron,

As a matter of fact, yes.  Not long ago, I had to see one of our home health 
patients as there was no one else available to see the patient.  She was post 
stroke several years and the family/patient and I identified her most pressing 
problem areas as inability to effectively communicate and inability to join 
most family household activities due to difficulty staying up in the wheelchair 
for more than short periods (due to lower extremity pain) and difficulty 
performing transfers (due to poor confidence in caregiver assist and poor set 
up the home).  I called the MD and got a ST order, but later found out that the 
ST did an evaluation  only.  The patient had PT on multiple occasions with 
little benefit so I didn't go there, but it was simple enough to get her 
active/social in the house with some simple modifications to the home and 
wheelchair and some caregiver instruction.  I found that the patient could 
communicate rather effectively by pointing to objects so I set up a 
communication board and did all the necessary training.  I'm still not certain 
why the ST would not have tried this. 

I wouldn't attempt to work with a patient on verbal expression or on other 
services out of my realm, but I felt comfortable setting up this simple means 
of communication.  I have a model of a communication board I could share if 
you're interested (I'll have to search for it actually).  Cook book boards 
seldom work effectively, but it can be used as a starting point.  Of course, I 
would only work on this within the context of occupational therapy goals.  If 
you feel speech is impaired and the patient would benefit from specific speech 
therapy intervention, it would be best to refer to a qualified speech and 
language professional.

Jimmie

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
Behalf Of Ron Carson
Sent: Monday, March 21, 2005 11:23 AM
To: [email protected]
Subject: [BULK] [OTlist] OT and Speech Deficits
Importance: Low


Hello:

Have  anyone  ever  worked with someone about 5 years post stroke, whose
primary complaint is speech?

Thanks,

Ron


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