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What are auditory processing problems and how are they treated?

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Last week, Pennsylvania Lieutenant Governor John Fetterman, the Democratic candidate for one of the nation’s most watched US Senate races, said his stroke nearly four months ago left him caused speech and communication problems.

Communication problems are common among stroke survivors, experts say. Here is an introduction to what patients may experience:

What language problems can a person have after a stroke?

Communication can be affected when the stroke has affected the left hemisphere of the brain, which handles most language functions, said Sarah Lantz, a speech pathologist at Magee Rehabilitation Hospital, part of Jefferson Health in Philadelphia.

Patients may have problems with oral communication or language processing through hearing, reading, or writing.

“Sometimes [a stroke] can affect all four [language functions]”speaking, reading, writing and understanding,” she said.

She said the potential constellation of symptoms can include difficulty retrieving words. For example, individuals may find themselves pausing to remember the correct phrase to express their thoughts. Others may struggle to keep up with the conversation.

The American Speech-Language-Hearing Association notes that auditory processing problems are not limited to stroke patients. They can also occur as a result of other neurological damage, prenatal or neonatal problems such as premature birth or because of genetic predispositions.

Does an auditory processing problem affect hearing or cognition?

Although the term auditory is associated with hearing, problems with auditory processing are related to how the brain interprets language.

“[Language is] really just a sequence of sounds, and it’s our brain’s job to process that sequence of sounds in a way that we understand them,” Lantz said.

It’s not a cognitive problem either: “It’s a language disorder, not the intellect,” she said.

How quickly can a patient recover from these communication problems?

Typically, patients make their greatest progress in recovery during the first six months to a year after stroke, but some patients continue to recover over the past three years, Lantz said. The months following a stroke are the best time to receive intense speech therapy for a communication problem, she said.

What treatments are available for stroke-related language problems?

Lantz says speech pathologists will work to address the “specific deficient area.” This may involve working on specific exercises to help patients find the word they would like to say. The goal is to help patients create new pathways in the brain.

Speech-language pathologists also work to help patients compensate, for example by developing strategies to circumvent the damage caused by stroke, whether that means improving their attention or changing the environment around them to facilitate the language processing.

Because communication issues can be so varied, she says, each speech therapy class is unique to the person it’s designed for.

The severity of these problems can vary, which also affects the therapy process. Lantz said a patient with a severe impairment might need to work on processing single words, while someone with mild issues might work through conversational “sharp jabs.”

What can you do if your loved one has a communication problem after a stroke?

The American Stroke Association responded to a request for information from The Inquirer about auditory processing problems by sharing its information on the common effects of a stroke. This includes a list of recommendations to help a loved one cope with aphasia, a common communication disorder that can occur after a stroke.

The association said it does not comment on specific cases, such as Fetterman’s health issues. His campaign did not use the term aphasia. On the contrary, he said that Fetterman had problems with auditory processing.

For patients with aphasia, the association suggests that friends and relatives can help by asking yes/no questions to make sure they understand a conversation. It can also be helpful to establish a daily routine for practicing language therapy and resting.

Other tips include speaking in shorter sentences and in a place where the person with aphasia can see you.

The association has more resources for stroke survivors at or 1-888-4-STROKE.

Q&A: Speech therapy can often help those whose speech is affected by stroke

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Margarita W. Wilson

The author Margarita W. Wilson