Teaching how to talk again

Anne Raudsepp Hardy vividly recalls the moment when she awoke in a Kansas City hospital following a stroke in October 2003, just days shy of her 46th birthday.

“When I came to in the hospital room, I looked at the clock on the wall. I knew it was a clock, but had no idea what the digits represented,” she explains. “The television was on and I couldn’t read the text.”

Ms. Raudsepp Hardy, a mental health counsellor, was suffering from aphasia: an impediment in a person’s ability to produce or comprehend language. In many patients, it manifests as a speech disorder, and often misunderstood as a physical impairment. But it’s ultimately a neurological condition, and in her case, it had robbed her ability to read.

“I had a masters degree, I was a college-educated woman, and I couldn’t read at all. It was like an Alice in Wonderland experience.”

Her family—her husband Doug and three school-aged children—pulled together in support, using humour to work through the challenging circumstances. But they were fearful, worried.

“One of my biggest fears was not being sure if this would get better,” says Mr. Hardy. “Was this how we’d have to live for the rest of our lives?”

Recovery through InteRACTion

It wasn’t, and a Dalhousie program played a key part in Ms. Raudsepp Hardy’s journey through recovery.

It’s called InteRACT, an acronym for “Intensive Residential Aphasia Communication Therapy.” Celebrating its 10th anniversary this year, it’s a four-and-a-half week immersion program delivered by Dal’s School of Human Communication Disorders that brings patients and a communication partner from home—a friend or family member—to Halifax for intense rehabilitation designed to develop the skills to jumpstart or sustain their recovery.

“We can help someone learn to speak or communicate clearly here at the program, but if all they do when they get back home is sit in front of the television for hours, they won’t be able to advance any further,” explains Linda Wozniak, the program’s director. “We want to give them not just speech skills, but life skills.”

The patients come from all across North America, from Scottsdale, Arizona to Mt. Pearl, Newfoundland, as there are only a handful of other programs that offer a rehabilitation experience as intensive as InteRACT. (A few that are similar, including programs in Chicago and in British Columbia, are actually based on the InteRACT model). The program involves both individual therapy sessions and group activities – not just at Dal, but also in the community. And students in the Master’s program program play a crucial part in that treatment regime.

Applied learning for students

Sarah O’Neill was one of those students; she now works for the Saskatoon Health Region in a rehabilitation unit working with patients in recovery after a stroke.

“You were really blessed to get to know the patients really well [in InteRACT],” she says. “That’s not always possible in all treatment environments, but in InteRACT, you really got to value the rapport with patients, identifying their goals for therapy and rehabilitation.”

“My internship at InteRACT was the most valuable learning experience of my three-year graduate degree,” wrote 2011 speech-language pathology graduate Julia Baylis in a letter, noting that before graduation she was contacted by two separate employers citing her InteRACT placement as reason for their interest.

And it’s not just speech therapy students who benefit: the program brings in students from other disciplines as well to support patients and bring together experience from a variety of different clinical perspectives.

Lindsay MacDonald is an occupational therapist with Capital Health’s Nova Scotia Rehab Centre. While she was a student at Dal, she did one of her clinical placements with InteRACT, providing support for patients’ mobility and access needs as well as daily living skills.

“It was the first time I’d had that sort of intensive interaction with another profession,” she says. “You really got a sense of how to work and provide support as part of a team. That, and an appreciation for working with patients dealing with communications challenges – those are lessons I still take with me in my work today.”

“They meet the family, they spend extensive time with the patient, and they get to understand the disorder in the broader context,” says Joy Armson, director of the School of Human Communication Disorders. “They come out of it having learned so much.”

The road to recovery

That learning process is doubly important for patients. For Ms. Raudsepp Hardy, the program made an immeasurable difference. Today, her speech is slow but clear, and she’s improved her reading to the point where she’s been able to complete graduate coursework in a Masters of Divinity Program.

She has also returned to Halifax several times, on Ms. Wozniak’s invitation, to assist in delivering InteRACT – both as an example of success to inspire current patients, but also to offer her skills as a councillor.

“It’s a rich experience, but rich because it varies with each individual,” she says of working with the program. “The privilege as a councillor is when you sit with people at their point of deepest pain and fear – not to fix it, but to let them know they’re not alone.”

And she has amazing things to say about the students and staff who work hard to give hope to InteRACT’s patients.

“They’re passionate professionals who do such good, life changing work.”

The InteRACT program is working to expand its business model to support more patients. Learn more about the program at http://www.aphasiaaction.com/ or make a donation to the program online.

There will also be a fundraiser for all of the School of Human Communications Disroders’ aphasia clinic services (including InteRACT, the communication group and book club) on March 30 from 7-9:30 p.m. at George Wright Hall (989 Young Avenue). The event will feature wine and cheese, a silent auction and live entertainment. Tickets are $20 at the door (or by email st442663@dal.ca or mn412838@dal.ca).