Stroke is caused by a lack of oxygen to the brain, due to a blood clot or leak into delicate brain tissue. There are two types of stroke: haemorrhagic and ischemic. A haemorrhagic stroke is caused by a ruptured blood vessel, however roughly 80% of all stokes are ischemic. The main causes of an ischemic stroke is either a thrombosis (obstruction of a blood vessel by a locally formed blood clot) or an embolism (obstruction of a blood vessel by a clot formed somewhere else.

PROBLEMS ASSOCIATED WITH THIS CONDITION

The main signs of a stroke are identified in the anagram FAST – Face, Arms, Speech and Time, if you notice any instant change in any of these aspects then your child may be experiencing a stroke. Following the initial impact of stroke, the neurological damage done can often be seen once home. Some of the long term symptoms of stroke are:

• Poor fine motor skills
• Difficulty jumping
• Difficulty processing instructions or spoken word
• Word finding/association difficulties
• Difficulty walking, moving smoothly
• Poor concentration
• Difficulty planning and executing movements

The list above is a snapshot of what the effects a complex and challenging condition like stroke can be.

HOW CAN THESE DIFFICULTIES IMPACT ON FUNCTION?

Stroke can have a dramatic effect on all aspects of childhood. None more so than the impact on the school, home and social aspects, below are some examples of how Stroke impacts upon these areas:

Home:

• Difficulty dressing independently
• Trouble eating or feeding themselves
• Difficulty concentrating or following instructions

School:

• Learning difficulties
• Poor concentration
• Needing support during lesson times

Social/behavioural:

• Stigma attached to being different
• Difficulty making friends

OCCUPATIONAL THERAPY TREATMENT AVAILABLE

An occupational therapist can assess the individualised needs of you, discuss with you the implications of a stroke (both short term and long term) and offer effective treatment which can help your child cope with the implications of having a stroke.

• Motor development
• Confidence
• Parental understanding of stroke and its long term implication
• Cognitive functional improvement

PHYSIOTHERAPY TREATMENT AVAILABLE

A stroke can affect your ability to move and get around in a number of different ways. These include:

• Weakness or paralysis down one side.
• Changes in sensation, such as heavy limbs, numbness and pins and needles.
• Balance problems.
• Joint pain and partial dislocation.
• Muscle stiffness, or muscle spasms known as spasticity.

All these problems are treated by physiotherapy. In the early stages, physiotherapy focuses on preventing complications and helping your recovery. Later, it can help you find ways to enable you to do things that are important to you, such as getting in and out of bed, or doing sports. You might use equipment, or find different movements patterns to complete a task. A physiotherapist can also help you adapt an activity or task so you can do it independently.

SPEECH THERAPY TREATMENT AVAILABLE

Speech therapists are experts in speech and language skills, speech therapists are also able address challenges such as difficulties with cognition, social communication skills, and/or eating and swallowing.

This is because all of these areas are closely intertwined. Communication involves physically producing speech through coordinated oral motor movements, cognitively comprehending and formulating a response, and behaviorally following the unwritten rules of socialization. Since coordinated oral motor movements are also involved in eating and swallowing, speech therapists are able to address these skills as well.

With this in mind, some of the primary conditions treated during speech therapy after stroke include:

• Aphasia: difficulty producing and/or understanding language
• Apraxia of speech: difficulty with coordinating movements required for speech
• Dysarthria: oral motor weakness resulting in speech that is difficult to understand
• Dysphagia: difficulty swallowing

HOW DOES SPEECH THERAPY WORK?

When the brain sustains damage due to a stroke, the damaged areas are no longer able to effectively carry out their respective functions. However, through a process referred to as neuroplasticity, the brain has the ability to rewire itself to allow undamaged areas of the brain to take over these functions.

Neuroplasticity is activated through consistent, repetitive practice. Practicing affected functions signifies to the brain that there is demand for those functions, promoting adaptive rewiring to occur. The more frequently an affected function is practiced, the stronger the neural connections for that function become.

Speech therapy after stroke is an excellent way to learn some of the most effective exercises and activities to improve affected functions and promote neuroplasticity. However, while practicing speech therapy exercises and activities during sessions is a great start, consistent repetition is essential for neuroplasticity.