This is an important but hard question to answer.
Here is how I would answer based on my experience (as a clinician) and knowledge (as a scientist).
What I’ve experienced as a clinician:
I often fumble this question and find it hard to balance honesty, hope and uncertainty
As a health professional the words that I say matter and can affect recovery
Everyone has a different post stroke timeline. If aphasia persists after hospital, it is more likely to continue. So the focus may shift to ‘living well with aphasia’.
Sometimes the battle for people with aphasia and loved ones is with wisdom and not the words. Meaning, regardless of the severity of aphasia, a major contributor to how a stroke survivor feels about their life is how they can embrace ‘post traumatic growth’ and adapt to a new identity. Unfortunately, depression and anxiety in people with aphasia is common. There is a grief process after stroke as the person with aphasia and loved ones go through periods of shock, depression and acceptance. The aim is to work towards accepting a ‘new normal’. They will be ready for different types of information at different stages along that journey.
Support is important – we don’t need science to tell us that who you have around you matters emotionally and psychologically.
What I know as a scientist:
Recovery is highly variable and difficult to predict
Rehabilitation matters but no one type of treatment is better
Rehabilitation should start as early as can be tolerated
Predictors of recovery that have been investigated are severity, type of aphasia, age, size of brain damage after stroke, sex and education. Initial aphasia severity is the most frequently shown to predict later recovery.
Different treatment doses are recommended at different times (resource post to follow)
I highlight key work from Dr Bonnie Ross at the University of Queensland. She asked questions about prognosis to people with aphasia, family members and speech pathologists. Her research papers are a worthwhile read for a scientific audience. The author highlights the complexity of emotions, the patient clinician relationship and that ‘recovery is more than words’.
AI and big data provides an opportunity to hopefully answer some prognosis questions
So will I recover from aphasia?
My answer: “We don’t know what predicts aphasia recovery which makes determining prognosis hard. A portion of people with aphasia recover completely within days, a portion will take longer and a portion will live with aphasia long term. Your recovery is related to the severity of your stroke and the amount of brain tissue lost. For those who have aphasia on leaving the hospital a process will begin of accepting a new normal. People with aphasia make good recovery with rehabilitation but it does take a lot of effort. It matters that you have support from your therapists and loved ones”
Additional recommended links:
Scientific audience
Understanding and predicting outcomes in aphasia rehabilitation by Professor Swath Kiran
Neurobiological principles and predictors of aphasia recovery by Professor David Copland
General
Stroke Foundation resources for general stroke recovery information
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