Speech difficulties

[Scottoppy]

Has anyone any experience using AAC software with PSP sufferers? My wife gets very frustrated now that her speech has degraded to the extent that she finds it very difficult to express ideas and comments. Her speed of assimilation and response has slowed a great deal. Monosyllabic responses are ok in reply to simple questions is all very well but she is excluded from conversation.

[LuisRodicioRodicio]

Hi Scottoppy!These are our experiences:

*Communication:

One of the symptoms of PSP is that its speech becomes slower and more difficult to understand but generally its intelligence remains. I reproduce some reflections of Kevin_1:

“As the illness develops their mental processing becomes slower. That is they think slower, but they still think as adults and draw on a lifetime of experience and most likely using all of that wisdom which comes with it. So the way to speak is in a straight forward manner, not fast, simple language, but not slow as if talking to an idiot as in a movie, and to give them time. Ask them of they understand if it is complicated and if they want you to clarify anything. This is basic good communications practice. It works.”

On our case, we intend an App but It was not possible to use it for more than few months. As her dexterity deteriorated, she had problems placing her finger on the appropriate word or letter and we were able to buy a plastic screen cover that had an opening for each key on it; this helped to direct her finger and keep it one the right letter. Another problem she developed was the inability to tap her finger in a key or letter, and as such she would often have several letters in a row. For example if she tried to tap the letter A, it would show as AAAAA because she could not get her finger off the letter A quickly enough.

Some have successfully used for some time a cheap iPad plus free software text-to-talk program called Claro (claro.com) with a BigKeys keyboard that attaches to the iPad through an Apple device that is used for connecting to camera to an iPad . A voice comes from the Claro program. It's like a GPS voice.

On our case we have used a plastic laminated A3 sheet with the alphabet in large letters (40x40 mm) supported on a music stand at the height of the patient's eyes. She points to the letters and another person writes on a blackboard the letters that she indicated.

You can also prepare "communication panels" with the alphabet and some pictograms that patient can be marked with a pointer. Up to the present time it is the best system we could find. Over time the pictograms become useless and it is necessary to use only letters, as large as possible.

Speak to the PSP patient as you would anyone else. When it comes time to ask a question try framing it to a yes or no response. It's not that the question is hard to understand but forming/finding the words for an answer may be difficult.

The communication with a patient of PSP is one of the most difficult problems to overcome.

When the patient can still verbalize it is important to know that saying NO requires less muscular effort than saying YES.

When verbalizing is almost imposible and the “communication panels” don´t work, to say YES by showing the thumb from the fist and saying NO by hitting the fist on a surface could be a solution. Alternatively taking the ”more active” patient´s hand and establishing that a squeeze is YES and no squeeze is NO.

There will come a time when the answers are slow and even erratic. In this case, it may be better to prepare the patient and tell that you are going to ask for a response later to a question that you are verbalizing at that moment. When the disease progresses, the response is slower, until making a thumb gesture or squeeze your hand may need at least 20 seconds.

To write down a big YES, NO on a sheet of paper and the patient could point to the correct one seems to be a good alternative.

When all fails, sticking out the tongue to indicate "YES" can be a solution.

Recently there has been an information related to ALS: Voice & Message Banking (Susan Mast ALS Foundation) that may be applied to patients with PSP.

youtube.com/watch?v=WCkjbiD...

Hug, luck and courage.

Luis

[Hidden]

Luis has shared excellent information Scottoppy. He & Kevin have provided helpful common sense tips for daily life. If you have time tap on the picture next to Luis' name and you will see some of his past post. Also on the opposite side of this page there other speech related post that may be helpful.

Speaking as a woman... searching for our words is terribly frustrating... and can lead us into seclusion and depression. Having understanding loved ones can make a world of difference. Sending hugs to you and your wife... Granni B

[Nanny857]

Scottoppy, I have posted photos of what my husband used to help him communicate. He didn't like technology!!

Hope you find something that helps both you and your wife.

Lots of love, Nanny857xx

Sorry wasn't able to attach them to this post.

[Scottoppy]

Bless you all for the helpful advice and support

[daddyt]

I haven't experience with any kind of speech software yet. However, I do understand the difficulties and challenges she experiences. I think some of it is in due in part to primary aphasia. Slowness in thought process and finding the right words or any at all, is quite frustrating. Check with an SLT for any suggestions and strategies your wife might be able to use, it's important to keep her part of the conversation.

Tim