Aphasia Treatment helping Gabby Giffords

It was January 8, 2011, in Tucson, Arizona, when Gabrielle “Gabby” Giffords was shot in a Safeway parking lot by Jared Lee Loughner.  Congresswoman Giffords captured the attention-and deep sympathy of our nation and beyond.  Her husband, Mark Kelly, contacted Nancy Helm-Estabrooks, CCC/SLP to help guide the direction of her ongoing rehabilitation to her damaged left hemisphere from the direct gunshot injury, which caused severe apahsia in Gabby.  She has made remarkable progess and speech & language pathologists have been instrumental specialists in her pathway to recovery.  Estabrooks was part of a team of specialists at the Boston Va Hospital back in 1972 when they discovered that a 48 yr. old patient at the VA who had left-hemisphere involvement after a stroke could finally get beyond her restricted ability of using repetitive productions of syllabic strings to mean a variety of intentions.  For example, “ni-ni-ni-na-na-na” could mean a question, or distress if used loudly, or to comment on someone’s fashion that was admired by this 48 year old woman. The team noticed that she could sing every word of the standards played by a pianist. This discovery led them to develop the treatment program called Melodic Intonation Therapy (MIT) after lots of work and trial and error to refine the method.  Gabby Giffords was exposed to this treatment approach early in her rehabilitation.  She was taught to separate words from a familiar tune and attach them to two rhythmically spaced, unassociated notes, while tapping out the syllables with her hand as she “sang” the notes.  For example, phrases with important meaning like “close the door” or “open the window”  or “I feel sick” could get communicated using this melodically intoning method.  Gabby showed great progress using melody and music in her early rehabilitation. In the summer of 2011, Helm-Estabrooks evaluated Gabby at Mark’s home in Texas.  She used a dynamic assessment approach and then hired three experienced speech-language pathologists to directly work with her.  Gabby continued to improve and a secure website was set up so Helm-Estabrooks could read her chart notes and make recommmendations & modifications if needed.  She then hired Marjorie Nicholas, CCC/SLP, a close colleague from Boston who now works at the MGH Institute for Health Professions, to come to Gabby in Texas and work for 70 hours during a 10 day span. Helm-Estabrooks and Marjorie Nicholas have been impressed with the many ways she has progressed across a variety of independent activities. This summer they are planning eight days of very intensive speech & language therapy in the Smoky Mtns. Gabby will receive day-long intensive language therapy.  One thing Helm-Estabrooks cautions about is the erroneous thinking that music therapy ALONE was the treatment that got Gabby to where she is now (some press accountants have intimated).  Her music therapy she received in Texas was also accompanied by lots of good language therapy that keeps up with her current skill level.  According to Helm-Estabrooks, “Gabby is on the road to a very good recovery and this is a testimony to the natural healing of the brain, good medical care, talented CCC/SLPs, OTs & PTs and rehabilitation medicine in general.” She continues, ” The issue, however, is that MOST people DO NOT GET as much therapy as Gabby. In most cases, the insurance of people with aphasia (if diagnosed) dries up quickly.”  Helm-Estabrooks sincerely hopes that Gabby’s progress secondary to all the services she has received, raises public awareness of the need for medical coverage of such services. 

(Some information & quotes taken from The ASHA LEADER, June 2012 issue).

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