Talking the talk

As most of y’all are aware, I am back enrolled at speech therapy since having vocal chord surgery. Under the ever-watchful eye of Blue Cross-Blue Shield of Texas, I am back at my original rehab hospital and have been allowed to return to my primary speech therapist from last year.

The major advantage (other than her professional skill) of using the same therapist is that she was familiar with all of my previous speech patterns and compensatory strategies. With my intelligibility still relatively poor, having somebody familiar with my deficiencies has definitely been an advantage.

So, you want to know what kind of things we are working on? You asked for it….

*** One of the main issues with my intelligibility relates to the lack of nerve innervation in my cheek, tongue and lip muscles (particularly on the left side). I now have a routine of stretches and strengthening exercises for these areas that I work on daily.

I have enough stretches and strengthening exercises that I do not need to repeat any of them throughout the day (I try to fit in two or three sets per day). One of the strengthening and stretching exercise sets was designed by Debra Beckman. To read more about her and the lovely oral motor exercises I perform, click here.

*** Once I finish all the stretching and strengthening work, my therapist and I are focused on forming proper sounds, thereby improving my intelligibility. For starters, we are working on pairs of sounds that are formed the same way, but one uses ‘voice’ and the other does not.

For example, the first set we worked on was |s| and |z|. These sounds should be formed by placing the tongue in the bottom of your mouth and forming a thin stream of air out the front. The only real difference between the |s| and |z| sound production, is that you ‘turn your voice on’ to make the |z| noise. Still with me?

If so, we have moved on to |f| and |v|. Again, two sounds with similar elements of production, only the voice is required to produce the |v| sound.

While it sounds simple enough, my complications arise from poor nerve innervation in the left side of my face. It is still difficult for me to pucker my lips, hold air in my cheeks and maintain control of my tongue musculature during speaking. All these issues are compounded by a brain that is thinking much faster than I can speak and sending too many signals to those muscles.

*** To work on functional intelligibility, I read word lists and paragraphs into a recorder. My therapist then plays the readings for a listener that was not present during the readings. This forces the listener to interpret the words I am saying solely by listening to the tape.

Early results are still pretty poor. When interpreting word list recordings, listeners are only able to correctly interpret about 15% of what I say. When listening to a paragraph and adding context to my speaking, listeners are able to translate closer to 45% of what I say.

There you have it! A glimpse (albeit a technical one) into the inner-workings of my trips to speech therapy. My therapist and I have established some longer-term goals relating to talking on the phone and speaking at the wedding. Of course, I am ever-hopeful that as my nerves continue to regenerate, that I will undergo stretches of significant improvement. Until then, I will keep the faith and keep working on my new motto, “Thay it – don’t thpray it!”