CARE Dawgs participant tackles aphasia with a new life goal in mind

After suffering a stroke at only 42 years old, Tracie-Ann Jessamy, a Barbadian participant in this summer's Comprehensive Adult Rehabilitation and Education (CARE) program at the College of Education, has been relearning how to verbally communicate her thoughts and desires for the past year—and miraculously, she's already come a very long way.

Hosted by the UGA Speech and Hearing Clinic, CARE Dawgs is a two-week intensive treatment program for adults with acquired speech or language problems. Like Jessamy, the other three participants in the research program suffer from a language disorder known as aphasia.

Aphasia is caused by a neurological injury to the left side of the brain where our capacity for language is held. Depending on where the lesion is, some people might have a stronger ability to express themselves, while others may struggle with auditory comprehension, reading and writing, or exhibit a sample platter of everything, said Seles Gadson, a doctoral student in the Department of Communication Sciences and Special Education.

Since Jessamy looks healthy despite her language problems, she often needs to explain her disorder in greater detail to other people, including friends and family members. People who suffer from aphasia can have difficulties with tasks that, before their traumatic brain injury, were very ordinary, including speaking, reading, writing and calculating sums.

"Oftentimes, one of the key hallmarks of aphasia is that individuals know what they want to say, but because of the damage that has occurred to pathways [in the brain], they're unable to fully communicate it," said Gadson.

Jessamy is the only black female participant in this year's program, which is being held in conjunction with the University of South Carolina. Unlike most intensive approaches to communication rehabilitation, CARE Dawgs contains a holistic component that specifically targets overall quality of life.

This approach, which features group counseling sessions as well as meditation and yoga practice, is one of the first of its kind to be carried out and studied in the United States.

According to Gadson, there's plenty of traumatic brain injury literature that supports holistic treatment for recovery.

"We're now starting to bridge and see those parallels in people with aphasia because it's all neurological," she said. "I'm just excited that UGA was open-minded and said, 'Yeah, let's try this holistic piece.'"

For Jessamy, meditation gives her a chance to refocus her busy mind. Not only is she participating in the program by herself, but she's also in a strange environment far from home. However, when she first heard about the program through Gadson, she knew she had to participate no matter the cost.

"My son said, 'Mom, you have to do it and get better,'" said Jessamy. "What I'm doing is fighting because I'm the only child and I'm a single parent—I have to."

Jessamy's ultimate goal is to get back to work so she can support her family. Before her injury, she worked as a customer service representative for numerous corporate clients in Barbados. It was her job to talk on the phone every day and keep track of numbers on a spreadsheet. Today, these seemingly simple tasks pose an incredible challenge to the 43-year-old.

Last August, Jessamy was on vacation when she started feeling extremely tired in her home.

"I remember thinking something was wrong," she said. "I tried to call my father, but I couldn't type so I just waited for about two hours."

When her father finally came home, he called her best friend who eventually rushed her to the emergency medical clinic. Her friend would later tell her months after the incident that half of her face was drooping.

At the hospital, the doctor took a brain scan, tested her blood and determined that Jessamy was having a stroke. Even though her blood test came back normal, Jessamy knew something was wrong since she could no longer speak properly. As a result, her doctor recommended speech therapy.

"I was frustrated because I could hear what I wanted to say, but I couldn't verbally say it out loud," she said. "I couldn't remember people or places, and I had trouble spelling."

There are only two speech therapists in Barbados and only one that specializes in adults. For 45 minutes twice a week, Jessamy worked on various exercises, including pronunciation, counting from one to 10 and learning how to form longer sentences. She even keeps a notebook with her at all times so she can write down phrases or words if she's having trouble communicating them verbally.

Even though her language skills progressed fairly quickly, Jessamy still felt like something was missing from her life in Barbados—she didn't know a lot of people with aphasia who could truly understand what she was going through.

This all changed after only a few days with CARE Dawgs. Jessamy has already moved up a couple levels in treatment and feels even more motivated by her partner who also has aphasia. With the group's help and motivation, Jessamy can finally say a word she's been struggling with since her injury, "yellow."

"Group therapy is great," she said. "Now my partner and I push ourselves, so if he says something, I try to say it too."

The goal of intensive speech therapy is to form longer, more complex sentences. In the program, participants practice auditory comprehension, which looks at their ability to understand spoken language and spontaneous types of production, such as storytelling and picture discourse. Many of the language activities are based in game formats so the participants can work on memory and matching.

In contrast, the yoga and counseling sessions target psychosocial development to enhance quality of life. According to Gadson, improving a patient's self-perception of themselves as well as their desire to participate in more activities can aid speech and language development.

"If you're more confident about doing something—whether you're doing it right or wrong—you're going to at least practice and put yourself out there more," she said. "And that can improve your language more than sitting in a session with me for an hour. We got to start looking at the whole person because the whole person can improve language."

Jessamy knows that she's luckier than most stroke survivors and that her injuries could have been worse. She doesn't have any motor-sequencing challenges and motor weakness to her tongue or lips, and most of her deficits are in word finding and understanding language. And while she still can't process language as quickly in loud environments and on the phone, Jessamy doesn't let that hold her back from going out to the movies or taking a stroll outside.

After she returns to Barbados, she no longer intends on going back to her old job. Instead, Jessamy is passionate about helping other people with aphasia as both a volunteer and an educator.

"There's no one better to tell their story than me," she said.

The bigger piece of UGA's program is to look at how providers can deliver speech therapy services to individuals more effectively. The goal is to compare evaluation reports and patient feedback from the University of South Carolina and the University of Georgia. The former institution will examine how participants respond to only the intensive speech and language treatment, while UGA will analyze how quality of life as well as treatment can affect language recovery.

"We're treating the entire person," said Gadson. "That's what makes me so excited. We're on the forefront of what needs to happen."

After the program ends, Jessamy will continue to work on improving her language skills. She will attend the first Young Stroke Convention in Jacksonville, Fla., on June 27 as a sponsored participant. While there, she's excited to meet even more people with her condition and to hear doctors disseminate new information to the public on aphasia.

Once the three-day convention is over, Jessamy will return to Athens and begin her one-on-one speech therapy session with Gadson. She wants to stay in Georgia even longer than originally planned to further improve her language skills.

"I'm telling people it's so good for you," said Jessamy. " The camp lets me meet new people that understand me, and that's a big thing for me. When I go back to Barbados, I'm going to tell everybody to come to Georgia. I love it here… You'll have to make me leave now."