After a stroke, regaining the ability to string words into simple sentences or finally being able to return to work are milestones. In Austin, Texas, speech language pathologists Shelley Adair and Shilpa Shamapant get to regularly witness such achievements.

Like the 36-year-old chemical engineer who is now able to conduct conversations after four years of intense therapy, and who still faces a difficult road as he relearns how to read and write. And like the young undergrad student who after two years of therapy was able to complete her degree and start a career.

Recovering speech can require months and years of intense drilling and practice. It’s just one of the possible disabilities following a stroke that requires a team of healthcare providers and caretakers with assorted expertise and viewpoints.

“To help people reach their maximum potential, we need to provide multidisciplinary support for as long as a person needs it,” said Shamapant, who partnered with Adair in 2008 to found Austin Speech Labs, a nonprofit that offers intensive, individualized therapy.

For National Rehabilitation Week, the American Heart Association/American Stroke Association released a stroke rehab kit to help doctors, patients and caregivers navigate the complex stages of recovery. The kit, which is supported by Kindred Rehabilitation Services, comes on the heels of the organization’s first-ever stroke rehabilitation guidelines issued last year.

[New guidelines offer how-to manual for stroke’s aftermath]

The guidelines call for intensive, multidisciplinary treatment and recommend fall prevention programs and using in-patient rehabilitation facilities rather than nursing homes whenever possible.

Stroke affects nearly 800,000 Americans each year and is a leading cause of serious long-term disability in the U.S., costing an estimated $33.9 billion.

The importance of rehabilitation after a stroke has achieved greater prominence in recent years, said Joel Stein, M.D., Simon Baruch Professor and chair for rehabilitation and regenerative medicine at Columbia University, and professor and chair for rehabilitation medicine at Weill Cornell Medicine. “There’s a growing body of scientific literature that shows that the human body is capable of changing as the body rewires itself,” said Stein, who helped write the stroke rehab guidelines. “We need to work together to harness that ability to maximize recovery.”

Stein said greater awareness about rehabilitation and resources is critical to help stroke patients reintegrate into the community.

“Historically, there was a perception that the recovery after a stroke was out of our control, and that patients will get back what they can get back,” Stein said. “Rehab matters, and both intensity and duration are important. Even years after a stroke, people can recover through concentrated efforts.”

Losing speech, whether the ability to find the words needed to express an idea or the ability to read and write, can be devastating for a stroke survivor, and can lead to the loss of one’s ability to work and ultimately social isolation.

“Language sets us apart as human beings,” Adair said. “The words we use—the vernacular and slang—it defines who we are as individuals.”

Shamapant and Adair formed Austin Speech Labs because of frustration. They saw patients who were forced to end therapy because they couldn’t afford services after their insurance benefits ran out.

Shilpa Shamapant (left) and Shelley Adair started Austin Speech Labs in 2008. (Photo courtesy of Austin Speech Labs)

Shilpa Shamapant (left) and Shelley Adair started Austin Speech Labs in 2008. (Photo courtesy of Austin Speech Labs)

“It wasn’t that they weren’t making progress or meeting goals—they just ran out of insurance,” Adair said. “You can do physical therapy on your own, but to do speech therapy, you have to have someone work with you to give you feedback.”

Much has changed since Adair first became a speech pathologist a quarter-century ago. She sees much younger stroke patients these days, something that motivates her and Shamapant to find more efficient approaches to rehabilitation.

[More strokes among younger people worry experts]

“Years ago, we always told people they had between six months to a year to recover,” Adair said. “Now we know people can continue to make progress after that year with continued work.”

  • The American Stroke Association will host a Facebook chat Sept. 22 at 10 a.m. CT to answer stroke rehab questions from patients and caregivers.