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TomBroussard, January 29,  2021  11:43am EST

Speech Therapists are the Trim Tab of Aphasia Recovery

Dear Stroke Suvivors,

A trim tab is a rudder within a rudder. It takes a lot to turn a big ship and requires huge rudders to change course. But they are so big that it often takes another rudder within the rudder. There's a tiny sliver at the edge of the rudder called a trim tab. It's a miniature rudder.

When people with aphasia (PWA) have lost their language, it takes a long time to get their language improved (granted more therapeutic activities) and replace what was lost.

The effort that is needed requires persistent, repetitive, and intensive language activities to induce plasticity (the capacity to convert thought and cognitive activities into neural matter) that increases the number of dendrites, synapses and fiber. More neural matter means more learning and language improvement.

The neurological inertia of the mothership of language is massive and measured in millions, billions and trillions of neural (brain) matter. The rudder for that ship is also huge and if damaged, needs the help of the SLPs. They provide the initial therapeutic activities, the habit that it acquired, and the ongoing language activities that become habitual, with less and less effort (and more and more improvement) for the same amount of work.

Speech therapists help start the sustainable component of the therapeutic equipment (and motive force) needed for the long journey towards recovery. They are the rudder within the rudder, helping steer the ship with the interest, support, and stimulation that is needed to establish the long-term therapeutic relationship between them and their PWA clients. Speech therapists are the trim tabs of aphasia recovery! Without them, we would be rudderless.

Please see my article and video at



1 Reply
  • MarcellaP
    MarcellaP, January 29,  2021  12:21pm EST

    Hi Tom, 

    I enjoyed your figurative language and storytelling here! I had a tough speech therapist in my first days after a stroke, and although I didn't like working with her (I was in pain, in denial and so cognitiely damanged), she helped re-shape my brain and give me a shot at a linguistically-rich life, post-stroke. Today, whenever I encounter someone who has had a stroke, I push HARD for them to get speech therapy, even if they don't think they need it,  or if they as caregivers don't think their loved one needs it. 

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