Speech-Language and Dysphagia Assessment in a Bilingual Female Post Cerebrovascular Accident
This case describes the speech-language/dysphagia assessment and intervention following a left hemisphere cerebrovascular accident (CVA) in an 81-year-old bilingual (Spanish/English) woman. This patient initially presented equal language impairment in both her native, Spanish, and second language, English. Patients like these can benefit immensely from assessment and treatment by a bilingual speech-language pathologist (SLP), who is able to accept responses in either language, as well as provide stimuli in either language.
AS, an 81-year-old woman, presented to the emergency room at a local acute care hospital with a past medical history of diabetes mellitus, hypertension, and hyperlipidemia. Initial computed tomography of the brain revealed no evidence of acute intracranial hemorrhage, mass effect, or midline shift. A focal area of diminished attenuation in the right basal ganglia compatible with lacunar infarct was noted. Given that AS arrived at the emergency room with signs/symptoms of stroke, she underwent and failed dysphagia screening (i.e., she coughed upon being given 3 ounces of water to drink without interruption) and was temporarily kept NPO (nil per os). According to AS’s daughter, AS was fully bilingual (Spanish/English) prior to this incident, but her native/primary language was Spanish. AS was a retired seamstress. In addition, AS was also employed as a home health aide for a short period of time. AS was originally from Honduras and had lived in the United States for more than 20 years.