Therapy in transit: managing aphasia in the early period post stroke

Document Type

Journal Article




School of Medical and Health Sciences




Originally published as: Hersh, D. (2016). Therapy in transit: managing aphasia in the early period post stroke. Aphasiology, 30(5), 509-516. Original article available here.


Background: There is a very particular set of circumstances facing people with aphasia in the early period following stroke. These circumstances often include a focus on discharge planning and fast transitions between acute, subacute, and community services at the same time as having substantial periods of inactivity (including communicative inactivity) between therapy sessions. Speech pathologists are typically focused on dysphagia in acute settings and have little time for managing aphasia. This is an important issue because of the risk of patients missing out on the potential to exploit a window of opportunity for neurological change in this very early period. Aims: This review uses the analogy of being in transit (likened to waiting for a possible flight after an unexpected disruption to one’s journey) following stroke, in order to introduce the articles which follow within this special issue on recovery and care in acute aphasia. Main Contribution: There is therapeutic potential in the early period for people with aphasia and the transit analogy serves to sensitise health professionals working with and for these patients at this time. Conclusions: What happens in this early period may have profound impacts for people with aphasia further down the recovery track. Health professionals have an opportunity to examine how they can assist smooth passage for people with aphasia on their unplanned journey. This may involve speech pathologists recognising and promoting the fundamental importance of communication in acute and subacute settings, about encouraging other health professionals to gain the skills needed for good communication with patients, and about finding ways to overcome the barriers of busyness, lack of time, and fast turnover of patients and staff. The analogy may be a useful way to frame how contexts and systems impact on recovery and care at this time. © 2016 Taylor & Francis.