Stroke – SLT for Severe Aphasia — SCE Neurology MCQ

Correct answer: C — Speech-language assessment with supported communication strategies and carer training

The best answer is “Speech-language assessment with supported communication strategies and carer training”. Severe aphasia does not remove the need for SLT: the team can assess residual communication, establish supported conversation and augmentative methods, train carers and revisit restorative work as participation changes. “Withdraw because therapy is useful after normal comprehension returns” is less appropriate because communication access and partner training remain possible despite severe impairment “Defer all communication input until six months after stroke” is less appropriate because early assessment prevents avoidable isolation and unsafe misunderstanding “Limit assessment to swallowing because aphasia is not within the service remit” is less appropriate because speech and language services cover both communication and swallowing “Require the patient to request therapy verbally before involvement” is less appropriate because a communication disability cannot ethically be used to block access to communication care

Reference: NICE NG236: Stroke rehabilitation in adults. https://www.nice.org.uk/guidance/ng236/chapter/Recommendations