It’s a Thursday morning in late April and the sound of excited voices and laughter are emanating from the large kitchen at the Aphasia House. Gathered inside are a small army of graduate students, clad in matching black polos embroidered with the name of their program: Communication Sciences and Disorders. They are all studying to become speech-language pathologists.
It’s graduation day. But not for the students.
It’s a commencement ceremony for their patients. In this case, four adults with aphasia — a communication disorder that can occur suddenly following a stroke or head injury but may also develop slowly from a brain tumor or a progressive neurological disease. June is Aphasia Awareness Month.
One of these four patients is Kyle Burke, a constantly smiling 25-year-old who seemingly knows everyone in the room.
He arrives at the ceremony in an orange Clemson University T-shirt. In May 2020, he was enrolled as a student and celebrating the completion of final exams and making the dean’s list when the pandemic brought him back home. It was there that a skateboarding accident would leave him with a traumatic brain injury and an inability to speak, write or understand language.
His family found the Aphasia House at UCF — one of just a few of its kind in the country and known for its intensive and highly-personalized treatment.
“Kyle’s a young guy and I just thought, ‘what a perfect environment,’ ” recounts his mother, Deborah Burke, in an early interview. “This is what he needs. He needs to be out with a bunch of people in a college environment. And he was excited.”
In October of 2021, Burke began his first delivery of the six-week program at UCF.
On April 21, 2023, he’s completed the program for what marks his eighth and final time.
Thriving Through Therapy
“Kyle came to us with severe expressive and receptive language deficits making understanding what people said to him in speech and in writing severely impaired, as well as being severely impaired in his ability to express himself,” says Angela Ziegler, an instructor in communication sciences and disorders and licensed clinical aphasia educator. “He initially didn’t know many of the errors he made while trying to communicate because he couldn’t hear his own errors.”
Burke’s treatment plan called for working on expressive and receptive language, making sure he could accurately understand what people say to him and easily formulate into words what he wants to say to others. His program consisted of individual therapy administered four hours a day, four days a week for six weeks. His therapists: a team of trained student clinicians —aspiring speech language pathologists, operating under the close supervision of a faculty clinician and themselves approaching graduation from UCF.
Communication sciences and disorders graduate student Nathalie Espinal ’21 served as Burke’s clinician in the summer of 2022 and then again in the fall. She focused heavily on conversation-based therapy treatments.
“Originally, he didn’t know any of his clinicians’ names,” Espinal says. “He would recognize us, of course, and we had a relationship, but he had trouble with that recall. By the second semester, he knew all the names and was able to get our attention and engage in more verbal conversation.”
By design, therapy was conducted in settings Burke would expect to be in naturally, like cooking, playing games and socializing with peers. Espinal coached Burke in Response Elaboration Training, or RET, a therapy technique that allows a patient to make a simple statement, and with a therapist’s assistance, expand on the original statement into something much richer and deeper.
“We did a lot of therapy in open areas interacting with other people,” Espinal says. “He would have a conversation and say a few words that were maybe not grammatically correct, but we would build on that sentence and add more details to it.”
Progress was steady, says Espinal, who personally worked with Burke up to seven hours a week over a 12-week period and drew from common interests in therapy sessions. Conversations covered movies, music and pop culture. Espinal also helped Burke improve his ability to use his phone to communicate with his friends.
“Initially, I worked with him on some ways to help him with texting some friends,” says Espinal. “He was using Snapchat a lot. We worked on spelling for texts and building his vocabulary on certain topics and areas of interest.”
“It genuinely felt like it was becoming a friendship,” Espinal says. “He was so adamant about working. He would ask about my life and my family, and we definitely bonded a lot.”
A Graduation Speech
The tradition at Aphasia House graduation is for the students to make speeches, sharing reflections on the progress of their clients and personal words of hope and encouragement.
On his graduation day, Burke also made a speech. He is the only one in his cohort of four to do so.
Since arriving, he has changed out of his Clemson T-shirt into a black polo shirt — the same one worn by student clinicians. It’s a graduation gift and a souvenir of his time at the Aphasia House.
His parents look on. The room is silent.
“Hi, I am Kyle. I have a brain injury. And I’m….I’m….phasia. I went to Clemson University, and I am from Greer, South Carolina.”
His speech is slow and deliberate. He uses his finger as a guide along the words of the paper.
“I love that Clemson won a bunch of football ACC championships.”
The room erupts in laughter.
He goes on to discuss his time at the Aphasia House. At times pausing. Sometimes reversing words. But the communication is clear.
“In the hospital, I cannot really speak or understand anything. Now I am…can talk and understanding the news, sports and TVs. I can read and understand song lyrics.”
“The students and I play mini basketball together. Watching movies…reading…talking and listening to songs is fun. Also, we had community outings such as bowling.”
He carefully acknowledges his parents, the students, their supervisors and — ever playful — his dog.
“Thank you for everyone helped me.”
Burke’s graduation speech is four minutes long.
Moving Forward
Research has shown that people with aphasia have higher rates of recovery when therapy is intensive, and at the Aphasia House, therapy spaces are designed to evoke a sense of home and belonging. The rooms are themed to help remind patients of favorite things: a garden room, a music room, a game room, and a garage room. Patients, students and faculty gather together in a working kitchen and a cozy living room.
“Our personal hope for Kyle is that he finds his way in this world that allows him to live well following a TBI and aphasia in whatever manner ‘living well’ feels for him,” Ziegler says.
Burke has set his sights on one day returning to school and driving a car.
“I want him to feel independent and successful,” Espinal says. “It’s so clear that he’s willing to put in so much work to get there. It’s only a matter of time before that ends up happening for him.”
