When most stroke survivors go home, that's not the end of recovery or therapy. They often get to go to an outpatient facility a few times a week to continue making progress with PT, OT, and speech therapy. It's great when that's feasible. Unfortunately, it can mean spending several hours to attend a 45 minute session. An it may require that not only from the survivor but also from a care partner. Transportation logistics, scheduling challenges, etc. can take energy that would better spent on recovery and rehab. But do we really need to travel? The pandemic radically sped up the adoption of telemedicine and remote healthcare. Facilities added infrastructure and patients learned to use Zoom and Teams. A lot of therapy -- especially speech therapy can be done online with a remote therapist. Lenora Edwards is a Speech Language Pathologist with Better Speech. Better Speech has more than 150 therapists around the US offering remote Speech Therapy. In this episode, Lenora tells us how this works, how it helps, and when remote therapy doesn't make sense. If you don't see the audio player below, visit http://Strokecast.com/MSN/BetterSpeech to listen to the conversation.   Click herefor a machine-generated transcript Who is Lenora Edwards? Lenora Edwards is an ASHA board certified Speech-Language Pathologist. Throughout her career as a speech therapist, she has enjoyed treating and evaluating a wide variety of speech and language issues across the lifespan. Aphasia, Apraxia, and Dysarthria These are three common speech challenges after a stroke. Aphasia is trouble finding words. A person has all their thoughts, feelings, and smarts, but they just can't access the vocabulary to express themselves. They're not dumb, and they still have all their intellectual capability and processes. They just can't use words. In some cases, they can understand things fine; in others, they lose the ability to understand words, too. Sometimes they can read and write. Sometimes those functions break. Apraxia is a challenge of getting the words in the right order. Once you can access your words, and pull them off a metaphorical shelf, you still need to chain them together into sentences and paragraphs to communicate with other people. Dysarthria isn't a language issue itself; it's a speech issue. Dysarthria happens when we have trouble with the mechanics of speech -- tongue, larynx, jaw, and lip movements for example. This is what had for a little while. My hemiparesis wasn't just my arm and leg, but also the muscles on the left side of my face and mouth. It resulted is some slurring and mild pronunciation challenges. Overall, it was one of my milder deficits at the time. Most folks thought it cleared up in a couple weeks; I continued to notice it for 6 months. One fascinating aspect of all this is just how much goes into language and communication. There are so many different ways it can go wrong, it's a wonder anyone can speak at all. Adjective Sequence We learn our first language intuitively We pick it up as a child from those around us, cultural tools, our environment, and later school. We don't learn the rules first. We learn them after we've already been using them for much of our lives. In English, adjective sequence is one of those rules. Many of us heard or read the children's books about Clifford, the big, red dog. Just saying that phrase will trigger a memory for many folks. Even if this is the first time you've heard about Clifford, you understand what I mean. You may not be aware that by big, I mean house-sized, but you get the point. If I mention Clifford, the red, big dog, it seems wrong. And it is because in English (in the US, at least), size adjectives come before color adjectives. That's the rule. When did I learn this? Last year. Seriously. I never knew this was a rule before, but I "kn