Stroke

Stroke occurs when the blood supply to the brain is cut off or disturbed. This destroys or causes damage to part of the brain where the stroke has occurred.

The damage to the brain caused by stroke can affect a child’s development and existing skills set. Depending on where in the brain the stroke has occurred, different aspects of development and pre-existing skills will be impacted upon, for example; damage to the left side of the brain can affect a child’s language abilities.

Our speech and language therapists can provide therapy to increase your child’s speech and language skills that have been impacted on by the stroke. They will work with your child to maintain their existing skills, improve their communication skills and create new skills.

When the blood supply to a child’s brain is cut off or disrupted, they will have a stroke. If blood is stopped from getting to the brain, the brain cells will begin to die as they aren’t receiving oxygen and nutrients, this will cause damage and destroy parts of the brain.

There are two main types of stroke:

• Ischaemic stroke - Blood supply to the brain is cut off due to a blockage such as a clot.
• Haemorrhagic stroke - Blood vessel bursts and causes a leakage of blood.

In children, both types of strokes are equally common. Children may also experience a transient ischaemic attack (TIA), this is when blood supply to brain is interrupted for a momentary period. Symptoms last for a few minutes or hours and usually disappear within 24 hours. There are no lasting symptoms.

The causes of a stroke vary between adults and children. In adults, stroke is usually the result of high blood pressure, irregular heartbeat and lifestyle choices. These causes are rare in children, the causes of a stroke in children tend to be the result of pre-existing conditions.

Causes include:

• Sickle cell disease
• Congenital heart diseases
• Trauma to the head and neck
• Infectious disease
• Vascular problems
• Heart disorders
• Blood disorders
• Surgery
• Arterial dissection
• Moyamoya disease

Stroke that occurs in children from pregnancy through to 28 days after birth is usually caused by blood clots from the placenta that have broken off and lodged inside the child’s brain as result of a blood clot disorder the mother or child has.

In the United Kingdom research suggest stroke occurs in 13 children per every 100,000 children. There are around 400 childhood strokes in the United Kingdom every year. There are approximately 200 babies who have a stroke every year in the United Kingdom.

The symptoms associated with stroke in adults are similar to those in children. Although they are very often missed in children of a young age. Some signs and symptoms include:

• Seizures in one part of the body, e.g. leg.
• Difficulties in breathing.
• Difficulties with eating.
• Preference of one particular hand earlier than developmentally appropriate.
• Developmental delay.
• Headaches.
• Vomiting.
• Weakness or paralysis on one side of the body.
• Blurred vision.
• Slurred speech.
• Language delay.
• Difficulties with swallowing.
• Restricted movement in arms or legs.
• Sudden change in mood and behaviour.
• Memory loss.

Childhood stroke can have a damaging effect on a child’s development and wellbeing. Depending on the type of stroke and the severity of the damage on the child’s brain the impact it will have on a child’s life will vary. The impact of stroke can have a big impact on a child’s development but their personality, support from their family and professionals can help to alleviate the impact it may have on their quality of life.

Some ways stroke impacts a child’s function includes:

• Difficulty with producing intelligible speech.
• Difficulty understanding what others are saying.
• Difficulties with social communication.
• Difficulties with activities that require eating, drinking and swallowing.
• Difficulty accessing the curriculum.
• Personality and behaviour change.
• Attention difficulties.

Our speech and language therapists can provide your child with a unique therapy program to work on their speech, language and communication difficulties. Communication is central to improving a child’s quality of life, through enhancing communication a child has the ability to access the world around them.

Our speech and language therapists can assess your child to see the impact the stroke has had on your child’s speech, language and communication skills. Our speech and language therapists can provide both formal standardised assessments as well as informal assessments depending on your child’s attention and other abilities.

Assessments used by our speech and language therapists include:

• Receptive language assessment
• Expressive language assessment
• Oro-motor examination
• Stammering assessment
• Speech assessment
• Dysphagia assessment
• Social communication assessment

Speech and language therapy can be very helpful for a child who has had a stroke. It can help to increase the child’s activity and participation in daily life, at school and at home. It can increase their levels of interaction with their family and friends. Our speech and language therapists will create an individualised therapy programme that is unique to your child’s abilities, needs, goals and motivations. It can include yours and your child’s school's priorities.

A child who has had a stroke can sometimes have weakness in the muscles used in speech, making it very difficult for them to be understood by others. This can have a great impact on a child’s life, stopping them from speaking in the classroom, talking to friends at break times or making conversation with family members. This can leave a child feeling very isolated and alone. Our speech and language therapists can help children with muscle weakness by providing them with oral-motor exercises that and help to make their speech more understandable to others. This would help to increase confidence and interaction levels.

Speech and language therapy programmes available include:

• Receptive language therapy
• Expressive language therapy
• Speech therapy
• Oro-motor exercises
• Augmentative and Alternative Communication
• Stammering therapy
• Social communication therapy

Stroke can have a great effect on a child’s development, health and well-being. It can leave children feeling frustrated and isolated. It can impact upon their learning and their social life. Our speech and language therapists can help with reducing the long term effects of stroke by providing them with individualised therapy programmes to increase their speech language and communication skills.