Stroke survivors may face many steps to recovery, and the first few months following a stroke can be crucial for positive outcomes. In those early days, William Osler Health System (Osler) patients benefit from the support of a team of skilled health professionals, including a communicative disorders assistant (CDA).

Shannon Bontius-Adams is a CDA in rehabilitation services at Brampton Civic Hospital, where she works with speech language pathologists to help patients achieve their goals. Many of these patients have experienced a stroke, while others have neurogenic disorders that impact communication.

A communication disorder can involve any or all processes of hearing, language, and speech. It can affect a patient’s ability to send, receive, or process verbal or nonverbal messages.

“Some areas of speech we target in our sessions are receptive language, understanding information, and verbal expression, which includes expressing ideas, thoughts, wants, and needs,” explains Shannon. “We also focus on reading, writing, and cognitive communication, including executive functioning, verbal reasoning, and memory.”

Once patients are admitted to the rehabilitation unit, a speech language pathologist assesses them for communication difficulties and creates goals. CDAs help to put those goals into action and prepare materials for 60-minute therapy sessions, which take place three to five days a week.

Early intervention is key to a patient’s progress. Studies show that the most improvement happens in the first three months after a stroke. Most often, CDAs will see patients for about a month, but the plan can unfold over two to four weeks or more. 

Through the inpatient rehab program, patients might also access physiotherapy, occupational therapy, and recreation therapy. With a busy agenda, team members work together to ensure patients’ needs are prioritized.

“We find out the best time to see the patient,” Shannon explains. “Sometimes patients respond to sessions better in the morning or afternoon. We collaborate with other disciplines to schedule the patient.”

Shannon takes great satisfaction in helping patients build their communication skills. “From my perspective, communication is key, because if you can't express your basic wants and needs—such as feeling pain, being sick, hunger, or thirst—this can be so frustrating for our patients.”

Therapy helps patients recover lost skills and uncover alternate methods of communicating. “Often our patients have word-finding difficulties,” Shannon says. “We teach our patients and their family members strategies to communicate when they are unable to find the words. Through supported conversation techniques, patients are able to better understand information as well as get their messages out.”

For patients who have difficulty saying words clearly, the team shares strategies for clear speech, such as speaking slowly, over-articulating, and ensuring good breath support. Patients who want to return to work might be asked to try tasks like listening to voicemails or reading a short story to see if they can retain key details.

Occasionally, CDAs also see patients with difficulty swallowing (dysphagia), guiding them through swallowing exercises or observing mealtimes to see how they tolerate a new diet.

Shannon joined the Osler team as a student in 2010, having switched from a previous career as an instructor therapist, working with kids. “When I did my placement here and was exposed to working with adults, it was a game changer. And I still love my job.”

Inpatient rehabilitation services are available at both Brampton Civic and Etobicoke General Hospital, with programs tailored for patients with diverse medical conditions, including neurological, medical, orthopedic, and other complex issues. The general rehabilitation program, located at Brampton Civic, offers intensive therapies to rebuild strength and independence, with session length and frequency based on individual needs.

For patients requiring extended rehabilitation, the Functional Enhancement Services (FES) program at Etobicoke General is designed to address chronic or complex conditions through low-intensity rehabilitation. In both programs, Osler’s collaborative approach involves working closely with patients to improve independence, mobility, and daily activities.

Looking towards the future, the new Peel Memorial will further expand Osler's rehabilitation capabilities, including units dedicated to functional enhancement, short-term medical management, outpatient rehab and spasticity clinics.

Shannon's story is just one example of the incredible care provided at Osler. You can make a difference in the lives of stroke survivors and others by helping to build Brampton's new hospital. Your donation will help us continue to provide cutting-edge care and expand our services to meet the growing needs of our community. Together, we can build a brighter, healthier future.

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