Frequently asked questions
Straight answers about virtual speech therapy for adults rebuilding communication after a stroke, brain injury, or aphasia — recovery timelines, the insurance “plateau,” cost, and how online sessions work.
Recovery, plateaus & timing
Does speech therapy still help years after a stroke?
Yes. Because of neuroplasticity — the brain's ability to form new pathways — people can make meaningful communication gains months or even years after a stroke or brain injury. Recovery isn't limited to the first few months. Motivation and regular, well-targeted practice matter more than how much time has passed.
My loved one was told they've “plateaued” — is that real?
A “plateau” is usually the limit of a coverage window or a particular approach — not a limit of the brain. When progress stalls, it often means therapy needs to change: new goals, different methods, or more frequent practice. Many people keep improving with individualized treatment after being told they'd plateaued.
How often should you practice for aphasia recovery?
Frequency matters. Evidence shows that more frequent practice — often several days a week — tends to produce better gains than occasional sessions. That's why Affinity pairs regular sessions with guided home practice: shorter, consistent repetitions between visits do much of the work of rebuilding communication.
What can I do when insurance stops covering speech therapy?
Insurance often ends coverage once it stops seeing rapid, documented change — but that doesn't mean progress has stopped. Many people continue privately: with a speech-language pathologist, structured home practice, and support from family. Affinity Therapy is built for exactly this stage — continuing recovery after insurance-covered therapy ends.
Who we help & how
What is the Life Participation Approach to Aphasia (LPAA)?
LPAA measures success by the life you get back: real conversations, relationships, work, and independence. Therapy focuses on the situations that matter most to you, so your progress shows up where you actually live, in the moments that count.
Do you offer speech therapy for primary progressive aphasia (PPA) or early dementia?
Yes. For progressive conditions like PPA and early dementia, therapy focuses on maintaining communication, building strategies and supports, and maximizing independence and connection for as long as possible. The goal isn't a cure but preserving function, confidence, and quality of life — and equipping families to communicate well together.
Can speech therapy help long-COVID brain fog?
Often, yes. “Brain fog” from long COVID can involve word-finding, memory, attention, and processing difficulties — all within a speech-language pathologist's scope. Cognitive-communication therapy provides strategies and structured practice to improve daily functioning, and it's well suited to virtual delivery, which helps when fatigue makes travel hard.
How is a specialist different from general speech therapy after stroke or brain injury?
General speech therapy covers all ages and needs. Affinity focuses specifically on adults with acquired and progressive neurological conditions: aphasia, apraxia, cognitive-communication, and executive function. That focus means the methods, materials, and coaching are built entirely around adult neurologic recovery and real-life participation.
Virtual therapy, cost & logistics
Is online (virtual) speech therapy as effective as in person?
For most adults with aphasia and cognitive-communication needs, yes. Research supports telehealth for naming practice, conversation-based therapy, script training, and caregiver coaching, and it removes travel barriers. A secure video session works well for the majority of clients; occasionally an in-person start is suggested for severe motor-speech involvement.
Can a family member or assistant help deliver practice at home?
Yes — and it helps. A speech-language pathologist can design a home program that a spouse, adult child, or trained assistant supports between sessions. Guided repetition at home, plus regular check-ins, is one of the most effective ways to keep progress going, especially once formal coverage ends.
How much does private speech therapy cost? Do you take insurance?
Affinity Therapy is private-pay. You'll get clear pricing before you start, and a superbill on request to submit to your insurer for possible out-of-network reimbursement. HSA and FSA funds are accepted, and Aetna is billed in-network. A free consultation lets you ask cost questions up front.
What states are you licensed in?
Marina Coakley, M.S., CCC-SLP is licensed to provide telehealth speech therapy in Tennessee, Kentucky, California, and North Carolina. If you live in any of these states, you can work with Affinity Therapy from home by secure video — no travel required.
Still have a question? The best next step is a free consultation.
Schedule a free consultation
