Rebuilding communication
after stroke or brain injury
A brain injury — whether from stroke, accident, concussion, or another neurological event — can change how you communicate in ways that are hard to explain to people who haven't experienced it. The words are there. The thoughts are there. But something in the pathway between them has shifted.
That shift is real. It's treatable. And it doesn't follow a fixed timeline for improvement. Affinity Therapy works with adults and their families through every stage of that process — from the weeks after an acute event to years of continued recovery.
For some people, that shift looks like aphasia — difficulty finding words, understanding language, reading, or writing after stroke or brain injury. For others it looks like slower processing, word retrieval difficulty, attention fatigue, or changes in how conversation feels. Both fall within what speech-language pathology treats, and both respond to consistent, individualized therapy.
If you've been told your progress has "plateaued," you're not alone — and it may not be true. The brain retains the capacity to rebuild communication well into the chronic phase of recovery. That's what this track is built around.
Who this track is for
STROKE SURVIVORS
Including chronic-phase aphasia
Many clients come to us months or years after their stroke — often after being discharged from prior therapy. Recovery doesn't have a hard stop, and neither does our work.
TBI & CONCUSSION
Cognitive-linguistic recovery
Brain injuries affect communication in ways that aren't always visible. We assess the full picture — attention, word retrieval, processing speed — and target what matters most in your daily life.
WORD-FINDING DIFFICULTIES
Anomia & expressive language
Knowing what you want to say but not being able to find the word is one of the most frustrating experiences after a stroke. It's also one of the most treatable — with the right approach.
UNSURE?
Start with the discovery call
If you're not sure whether this track is the right fit, the free 15-minute call is the place to start. We'll review your history and identify what's most relevant to target.
What a session actually looks like
Every 45-minute session is task-driven and functional — grounded in what you actually need to do in your life, not abstract drills.
OPEN
0–5 min
Where are you today?
We start with a brief check-in — what's felt hard this week, what's felt better, what you want to focus on. Your real-life experience between sessions directly shapes what we do next.
CORE
5–35 min
Functional, task-based work
The heart of each session is targeted practice on something that matters to your daily life — finding words in conversation, managing a phone call, navigating a social situation, or returning to a role or activity you've missed. Marina draws on proven approaches (such as Semantic Feature Analysis, VNEST, or Spaced Retrieval), chosen for your profile and goals. She fits the method to you and adjusts as you go.
CLOSE
35–45 min
One thing to carry into your week
Every session ends with a clear debrief — what worked, what it tells us about your progress, and one concrete strategy to practice before next time. Small, consistent repetition between sessions is where the real neuroplasticity happens.
How we build your plan
No two stroke survivors present the same way. Your plan is built collaboratively — starting with what you bring, refined by what the evaluation reveals.
It starts with your goals
In early sessions, we work together to identify what you most want to recover — a conversation, a role, an activity. Your priorities drive the direction.
Grounded in your eval
The clinical assessment maps your cognitive-linguistic strengths and barriers, giving Marina the data to target the "next right step" for you.
Methods chosen for you
Marina selects from proven treatment approaches based on your specific profile: anomia treatment, processing strategies, or cognitive-communication support as needed.
Family involvement
Caregivers and family members can be part of sessions when it's helpful — participating directly or observing. This is always guided by your preference and what serves your progress best.
How we know it's working
Progress is measured against your life — not a standardized chart.
Early Wins
- Increased confidence initiating conversation
- Noticing more word retrieval success in daily life
- Reduced frustration when communication breaks down
- Clearer understanding of your own communication profile
Longer-Term Gains
- Sustaining conversation in complex or high-demand situations
- Returning to a role, relationship, or activity that felt out of reach
- Managing communication breakdowns independently
- Confident use of compensatory strategies as needed
Maintenance Phase
Once your primary goals are met, we don't just discharge and disappear. A Maintenance Track — monthly or bi-monthly check-ins — is available to ensure long-term stability and confidence before final discharge. You decide when you're ready.
6
month increments
between formal
goal reviews
1–2×
sessions per week,
based on your needs
45
minutes per session,
billed at $100
Payment & Billing
Once you're onboarded as a client, you'll receive a text message with a secure link to provide your payment information through IvyPay — a HIPAA-compliant payment platform built specifically for healthcare providers. Sessions are billed per appointment at $100. Aetna members are billed through insurance; you are only responsible for your plan's copay or deductible.
Related services
Communication After Brain Injury
For adults experiencing word-finding difficulty, processing slowness, attention fatigue, or other cognitive-communication changes following TBI, concussion, or acquired brain injury. You don't need a formal diagnosis to explore whether therapy can help.
TBI · concussion · cognitive communication · word finding · processing speed · acquired brain injury
Learn moreAphasia Therapy
For individuals experiencing difficulty with speaking, understanding, reading, or writing following stroke or brain injury. Focused on functional communication, confidence, and the daily life moments that matter most.
Aphasia · stroke · brain injury · expressive aphasia · receptive aphasia
Learn moreApraxia of Speech
For adults with motor planning challenges affecting speech production. Intensive, repetition-based approaches to rebuilding reliable speech — for both acquired apraxia and childhood apraxia that persists into adulthood.
Acquired apraxia of speech · motor speech disorder · CAS
Learn moreCommunication Partner Training
Coaching for family members and caregivers on how to support communication at home — including strategies for communication breakdowns, pacing, and staying connected through the hard moments.
Aphasia caregivers · post-stroke families · caregiver coaching
Learn moreCommunity & Connection Resources
Recovery doesn't happen in sessions alone. Marina can help connect you with aphasia support groups, adaptive resources, and community networks — including Aphasia Recovery Connection (ARC) and other organizations that support long-term wellbeing.
Aphasia support groups · ARC · community resources · life participation
Frequently Asked Questions
Why a specialist
Adult neurologic communication recovery is my specialty
After a stroke or brain injury, the person is still fully there. Their thoughts, their humor, their personality are all intact. What's changed is the bridge between thought and word, and that bridge can be rebuilt. Helping adults do that, after aphasia, brain injury, and stroke, is the work I trained for in skilled-nursing and outpatient rehab, and the work I care most about.
Credentialed and trained for it
M.S., CCC-SLP, licensed in four states, with clinical training in skilled-nursing and outpatient rehab supporting adults after stroke and brain injury.
Methods that fit you
Approaches with a track record, chosen for your goals and the life you want back.
Virtual across four states
Telehealth in Tennessee, Kentucky, California, and North Carolina, from home.
Ready to talk through what recovery can look like?
Consultations are free. There's no commitment — just a conversation about where you are and how we can help.
Schedule a Consultation