Words of inspiration

Features: Alexandra Knight
Alexandra Knight holding Wrinklies’ Wit & Wisdom outside Bostall House

Community Speech and Language Therapist, Alexandra Knight, has adopted what she called “an inspirational course” to help her patients improve their speech.

Alex, 58, started working for the trust last year, is dyslexic herself, so she has an extra affinity with her patients.

One area of her working life that she is particularly proud of is the work she does with people suffering with Parkinson’s disease. She has adopted an expensive, one-to-one, labour intensive form of treatment to group sessions with some impressive results.

Alex, who is based at Bostall House on the Goldie Leigh site and works for Bexley Community Health Service, takes up the story: “I went on the course back in 2005. It involved spending one hour, with one patient for four days over a four week period. I have adopted this to work in group sessions in a course that last five weeks.”

She believes that her work should where possible include some fun. To that end she is a big fan of wonderful tome called Wrinklies’ Wit and Wisdom by Rosemarie Jarski. Snippets from which she uses in her sessions … gems like this from Denis Norden: ‘You know you’re getting old when you go on holiday and pack a sweater’ or Bruce Forsyth’s quip: ‘I am so old I daren’t buy green bananas.’ Alex said that patients really enjoy a little humour.

Alex came late to the NHS. A mother of two grown up children she said: “I hit 40 with a number of different jobs behind me and decided life was passing me by. I enrolled at City University London and graduated with a BSc in Human Communication. In fact it was at university it was discovered I was dyslexic.”

Most of Alex’s patients have “acquired disorders” – developed while an adult, such as: strokes; Parkinson’s; Multiple Sclerosis; Motor Neurone Disease; Huntington’s; dementia, Alzheimer’s or general ageing. Specialising in speech and swallowing difficulties, Alex accepts referrals from GPs, hospitals, care home managers and district nurses to name but a few.

A lot of her patients have slurred speech and Alex works with them to improve tongue, cheek and lip movement. She said: “I give them tips on how to improve the clarity of their speech. For instance to slow down the delivery of the words they use, rather like a BBC newsreader. I also encourage them to leave out what can be unnecessary social speech ie long sentences where a short phrase will do.”

At the beginning and end of one of the courses patients’ progress is assessed, using a sound level meter, a stop watch and the patients’ own views of how their voices might have improved. Alex takes up the story again: “During session one I measure the length of a patient’s voice in one breath as well as the volume in decibels from five feet away using a sound level meter. I also take note of how the patient views their own voice on a self-rating scale between one and five, with five being the lowest and one being the highest.”

Recently Alex treated a monk with Parkinson’s disease. He was finding life difficult as his voice was such an important part of monastic life, what with the vocal prayers and singing required. His initial length of voice on one breath was timed at nine-and-a-half seconds. After Alex’s five week course it was more than 12 seconds. His initial voice decibel level was 52 and ended up a “loud” 64 decibels. And the patient’s own assessment of his voice went up from between three and four to between two and a top rated one.