Aphasia Flashcards by Niamh O Leary

aphasia is an acquired communication disability caused by focal brain damage giving rise to impairment of language modalities

berg et al. (2022)

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aphasia categorisations have some clinical usefullness. e.g. as inclusion/exclusion criteria in research and by providing a broad descriptive label understood by the wider clinical community they allow for ease of transfer of care

Marshall (2010)

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Aphasia Framework for Outcome Measurement

Kagan et al. (2008)

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the ultimate goal of aphasia intervention is to increase participation in communicative life

Simmons-Mackie (2013)

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principles of neuroplasticity

Kleim & Jones (2008)

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intervention should focus on preparing individuals for the communicative needs of community life

Simmons-Mackie et al. (2013)

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Life Participation Approach to Aphasia Principles - enhancement of life participation as an explicit goal of aphasia treatment, sucess measures should include documented life enhancement changes, personal and environmental factors should be targets, services should be available to all affected and service delivery should be available at every stage of recovery

LPAA project group (2000)

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aphasia centres provide for people with aphasia and sometimes their families

Simmons-Mackie & Holland (2011)

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aphasia centres emphasise individual and group therapy

Elman (2016)

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establishment of a supportive communicative environment is key

Speech Pathology Australia, Aphasia Best Practice Guidelines (2014)

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developing social relationships (interaction) is as important as information content exchange (transaction)

Brown & Yule 1983

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researchers have traditionally focused on the exchange of information as a goal rather than the development of social closeness

Light (1988)

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Supported Conversations for Adults

Kagan et al. (2001)

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family members of people with aphasia should be signposted to family therapy

Henihan & Jagoe (in press)

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families should be provided with key information such as aphasia’s definition and causes, finding’s of communication assessments, their loved one’s expected progress, strategies for effective communication and living well and available community supports

Rose et al. (2019)

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family members preferred recieving infomation from face-to-face conversations, written materials such as pamphlets, websites, support groups and posters

Rose et al. (2019)

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script training

Kaye & Cherney (2016)

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multimodal communication prioritises communicative adequacy over linguistic accuracy

Marshall (2002)

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total communication approaches involve AAC, conversation partner training and interaction-based strategies

Simmons-Mackie (2009)

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multimodal communication involves the use of any communication modality other than speech

Speech Pathology Australia (2011)

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M-MAT is delivered via interactive card games and encourages all communication modalities however there is an emphasis on verbal phrase production

Rose et al. (2013)

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study comparing M-MAT to CIAT Plus n=2

Attard et al. (2012)

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study comparing M-MAT to CIAT Plus N=11

Rose et al. (2013)

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Attard et al. (2013) & Rose et al. (2013) findings

M-MAT as efficacous as CIAT Plus
many participants in both studies expressed a preference for M-MAT
citing it as more enjoyable, less frustrating and provides more opportunities to practice communication repair strategies for different communication breakdowns

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Attard et al. (2013) & Rose et al. (2013) limitations

small sample sizes limiting strength of findings

in hyperacute and acute stages of stroke recovery there is enhanced brain plasticity characterised by increased denditritic growth, axonal sprouting and new synapses

Ji et al. (2021)

Stroke recovery is variable

Grefkes & Fink (2020)

RCTs which showed no difference between early and later interventions

- ANELTA-3 - Rotterdam Aphasia Therapy Study

VERSE trial

Goedecke et al. (2018; 2020)

VERSE trial findings

- 22h/week for 32 days not beneficial over 9.5h/week for 28 days - early intervention feasible and not harmful - should start before 10 days post stroke - more is not better in early days - early intervention is good, intensive early intervention not necessary - intensive intervention may be more appropriate in the chronic phase

aphasia intervention should be bilingual if possible

Speech Pathaology Australia Aphasia Best Practice Guidelines (2014)

mixed evidence on cross-language transfer in aphasia therapy

Faroqui et al. (2010)

some evidence to suggest that language proficiency, use and current language environment influence across-language and within-language generalisation

Kiran et al. (2014)

auditory comprehension refers to the ability to understand spoken language

Wallace et al. (2022)

auditory comprehension deficits can be caused by deficits of speech perception and analysis leading to misidentification of phonemes and thus words leading to eventual comprehension breakdown

Szelag et al. (2014)

auditory comprehension difficulties can stem from difficulty comprehending lexical and syntactic aspects of grammar

Thomas & Shaprio (2005)

complex attention deficits (i.e. in sustaining, alternating and or dividing attentional resources) can lead to difficulty with sentence or discourse processing

Murray et al. (2006)

working memory difficulties can lead to difficulties processing syntactically complex information which requires maintaining several linguistic units over a period of time

Zakariás et al. (2018)

context-based approach

Marshall (2008)

context-based approach findings

- direct yes/no questions more difficult - sentence to picture matching easier despite it's greater level of complexity

optimal outcomes for phonological-based impairments | expression at verb level

Raymer & Rothi (2008)

best practice when working on verbal expression at single word level is to incorporate a combination of phonological and semantic interventions

Raymer & Rothi (2008)

systematic review of SFA

Esfratiadou et al. (2018)

Esfratiadou et al. (2018) findings

significant effects of SFA on treated words and small generalisation effect to untreated words

Verb Network Strengthening Treatment

Edmonds et al. (2008; 2009; 2011)

VNeST leads to gains in noun and verb retrieval & sentence production. Non-fluent participants showed improved spontaneous speech, fluent participants showed improved comprehension and production

Edmonds et al. (2009)

Constraint-Induced Language Therapy

Pulvermuller et al. (2001)

neuroimaging studies show that after CIAT, brain areas activated during language tasks are primarily in the left hemisphere

Nenert et al. (2017)

growing evidence base to support use of CIAT

Cherney et al. (2008)

systematic review investigating efficacy of CIAT

Wang et al. (2021)

Wang et al. (2021) SR findings

improved outcomes for language performance in relation to naming, comprehension, repetition and oral and written language production

Wang et al. (2021) SR limitations

- studies had small sample sizes reducing statistical power - not every study reported blinding of their participants and research personel resulting in possible performance or detection bias

melodic intonation therapy is aimed at people with nonfluent aphasia

Albert et al. (1973)

neuroimaging studies support the theory that MIT capitalises on neuroplasticity and moves language function to language-capable regions in the right cerebral hemisphere

e.g., Merrit et al. (2014)

systematic review of MIT containing 4 RCTS

Haro-Martinez et al. (2021)

Haro-Martinez (2021) SR findings

significant effect of MIT on functional communication

first defined broad parameters of ICAPS

Rose et al. (2013)

scoping review of ICAPs

Monnelly et al. (2021)

Monnelly et al. (2021) findings

- 17 ICAPs reported in 20 studies - no consensus on rationale - variability in procedures, group sizes, length, hours of therapy, SLT:patient ratios - too much variability to synthesise outcomes - limited robustness

systematic review of ICAPs

Monelly et al. (2024)

Monnelly et al. (2024) findings

- gains made in WF, overall communication abilities, activity and participation levels, and communication-related quality of life - other than WF (consitently reported across studies) benefits mostly reported by single studies - 3 studies reported significant long-lasting gains for activity/participation - 1 study reported nonsignficant gains - only 4 studies reported level 2/3 evidence for outcomes in more than one ICF domain - comprehensive where

cogitive enhancing/brain stimulating drugs may maximise gains from SLT and other MDT interventions

Berthier et al. (2011); Gill & Leff (2014)

acetylcholine is implicated in experience-dependent plasticity

Kilgard & Merzenich (1998)

acetylcholinesterase inhibitors (i.e. drugs which inhibit the enzyme that breaks down acetylcholine) mat treat post-stroke language and cognitive deficits

Berthier et al. (2020); Kim et al. (2020)

Donezepil (acetylcholinesterase inhibitor) shows promise for mild-moderate post stroke aphasia but no benefits for severe language and communication deficits

Berthier et al. (2011); Woodhouse et al. (2017)

low frequency rTMS applied to contralateral region can improve language

Naser et al. (2005; 2010)

1Hz rTMS can maximise language benefits when augmenting SLT

(e.g., CILT) Naser et al. (2013)

studies finding no difference between groups for TCDS

Otal et al. (2015); Elner et al. (2013; 2015)

study which found item specific improvements for auditory & written word-picture matching and object naming using TCDS

de Aguiar et al. (2015)

study which found improvements in naming for chronic aphasia patients using TCDS

Biou et al. (2019)