Aphasia classification and types.

Question 1

When have classification systems been used since?

Answer 1

Theynhave been used since Broca (1860’s) and Wernicke’s (1870’s).

Question 2

What were classifications traditionally based on?

Answer 2

Neuro-anatomy; where distinct patterns of language impairment were associated with certain areas of brain damage in the language dominant hemisphere (LH for most).

Question 3

What is there overlap between?

Answer 3

Types of aphasia and individual variation within types.

It’s not often you get a neat stroke!

Question 4

What is the most basic form of classification?

Answer 4

Non-fluent and Fluent

Question 5

What does fluency refer to?

Answer 5

Characteristics of spontaneous speech output.

Fluency refers to speech availability or flow of language.

Question 6

What damage is non-fluent aphasia associated with?

Answer 6

It’s typically associated with damage to the anterior part of the brain. (in front of the central sulcus).

Question 7

What are the features of non-fluent aphasia?

Answer 7

Slow effortful rate
Short phrase length
Reduced prosody 
Impaired articulation
Some paraphasias
Mostly content words, loss of function words
Limited agrammatic sentence production
Likely hemiparesis

Question 8

What damage is fluent aphasia typically associated with?

Answer 8

Normal-fast rate
Normal-long phrase length
Normal or over-exaggerated prosody 
Normal, natural articulation
Lots of paraphasias
Empty, inappropriate word choice
Appropriate grammatical structure but errors with tense and number
less likely to have a physical impairment.

Question 9

Why are people with fluent aphasia less likely to have physical impairment?

Answer 9

Lesion less close to motor area of brain.

Question 10

From the 2nd half of the 19th century what system became in place?

Answer 10

The connectionist system-based on all language modalities so it’s more detailed than fluent and non-fluent.

Question 11

Name fluent types of aphasia

Answer 11

Wernicke's
Jargon
Anomic 
Conduction
Transcortical Sensory

Question 12

Name non-fluent types of aphasia

Answer 12

Broca’s
Global
Transcortical motor.

Question 13

What are some advantages of classification?

Answer 13

• common language allows professionals to understand and communicate with each other
• can help aid diagnosis of aphasia
• Can assist in identifying likely priorities for therapy

Question 14

What are some disadvantages of classification?

Answer 14

-Clear and discrete categorisation isn’t typical- there are a few textbook cases, mostly there’s overlap between types and variation within types.

Staightforward one to one correspondence between brain lesion and aphasic symptoms isn’t always the case.

Patient’s aphasia type can evolve e.g. from global at onset to broca’s.

Question 15

What is important for treatment?

Answer 15

It’s important to treat the person, not the class/type of aphasia!

Question 16

What else affects presentation apart from lesion?

Answer 16

People are individuals- presentation is affected by age, personality, individual cerebral organisation, plasticity etc.

Question 17

Where a profile doesn’t correspond to a recognised class, what should be done instead?

Answer 17

Detailed description would be appropriate.

Question 18

Why is it important not to identify lesions from language profiles?

Answer 18

Only brain scans can do this.

E.g. Not all people with broca’s aphasia will have lesions in Broca’s area- variation exists.