COMMDIS 415 APHASIA

Question 1

Aphasia

Answer 1

Occurs after language has been mastered

■ Neurological injury to language dominant area of brain (usually stroke)

■ Compromises receptive/expressive spoken and written language

Question 2

Aphasia in Stroke Survivors

Answer 2

24 – 40% of stroke survivors will experience aphasia

Question 3

Incidence/Prevalence of Aphasia

Answer 3

■ Incidence: 180,000 new cases/year (NIDCD)
■ Prevalence: 1 in 250 Americans

Question 4

What Factors Affect Aphasia Outcome?

Answer 4

■ Initial aphasia severity, lesion site and size of the infarct are most predictive
■ Impairment can range from mild to severe
■ Post-stroke depression, social isolation after onset

Question 5

Varying degrees of impairment in 4 areas

Answer 5

– Spoken language expression
– Spoken language comprehension
– Written expression
– Reading comprehension

Question 6

With Aphasia, are non-linguistic skills still intact?

Answer 6

Nonlinguistic cognitive skills usually intact
– Memory and executive function

Question 7

Aphasia is not..

Answer 7

■ A psychiatric condition
■ A motor speech disorder
■ A cognitive communication disorder

Question 8

There are Different Aphasia Types

Answer 8

Type is classified by pattern of language impairment and site of brain injury
– Not all cases are neatly classified
– Classification can change with recovery
■ ‘Aphasia’ alone is a non-specific term

Question 9

Two Broad Aphasia Types

Answer 9

Fluent - Wernickes
Non-Fluent - Brocas

Question 10

Fluent Aphasia: Wernicke’s Aphasia

Answer 10

■ Damage to left posterior temporal lobe of cortex (Wernicke’s area)
left - language dominant

Question 11

Wernicke’s Characteristics

Answer 11

Speech production is fluent, but has little meaning
– described as ‘verbose’ (i.e., logorrhea)
■ Normal prosody
■ Utterance length unaffected
speech that they are using means nothing
not aware that what they are saying has no meaning

Question 12

More Wernicke’s Characteristics

Answer 12

Severe language comprehension problems (spoken and written)
– Unable to follow simple directions
– Low self-awareness of language impairment

Question 13

Paraphasia: Phonemic

Answer 13

(“tephelone” instead of “telephone”)
- substitute word with non word, but still perserving half of original segment

Question 14

Paraphasia: Verbal

Answer 14

(“son” instead of “daughter”)

completely subs. word with wrong word than intended word

Question 15

Paraphasia: Neologism

Answer 15

“shirt” is said as “glimbop”
non-word

Question 16

Anomia

Answer 16

inability to retrieve words

Question 17

Other Types of Fluent Aphasia

Answer 17

~Different lesion site from Wernicke’s aphasia
■ Transcortical Sensory
– Marked by excellent repetition skills
■ Conduction
– Fair to good language/ reading comprehension, but in ability to read aloud (hallmark)
■ Anomic (most common type)
- Impairment only in naming (good language comprehension)

Question 18

Non-fluent: Broca’s Aphasia

Answer 18

■ Lesion is in frontal lobe (Broca’s area)

Question 19

Brocas Characteristics

Answer 19

■ Slow, labored speech output (effortful articulation)
■ Prosody and utterance length affected
■ Variable repetition
■ Agrammatism
– Leads to telegraphic speech (E.g. “I hungry”)
■ Anomia
drop articles and prepositions

Question 20

Assessment

Answer 20

■ Spoken Language Comprehension – Simple questions to conversation
■ Spoken Language Production – Spontaneous
– Repetition
– Naming
■ Written Language Comprehension (Reading) ■ Written Language Production (Writing)

Question 21

Aphasia Diagnostic Profile

Answer 21

■ Aphasia classification
■ Aphasia severity profile
■ Administration Time: 40-45 minutes
■ Ages: Adults

Question 22

Treatment Options

Answer 22

■ All individuals will experience some spontaneous recovery
■ Goal is for successful communication
■ Use of cues / prompts / pictures / compensatory strategies
■ Family involvement is common

• 1-3 months post stroke - where you
  see the most improvement
  after these months, most loss will not be restored

Question 23

Treatment Options 2

Answer 23

■ Community Support and Integration
– Community support groups for helping people manage
aphasia (E.g. Aphasia Café; Aphasia Coffee Group)
■ Partner Treatment
– Treatment that engages a primary partner

Question 24

Treatment Options 3

Answer 24

■ Computer Based Treatment
– Use of tablets of touch screens to facilitate language in a clinic
setting
– AphasiaScripts® is a software program designed for script practice. It uses a Personal Animated Therapist (PAT).
■ Multimodal Treatment – AAC

Question 25

Linguistic Based Options

Answer 25

■ Syntax treatment
– Complexity approach
■ Word finding treatment
– Semantic feature analysis
– Verb network strengthening