COMMDIS 415 APHASIA Flashcards
Aphasia
Occurs after language has been mastered
■ Neurological injury to language dominant area of brain (usually stroke)
■ Compromises receptive/expressive spoken and written language
Aphasia in Stroke Survivors
24 – 40% of stroke survivors will experience aphasia
Incidence/Prevalence of Aphasia
■ Incidence: 180,000 new cases/year (NIDCD)
■ Prevalence: 1 in 250 Americans
What Factors Affect Aphasia Outcome?
■ 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
Varying degrees of impairment in 4 areas
– Spoken language expression
– Spoken language comprehension
– Written expression
– Reading comprehension
With Aphasia, are non-linguistic skills still intact?
Nonlinguistic cognitive skills usually intact
– Memory and executive function
Aphasia is not..
■ A psychiatric condition
■ A motor speech disorder
■ A cognitive communication disorder
There are Different Aphasia Types
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
Two Broad Aphasia Types
Fluent - Wernickes
Non-Fluent - Brocas
Fluent Aphasia: Wernicke’s Aphasia
■ Damage to left posterior temporal lobe of cortex (Wernicke’s area)
left - language dominant
Wernicke’s Characteristics
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
More Wernicke’s Characteristics
Severe language comprehension problems (spoken and written)
– Unable to follow simple directions
– Low self-awareness of language impairment
Paraphasia: Phonemic
(“tephelone” instead of “telephone”)
- substitute word with non word, but still perserving half of original segment
Paraphasia: Verbal
(“son” instead of “daughter”)
completely subs. word with wrong word than intended word
Paraphasia: Neologism
“shirt” is said as “glimbop”
non-word
Anomia
inability to retrieve words
Other Types of Fluent Aphasia
~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)
Non-fluent: Broca’s Aphasia
■ Lesion is in frontal lobe (Broca’s area)
Brocas Characteristics
■ 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
Assessment
■ Spoken Language Comprehension – Simple questions to conversation
■ Spoken Language Production – Spontaneous
– Repetition
– Naming
■ Written Language Comprehension (Reading) ■ Written Language Production (Writing)
Aphasia Diagnostic Profile
■ Aphasia classification
■ Aphasia severity profile
■ Administration Time: 40-45 minutes
■ Ages: Adults
Treatment Options
■ 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
Treatment Options 2
■ 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
Treatment Options 3
■ 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
