Aphasia

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Aphasia

• Causes, Classification, and Treatment

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Definition

• aphasia (uh-fay'-zhuh) According to the
  National Aphasia Association, Aphasia is an
  impairment of the ability to use or comprehend
  words, usually acquired as a result of a stroke
  or other brain injury (http//www.aphasia.org).
  There are different types of aphasia depending on
  the site of damage.

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Causes

• The most common cause is a cerebral vascular
  accident (CVA)
• Damage to the perisylvian area of the left
  hemisphere

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Classification

• Non-fluent (expressive)
• Brocas
• Transcortical motor
• Global
• Fluent (receptive)
• Wernickes
• Transcortical sensory
• Conduction
• Anomic

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Brocas Aphasia

• Damage to Brocas area
• Some deficits in all areas
• Severely impaired fluency
• Abnormal prosody
• Telegraphic speech
• Short phrase length
• Auditory comprehension deficits are mild to
  moderate
• Repetition deficit is mild to severe
• Naming deficit is mild to severe

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Transcortical Motor

• Remarkably well-preserved repetition
• Conversational speech is severely impaired
• Auditory comprehension is mild-moderately
  impaired
• Naming deficit is mild to severe
• Difficulty initiating speech or writing

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Global

• Most debilitating form of aphasia
• Severe deficits in all areas
• Limited expressive output
• Auditory comprehension deficits are severe
• Reading comprehension deficits are severe

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Wernickes Aphasia

• Hyperfluent speech
• Auditory comprehension deficits
• Paraphasia
• semantic association (fork/spoon)
• clang associations (spood/spoon)
• Neologisms invented words
• Jargon streams of nonsense sounds

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Transcortical Sensory

• Rarest of the fluent types
• Conversational speech abounds with paraphasia and
  is lacking in nouns
• Naming is moderately-severely impaired
• Preserved ability to repeat
• Impaired auditory comprehension

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Conduction Aphasia

• Extremely poor repetition ability
• Naming deficit is mild to severe
• Auditory comprehension deficit is mild to
  moderate
• Conversational speech is fluent, good
  articulation, syntax, and prosody

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Anomic Aphasia

• Spontaneous speech is fluent, good articulation,
  syntax, and prosody
• Mild-moderate impairment of auditory
  comprehension
• Significant difficulty with confrontation naming

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Treatment for Aphasia

• General information
• Treatment benefits are greater for Brocas
  aphasia than for fluent types of aphasia
• Benefits are greater if a single-stroke etiology
• Benefits are greater in younger patients
• Frequent sessions are better than sporadic during
  first 6 months

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Treatment orientations

• Stimulation-facilitation
• Intensive, repeated stimulation (primarily
  auditory) to facilitate damaged areas recovery
• Deblocking
• Intact systems used to help deblock damaged
  areas
• Operant conditioning
• Loss of knowledge demands relearning
• Functional/compensatory

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Specific procedures

• Stimulation-facilitation review of Brubaker
• Ameri-Ind AAC or facilitative approach
• Visual Action Therapy
• Promoting Aphasics Communicative Effectiveness
  (PACE) functional approach
• Melodic Intonation Therapy Estabrooks video