Aphasia is a communication disorder that is caused by brain damage (damage to the portions/area that is responsible for language). The most common cause of aphasia is stroke. Aphasia occurs suddenly following a stroke or head injury. Aphasia affects the sounds, vocabulary or grammar in both speaking (expression) and understanding (reception).

A patient with aphasia may have difficulty in reading (dyslexia), writing (agraphia) and calculation (acalculia). The severity of aphasia depends on various things including the cause and extent of the brain damage. Aphasia is characterized by the impairment of language formulation, comprehension and use.

TYPES OF APHASIA

PICTURE COURTESY : TEXTBOOK OF REHABILITATION BY S SUNDER

GLOBAL APHASIA

Here the patient is having non-fluent aphasia where there is a severe loss in comprehension and repetition. This condition is considered as a global aphasia. Severe deficits are found in all the language processes that includes speech production, auditory comprehension, reading and writing.

ISOLATION APHASIA

Isolation aphasia is more or less similar to global aphasia except for the ability to repeat. The language processes are also poor.

BROCA’S APHASIA

Speech production is poor and slow along with impaired articulation and grammar. Comprehension is much good but not for complex sentences. In this type of aphasia, reading is superior to writing.

TRANSCORTICAL MOTOR APHASIA

The speech of the patient who is having transcortical motor aphasia is somewhat similar to patients who is having broca’s aphasia. The main feature of this syndrome is the preserved ability to repeat fluently.

WERNICKE’S APHASIA

The speech is fluent with some paraphasic errors. The fluent aphasic patient produces speech effortlessly. But the content of the speech is not clear, they produce repeated unintelligible and stereotyped phrases. Also the patients are not aware that they are communicating to the listener. This type of aphasia is also called as Jargon aphasia.

TRANSCORTICAL SENSORY APHASIA

It is a rare syndrome and is similar to Wernicke’s aphasia. The affected persons have poor comprehension but the speech is fluent and grammatical. These people do not use correct word, but use another word of similar content like ‘biscuit’ for ‘bread’.

CONDUCTION APHASIA

Here, the person can understand what is spoken and is also fluent in his speech. But there is a selective loss of repetition. Patients will display errors while giving a spontaneous speech, and substituting sounds.

ANOMIC APHASIA

Speech is well performed and it is grammatical and fluent. But these people found severe difficulty in finding words. The patient always seems to search for the right word for an object, though he knows what its function is. Auditory comprehension is good.

Letters coming out of head. On wooden background

TESTS FOR APHASIA

Aphasic tests are not diagnostic. The tests for aphasia includes MTDDA (Minneapolis Test for Differential Diagnosis for Aphasia) and PICA (The Porch Index of Communicative Ability).

MTDDA is the most comprehensive and commonly accepted test for aphasia. This takes three hours to administer. It consists of 46 subtests which are classified under 5 sections:

  1. Speech and language disturbances
  2. Auditory disturbances
  3. Disturbances of numerical relations and arithmetic processes
  4. Visual and reading disturbances
  5. Visuomotor and writing disturbances

TREATMENT METHOD

The treatment methods for aphasia includes:

  1. Computer based treatment
  2. Augmentative and Alternative Communication (AAC)
  3. Visual Action Therapy (VAT)
  4. Reciprocal Scaffolding Treatment (RST)

COMPUTER BASED TREATMENT

As the name of the title indicates, this involves the use of computer technology and software programs to target various language skills and modalities.

AAC – AUGMENTATIVE & ALTERNATIVE COMMUNICATION

AAC treatment replaces the natural communication modalities with aided or non-aided symbols. Aided symbols are picture communication symbols, line drawings, tangible objects etc., whereas unaided symbols include gestures, manual signs and finger spelling. Unaided communication uses no equipment whereas aided communication uses external tools/objects.

VAT – VISUAL ACTION THERAPY

Visual action therapy is most often used for the individuals who have global aphasia. It is a non-verbal treatment approach i.e this method uses demonstration. This trains the individuals to use hand gestures for indication of visually absent items.

VAT includes a 12 step training hierarchy that starts with tracing objects, then matching the objects, then producing pantomimed gestures for visible objects, and finally ends with producing a gesture for an item that the participant cannot see.

RST – RECIPROCAL SCAFFOLDING TREATMENT

It is a group therapy treatment. Here an aphasic person would be given an opportunity to teach an information/skill to a group of people. The persons with aphasia and SLP(Speech Language Pathologists) will work together here. The SLP provides a good support to them.

Preparing and providing the information to the group of people may provide a opportunity to aphasic patients to practice a lot. As a result RST improves vocabulary finding and sentence production along with a good social interaction and improved life participation.

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