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PubMed2004

Aphasia, alexia, and oral reading.

Alexia is an acquired disturbance in reading. Alexias that occur after left hemisphere damage typically result from linguistic deficits and may occur as isolated symptoms or as part of an aphasia syndrome. This article presents an overview of the classification of the alexias, including both the traditional neuroanatomical perspective and the more recent psycholinguistic approach. Then, assessment procedures are reviewed, followed by a summary of treatment approaches for alexia. Finally, two case studies illustrate how oral reading of connected language (sentences and paragraphs rather than single words) has been used as a technique for treating alexia in patients with aphasia.

Aphasia↗
PubMed1977

[Speech therapy in aphasia].

The speech therapy in fifteen aphasic patients was studied. The group consisted of 8 male and 7 female patients and their ages ranged from less than ten to more than fifty years. In eleven cases the aphasia was due to cerebrovascular disease and in the remaining four cases to traumatic injury to the brain. Predominantly expressive aphasia accounted for five patients while in the others a comparable degree of receptive and expressive deficits existed. Six patients had their therapy programme started within the first three months after the acute phase and the rest of the group started it after more time had elapsed. Eleven patients showed a satisfactory recovery regardless the inicial deficit severity, the patients age, the pathology of the lesion or the period of time which elapsed from the beginning of the disease to the start of the therapy. The speech therapy in aphasic patients is effective although a firm prognosis cannot be established at the beginning of the programme. Useful information concerning prognosis only can be taken from the follow-up and after thoroughly retesting the patients.

Adolescent↗
PubMed1995

[Hemispheric functional specialization in motor aphasia. Neurophysiologic findings with computerized electroencephalographic brain mapping during musical and oral sound stimulation. Study of 2 cases].

This study concerns about brain electrical activity during auditory stimulation in 2 aphasic patients, one with classical (left hemisphere lesion) and another with cross aphasia (right hemisphere lesion). Both cases were submitted to dichotic listening test (consonant-vowel-consonant task) and music audition (gregorian chant), during brain mapping examination. We found, in both cases, a great proportion in delta frequency and power in non-lesional hemisphere during dichotic and musical stimulation. Besides, increasing in frequency of alpha activity was observed only in the non-lesional hemisphere restricted to temporal lobe region. Such findings suggest an interesting field of research about measurements of neurophysiological correlates of auditory stimulation and brain electrical activity in aphasia.

Acoustic Stimulation↗
PubMed1998

Complex partial seizures and aphasia as initial manifestations of non-ketotic hyperglycemia. Case report.

We describe a case of non-ketotic hyperglycemia (NKH), heralded by complex partial seizures and aphasia of epileptic origin, besides versive and partial motor seizures. This clinical picture was accompanied by left fronto-temporal spikes in the EEG. The seizures were controlled by carbamazepine only after the control of the diabetes. A month later, carbamazepine was discontinued. The patient remained without seizures, with normal language, using only glybenclamide. Complex partial seizures, opposed to simple partial seizures, are rarely described in association to NKH. Epileptic activity localized over language regions can manifest as aphasia.

Anticonvulsants↗
PubMedDate not supplied

Animal-assisted therapy for persons with aphasia: A pilot study.

This study explored the effects and effectiveness of animal-assisted therapy (AAT) for persons with aphasia. Three men with aphasia from left-hemisphere strokes participated in this study. The men received one semester of traditional therapy followed by one semester of AAT. While both therapies were effective, in that each participant met his goals, no significant differences existed between test results following traditional speech-language therapy versus AAT. Results of a client-satisfaction questionnaire, however, indicated that each of the participants was more motivated, enjoyed the therapy sessions more, and felt that the atmosphere of the sessions was lighter and less stressed during AAT compared with traditional therapy.

Activities of Daily Living↗
PubMed1994

Communicative responsibility and semantic task in aphasia and "schizophasia".

A probe technique requiring convergent and divergent semantic behavior and representing five levels of communicative responsibility served as the research tool. Stimuli were presented to 29 asphasic adults (13 Broca's, 7 Wernicke's, and 9 anomic), 26 adults with chronic undifferentiated schizophrenia, and 32 normal elderly control subjects. Within each group significant differences were observed on the semantic task (convergent and divergent) and on level of communicative responsibility. Among subjects with aphasia, differences appeared to relate more to severity than type. Differences between unclassified aphasic and "schizophasic" groups occurred only when multiword responses were required. We conclude that continued use of the term "schizophasia" may be unwarranted and that the linguistic behaviors we observed in aphasia and the language of schizophrenia may contribute to differential diagnosis.

Adult↗
PubMed1994

Motor performance in aphasia and ideomotor apraxia.

Motor performance in 11 patients with ideomotor apraxia, 11 with aphasia without such apraxia, and 11 normal controls was compared. These three groups were matched on age, sex, education, severity of aphasia, intelligence, and size of lesion. Measures of aiming, tapping, line-following, and steadiness developed by Schoppe in 1974 were used. Both apraxic and aphasic groups showed difficulties with motor performance, and the data of the apraxic group were poorer than those of the aphasic group. These results were consistent with Liepmann's theory.

Aphasia↗
PubMed1988

Category-specific versus modality-specific aphasia for colours: a review of the pioneer case studies.

This paper addresses the long-standing dichotomy between category-specific (colour-name aphasia) and modality-specific impaired colour-naming (optic aphasia for colours) in posteriorly brain injured patients with preserved colour vision and language abilities. The data gathered for this paper were obtained from a critical review of the pioneer case studies and the analysis of the author's research findings. A number of easily applicable colour tasks, especially the so-called "verbal-verbal" ones are recommended and are believed to be equipped to refine the clinical assessment of impaired visual and verbal knowledge of colours in the brain damaged as well as to pinpoint the functional defects underlying the varieties of colour-naming impairments.

Adolescent↗
PubMed1998

Crossed cerebro-cellular diaschisis in a patients with melas with aphasia but without hemiparesis.

We describe a 25 year old woman diagnosed with MELAS during an acute stroke-like episode. Global aphasia, migraine-like headaches and hemi-anopsia were her main clinical features. MR imaging revealed extensive cortical and subcortical left hemispheric signal abnormalities. [Tc-99m]ECD SPECT scanning revealed crossed cerebrocerebellar diaschisis. Aphasia in the absence of gross hemiparesis can be related to cross-cerebellar diaschisis in MELAS.

Adult↗
PubMed1998

Counselling someone with severe aphasia: and explorative case study.

PURPOSE: To explore a counselling approach for a client, H.N., with a severe aphasia. METHOD: The principles of Personal Construct Therapy were used. Therapy (six sessions) was started and finished by H.N. producing a repertory grid. Sessions were patient-led but the information from the repertory grids was used to help facilitate the process. Each session was video taped. RESULTS: Analysis of therapy sessions revealed H.N. was following a pattern, if erratic. He used good conversational strategies to control the less structured sessions. The therapist was dominant when the repertory grids were produced. Statistical analysis of the repertory grids was mainly nonsignificant but there was a shift for the final grid to a greater variety of and more positive responses. General improvement in comprehension was also noted. CONCLUSION: A 'counselling' approach with someone with severe aphasia is possible. Using a repertory grid was a useful tool for understanding H.N. better. It seemed to initiate H.N. to discuss things of importance. The changes seen in him could have been due to an improvement in confidence as a communicator. This study has implications for how we can enable people with limited language to adapt to their situations.

Adaptation, Psychological↗
PubMed2001

Treatment of word retrieval in aphasia: generalisation to conversational speech.

The question of whether treatment gains in picture naming generalise to conversation remains relatively unexplored. Several difficulties surround data collection and analysis. A quantitative measure of word retrieval in aphasia is presented along with relevant details relating to the reliability of the measure, and the relationship between word retrieval in picture naming and noun retrieval in conversation. We discuss the clinical application of the measure and its applicability outside the field of aphasia.

Aphasia↗
PubMed2001

Supporting Partners of People with Aphasia in Relationships and Cconversation (SPPARC).

This paper reviews new theoretical and practical developments in working with partners of people with aphasia and describes the development of a clinician's resource entitled 'SPPARC: Supporting Partners of People with Aphasia in Relationships and Conversation'. It focuses particularly on one part of that resource: the SPPARC Conversation Training Programme, which adapts conversation analysis for clinical use. The paper describes the stages involved in assessing and working on conversation in everyday life.

Aphasia↗
PubMed2001

Experiences of ending aphasia therapy.

Despite a considerable literature on assessment and treatment issues in aphasiology, little has been written about how therapy ends. We lack detail about how clinicians decide to terminate treatment and about how patients and carers view leaving therapy. This paper explores experiences and perceptions of aphasia treatment termination. It uses in-depth interview data gathered in South Australia as part of a doctoral study with a speech pathologist, three ex-patients with aphasia and one spouse. This case study allows comparison of client and professional narratives to each other and also to the official discharge documentation in the medical file. The discharge process arising from this analysis is discussed.

Aged↗
PubMed1991

An aphasia group intensive efficacy study.

The response of five adults with chronic aphasia to a 4-week intensive treatment course is presented. Using four language tests, pre-intervention stability was demonstrated over the month preceding the treatment programme. Following the intervention period, two subjects showed improvement in one test, and more widespread changes occurred in three subjects. On further assessment 1 month after treatment had finished, one of the two subjects who had made least progress performed better than at the end of the course, and one had returned to pre-treatment level. Although there were indications of regression in two of the three other subjects, this was not to pre-treatment level. Only one subject maintained the gains made fully. Given the short duration of the course, the changes in performance noted suggest that, providing transport is available, intensive treatment of aphasia should be available to patients with sufficient motivation and stamina.

Aged↗
PubMed1991

A profile of aphasia services in three health districts.

The study examines language rehabilitation provisions for aphasic people and their families in three health districts, as perceived by speech and language therapists. The study is exploratory. Semi-structured interviews were carried out with each District Speech Therapist and with speech and language therapists whose caseloads regularly included aphasic people, and documentary evidence was used where available. Comparison is made of: speech and language therapy expenditure and staffing in the three districts (West Suffolk, West Essex and Newcastle-upon-Tyne); aphasia therapy staffing; caseloads of aphasic people; patterns of treatment (inpatient/outpatient/community; individual/group) and reasons for these; provision for relatives; relationships between speech and language therapy and other services; volunteer involvement; and speech and language therapists' work situations (support from colleagues, post-qualification training, secretarial support and accommodation). Differences are found in levels of provision, with Newcastle having considerably more resources devoted to aphasia services than the other two districts, and modes of service delivery. Some shared concerns are identified (e.g. relationships with other professions, accommodation and transport). Implications of the findings are discussed and areas for further research identified.

Adolescent↗
PubMed1995

Reliability of the Assessment of Communicative Effectiveness in Severe Aphasia.

The Assessment of Communicative Effectiveness in Severe Aphasia (ACESA) was developed to measure the communicative effectiveness of people with severe aphasia following a stroke. The reliability was evaluated. Ten patients with severe communication difficulties (particularly limited expression) were assessed and videoed. The videos were rated by three trained raters. Reliability was calculated to demonstrate intrarater and interrater reliability, and test-re-test reliability. Reliability was good but needed to be improved across raters. It was concluded that the ACESA has the potential to be a useful clinical and research tool.

Adult↗
PubMed1998

Treatment for aphasia following stroke: evidence for effectiveness.

A systematic review of SLT for aphasia following stroke, for the Cochrane Collaboration Stroke Group. Twelve randomised controlled trials were identified, however there was no standard comparison group amongst the trials. Based on this review, it is not possible to reach a conclusion about the effectiveness of the treatments evaluated in these trials. Further research is therefore indicated, and SLTs must base decisions about treatment for aphasia on other forms of evidence.

Aphasia↗
PubMed1998

Children's acquired aphasia screening test.

Diagnosis in acquired childhood aphasia (ACA) is a multi-stage process. After the medical condition has stabilised, the diagnostic evaluation requires careful assessment to establish a profile in the differential diagnosis of listening, understanding speaking, and gesture. Children with ACA were traditionally assessed on adapted batteries often used for adults. The Children's Acquired Aphasia Screening Test (CAAST) was specifically designed to evaluate linguistic and non-linguistic function in brain-damaged children aged between 3 and 7 years.

Aphasia↗