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At least 973 records · Page 54Linked to original sources
PubMed2006

Brain regions essential for improved lexical access in an aged aphasic patient: a case report.

BACKGROUND: The relationship between functional recovery after brain injury and concomitant neuroplastic changes is emphasized in recent research. In the present study we aimed to delineate brain regions essential for language performance in aphasia using functional magnetic resonance imaging and acquisition in a temporal sparse sampling procedure, which allows monitoring of overt verbal responses during scanning. CASE PRESENTATION: An 80-year old patient with chronic aphasia (2 years post-onset) was investigated before and after intensive language training using an overt picture naming task. Differential brain activation in the right inferior frontal gyrus for correct word retrieval and errors was found. Improved language performance following therapy was mirrored by increased fronto-thalamic activation while stability in more general measures of attention/concentration and working memory was assured. Three healthy age-matched control subjects did not show behavioral changes or increased activation when tested repeatedly within the same 2-week time interval. CONCLUSION: The results bear significance in that the changes in brain activation reported can unequivocally be attributed to the short-term training program and a language domain-specific plasticity process. Moreover, it further challenges the claim of a limited recovery potential in chronic aphasia, even at very old age. Delineation of brain regions essential for performance on a single case basis might have major implications for treatment using transcranial magnetic stimulation.

Aged↗
PubMed2003

A history of music therapy journal articles published in the English language.

Music therapists have had an interest in bibliographic research for over 20 years, beginning with Jellison's 1973 analysis of the frequency and types of articles appearing in the existing music therapy literature. Since then, several other researchers have continued in this line of inquiry. The purpose of this study was to (a) identify historical trends in the types of articles that have been published in major music therapy periodicals in the English language, (b) identify historical trends for each type of article within each music therapy journal, (c) to compare percentages of article types within each music therapy journal and (d) to compare percentages of article types across journals. Specifically, how many quantitative, qualitative, historical, philosophical/theoretical, clinical and professional articles have been published throughout the history of the following journals: Journal of Music Therapy, Music Therapy: Journal of the American Association for Music Therapy, Music Therapy Perspectives, The Arts in Psychotherapy, Journal of the Association for Music & Imagery, The Australian Journal of Music Therapy, The Nordic Journal of Music Therapy, The British Journal of Music Therapy, and The New Zealand Society for Music Therapy Journal.

Bibliometrics↗
PubMed1992

The provision of speech, language and hearing services in a rural district of South Africa.

In this paper the delivery of a speech, language and hearing therapy (SLHT) service in a rural area is discussed. In the light of the need to relate the delivery of this service to principles of primary health care (PHC) and community based rehabilitation (CBR), a brief theoretical background is given. Obstacles to service delivery are then presented, followed by a description of some attempts to implement principles of PHC and CBR. The author concludes that many challenges need to be faced in providing SLHT services that will benefit the majority of the population of South Africa.

Community Health Services↗
PubMed2002

Evaluation of a structured test and a parent led method for screening for speech and language problems: prospective population based study.

OBJECTIVE: To evaluate two methods for identifying speech and language problems in preschool children. DESIGN: Prospective population based study. SETTING: Inner London. PARTICIPANTS AND METHODS: 37 health visitors were randomly assigned to use a structured screening test (18) or a parent led method (19). Of 623 eligible children aged 30-36 months, the parents of 582 agreed to participate (353 using the structured test and 229 the parent led method). MAIN OUTCOME MEASURES: Children were assessed by a speech and language therapist blinded to the test result, using the Reynell developmental language scales. Children were classified as having "severe language problems" if the Reynell score was below the third centile for receptive language and as "needing therapy" if the Reynell score was below the seventh centile for receptive or expressive language and clinical opinion. RESULTS: Reference assessments and usable scores were obtained for 458 (97%) of the 474 children screened. 98 (21%) children had severe language problems and 131 (29%) needed therapy. The sensitivity and specificity for the structured screening test were 66% (95% confidence interval 53% to 76%) and 89% (85% to 93%) respectively for severe language problems and 54% (43% to 65%) and 90% (85% to 93%) for those needing therapy. The sensitivity and specificity for referral by the parent led method were 56% (40% to 71%) and 85% (78% to 90%) for severe language problems and 58% (44% to 71%) and 90% (83% to 94%) for those needing speech and language therapy. CONCLUSIONS: Both approaches failed to detect a substantial proportion of children with severe language problems and led to over-referral for diagnostic assessments. Screening is likely to be an ineffective approach to the management of speech and language problems in preschool children in this population.

Child, Preschool↗
PubMed2005

Long-term stability of improved language functions in chronic aphasia after constraint-induced aphasia therapy.

BACKGROUND AND PURPOSE: In response to the established notion that improvement of language functions in chronic aphasia only can be achieved through long-term treatment, we examined the efficacy of a short-term, intensive language training, constraint-induced aphasia therapy (CIAT). This program is founded on the learning principles of prevention of compensatory communication (constraint), massed practice, and shaping (induced). METHODS: Twenty-seven patients with chronic aphasia received 30 hours of training over 10 days. Twelve patients were trained with the CIAT program. For 15 patients the training included a module of written language and an additional training in everyday communication, which involved the assistance of family members (CIATplus). Outcome measures included standardized neurolinguistic testing and ratings of the quality and the amount of daily communication. RESULTS: Language functions improved significantly after training for both groups and remained stable over a 6-month follow-up period. Single case analyses revealed statistically significant improvements in 85% of the patients. Patients and relatives of both groups rated the quality and amount of communication as improved after therapy. This increase was more pronounced for patients of the group CIATplus in the follow-up. CONCLUSIONS: Results confirm that a short-term intense language training, based on learning principles, can lead to substantial and lasting improvements in language functions in chronic aphasia. The use of family and friends in the training provides an additional valuable element. This effective intervention can be successfully used in the rehabilitation of chronic aphasia patients. Additionally, its short-term design makes it economically attractive for service providers.

Adult↗
PubMed1998

Modelling the consultation process in a secondary referral unit for children.

This paper overviews a detailed study of a consultation service for children with severe and/or intractable speech and language difficulties. The Speech Therapy Clinical Unit at the University of Central England in Birmingham (UCE) offered multidisciplinary, in-depth assessment of such children to speech and language therapists, parents and other professions involved in their management. Documentary materials generated by the service were analysed using Grounded Theory to develop a model of the process of assessment and consultation employed in the Unit. The implications of this model for clinical education and practice are discussed.

Child↗
PubMed1999

The role of piracetam in the treatment of acute and chronic aphasia.

Piracetam has been shown to improve speech in aphasic patients. This paper reviews the evidence for this benefit in aphasic patients with acute stroke and, in conjunction with language treatment, in post-acute and chronic aphasia. Early double-blind, placebo-controlled trials in acute stroke showed improvement in several neurologic parameters including aphasia. Subsequently two randomized double-blind placebo-controlled studies were performed which utilised the Aachen Aphasia Test (AAT), a validated and standardized procedure, to assess language function. Patients received placebo or piracetam 4.8g daily for 12 weeks in one study and for 6 weeks in the other. In both studies patients received concomitant intensive speech therapy; one included patients 6-9 weeks after stroke while in the other the duration of aphasia varied between 4 weeks and 3 years. Compared with placebo there was improvement in both studies on piracetam in all 5 subtests of the AAT and significant overall improvement in aphasia. This indicated that, given in conjunction with language therapy, piracetam improved speech in patients with post-acute and chronic aphasia. In the Piracetam in Acute Stroke Study (PASS), of 927 patients treated within 12 hours of the onset of acute ischemic stroke, 373 were aphasic. Treatment consisted of placebo or an intravenous bolus of 12g piracetam, 12g piracetam daily for 4 weeks and 4.8 g daily for a further 8 weeks. After 12 weeks significantly more patients (approximately 10%, P=0.04) had recovered from aphasia on piracetam than placebo while in 197 patients treated within 7 hours of stroke onset, the difference in favor of piracetam was 16% (P= 0.02). These studies indicate that piracetam improves aphasia in acute stroke and, as an adjuvant to language therapy, in post-acute and chronic aphasia.

Acute Disease↗
PubMed1981

Veterans Administration cooperative study on aphasia: a comparison of individual and group treatment.

Five Veterans Administration Medical Centers participated in an investigation designed to compare individual with group treatment for aphasic patients who had suffered a left hemisphere cerebral vascular accident. Patients who met selection criteria were assigned randomly to either traditional, individual, stimulus-response type treatment of specific language deficits or group therapy designed to improve communication through group interaction and discussion with no direct treatment of specific language deficits. All patients received eight hours of therapy each week beginning at four weeks postonset and continuing until 48 weeks postonset or until they dropped out of the study. A battery of language measures and a clinical neurologic evaluation were administered at intake and every 11 weeks a patient was in the study. Results show both individually and group-treated patients made significant improvement in language abilities. Individual treatment resulted in significantly better overall performance on the Porch Index of Communicative Ability; however, no significant differences were observed between groups on the other language measures. If the traditional belief is correct that significant spontaneous recovery is complete by three to six months postonset, significant improvement in both groups beyond 26 weeks postonset indicates both individual and group treatment are efficacious methods for managing aphasic patients.

Adult↗
PubMed1996

"Dichos" therapy group: a therapeutic use of Spanish language proverbs with hospitalized Spanish-speaking psychiatric patients.

Physical, emotional, and cultural barriers have resulted in the underutilization of mental health services by Hispanic/Latino individuals. Described in this article is a culturally sensitive intervention that has been developed based on existing elements within Hispanic/Latino culture. The therapeutic uses of dichos--Spanish language proverbs and refranes (sayings)--are explored in the treatment of a regressed population of Hispanic/Latino psychiatric inpatients. The dichos therapy group described in this article utilizes dichos to draw patients into discussions about a wide range of issues, and is able to do so where other efforts fail because of their cultural and familial relevance, vivid imagry, and the flexibility with which they can be used. This intervention effectively facilitates building rapport, decreasing defensiveness, enhancing motivation and participation in therapy, improving self-esteem, focusing attention, stimulating emotional exploration and articulation of feelings, and development of insight, and assists in exploring cultural values and identity. Clinical examples are provided to exemplify these therapeutic effects.

Aphorisms and Proverbs as Topic↗
PubMed2006

Language rehabilitation in chronic aphasia and time postonset: a review of single-subject data.

BACKGROUND AND PURPOSE: This article is a comprehensive review of aphasia treatment studies for the purpose of investigating the relationship between time postonset of aphasia and response to treatment for aphasia in chronic patients at >/=1 year after symptom onset. METHODS: Studies that demonstrated treatment response (defined as a measurable change in task performance compared with a control task performance) through the use of single-subject design methodologies on measures of verbal output or auditory comprehension were selected. Individual subject data were extracted from the 23 studies that met criteria identifying the subjects as those who received direct continuous therapy for spoken language deficits and whose changes in response to therapy were measurable. Percent of maximum possible change was used as a measurement of outcome. RESULTS: Nonparametric correlation statistics (Spearman rho) and comparisons of group means (Kruskal-Wallis) were used to compare the relationship between time postonset and improvement. Time postonset at which treatment was initiated did not correlate with response to treatment. No significant differences in response to treatment were found between groups of patients according to times postonset. CONCLUSIONS: Time postonset is not related to response to treatment for aphasia in patients >1 year postonset of aphasia.

Aphasia↗