ASLP 5840 Aphasia Review

Aphasia Etiology

Focal damage (not diffuse), usually from a stroke, in the cortex and/or subcortex of the domain hemisphere, which is usually the left cerebral hemisphere. can also result from damage to the thalamus and internal capsule

Aphasia Definition

Acquired inability to comprehend and express language; acquired inability to use the words and rules of a language for communication

Hemorrhages

Majority of aphasias are caused by___; when blood vessels in or around the brain raptures, causing bleeding into the brain tissues 

Fluent

Typically have damage in the language-dominant hemisphere, posterior to the central sulcus; speak smoothly; little effort needed; speech rate appears normal; intonation, emphatic stress like normal speakers

Non-fluent

Typically have damage in the front half of the language dominant hemisphere, anterior to the central sulcus; slow rate of speech; high effort; pauses between syllables and words

Speech Fluency

One of the two main ways we characterize aphasia; the prosodic and melodic characteristics of speech

Paraphasia

One of the two main ways we characterize aphasia; speech errors produced by a person with aphasia

Phonemic/Literal Paraphasia

Phonological errors where correct sounds are replaced by incorrect sounds or sounds within words are transposed (e.g., “shooshbruss” for “toothbrush”)

Semantic/Verbal Paraphasia

Errors when an incorrect word (usually semantically related to the target) is unintentionally substituted for the target word (e.g., “door” for “window”); 3 subtypes include semantic, unrelated, and perseverative  

Semantic Feature Analysis 

Addresses: improved speed of using cueing categories, improved accuracy of naming trained and untrained words, increased information retrieved about a target topic 

Lexical Retrieval Cascade Treatment

Word retrieval approach that systemically uses self-cueing to improve naming of trained words, as well as teaches self-cueing; when someone can’t think of a word, this teaches them to go through a series of cues until they retrieve the word themself: “try to think of the word meaning →  think of related words or category → think of what the word sounds like→ try to say it or write it” 

Melodic Intonation Therapy

A structured treatment for phrase/sentence production, using melody; helps people speak in phrase or sentences by using melody and rhythm (singing to talk)

Response Elaboration Training 

Language treatment that uses cueing and modeling to help a client expand their original utterance. it is a loose training method — not one specific outcome is the target, meaning a person is likely to generate the type of language they will need to use on a regular basis; helps people say longer, more complete sentences by encouraging them to add more information to what they say 

Script Training

Intervention that uses repetitive practice of personalized words, phrases, or sentences (scripts) to improve accuracy and efficiency of producing the target material; helps people say real life phrases or sentences that they want or need to use in daily life — like ordering coffee, greeting someone, etc.

Word-Picture Verification

Treatment idea being looked at for severe auditory comprehension deficits due to aphasia. More research is needed, but preliminary testing shows promise for severe word-level comprehension deficits for those with chronic aphasia 

Treatment of Wernicke’s Aphasia

A method of improving auditory comprehension of spoken information at the word level, using multiple modalities in a hierarchy. This method has not been formally studied, but is included as a recommendation by leaders in our field 

Anagram, Copy, and Recall Treatment

A writing/spelling intervention for target words, for those with severe agraphia due to aphasia

Multiple Oral Reading

An intervention for Alexia/acquired reading disorders. Aims to improve oral reading rate and accuracy by repeatedly reading aloud a passage

Life Participation Approach

Focuses on activities that are functional for the patient; more integrative across patient-centered, partner involved, and context manipulators; goal of treatment is focusing on alleviating the participatory limitations or restrictions on the PWA that are imposed by the aphasia 

Broca’s Aphasia

Nonfluent aphasia; appear to comprehend spoken and written language better than they speak or write themselves 

Wernicke’s Aphasia

Fluent aphasia; difficulties with semantics; difficulties are exacerbated by short term retention and recall of verb stimuli-complicating auditory comprehension; dissociations between the sound (or sight) or words and their meanings 

Global Aphasia

Large lesion involving both Broca’s and Wernicke’s areas; severely nonfluent; comprehension is severely impaired; repetition is severely impaired

Conduction Aphasia

Large lesion in the arcuate fasiculus or supramarginalgyrus (connection between Broca’s and Wernicke’s); fluent with phonemic paraphasia; comprehension is good; repetition is disproportionately impaired (hallmark) 

Transcortical Motor Aphasia (TMA) 

Lesion in anterior superior frontal lobe; nonfluent; good comprehension; repetition intact (distinguishing feature)

Transcorital Sensory Aphasia (TSA)

Lesion in posterior temporal-parietal junction; fluent but meaningless speech; poor comprehension; repetition intact 

Mixed Transcortical Aphasia

Watershed lesion isolating language areas from rest of cortex; nonfluent, poor compression, repetition intact (defining feature)