Acquired language Disorders aphasia…and

important ideas about aphasia …is a symbolic disruption …is acquired …involves any or all language modalities comprehension: auditory, reading, signed/visual expression: oral, writing, signed/manual …is not a problem of sensation or intellect

Common causes of aphasia CVA TBI tumors infections epilepsy Over 1,000,000 individuals with the US have aphasia - National Aphasia Association

describing aphasia various impairments in any/all language modalities the most commonly observed deficits are in naming and auditory processing generally describe an the language profile as: fluent/receptive; nonfluent/expressive; or severe or global Hegde (1998); Brookshire (1997)

General symptoms: Impairments impacting language use include: impaired auditory comprehension anomia: word retrieval/naming difficulty paraphasias: word or sound substitutions agrammatism: asyntactic production (or reduced syntax) reading and writing disruptions

the WHO ICF Functioning and Disability Contextual Factors body functions and structures activity and participation Contextual Factors environmental factors personal factors

Treatment and assessment - Linking the WHO ICF restorative/process oriented approaches – impairment (body structure/function) approaches aimed at improving underlying motor or cognitive processes, resulting in generalized improvement in function skills based/compensory approaches – activity/participation approaches that train a new skill/behavior -or- alternative method for communicating participation focused approaches – participation approaches focused on improved community participation and quality of life

case example

Multiple oral rereading WHO ICF: impairment target: increased access to whole words in the lexicon, resulting in faster reading candidates: traditionally, clients with pure alexia who read letter-by-letter outcome: faster reading of novel text; improved comprehension Basic MOR procedure determine rate and accuracy for a passage have patient re-read text, cueing to correct reading errors setup homework – copied text and log ---- review homework log probe rate and accuracy of practiced passage determine target rate (e.g., 75 wpm); provide new passage when criterion is reached

Anagram and copy Treatment (ACT) WHO ICF: activity/participation target: improved representation of single words in the lexicon (thereby increasing access) candidates: clients with little to no writing, but who show abilities with writing letters and letter identification; ability to complete homework outcome: independent writing of functional single words for everyday communication