Aphasia

Question 1

What is aphasia?

Answer 1

Without language
Acquired language disorder caused by disturbance in the language system after language has been established
Results from localized brain damage
Stroke leading cause
Includes deficits in spoken and written language

Question 2

Aphasia Considerations

Answer 2

NOT:
A developmental disorder
Psychological problem
Motor speech disorder
Intellectual impairment

IS:
A language disorder

Question 3

How is aphasia classified?

Answer 3

Site of lesion
Behavioral symptoms:
Fluency
Motor output
Comprehension
Repetition
Reading and writing
Naming

Question 4

Fluency

Answer 4

Qualitative aspect of communication and speech used to describe its forward flow, including phrasing, intonation and rate
Fluent speech:
May include jargon, neologisms, circumlocution and logorrhea.

Nonfluent speech:
Short, choppy phrases with telegraphic quality missing morphemes and other grammatical omissions and errors. Slow and labored speech

Question 5

Motor output

Answer 5

May be compromised after stroke and co-occur with aphasia

Question 6

Comprehension

Answer 6

Ability to understand spoken language
Most experience some degree of comprehension deficit

Question 7

Repetition

Answer 7

Ability to repeat verbal stimuli major factor in differentiating among aphasia syndromes

Question 8

Naming

Answer 8

Word retrieval, anomia, paraphasia, jargon and neologisms

Question 9

Reading and writing

Answer 9

Deficits often parallel to verbal language deficits

Question 10

Concomitant deficits to aphasia: Physical

Answer 10

Hemiparesis: Weakness on one side of body where contralateral hemisphere is damaged

Dysphagia: Paresis/paralysis and sensory impairment involving neck and face may lead to difficulty chewing and swallowing

Question 11

Anomia

Answer 11

Difficulty naming entities
Incorrect response may continually be produced even if they recognize that it’s incorrect

Question 12

Jargon

Answer 12

Meaningless/irrelevant speech with typical intonation rate and patterns of language
Strong flow, syntactically correct and rich but makes no sense

Question 13

Neologisms

Answer 13

Making up a new word and using it confidently; may not be aware that they aren’t saying what they are thinking
May be included in jargon

Question 14

Paraphasia

Answer 14

Saying the wrong word

Phonemic paraphasia: Saying a different word that sounds phonetically similar (i.e. paint for pasta)

Semantic paraphasia:
Saying a different word in same semantic category (i.e. chicken for pasta)

Question 15

Circumlocution

Answer 15

Using unnecessarily large number of words to express an idea followed by anomia and word finding difficulties

Question 16

Logorrhea

Answer 16

Excessive, verbose talkativeness leading to jargon

Question 17

Aphasia syndromes

Answer 17

Wernickes
Anomic
Conduction
Transcortical sensory
Broca’s
Transcortical motor
Mixed transcortical
Global

Question 18

Wernickes aphasia

Answer 18

Fluent, no comprehension, no repetition

Characteristics:
Rapid-fire strings of sentences with little pause. Filled with jargon, neologism, logorrhea.

Lesion: Superior and posterior temporal lobe of dominant hemisphere

Question 19

Anomic aphasia

Answer 19

Fluent, comprehends, repeats

Characteristics:
Anomia naming difficulty most difficult with few deficits in other modalities.

Question 20

Conduction aphasia

Answer 20

Fluent, comprehends, no repetition

Characteristics:
Paraphasia
Hallmark repetition difficulty with mild to moderate anomia

Lesion: Temporal-parietal region of brain, arcuate fasciculus

Question 21

Transcortical sensory aphasia

Answer 21

Fluent, no comprehension, repetition

Characteristics:
Strong repetition leading to echolalia

Lesion: Border of temporal and occipital lobe

Question 22

Broca’s aphasia

Answer 22

Not fluent, comprehends, no repeat

Characteristics:
Short sentences, labored speech, low repetition.

Lesion: Anterior frontal lobe of broca’s area of language dominant hemisphere

Question 23

Transcortical motor aphasia

Answer 23

Not fluent, comprehends, repeats

Characteristics:
Difficulty initiating speech and writing, better repetition than spontaneous speech

Lesion:
Frontal lone

Question 24

Mixed transcortical aphasia

Answer 24

No fluent, no comprehend, repeats

Question 25

Global aphasia

Answer 25

Not fluent, no comprehend, no repetition Characteristics: Most debilitating form of aphasia, profound language disorder in all modalities Lesions: Multiple sites of language dominant hemisphere

Question 26

Assessment for aphasia

Answer 26

Interdisciplinary and cooperative team members Diagnosing and documenting presence/absence of aphasia and what type, and referring to other professions Also prognosis

Question 27

Spontaneous recovery

Answer 27

Sudden recovery of symptoms after swelling edema of brain goes down post stroke

Question 28

Treatment/intervention

Answer 28

Restorative/correcting: Aimed at improving/restoring impaired function Compensatory: Aimed at compensating for deficits not amenable to retraining Either way, follow life participation approach which emphasizes achieving or re-engaging in life/function life concerns and daily participation in activities of choice Working on complex thing will help complex and simple, but simple will not help complex

Question 29

Treatment settings

Answer 29

Acute care, inpatient, outpatient

Question 30

Multilingualism and aphasia

Answer 30

Parallel impairment: Similar strengths and weakness in both languages Differential impairment: Greater impairment in one over the other Differential aphasia: Different aphasia symptoms for different languages Blended impairment: Mixing features of languages Selective aphasia: One language has deficit while other is preserved

Question 31

EBP for aphasia

Answer 31

Intervention services benefit those with aphasia more than just spontaneous recovery Low frequency repetitive transcranial magnetic stimulation and intervention effective Repetition important More intense, better the results