Presentation on theme: "Communication after a Stroke"— Presentation transcript:
1Communication after a Stroke Aphasia and Apraxia of Speech
2Topics to cover Aphasia Apraxia Definition Incidence/Prevalence CharacteristicsAssessment MeasuresTreatmentSupportDefinitionCausesCharacteristicsAssessment MeasuresTreatmentSupport
3What is Aphasia?Aphasia is an acquired neurogenic language disorder resulting from an injury to the brain, most typically the left hemisphere, that affects all language modalities (ASHA, 2015).Stroke is the most common cause of aphasia and apraxia; however, it can also be diagnosed after a lesions or trauma to the brain.
4Incidence and Prevalence- Aphasia Approx 35-40% of patients who suffer a stroke are diagnosed with some form of aphasia. (Dickey et al., 2010; Pedersen, Jorgensen, Raaschou, & Olsen, 1995).It is estimated that there are 80,000 new cases of aphasia per year in the United States (National Stroke Association, 2008).The National Institute of Neurological Disorders and Stroke (NINDS) estimates that approximately 1 million people, or 1 in 250 in the United States today, suffer from aphasia (NINDS, n.d.).
5AphasiaA language disorder resulting in the difficulty to communicate and understand language.The four modalities of languageListening comprehensionReading comprehensionVerbal expressionWriting expressionAffects on language, not on intellect
7Types of Aphasia Wernicke’s Broca’s Decreased auditory comprehension Fluent AphasiaMost associated with ApraxiaDecreased verbal expressionNon-Fluent AphasiaSlow, halting, effortful speech
8Wernike – Geshwind Model (The Brain from Top to Bottom) A word is heardprocessed in your auditory cortexWernike’s area (links with a word in your memory)word is now associated with a meaningA word is readprocessed by your visual cortexsent to Wernike’s and again is linked with memoryA word is read aloudoriginates from the “dictionary” in Wernike’sgets looped to Broca’s area in order to be pronouncedplanning articulatorsmotor cortex for speech movementA word is spoken
9Characteristics of Aphasia Listening ComprehensionDecreased understandingUnreliable Y/NReading ComprehensionAlexia: loss in ability to recognize letters, words, etc.Writing ExpressionAgraphia: loss in the ability to communicate by writingVerbal ExpressionWord finding: AnomiaParaphasiasperseverative, phonemic, verbal, neologistic etc.Phonemic: “speep” for “speech”Verbal: “garbage” for “garage”
12Aphasia supportFor information on organizations, research and clinical trialsSt. Luke’s Stroke clubAcademy of Neurologic Communication Science and DisordersAphasia HopeNational Aphasia AssociationStroke AssociationEmotional aspects of a stroke, and loss of communication
13What is Apraxia of Speech? - Adults Apraxia of speech is a motor disorder that is a result of vascular lesion in the left subcortical region.The inability for volitional movement of the speech articulators.It is not muscle weakness.
14ApraxiaDisconnect between the words in the brain, and how to form the movements of those speech sounds.Limited research on prevalence and incidence.Often co-morbidities such as dysarthria (muscle weakness) or aphasia (language disorder).
15Characteristics of Apraxia Groping – most often with initiationSlowed paceLimited or no usable speechDifficulty performing “non-speech” tasks upon requestAwareness and frustrationInconsistent errors
16Causes of ApraxiaAcquired versus DevelopmentalAdult is acquired
17Assessment Measures - Apraxia Diagnosed by a speech-language pathologist after informal and formal testing proceduresSpeech sample in conversationOral mechanical examinationMotor speech evaluationApraxia vs Dysarthria
18Treatment for Apraxia Three steps PlanningSequencingMuscle coordination (slow rate, pacing)Retraining the brain. Make new connections. Repetitive practice.GesturesGuess my communicative intentWritingAACAlphabet boardsPicture boardsSpeech isn’t just speech
19Treatment of Apraxia Melodic Intonation Therapy (MIT) PROMPT – involving tactile cues for articulatorsMinimal pairs imitationKey word approachPhonetic placementPractice, practice, practice
20Apraxia supportFor information on organizations, research and clinical trialsSt. Luke’s Stroke clubNational Institute of Neurological Disorders and StrokeNational Institute of Deafness and other Communication Disorders
21ReferencesAphasia and the Brain (2015). Wernike and Broca History. Image retrieved January 11, 2015 fromThe Brain from Top to Bottom (2015). Broca’s Area, Wernike’s Area, and other Language-Processing Areas in the Brain. Retrieved January 11, 2015 fromNational Institute on Deafness and Other Communication Disorders (2015). Apraxia of Speech. Retrieved January 11, 2015 fromNational Institute of Neurological Disorders and Stroke (2015). Apraxia Information Page. Retrieved January 11, 2015 fromThe Stroke Comeback Center, VA. Williamson, Darlene M.S., CCC-SLP. Adult Acquired Apraxia of Speech: Principles, Practice and Technology. Retrieved January 11, 2015 from