CSD 2230 HUMAN COMMUNICATION DISORDERS Topic 6 Language Disorders Adult Disorders Aphasia and Right Hemisphere Injury

Aphasia Language disorder due to damage to the left hemisphere of the brain.. Most often times the results of a CVA or stroke. Can cause deficits to auditory comprehension, verbal expression, reading and writing

Patterns of Communication Performance Seen with Aphasia 1. Naming Process of knowing and retrieving the label for an object, picture, or concept Complex process recognize the object retrieve the semantic label for the object develop the phonological form for the label program the speech movements needed to say the word Examples saying the wrong name saying a word that is phonologically or semantically similar using a nonsense word avoiding saying the name.

Patterns of Communication Performance Seen with Aphasia 2. Fluency speech output may be nonfluent hesitations stops and starts slow and effortful production absence of normal pitch and stress variation

Patterns of Communication Performance Seen with Aphasia 3. Auditory Comprehension The ability to understand spoken language Complex process that involves being able to segment the sounds heard into meaningful phonemes understanding the meaning of words within the sentence retaining the message in memory long enough to understand it and formulate a response

Patterns of Communication Performance Seen with Aphasia 4. Repetition Being able to repeat words or phrases requires good connecting pathways between Wernicke’s area and Broca’s area Broca’s area is important for the programming and movements for speech production. Wernicke’s area is critical for processing and understanding auditory information.

CD-ROM Example of Aphasia Ch CAT scan showing left frontal lesion Ch Example of naming problems Ch Example of word retrieval problems Ch Example of auditory comprehension Ch and Examples of repetition ability

Audio Tape Example of Aphasia Here’s a great example of a number of language deficits due to aphasia. This is an audio example of an 80-something year old woman who suffered a CVA. Listen for examples of word and phrase repetition, jargon (gibberish), neologisms (nonsense words with no apparent symbolic meaning, agrammatism (unusual sentence structures), and word retrieval problems.

Other Problems That May Accompany Aphasia Physical impairments 1. Hemiparesis (weakness on one side of the body) 2. Hemiplegia (paralysis on one side of the body) 3. Hemisensory impairment (loss of ability to perceive sensory information on one side of the body) 4. Hemianopsia is blindness in the right visual field of each eye 5. Problems in chewing or swallowing 6. Seizure disorders or epilepsy Psychosocial changes 1. Behavior (perseveration, disinhibition, and emotional problems) 2. Mood swings 3. Depression

Categorizing the Types of Aphasia Fluent types Nonfluent types

Fluent Aphasia Types Wernicke’s Aphasia Overly fluent speech Neologisms Jargon Impaired naming and repetition

Fluent Aphasia Types Anomic Aphasia Naming problems in speech and writing Word retrieval difficulties Auditory comprehension problems

Fluent Aphasia Types Conduction Aphasia Phoneme and word substitutions Naming deficits Poor repetitive or imitative speech

Fluent Aphasia Types Transcortical Aphasia Very rare Word errors Severe naming problems Poor auditory comprehension

Nonfluent Aphasia Types Broca’s Aphasia Agramatical structures Word finding deficits Problems with imitation and repetition Slow, labored speech Writing errors Articulation errors

Nonfluent Aphasia Types Transcortical Motor Aphasia Impaired conversational speech Good verbal repetition skills Good auditory comprehension Problems initiating speaking and writing

Nonfluent Aphasia Types Global (Mixed) Aphasia Most debilitating form Limited spontaneous expressive ability Severe deficits in auditory comprehension Severe deficits in visual comprehension

Assessment and Diagnosis Assessment is best done immediately after the brain injury event, when the language ability is most impaired Spontaneous recovery Formal assessment using a variety of aphasia (standardized) test batteries The Boston Diagnostic Aphasia Examination The Porch Index of Communicative Ability The Western Aphasia Examination

Treatment Individual or group settings Fundamental goal is to help the patient communicate successfully in everyday situations Compensatory strategies Role of the family

Right Hemisphere Communication Deficits Characteristics 1. Affective processing 2. Comprehension of indirect meaning 3. Structuring of conversational and narrative discourse