1. Acquired language Disorders
aphasia…and

2. 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

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

4. 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)

5. 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

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

7. 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/compensatory 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

8. TReatment examples

9. Anagram and copy Treatment (ACT)
WHO ICF: activity/participation
client profile: clients with little to no writing, but who show abilities with writing letters and letter identification; ability to complete homework
target: independent writing of functional single words for everyday communication
rationale: repeated exposure to words through solving anagrams and copying improves representation of single words in the lexicon (thereby increasing access)

10. ACT
Protocol:

11. measurement in session data: outcome measure:
in SOAP note, report independent writing of target words
if not independent, ability to write word in step 4 of protocol
still take data on anagram and anagram+foil steps in order to note any trends
outcome measure:
independent writing of target words in everyday conversation; self and SO reports of increased understanding, reduced frustration, etc
may incorporate logs, rating scales, GAS

12. response elaboration training (RET)
WHO ICF: impairment
client profile: individuals with reduced oral expression; variety of aphasia profiles and severities
target: oral discourse  increased content units and length of utterance
rationale: combining behavioral techniques of modeling and forward chaining with cognitive stimulation using loose training results in expanded oral expressive output
loose training - uses the client’s response as stimulus

13. RET
Protocol: uses simple line drawings important: use modified RET (mRET) for clients with significant apraxia

14. measurement in session data:
content: number of information units produced (steps 1 and 6) - may vary based on severity of client
possibly grammatical production: number of morphemes, nouns, verbs, and modifiers
outcome measure: increased MLU in everyday conversation; measure of impact (e.g., questionnaire, GAS)