This textbook is intended for courses in aphasia and other neurogenic communication disorders. The Coursebook offers a comprehensive description and critical review of basic and applied research on ...aphasia, right hemisphere disorder (RHD), traumatic brain injury (TBI), and dementia--the four major language and communication disorders associated with neurological pathologies. The relationship between the brain and language, major features of aphasia and other disorders, their assessment, and treatment have been described in streamlined and clinician-friendly language. Critical review of theories, assessment, and treatment research helps speech-language pathologists distinguish valid from the questionable in the professional and scientific literature. All assessment and treatment chapters give an outline of comprehensive and practical procedures, integrating current practices that clinicians might readily use.
The current study aimed to validate the Cantonese version of the Amsterdam-Nijmegen Everyday Language Test (CANELT), a functional communication assessment tool for Cantonese speakers with aphasia. A ...quantitative scoring method was adopted to examine the pragmatics and informativeness of the production of people with aphasia (PWA). CANELT was translated from its English version with cultural adaptations. The performance on the 20-item CANELT collected from 56 PWA and 100 neurologically healthy Cantonese-speaking controls aged 30 to 79 years was orthographically transcribed. Scoring was based on the completeness of the main concepts produced in the preamble and subsequent elaborations, defined as Opening (O) and New Information (NI). Measures examining the validity and reliability were conducted. An age effect was found in neurologically healthy controls, and therefore z scores were used for subsequent comparisons between neurologically healthy controls and PWA. The test showed strong evidence for known-group validity in both O X.sup.2 (2) = 95.2, p < .001 and NI X.sup.2 (2) = 100.4, p < .001. A moderate to strong correlation was found between CANELT and standardized aphasia assessment tools, suggesting satisfactory concurrent validity. Reliability measures were excellent in terms of internal consistency (Cronbach's alpha of .95 for both 'O' and 'NI'), test-retest reliability (ICC = .96; p < .001), intra-rater reliability (ICC = 1.00; p < .001), and inter-rater reliability for O (ICC = .99; p < .001) and NI (ICC = .99; p < .001). Sensitivity and specificity for O are 97% and 76.8%, respectively, while for NI, a sensitivity of 95% and specificity of 91.1% were obtained. Measures on validity and reliability yielded promising results, suggesting CANELT as a useful and reliable functional communication assessment for PWA. Its application in managing PWA and potential areas for development are discussed.
Purpose: This study investigated the communicative benefits of self-repair during conversation for persons with aphasia (PWAs). Self-repair of trouble sources is an interactional priority that ...emphasizes autonomy and competence. Of equal importance, conversationalists desire to minimize silences and work together to ensure forward movement (progressivity) of conversation. Simultaneously achieving progressivity and self-repair is challenging in aphasia, and PWAs and their partners often make trade-off decisions between these two activities. Conversation-level aphasia interventions usually focus on supportive techniques that promote participation while maintaining progressivity, effectively favoring progressivity over self-repair. This study evaluates the benefits of an alternative approach that shifts the emphasis to self-repair, thereby highlighting potential trade-off costs of routinely forgoing self-repair to achieve progressivity. Method: Ten people with mild-to-moderate aphasia each held two conversations with two different partners. When trouble sources characterized by silent and/or filled pauses occurred, partners maintained a supportive and engaged stance, allowing PWAs time to self-repair. We analyzed language produced during these "edited turns" using three paradigms considering form, content, and use. Results: The data yielded 311 edited turns. For form, on average, each edited turn resulted in 3.72 words; for content, most edited turns contained autobiographical information; for use, approximately 40% of edited turns introduced new information, and 40% added to the ongoing topic. The remainder were either ambiguous or comments such as, "I can't think of it." Conclusions: When given engaged support and time to self-repair, PWAs contributed meaningful personal information to conversations for approximately 80% of edited turns. Importantly, self-repair often resulted in self-expression that directed the conversation, which is a communicative role critical for empowering agency and identity. This research opens a dialogue about benefits and limitations of approaches that prioritize either progressivity or self-repair and how to balance the two to optimize therapeutic benefits for each individual. Supplemental Material:
Introduction. Aphasia and dysarthria are permanent consequences of stroke in many patients. These disorders significantly disrupt the person's functioning in everyday life. The aim of this paper is ...to examine the quality of communication and quality of life in patients with aphasia and dysarthria. Material and Methods. The clinical group included 25 patients with aphasia and 20 patients with dysarthria due to stroke. The control group included 15 post-stroke people without speech and language disorders and 15 neurologically healthy subjects. The Quality of Communication Life Scale was used to assess the quality of communication. This scale provides information about the impact of speech and language disorders on individuals' ability to communicate and quality of life in general. The scale consists of 18 items scored from 1 to 5. Results. Patients with aphasia and dysarthria have a significantly lower quality of communication compared to stroke survivors with preserved speech and language functions and neurologically healthy subjects. The severity of the language and speech disorder proved to be a significant factor in determining the quality of communication. Namely, patients with more severe forms of aphasia and dysarthria scored significantly lower on the Quality of Communication Life Scale compared to the patients with milder forms. It was also shown that patients with flaccid dysarthria have the worst quality of communication compared to the patients with other types of dysarthria. Conclusion. Aphasia and dysarthria following a stroke significantly impair the quality of communication and quality of life of the affected persons. Key words: Aphasia; Dysarthria; Communication; Quality of Life; Stroke Uvod. Afazija i dizartrija ostaju kao trajne posledice moždanog udara kod mnogih pacijenata. Ovi poremecaji znacajno remete funkcionisanje osobe u svakodnevnom životu. Cilj ovog rada je utvrdivanje kvaliteta komunikacije i kvaliteta života kod pacijenata sa afazijom i dizartrijom. Materijal i metode. Klinicku grupu cinilo je 25 ispitanika sa afazijom i 20 ispitanika sa dizartrijom usled moždanog udara. U kontrolnu grupu ukljuceno je 15 ispitanika sa moždanim udarom bez poremecaja govora i jezika i 15 neurološki zdravih govornika. Za procenu kvaliteta komunikacije primenjena je Skala kvaliteta komunikacionog života. Primenom ove skale dobijaju se informacije o uticaju govornih i jezickih poremecaja na sposobnost komunikacije pojedinca i kvalitet života uopšte. Skala se sastoji od osamnaest tvrdnji koje ispitanici vrednuju ocenom od jedan do pet. Rezultati. Ispitanici sa afazijom i dizartrijom imaju znacajno niži kvalitet komunikacije u poredenju sa osobama sa moždanim udarom ocuvanih govornih i jezickih funkcija i neurološki zdravim govornicima. Težina jezickog i govornog poremecaja se pokazala znacajnim faktorom u odredivanju kvaliteta komunikacije. Utvrdeno je da pacijenti sa težim formama afazije i dizartrije imaju znacajno niži skor na Skali kvaliteta komunikativnog života u odnosu na pacijente sa lakšim formama. Takode je pokazano da pacijenti sa flacidnom dizartrijom imaju najlošiji kvalitet komunikacije u grupi ispitanika sa dizartrijom. Zakljucak. Afazija i dizartrija nakon moždanog udara znatno narušavaju kvalitet komunikacije i kvalitet života pogodenih osoba. Kljucne reci: afazija; disartrija; komunikacija; kvalitet života; moždani udar
Abstract only Introduction We detail the presentation and diagnostic workup of a woman who was ultimately diagnosed with Amyloid Beta‐Related Angiitis (ABRA), which can be a challenging condition to ...diagnose. Methods This is a case report which describes the presentation and workup that led to the diagnosis of ABRA. Results 64‐year‐old woman with history of hypertension, hypothyroidism, hyperlipidemia and diabetes mellitus presented to outside hospital with progressive encephalopathy and worsening expressive aphasia for three months who was transferred to our center for a left frontal lobe mass with vasogenic edema. MRI brain with and without gadolinium showed multiple small enhancing cerebral regions, diffuse swelling, and leptomeningeal enhancement. Lumbar puncture was within normal limits. Cytology and CA 19‐9, CEA, and alpha‐fetoprotein were all normal. CT thorax, abdomen, and pelvis with contrast did not reveal findings suspect for malignancy. Given diagnostic uncertainty, brain biopsy of the left frontal lesion was completed. Findings were consistent with amyloid beta deposition in the walls and concerning for an inflammatory angiitis, without features to suggest infectious or malignancy related process. Vasculitic labs were notable for positive ANA (1:160), speckled pattern, but were otherwise negative. She completed a five day course of methylprednisolone 1g IV with some improvement in encephalopathy and aphasia. She was started on a prednisone taper and cyclophosphamide and discharged to a skilled nursing facility with follow up with vascular neurology and neuroimmunology planned. Conclusion ABRA is a complication seen in cerebral amyloid angiopathy and is a rare cause of CNS vasculitis. This condition should be suspected in the appropriate clinical scenario, particularly given the improvement often noted with immunosuppression (1).
Objective: In this study, it was investigated the effects of intensive aphasia treatment applied to individuals with non-fluent aphasia.
Methods: Sixteen patients diagnosed with non-fluent aphasia ...were included in the study and were randomly divided into two groups. The therapy interventions were one day per week for the eight patients in the first group, for a total of 8 hours in 2 months (standard intervention). For the eight patients in the second group, therapy was applied for a total of 48 hours in 2 months, for one hour per day, six days a week, excluding Sundays (intensive intervention). Participants were tested using the Turkish aphasia test (ADD), Aphasia Impact Scale-21 (AIQ-21), and Boston Naming Test (BNT) before starting the treatment (pretest), after the treatment (posttest), and one month after the treatment ended (follow-up).
Results: At the end of the treatments, a significant increase in ADD and BNT scores and a significant decrease in AIQ-21 scores were observed in both groups. Although there was a change in the follow-up test, the scores were still significantly different than the pretest scores. The rate of improvement in test scores of group II patients who received intensive aphasia treatment was superior to the group I patients.
Conclusion: Intensive application was superior to once-weekly aphasia treatment, and post-treatment improvement continued for at least one month after the treatments.
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