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In aphasia, a person may be unable to comprehend or unable to formulate language because of damage to specific brain regions. The major causes are stroke and head trauma; prevalence is hard to determine but aphasia due to stroke is estimated to be 0.1–0.4% in the Global North. Aphasia can also be the result of brain tumors, epilepsy, brain damage and brain infections, or neurodegenerative diseases.
Expressive aphasia, also known as Broca's aphasia, is a type of aphasia characterized by partial loss of the ability to produce language, although comprehension generally remains intact. A person with expressive aphasia will exhibit effortful speech. Speech generally includes important content words but leaves out function words that have more grammatical significance than physical meaning, such as prepositions and articles. This is known as "telegraphic speech". The person's intended message may still be understood, but their sentence will not be grammatically correct. In very severe forms of expressive aphasia, a person may only speak using single word utterances. Typically, comprehension is mildly to moderately impaired in expressive aphasia due to difficulty understanding complex grammar.
Wernicke's aphasia, also known as receptive aphasia, sensory aphasia or posterior aphasia, is a type of aphasia in which individuals have difficulty understanding written and spoken language. Patients with Wernicke's aphasia demonstrate fluent speech, which is characterized by typical speech rate, intact syntactic abilities and effortless speech output. Writing often reflects speech in that it tends to lack content or meaning. In most cases, motor deficits do not occur in individuals with Wernicke's aphasia. Therefore, they may produce a large amount of speech without much meaning. Individuals with Wernicke's aphasia are typically unaware of their errors in speech and do not realize their speech may lack meaning. They typically remain unaware of even their most profound language deficits.
Speech disorders or speech impairments are a type of communication disorder in which normal speech is disrupted. This can mean fluency disorders like stuttering, cluttering or lisps. Someone who is unable to speak due to a speech disorder is considered mute. Speech skills are vital to social relationships and learning, and delays or disorders that relate to developing these skills can impact individuals function. For many children and adolescents, this can present as issues with academics. Speech disorders affect roughly 11.5% of the US population, and 5% of the primary school population. Speech is a complex process that requires precise timing, nerve and muscle control, and as a result is susceptible to impairments. A person who has a stroke, an accident or birth defect may have speech and language problems.
Aphasiology is the study of language impairment usually resulting from brain damage, due to neurovascular accident—hemorrhage, stroke—or associated with a variety of neurodegenerative diseases, including different types of dementia. These specific language deficits, termed aphasias, may be defined as impairments of language production or comprehension that cannot be attributed to trivial causes such as deafness or oral paralysis. A number of aphasias have been described, but two are best known: expressive aphasia and receptive aphasia.
Anomic aphasia is a mild, fluent type of aphasia where individuals have word retrieval failures and cannot express the words they want to say. By contrast, anomia is a deficit of expressive language, and a symptom of all forms of aphasia, but patients whose primary deficit is word retrieval are diagnosed with anomic aphasia. Individuals with aphasia who display anomia can often describe an object in detail and maybe even use hand gestures to demonstrate how the object is used, but cannot find the appropriate word to name the object. Patients with anomic aphasia have relatively preserved speech fluency, repetition, comprehension, and grammatical speech.
Global aphasia is a severe form of nonfluent aphasia, caused by damage to the left side of the brain, that affects receptive and expressive language skills as well as auditory and visual comprehension. Acquired impairments of communicative abilities are present across all language modalities, impacting language production, comprehension, and repetition. Patients with global aphasia may be able to verbalize a few short utterances and use non-word neologisms, but their overall production ability is limited. Their ability to repeat words, utterances, or phrases is also affected. Due to the preservation of the right hemisphere, an individual with global aphasia may still be able to express themselves through facial expressions, gestures, and intonation. This type of aphasia often results from a large lesion of the left perisylvian cortex. The lesion is caused by an occlusion of the left middle cerebral artery and is associated with damage to Broca's area, Wernicke's area, and insular regions which are associated with aspects of language.
Transcortical sensory aphasia (TSA) is a kind of aphasia that involves damage to specific areas of the temporal lobe of the brain, resulting in symptoms such as poor auditory comprehension, relatively intact repetition, and fluent speech with semantic paraphasias present. TSA is a fluent aphasia similar to Wernicke's aphasia, with the exception of a strong ability to repeat words and phrases. The person may repeat questions rather than answer them ("echolalia").
Landau–Kleffner syndrome (LKS)—also called infantile acquired aphasia, acquired epileptic aphasia or aphasia with convulsive disorder—is a rare childhood neurological syndrome.
Transcortical motor aphasia (TMoA), also known as commissural dysphasia or white matter dysphasia, results from damage in the anterior superior frontal lobe of the language-dominant hemisphere. This damage is typically due to cerebrovascular accident (CVA). TMoA is generally characterized by reduced speech output, which is a result of dysfunction of the affected region of the brain. The left hemisphere is usually responsible for performing language functions, although left-handed individuals have been shown to perform language functions using either their left or right hemisphere depending on the individual. The anterior frontal lobes of the language-dominant hemisphere are essential for initiating and maintaining speech. Because of this, individuals with TMoA often present with difficulty in speech maintenance and initiation.
Primary progressive aphasia (PPA) is a type of neurological syndrome in which language capabilities slowly and progressively become impaired. As with other types of aphasia, the symptoms that accompany PPA depend on what parts of the left hemisphere are significantly damaged. However, unlike most other aphasias, PPA results from continuous deterioration in brain tissue, which leads to early symptoms being far less detrimental than later symptoms. Those with PPA slowly lose the ability to speak, write, read, and generally comprehend language. Eventually, almost every patient becomes mute and completely loses the ability to understand both written and spoken language. Although it was first described as solely impairment of language capabilities while other mental functions remain intact, it is now recognized that many, if not most of those with PPA experience impairment of memory, short-term memory formation and loss of executive functions. It was first described as a distinct syndrome by M. Marsel Mesulam in 1982. Primary progressive aphasias have a clinical and pathological overlap with the frontotemporal lobar degeneration (FTLD) spectrum of disorders and Alzheimer's disease. However, PPA is not considered synonymous to Alzheimer's disease due to the fact that, unlike those affected by Alzheimer's disease, those with PPA are generally able to maintain the ability to care for themselves, remain employed, and pursue interests and hobbies. Moreover, in diseases such as Alzheimer's disease, Pick's disease, and Creutzfeldt-Jakob disease, progressive deterioration of comprehension and production of language is just one of the many possible types of mental deterioration, such as the progressive decline of memory, motor skills, reasoning, awareness, and visuospatial skills.
Auditory verbal agnosia (AVA), also known as pure word deafness, is the inability to comprehend speech. Individuals with this disorder lose the ability to understand language, repeat words, and write from dictation. Some patients with AVA describe hearing spoken language as meaningless noise, often as though the person speaking was doing so in a foreign language. However, spontaneous speaking, reading, and writing are preserved. The maintenance of the ability to process non-speech auditory information, including music, also remains relatively more intact than spoken language comprehension. Individuals who exhibit pure word deafness are also still able to recognize non-verbal sounds. The ability to interpret language via lip reading, hand gestures, and context clues is preserved as well. Sometimes, this agnosia is preceded by cortical deafness; however, this is not always the case. Researchers have documented that in most patients exhibiting auditory verbal agnosia, the discrimination of consonants is more difficult than that of vowels, but as with most neurological disorders, there is variation among patients.
Language disorders or language impairments are disorders that involve the processing of linguistic information. Problems that may be experienced can involve grammar, semantics (meaning), or other aspects of language. These problems may be receptive, expressive, or a combination of both. Examples include specific language impairment, better defined as developmental language disorder, or DLD, and aphasia, among others. Language disorders can affect both spoken and written language, and can also affect sign language; typically, all forms of language will be impaired.
Speech-language pathology is a field of healthcare expertise practiced globally. Speech-language pathology (SLP) specializes in the evaluation, diagnosis, treatment, and prevention of communication disorders, cognitive-communication disorders, voice disorders, pragmatic disorders, social communication difficulties and swallowing disorder across the lifespan. It is an independent profession considered an "allied health profession" or allied health profession by professional bodies like the American Speech-Language-Hearing Association (ASHA) and Speech Pathology Australia. Allied health professions include audiology, optometry, occupational therapy, rehabilitation psychology, physical therapy and others.
Muteness or mutism is defined as an absence of speech while conserving or maintaining the ability to hear the speech of others. Mutism is typically understood as a person's inability to speak, and commonly observed by their family members, caregivers, teachers, doctors or speech and language pathologists. It may not be a permanent condition, as muteness can be caused or manifest due to several different phenomena, such as physiological injury, illness, medical side effects, psychological trauma, developmental disorders, or neurological disorders. A specific physical disability or communication disorder can be more easily diagnosed. Loss of previously normal speech (aphasia) can be due to accidents, disease, or surgical complication; it is rarely for psychological reasons.
Apraxia of speech (AOS), also called verbal apraxia, is a speech sound disorder affecting an individual's ability to translate conscious speech plans into motor plans, which results in limited and difficult speech ability. By the definition of apraxia, AOS affects volitional movement pattern. However, AOS usually also affects automatic speech.
Frank R. Kleffner was an American pathologist who was a professor at Washington University in St. Louis, noted for his contributions in the fields of speech and language pathology and hearing.
In psychology, graphorrhea, or graphorrhoea, is a communication disorder expressed by excessive wordiness with minor or sometimes incoherent rambling, specifically in written work. Graphorrhea is most commonly associated with schizophrenia but can also result from several psychiatric and neurological disorders such as aphasia, thalamic lesions, temporal lobe epilepsy and mania. Some ramblings may follow some or all grammatical rules but still leave the reader confused and unsure about what the piece is about.
Music therapy for non-fluent aphasia is a method for treating patients who have lost the ability to speak after a stroke or accident. Non-fluent aphasia, also called expressive aphasia, is a neurological disorder that deprives patients of the ability to express language. It is usually caused by stroke or lesions in Broca’s area, which is a language-dominant area responsible for speech production in the left hemisphere. However, lesions in Broca’s area only affects patients’ speech ability, while their ability to sing remains unaffected. Since several studies have shown that right hemispheric regions are more active during singing, music therapy involving melodic elements is deemed to be a potential treatment for non-fluent aphasia, as singing might activate patients’ right hemisphere to compensate with their lesioned left hemisphere. Aside from singing, many other music therapy techniques have also been attempted and the effectiveness of some techniques is shown. Although there are many possible explanations for the mechanism of music therapy, the underlying mechanism remains unclear, as some studies indicate contradictory results.
Elena Margaret Plante is a researcher and speech-language pathologist specializing in developmental language disorders in children and adults. She holds the position of Professor and previously was Head of the Department of Speech, Language, and Hearing Sciences (SLHS) at the University of Arizona (UA). She is the principal investigator at the eponymous Plante Laboratory at UA. Plante is also affiliated with the Cognitive Science program at UA.
References
- 1 2 "Western Carolina University". Nancy Helm-Estabrooks. Retrieved 2022-09-09.
- ↑ "Spotlight on a member Nancy Helm-Estabrook, Ph.D." (PDF). June 17, 2013. pages 11-13
- ↑ Reyes, Erin. "ANCDS Past Presidents". www.ancds.org. Retrieved 2022-09-12.
- ↑ Sparks, Robert; Helm, Nancy; Albert, Martin (1974-12-01). "Aphasia Rehabilitation Resulting from Melodic Intonation Therapy". Cortex. 10 (4): 303–316. doi: 10.1016/S0010-9452(74)80024-9 . ISSN 0010-9452. PMID 4452250.
- ↑ "Singing Your Way Past Stroke with Melodic Intonation Therapy". 8 January 2019.
- ↑ Helm-Estabrooks, Nancy; Albert, Martin L. (2004). Manual of Aphasia and Aphasia Therapy. Pro-Ed. ISBN 978-0-89079-963-5.
- ↑ Approaches to the treatment of aphasia. Nancy Helm-Estabrooks, Audrey L. Holland. San Diego: Singular Pub. Group. 1998. ISBN 1-56593-841-0. OCLC 37362356.
{{cite book}}: CS1 maint: others (link) - ↑ "Interview With Nancy Helm-Estabrooks, Recipient of the 2000 Honors of the Association". Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders. 10 (4): 3–4. 2000-12-01. doi:10.1044/nnsld10.4.3.
- ↑ "Fellowship of the Association Recipients". American Speech-Language-Hearing Association. Retrieved 2022-09-09.
- ↑ "Honorees". www.ancds.org. Retrieved 2022-09-09.
- ↑ "Frank R. Kleffner Lifetime Clinical Career Award recipients prior to 2017" (PDF). American Speech-Language-Hearing Foundation.
- ↑ "Edith Kaplan Award - Massachusetts Neuropsychological Society". mns.clubexpress.com. Retrieved 2022-09-09.
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