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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.
Conduction aphasia, also called associative aphasia, is an uncommon form of difficulty in speaking (aphasia). It is caused by damage to the parietal lobe of the brain. An acquired language disorder, it is characterised by intact auditory comprehension, coherent speech production, but poor speech repetition. Affected people are fully capable of understanding what they are hearing, but fail to encode phonological information for production. This deficit is load-sensitive as the person shows significant difficulty repeating phrases, particularly as the phrases increase in length and complexity and as they stumble over words they are attempting to pronounce. People have frequent errors during spontaneous speech, such as substituting or transposing sounds. They are also aware of their errors and will show significant difficulty correcting them.
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").
Barnwood House Hospital was a private mental hospital in Barnwood, Gloucester, England. It was founded by the Gloucester Asylum Trust in 1860 as Barnwood House Institution and later became known as Barnwood House Hospital. The hospital catered for well-to-do patients, with reduced terms for those in financial difficulties. It was popular with the military and clergy, and once counted an Archbishop amongst its patients. During the late nineteenth century Barnwood House flourished under superintendent Frederick Needham, making a healthy profit and receiving praise from the Commissioners in Lunacy. Even the sewerage system was held up as a model of good asylum practice. After the First World War service patients, including war poet and composer Ivor Gurney, were treated with a regime of psychotherapy and recreations such as cricket.
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.
Mixed transcortical aphasia is the least common of the three transcortical aphasias. This type of aphasia can also be referred to as "Isolation Aphasia". This type of aphasia is a result of damage that isolates the language areas from other brain regions. Broca's, Wernicke's, and the arcuate fasiculus are left intact; however, they are isolated from other brain regions.
Speech is a human vocal communication using language. Each language uses phonetic combinations of vowel and consonant sounds that form the sound of its words, and using those words in their semantic character as words in the lexicon of a language according to the syntactic constraints that govern lexical words' function in a sentence. In speaking, speakers perform many different intentional speech acts, e.g., informing, declaring, asking, persuading, directing, and can use enunciation, intonation, degrees of loudness, tempo, and other non-representational or paralinguistic aspects of vocalization to convey meaning. In their speech, speakers also unintentionally communicate many aspects of their social position such as sex, age, place of origin, physical states, psychological states, physico-psychological states, education or experience, and the like.
Telerehabilitation (or e-rehabilitation is the delivery of rehabilitation services over telecommunication networks and the internet. Telerehabilitation allows patients to interact with providers remotely and can be used both to assess patients and to deliver therapy. Fields of medicine that utilize telerehabilitation include: physical therapy, occupational therapy, speech-language pathology, audiology, and psychology. Therapy sessions can be individual or community-based. Types of therapy available include motor training exercises, speech therapy, virtual reality, robotic therapy, goal setting, and group exercise.
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.
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.
Asemia is the term for the medical condition of being unable to understand or express any signs or symbols. It is a more severe condition than aphasia, which is the inability to understand linguistic signs. Asemia is caused by damage to the areas of the brain that process communication – more specifically, when there is damage to the left side of the brain in the areas that process communication such as Broca's and Wernicke's areas. Damage can be inflicted by physical trauma to the brain, but is more commonly caused by stroke and sometimes tumors. The onset of this condition is usually quick but not permanent. Treatment of this condition is traditional speech therapy in which the individual must relearn how to read, write, and talk. Depending on the severity of the injury, recovery can take days to years. Considerable recovery is common, but often not to the full extent of baseline ability.
The Royal College of Speech and Language Therapists is the professional body for speech and language therapists in the United Kingdom and is a registered charity. It was established on 6 January 1945 to promote the study of speech therapy in the UK, to seek improvement and maintain a high standard of knowledge and to unite all members of the profession. The RCSLT’s current patron is the Duchess of Edinburgh. The RCSLT has offices in Edinburgh, Belfast, Cardiff and London.
Muriel Elizabeth Morley (1899–1993) was an English speech and language therapist who specialised in the management of cleft palate. She was the president of the Royal College of Speech and Language Therapists.
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.
Anne Hutchison McAllister was a leading Scottish speech therapist and teacher.
Emil Fröschels was an Austrian speech and voice therapy specialist. As a laryngologist and chief speech therapist, in 1924 he introduced the term logopedics into medical usage. He established the International Society of Logopedics and Phoniatrics and was a co-founder, with Karl Cornelius Rothe, of the Vienna School for Speech-Disturbed Children.
Gillian Dorothy Kennedy is a Consultant speech and language therapist specialising in neonates and paediatrics at University College Hospital.
References
- ↑ "Sally Byng, Chief Executive". Barnwood Trust. Retrieved 1 November 2018.
- ↑ "City's Extraordinary Women". City, University of London. Retrieved 1 November 2018.
- ↑ Flowers, S. (8 March 2018). "Revealed: 50 Greatest Gloucestershire Women of all time". Gloucestershire Live. Retrieved 1 November 2018.
- ↑ "RCSLT Honours Roll Call". Royal College of Speech and Language Therapists. Retrieved 1 November 2018.
- ↑ "SUPPLEMENT TO The London Gazette". The Gazette: Official Public Record. 12 June 1987. p. 9.
- ↑ "Dr Sally Byng". Lord-Lieutenant of Gloucestershire. Retrieved 1 November 2018.
- ↑ "Meet the Trustees". Gloucestershire Wildlife Trust. Retrieved 1 November 2018.