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					      CSD 2230

             Topic 6
        Language Disorders
          Adult Disorders
Aphasia and Right Hemisphere Injury

   Language disorder due to damage to the
    left hemisphere of the brain..
   Most often times the results of a CVA or
   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
   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
  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
   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.19.01
    CAT scan showing left frontal lesion
   Ch.19.02
    Example of naming problems
   Ch.19.03
    Example of word retrieval problems
   Ch.19.04
    Example of auditory comprehension
   Ch.19.05 and 19.06
    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
Fluent Aphasia Types
          Anomic Aphasia
               Naming problems in
                speech and writing
               Word retrieval
               Auditory
Fluent Aphasia Types
          Conduction Aphasia
           Phoneme and word

           Naming deficits

           Poor repetitive or

            imitative speech
Fluent Aphasia Types
          Transcortical Aphasia
           Very rare

           Word errors

           Severe naming
           Poor auditory
Nonfluent Aphasia Types
            Broca’s Aphasia
              Agramatical structures
              Word finding deficits
              Problems with imitation and
              Slow, labored speech
             Writing errors

              Articulation errors
Nonfluent Aphasia Types
            Transcortical Motor Aphasia
              Impaired conversational
              Good verbal repetition skills
              Good auditory
             Problems initiating speaking
               and writing
Nonfluent Aphasia Types
            Global (Mixed) Aphasia
              Most debilitating form
              Limited spontaneous
               expressive ability
              Severe deficits in auditory
             Severe deficits in visual
      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
Individual or group settings
Fundamental goal is to help the patient
  communicate successfully in everyday
Compensatory strategies
Role of the family
         Right Hemisphere
       Communication Deficits
  1. Affective processing
  2. Comprehension of indirect meaning
  3. Structuring of conversational and
     narrative discourse

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