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MANAGEMENT OF APHASIA

How is Aphasia treated?

Aphasia therapy aims to improve a person's ability to communicate by helping him or her to use remaining language abilities, restore language abilities as much as possible, and learn other ways of communicating, such as gestures, pictures, or use of electronic devices. Recent technologies have provided new tools for people with aphasia. "Virtual" speech pathologists provide patients with the flexibility and convenience of getting therapy in their homes through a computer. The use of speech-generating applications on mobile devices like tablets can also provide an alternative way to communicate for people who have difficulty using spoken language.



Aphasia Management


Auditory Stimulation

Sensory stimulation affects brain activity, e.g. sensory input alters the electrical activity of the brain. Increasing stimulus strength increases the frequency of firing of neurons and the number of fibres activated, thus the threshold of responses can be altered by repetitive stimulation. Thus at the neurophysiological level stimulation can and does influence brain structures and functions


Thematic Language Stimulation (TLS)

TLS is an organised program of aphasia therapy that uses thematically related vocabulary in multi – modality stimulation to improve language processing and functional communication in adults. Specifically it begins with the selected group of words related in meaning, places them in a particular linguistic context, uses them in tasks that employ both input and output modes and targets improvements of underlying language processes to impart conversational success.


Cueing

Aphasia Management

One of the common techniques used with aphasics who presents word retrieval deficits. Cues can be broadly divided into two categories.

Semantic cues: These cues activate an area in the field of information about the object in semantic memory (e.g. it’s a fruit).

Lexical/phonemic cues: These cues point to the word itself in the mental lexicon. (e.g. it starts with /p/).


Social rehabilitation

The Social Rehabilitation sector covers a wide range of programme activities and approaches. After a period of rehabilitation, most people return to their home where they are confronted with a social and physical environment, unadjusted to the consequences of aphasia. Mostly they do not succeed in picking up their life as before the stroke. People with aphasia experience a changed social participation. Few of behaviours of aphasic patients which include social isolation, loss of confidence, decreased roles, and limited communication opportunities, restricted activities and role changes and stigmatization.


Goals within social rehabilitation

  • Enhancing communication.

  • Increasing participation in events.

  • Providing support systems.

  • Increasing confidence and positive identity.

  • Promoting self advocacy.


Conversation therapy.

The goal of having a conversation is to exchange information and fulfill social needs; it improves one’s skill and confidence as a conversational participant. Improving skill in activities such as arguing, joke telling, storytelling, and gossiping might be addressed, along with usual speech act repertoire.


Compensatory Strategy Training

Improving natural interactions often requires use of compensatory strategies. Here, compensatory strategies would be designed to enhance message transmission across a variety of situations. The compensatory strategies which could be used are gesture, writing, asking for repetition and use of augmentative aids.


Conversational Coaching

Communicative scenarios/scenes with the guidance of the Speech-Language

Pathologist.

  • Identifying a goal or scenario to target in therapy

  • Planning what is needed,

  • Developing a script and resources,

  • Practicing with coaching as needed,

  • Performing the scenario, and

  • Evaluating the outcome.


Group Therapy

The key here is the interaction rather than practicing naming and sentence formulation. Group therapy helps in facilitating participation, equalizing control and promoting confidence.


Partner training

Training speaking partners actually improves the communication of the person with aphasia. Make the partner to learn concrete strategies to support communication when aphasia interferes. Make the partner to learn the augmentative tools which encourages the aphasic partner to use such modes. Increasing participation in events. Relevant life activities should be accessible and successful. Activities like hobbies, interests, functional tasks, volunteer jobs, or employment in which the client would like to participate.


Vocational rehabilitation

The presence of aphasia has often been considered a negative factor for brain injured patients who wished to return to work. The following problems were found to be present in aphasics who returned to work:

  • Fatigue

  • Short attention span

  • Poor memory (frequent lapses, everything must be written down)

  • Slowness of mental operations and in the performance of routine tasks.

  • Oral communication difficulties.

  • Intrinsic skills

  • Extrinsic skills

  • Motivation

  • Social adaptation


Aphasia Clubs


Aphasia Management

Aphasia therapy strives to improve an individual’s ability to communicate by helping the person to use remaining abilities, to restore language abilities as much as possible, to compensate for language problems, and to learn other methods of communicating. Treatment may be offered in individual or group settings. Stroke clubs, which are regional support groups, formed by individuals who have had a stroke, are available in most major cities. These clubs also offer the opportunity for individuals with aphasia to try new communication skills. In addition, stroke clubs can help the individual and his or her family adjust to the life changes that accompany stroke and aphasia. Family involvement is often a crucial component of aphasia treatment so that family members can learn the best way to communicate with their loved one.


Family members can help Aphasia Patients in the following ways:

  • Simplify language by using short, uncomplicated sentences.

  • Repeat the content words or write down key words to clarify meaning as needed.

  • Maintain a natural conversational manner appropriate for an adult.

  • Minimize distractions, such as a blaring radio, whenever possible.

  • Include the person with aphasia in conversations.

  • Ask for and value the opinion of the person with aphasia, especially regarding family

  • matters.

  • Encourage any type of communication, whether it is speech, gesture, pointing, or

  • drawing.

  • Avoid correcting the individual’s speech.

  • Allow the individual plenty of time to talk.

  • Help the individual to become involved outside the home. Seek out support groups such

  • as stroke clubs.

These groups aim to provide a therapeutic environment that promotes successful living with aphasia, create opportunities for social connection, break down barriers to communication, advocate through research and education initiatives foster hope.

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