Cases reported "Aphasia"

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1/38. A comparison of the codeswitching patterns of aphasic and neurologically normal bilingual speakers of English and Spanish.

    Conversational discourse samples were obtained from four aphasic and four neurologically normal Hispanic bilinguals in monolingual English, monolingual Spanish, and bilingual contexts to identify codeswitching patterns. Analysis of the samples based on the Matrix language Frame (MLF) Model (Myers-Scotton, 1993a) revealed consistent matching of the language context by the aphasic and normal subjects. The aphasic subjects demonstrated a greater frequency of MLF constituents and codeswitching patterns not evident in the speech samples of the normal subjects. Results suggest an increased dependence on both languages for communication following neurological impairment.
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2/38. Spared comprehension of emotional prosody in a patient with global aphasia.

    BACKGROUND: Several studies have demonstrated that patients with right hemisphere damage, when compared with left-hemisphere damaged controls, are impaired at comprehending emotional prosody. Critics of these studies, however, note that selection may have been biased because left-hemisphere-damaged subjects had good verbal comprehension. OBJECTIVE: To learn whether a subject with a large left hemisphere stroke and global aphasia could comprehend emotional prosody in spoken material. METHOD: The authors formally tested speech and language with the Western aphasia Battery and comprehension of emotional prosody and emotional facial expression with the florida affect Battery. RESULTS: The patient could not perform verbally mediated tests but demonstrated spared ability to match emotional prosody to emotional facial expressions under a variety of conditions. CONCLUSIONS: These observations further support the idea that verbal and emotional communication systems are independent and mediated by different hemispheres.
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3/38. Written communication in undifferentiated jargon aphasia: a therapy study.

    A subject, R.M.M., with a 2-year history of jargon aphasia is described. At the beginning of this study she had minimal meaningful spoken output and showed little awareness of her speech despite having relatively well-preserved auditory comprehension. Her spoken output had proved resistant to earlier periods of therapy. In contrast, R.M.M.'s written output showed some ability to access orthographic information and monitoring of this modality was shown by an acute awareness of her errors. A 3-stage therapy programme is described. This was designed to improve R.M.M.'s writing of single words and to encourage use of writing as an alternative means of communication. The initial stage of therapy aimed to increase R.M.M.'s access to written word forms by use of picture stimuli. She showed significant improvement in writing treated items in response to pictures both immediately after therapy and at re-assessment 6 weeks later. Despite the acquisition of these skills, R.M.M. failed to use them in communicative contexts. A second stage of therapy replicated the results of the first and sought to facilitate R.M.M.'s functional use of her written vocabulary by asking her to write words to spoken questions. She again showed improved written naming of the treated items and could now produce written names appropriately in a questionnaire-type assessment. Generalization of this ability extended to items that had not been trained in this way. Functional use of writing in everyday communication remained absent, however. The final stage of therapy made explicit the potential links between items which R.M.M. could now write and functional messages which they might convey. She again showed significant changes in the acquisition of new vocabulary and, encouragingly, progress was also seen in her use of the strategy in functional communication. R.M.M.'s speech is almost entirely incomprehensible. It has remained unchanged for 2 years and has not responded to therapy. Relatively well-preserved auditory comprehension and good monitoring of written output allowed therapy to effectively target a small written vocabulary. Despite significant progress in the acquisition of new items, transfer of this skill to functional communication was initially absent. Further therapy which specifically targeted the impairment causing this failure was needed before functional use was seen. The potential for treating written output in cases of jargon aphasia which have been resistant to therapy for spoken language is discussed.
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4/38. Technological applications in the treatment of acquired neurogenic communication and swallowing disorders in adults.

    Clinicians can use the computer as an effective clinical tool by incorporating what is known about neurogenic communications disorders, treatment, and technology. computers can be used to administer activities designed by clinicians, vary stimulus characteristics, adjust response requirements, present cues, and select tasks, all in response to patient performance. Specialized devices can be used to measure small physiologic changes, help patients communicate with and control their environment, and allow clinicians to view closely what we could only imagine only a few years ago. Users of technology must focus not only on effectiveness and operational efficiency, but also ensure an optimal quality of treatment. This article reviews many of the ways technology is used in the treatment of people suffering from neurogenic communication and swallowing problems.
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keywords = communication
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5/38. Selective impairment of verb processing associated with pathological changes in Brodmann areas 44 and 45 in the motor neurone disease-dementia-aphasia syndrome.

    We report six patients with clinically diagnosed and electrophysiologically confirmed motor neurone disease (MND), in whom communication problems were an early and dominant feature. All patients developed a progressive non-fluent aphasia culminating in some cases in complete mutism. In five cases, formal testing revealed deficits in syntactic comprehension. comprehension and production of verbs were consistently more affected those that of nouns and this effect remained stable upon subsequent testing, despite overall deterioration. The classical signs of MND, including wasting, fasciculations and severe bulbar symptoms, occurred over the following 6-12 months. The behavioural symptoms ranged from mild anosognosia to personality change implicating frontal-lobe dementia. In three cases, post-mortem examination has confirmed the clinical diagnosis of MND-dementia. In addition to the typical involvement of motor and premotor cortex, particularly pronounced pathological changes were observed in the Brodmann areas 44 (Broca's area) and 45. The finding of a selective impairment of verb/action processing in association with the dementia/aphasia syndrome of MND suggests that the neural substrate underlying verb representation is strongly connected to anterior cortical motor systems.
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6/38. Direct and indirect therapy for word sound deafness.

    This paper evaluates two therapy programmes conducted with PK, an aphasic individual with word sound deafness. The first aimed directly to improve discrimination skills, using minimal pair tasks supported with lip reading. Disappointingly, there were no changes on discrimination tests after this therapy, even when PK could benefit from lip reading information. The second, indirect, programme of therapy aimed to change the communication behaviours of PK's wife. Strategies such as writing and simplifying information were modelled and practiced. A detailed information booklet, outlining the target strategies and explaining PK's main strengths and weaknesses supported the programme. Evaluation of this therapy involved pre- and post-therapy analysis of interactions between PK and his wife, with biographical questions forming the basis of the interactions. There were several changes after therapy on this measure. The number and length of communication breakdowns were reduced, and more questions were answered accurately. This study suggests that, in some cases of severe word sound deafness, indirect therapies may be most effective.
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ranking = 2
keywords = communication
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7/38. 'Insuring' a correct differential diagnosis--a 'forensic' collaborative experience.

    Mr. J was referred to a speech and language therapist (SLT) by a consultant psychiatrist. He had sustained an industrial accident which he claimed was responsible for a range of problems which included a speech and language problem. Some three years after his accident, he brought an action for damages arising out of the accident. His solicitor, on the recommendation of the consultant psychiatrist, contacted the SLT requesting his views as to whether Mr. J's speech difficulties were due to the injuries sustained and requesting recommendations for further treatment. The SLT saw Mr. J and concluded that he had problems at all communication levels, the greatest being an articulatory impairment. Some reports suggested a psychological basis for his problems and others, including the psychiatrists', suggested an organic basis.
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keywords = communication
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8/38. Intonation in partner accommodation for aphasia: a descriptive single case study.

    Previous research has suggested that speaking partners adjust their intonation when conversing with people who are ill or elderly. In the descriptive case study presented in this paper we ask, what adjustments in intonation might be made by the communication partner of an aphasic speaker? A sociolinguistic, semantic analysis of intonation was used to describe the intonation pattern used by the neighbor of an aphasic speaker, during a 15-min natural interaction with the aphasic speaker, his wife, and the first author. The neighbor was found to make more use of two dimensions of intonation that reflected differences in her relationship to the information conveyed, when addressing the aphasic speaker in contrast to when addressing his wife. Firstly, she made proportionally more use of pitch movements associated with referring to shared information, and secondly, she made more use of marked tones (rising-falling, and rising tones). We discuss whether the observed differences may represent an accommodation to speaking to a person with aphasia. learning Outcomes: The reader will be able: (1) to recognize the role of intonation in discourse as a resource for the exchange of interpersonal meaning, and (2) to identify when speakers are using intonation as part of their speech accommodation for aphasia.
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9/38. Narrative and procedural discourse production by severely aphasic patients.

    Five cbronically aphasic subjects were trained on a computerized iconographic communication system (C-VIC). Their performance in producing single sentences scripts. and narratives was assessed using both spoken English and C-VIC. The requisite vocabulary necessary and the narrative complexity of the target productions were controlled. Subject performance using C-VIC indicates that the ability to construct discourse at the macrostructural level is largely intact. Despite significant improvements in spoken production after C-VIC training, especially at the single sentence level, the subjects' spoken discourse remains severely impaired by their failures at the microlinguistic level. These results point to the limits of currently available approaches to the remediation of aphasia and suggest avenues for future research.
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keywords = communication
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10/38. writing with voice: an investigation of the use of a voice recognition system as a writing aid for a man with aphasia.

    BACKGROUND: People with aphasia may experience difficulties that prevent them from demonstrating in writing what they know and can produce orally. voice recognition systems that allow the user to speak into a microphone and see their words appear on a computer screen have the potential to assist written communication. AIM: This study investigated whether a man with fluent aphasia could learn to use Dragon NaturallySpeaking to write. methods & PROCEDURES: A single case study of a man with acquired writing difficulties is reported. A detailed account is provided of the stages involved in teaching him to use the software. The therapy tasks carried out to develop his functional use of the system are then described. Outcomes included the percentage of words accurately recognized by the system over time, the quantitative and qualitative changes in written texts produced with and without the use of the speech-recognition system, and the functional benefits the man described. OUTCOMES & RESULTS: The treatment programme was successful and resulted in a marked improvement in the subject's written work. It also had effects in the functional life domain as the subject could use writing for communication purposes. Conclusions: The results suggest that the technology might benefit others with acquired writing difficulties.
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ranking = 2
keywords = communication
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