Diagnosis of aphasia is based on the results of neurological, neurolinguistic, and neuropsychological assessment. A series of tests for language and other cognitive abilities are administered to determine aspects of language that are impaired. In addition, in depth testing reveals patterns of impairment within language domain. In the domain of word production, for example, some classes of words may be more impaired than others (i.e., objects may be less impaired than actions or vice versa). Further, within the impaired word class, the problem may relate to disruptions in accessing the correct word from the lexicon and/or disruptions in accessing the correct sounds (or phonemes) to produce the word. In the former case, the word “dog” might be produced, when the intended word is “cat”; in the latter case, the word “tat” may be produced for “cat”. An extensive evaluation determining these patterns is important for treatment planning, since different treatments are prescribed based on deficit patterns.
People with aphasia show improved language ability when provided with treatment. Aphasia therapy aims to restore language abilities as much as possible by providing treatment focused on specific language impairments. The most beneficial therapy focuses on the aspect(s) of language that are impaired as well as their source. Using the example above pertaining to errors in production of the word “cat”, treatment for word production deficits of the two types differs. Compensatory strategies also are provided to help people communicate.
The Life Participation Approach to treatment also helps people with aphasia to obtain short term and long term communication goals, focusing on reengagement in life. Both individual and group therapy are helpful. Individual therapy focuses on improving specific language abilities as well as how to use those skills (and/or compensatory strategies) to communicate. Group therapy provides opportunity to use new communication skills in a small-group setting.
Neural Mechanism of Language Recovery
When language recovers, so too does the brain. Until recently, it was thought that recovery of language occurs within the first few months or year following the onset of aphasia and that beyond that little recovery can be expected. However, it is now a known fact that this is NOT true. Recent research findings show that language and brain function improve for many years following the onset of aphasia. The brain has the capacity to change throughout the life span, even after brain injury.
Importantly, treatment boosts recovery of the brain and language. A large body of research shows that there are strong effects of training on organization and reorganization of brain function. When people with aphasia are provided with treatment focused on the specific language processes that are impaired, neural repair is enhanced.