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[Dysphagia] Aphasia therapy
Congratulations and sincere thanks to anyone who attempts to improve the lot
of patients with aphasia who are a woefully underserved population. A
special congrats to those therapists who help to refute the idea presented
by "tradition wisdom" (too often an oxymoron phrase :) ) that limits
recovery potential after a stroke. Some of the concepts and ideas presented
in this and related articles are most welcome. The concept of mass practice
is of course an excellent idea as long as the practice activities are smart.
The mental processes used in human communication are infinitely more complex
than those used for limb movement and the best definition for aphasia I have
ever seen is that "Aphasia is different for everybody." Accordingly, the
approach and philosophy needs to reflect this fact. Working on many
different mental processes that subserve human communication is essential
(e.g., attention, verbal working memory, anchoring, mental resource
allocation.)
The 'conventional language treatment' group in this study received what many
believe to be not smart treatment activities (naming, repetition, closure,
following commands). These do not encourage the use of neural pathways used
for propositional speech but instead their massed practice uses imitative
type pathways - not a good idea given propensity toward perseveration. We
no longer believe that because a patient imitates a name or counts in
sequence that this will ever lead to propositional speech and indeed as Dr.
Small discussed, may well be detrimental and/or harmful. So of course the
control group would not improve even with massed practice.
It is our opinion that treatment schedule optimization is not a matter of
blocked, massed, intense or spread out scheduling but is a matter of
applying innovative techniques that prove to be effective for the individual
utilizing pathways normally used for adult, propositional language in any
modality, sometimes focusing on one but quickly incorporating any/all as per
normal human communication.
Bill Connors
The Aphasia Center of Innovative Treatment
724.494.2534
www.aphasiatoolbox.com
-----Original Message-----
From: dysphagia-bounces at b9.com [mailto:dysphagia-bounces at b9.com] On Behalf
Of Irene Campbell-Taylor
Sent: Sunday, February 11, 2007 9:02 AM
To: dysphagia at b9.com
Subject: [Dysphagia] Aphasia therapy
Many thanks to Pam. This is an associated full article:
http://stroke.ahajournals.org/cgi/content/full/36/7/1462
Long-Term Stability of Improved Language Functions in Chronic Aphasia
After Constraint-Induced Aphasia Therapy
Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com
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