الفهرس 
coverOnly 14 pages are availabe for public view
 |  | from | 141 |  |  |
| | | from | 141 | | |
Abstract
’’Aphasia’’ is an acquired language disorder in which there is an impairment of any language modality, it is not the result of a sensory or motor deficit, a general intellectual deficit, confusion or a psychiatric disorder. It usually occurs as the result of a stroke or head injury, but it may also caused by a brain tumor, an infection, degenerative conditions, exposure to neurotoxic agents or dementia. The disorder impairs the expression and understanding of language as well as reading and writing. Aphasia can be divided into three categories: fluent, non-fluent and pure aphasias. Fluent aphasias are impairments related mostly to the input or reception of language, Nonfluent aphasias are difficulties in articulation, and Pure aphasias are selective impairments in reading, writing, or the recognition of words (Chapey, 2008).
Aphasia related disorders:
It is common for patients with aphasia to present with a variety of impairments that may directly or indirectly affect their functional communicative abilities. Specifically, motoric deficits may impair the speed and accuracy of patientُ s motor speech, gestural, and graphomotor abilities (Chapey, 2008).
The common forms of apraxia that may co-occur with aphasia and may negatively impact a patient`s communication abilities are: apraxia of speech (AOS) and oral apraxia. Apraxia generally refers to impairment in the capacity to position muscles and to plan and sequence muscle movements for volitional purposes (chaepy, 2008).
A focal lesion in the language dominant hemisphere that results in aphasia may also result in neuromotor speech disorders. The neuromotor speech disorder most likely to be associated with such a lesion is dysarthria. Dysarthria is any combination of disorders of respiration, phonation, resonation, articulation and prosody (Wanda & Richard, 2008).
Dysphagia and swallowing difficulty are highly prevalent among acute stroke patients. It places the patient (with acute stroke) at risk for poor nutrition and hydration and for complications such as aspiration related pneumonia (Finestone et al., 2001).
Occasionally, patients with aphasia, particularly those who have suffered bilateral brain damage, may present with auditory or visual agnosia (Chapey, 2008). Brain (1961) has indicated that auditory agnosia (one of the auditory processing problems) occurs when a patient whose hearing is unimpaired fails to recognize or identify the sounds that had been heared. Visual agnosia (one of the visual processing problems) refers to impairment in the recognition of visual stimuli despite adequate visual sensitivity (Farah, 2004).
Theraputic approaches for the treatment of aphasia related disorders:
Treatment for apraxia of speech: The AOS treatment Guidelines Committee reported that existing AOS treatment is one of the following approaches: (1) articulatory-kinematic treatments, (2) rate/rhythm control treatments, (3) intersystemic facilitation/reorganization treatments, and (4) alternative augmentative communication (AAC) approaches (Wambaugh et al., 2006a).
Treatment for oral apraxia: Chapey (1994) mentioned that oral apraxia treatment may be achieved by these techniques: Laryngeal activity techniques, Speech activity technique, and Tongue activity techniques.
Treatment for dysarthria: Darley et al. (1975) suggests general fundamental principles that underlie therapy for the motor speech disorders, in addition ; Modification of articulation, Modification of phonation, Modification of resonance, Modification of respiration, Modification of prosody (Hegde, 2008).
Treatment for dysphagia should be based on results of the comprehensive assessment. The major techniques used by speech language pathologist (SLP) for swallowing therapy are (1) compensatory techniques (postural tech.), (2) swallowing maneuvers, (3) diet modification, (4) motor exercises, (5) sensory and facilitation techniques, (6) biofeedback, and (7) surgical intervention (Murphy and Gilber, 2009).
Treatment for auditory processing: treatment has been divided into two major categories: (1) Auditory Perceptual Processing deficits; (2) Auditory comprehension deficits (chapey, 2008).
Treatment for visual processing: treatment can be divided into visual perception and reading comprehension, so treatment is subdivided into six areas. Three of these areas fall under the category of visual perception, Two areas for treatment of visual comprehension and the final area for treatment of reading comprehension activities (Wang & Goodglass, 1992).
Prognosis in therapy: Some of the prognostic indicators include: biographical variables such as age, gender, education, premorbid intelligence, personal and family attitude and level and type of life participation (Basso, 1992), Medical variables such as etiology and duration of aphasia, site and extent of brain lesion and concomitant physical and mental-health problems (Brookshire, 2003), Language and cognitive variables (Robey, 1998 and Davis, 2000).