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Aphasia treatment is an extremely important aspect of life after a stroke which has affected
someone's ability to speak. In general terms, aphasia is a disturbance in the production,
processing, or understanding of language due to brain damage, most commonly from stroke.
Although multiple forms of treatment exist for the different types of aphasia, only a few of them
have been studied rigorously enough to have proven efficacy. As a result, most forms of aphasia
treatment are based on theoretical grounds which await further testing to prove their benefits.
However, based on their experience with patients, most speech pathologists and physicians attest
to the benefits of aphasia therapy.
General Principles
Several principles of therapy have been shown in small studies to improve the outcome of
therapy.
Regardless of the type of therapy used, the outcome is better if the intensity of therapy is
increased. In other words, a given number of hours of therapy will yield a much better
outcome if they are given in a few sessions over a few days rather than in many sessions
over many days.
The effectiveness of aphasia therapy increases when therapists use multiple forms of
sensory stimuli. For instance, auditory stimuli in the form of music, and visual stimuli in
the form of pictures, drawings, are routinely used during aphasia therapy sessions.
Gradual increases in the difficulty of language exercises practiced during a given therapy
session improves the outcome.
Programmed Simulation:
This type of therapy uses multiple sensory modalities, including pictures and music, introduced
in a gradual progression from easy to difficult.
Stimulation-Fascilitation Therapy:
This form of aphasia therapy focuses mostly on the semantic and syntactic parts of language. The
main stimulus used during therapy sessions is auditory stimulation. One of the main assumptions
of this type of therapy is that improvements in language skills are best accomplished with
repetition.
Group Therapy:
This type of therapy provides a social context for patients to practice the communication skills
they have learned during individual therapy sessions, while getting important feedback from
therapists and other aphasics. Family treatment strategies have a similar effect, while also
facilitating the communications of aphasics with their loved ones.
Pharmacotherapy:
This is one of the most appealing forms of aphasia therapy although its efficacy has yet to be
proven. The list of medications tried so far include piracetam, bifenalade, piribedil,
bromocriptine, idebenone and dextran 40, donezepil, amphetamines and several antidepressants.
Although the evidence is not very strong, it appears that at least donezepil, piribedil and
amphetamines might have some degree of efficacy in aphasia treatment. The latter appears to be
especially helpful at enhancing the benefits of traditional non-medication based therapy, as some
studies have shown a better outcome of therapy when patients are given amphetamines before
therapy sessions.