Assessment and treatment of linguistic deficits in aphasic patients

Aphasia is a language disturbance caused by brain damage, usually a stroke. Aphasia has a large impact on a patient’s life, often turning everyday communicative situations into a struggle to understand and be understood. Improvement of these patients’ communicative ability in daily life is the main goal of aphasia therapy. The verbal communicative ability of aphasic patients may be disturbed by semantic (word meaning), phonological (word form) and/or syntactic (grammatical structure) deficits. Cognitive linguistic treatment aims to improve processing at the affected linguistic level, implicitly assuming that training of basic language skills will result in improved verbal communication. In this thesis, the relative impact of semantic and phonological deficits on verbal communication is explored. Furthermore, the results of both diagnostic and therapeutic studies in patients with aphasia after stroke are presented

Recovery of linguistic deficits in stroke patients: a three-year-follow-up study

In a three-year-follow-up study aphasic patients (n=17) received the ScreeLing, a screeningstest for semantic, phonological and syntactic processing, the Token Test and an interview at 2-4 days, 9-12 days, 2 months, 3 months, 6 months and 3 years post onset. The greatest improvement on all measures occurred between 9-12 days and 2 months post onset. The severity at 2 months post onset was decisive for the final outcome at 3 years p.o

Linguistic deficits in the acute phase of stroke

Background and Purpose: For the diagnosis of aphasia early after stroke, several screening tests are available to support clinical judgment. None of these tests enables the clinician to assess the underlying linguistic deficits, i. e. semantic, phonological and syntactic deficits, which provides indispensable information for early therapeutic decisions. The ScreeLing was designed as a screening test to detect semantic, phonological and syntactic deficits. The ScreeLing's sensitivity, specificity and accuracy in detecting aphasia and semantic, phonological and syntactic deficits were determined. Methods: The ScreeLing was validated in an acute stroke population against a combined reference diagnosis of aphasia (aphasia according to at least two of the following measures: neurologist's judgment, linguist's judgment, Tokentestscore). The three ScreeLing subtests were validated in the aphasic population against the presence or absence of a semantic, phonological and/or syntactic deficit according to an experienced clinical linguist. Results: From a consecutive series of 215 stroke patients, 63 patients were included. The ScreeLing was an accurate test for the detection of aphasia (0.92), with a sensitivity of 86% and specificity of 96%. Sensitivity of subtests was 62% for semantics, 54% for phonology and 42% for syntax. Specificity was 100% for semantics and phonology and 80% for syntax, and accuracy 0.84 for semantics, 0.87 for phonology and 0.64 for syntax. Conclusions: The ScreeLing is an accurate test that can be easily administered and scored to detect aphasia in the first weeks after stroke. Furthermore, the ScreeLing is suitable for revealing underlying linguistic deficits, especially semantic and phonological deficits