Aphasia in Children

Brain Plasticity

Main Point

Anyone can be diagnosed with aphasia, but recent studies show a strong correlation between recovery of aphasia and age of onset. Acquired aphasia, speech disabilities that occur after the appearance of speech, accompanied with speech-language therapy is thought to have a more successful language outcome in children than adults because of the functional plasticity of the brain.

Aphasia

Aphasia is a disorder that results from damage to the parts of the brain that contain language. Aphasia causes problems with any or all of the following: speaking, listening, reading, and writing.


Broca's: non-fluent aphasia, you know what you want to say, but you have trouble saying or writing what you mean


Wernicke's: fluent aphasia, you hear the voice or see the print, but you can't make sense of the words

Global: non-fluent, you can't speak, understand speech, read, or write

Aphasia does not have any single specific impairment in language. Instead, it affects a family of disorders in four primary areas: spoken language expression, spoken language comprehension, written expression, and reading comprehension.


(American Speech-Language- Hearing Association [ASHA], 2014)

Brain Plasticity

>Brain plasticity refers to the way the brain is able to modify its own structure and function following changes within the body or external environment. It underlies the normal brain function such as our ability to learn and modify our behavior

>Brain plasticity is strongest in childhood, which explains the better prognosis for children with acquired aphasia. In childhood the brain has more strategies and more capacity to recover than the adult brain. Also during childhood, the brain has the ability to transfer language to either the right hemisphere, or to, uncommitted areas of the left hemisphere. This process is also known as intro-hemisphere or inter-hemisphere reorganization

>Pre-pubertal focal brain lesions would have a higher recovery rate than a post-pubertal focal brain lesion. This “critical period” was defined as the biologically determined time-window in which the brains plasticity was maximal.


(Frostig, 2014)

Intervention

Oral Reading for Language in Aphasia

> Can be delivered to a client with chronic non-fluent aphasia
> At first the client reading paragraphs or sentences aloud with the clinician and then the client is asked to repeat the same paragraph or sentence independently.
> Improves reading comprehension by providing practice in phonological and semantic reading routes
> Other improvements include improvement in oral expression, auditory comprehension, and written expression.


(Cherney, 2010)

Comparison

> Age 3;4 a young boy acquired aphasia and displayed severe expressive and receptive impairments
*3;10- decreasing production of one word utterances and increasing production of two word utterances
*5;6- sharp increase in MLU (1.7-->3.3)
*6;6- was able to produce morphologically complete simple sentences including both adverbial and adjectival expansions


(Kojima, Mimura, Auchi, & Kato, 2009)

>55-year old male acquired mild fluent aphasia and was studied over a 12-month period
*minimal change in the sentence-level grammar and showed a consistence significant impairment in story grammar


(Coelho, 2003)

Acquired Aphasia
(Cynthia, 2013)

Put it all together

Children with acquired aphasia show relative improvements in their language development when adequate treatment is paired with prompt rehabilitation treatment. Prompt rehabilitation treatment is a characteristic of the child’s immature and plastic brain that allows for intro-hemisphere and inter-hemisphere reorganizations of speech functions

Although there is not a single specific aspect of language that recovers from a child’s plastic brain there is an overall improvement in the child’s language abilities


(Stojmenovska & Filipova, 2004)

References

American-Speech-Language-Hearing Association. (2014). Aphasia. Clinical topics. Retreived from http://www.asha.org/Practice-Portal/Clinical-Topics/aphasia/

Cherney, L. (2010). Oral reading for language in aphasia (orla): Evaluating the efficacy of computer-delivered therapy in chronic nonfluent aphasia. Topics in Stroke Rehabilitation, 17(6), 423-431. doi:10.1310/tsr1706-423


Coelho, C. A. (2003). Longitudinal assessment of coherence in an adult with fluent aphasia: A follow-up study. Aphasiology, 17(2), 173. doi:10.1080/02687030244000590


Cynthia, M., (2013, March 20). Acquired Aphasia [Video File]. Retrieved from https://www.youtube.com/watch?v=lNCTApcX1iY


Frostig, R. (2014). What is brain plasticity, and can it help relive psychiatric or degenerative brain disorders? Society of neuroscience. Retrieved from http://www.brainfacts.org/about-neuroscience/ask-an-expert/articles/2012/what-is-brain-plasticity


Kojima, T., Mimura, M., Auchi, K., & Kato, M. (2009). Early recovery from acquired child aphasia and changes of cerebral blood flow. Journal of Neurolinguistics, 22(5), 451-464. doi:10.1016/j.jneuroling.2009.03.005


Stojmenovska, M., & Filipova, S. (2004). Review of a case of child with acquired aphasia. Journal of Special Education & Rehabilitation, (3/4), 97-102.