Generally speaking, there are two major approaches to the treatment of understanding inaphasia:
- A treatment based on type of aphasia
- A treatment based on level of impairment
As for the first type of treatment, we know that there are specific protocols. For example, with regard to global aphasia, Marshall (1986) created a series of four stages to achieve an adequate response:
- Request any response (even non-verbal)
- Encourage a differentiated response
- Request an appropriate response
- Request an accurate answer
For Wernicke's aphasia, there are specific protocols such as TWA (Helm-Estabrooks and colleagues). In general, the treatments of posterior aphasias, which have a higher degree of impairment, are based on the recognition of verbal stimuli, on the understanding of isolated words, on the reduction of perseverations and on self-monitoring.
In the case ofBroca's aphasiainstead, the treatment of understanding often takes a back seat. However, it is always necessary to investigate comprehension skills with, for example, non-canonical and revisable sentences.
Level-based treatments try to break understanding into its components (from auditory input to speech understanding) to investigate level of impairment. Some activities, depending on the level involved, can be:
- Discrimination of syllables and words
- Phoneme-grapheme, word-image, word-word, semantically linked image-image, word-definition association
- Pure semantic treatments (for example, the Semantic Feature Analysis)
- Judgments of synonymy
- Yes / no questions and with distractors.
Regardless of the specific case, it is important to keep in mind that:
- Understanding disorder manifests itself immediately in the acute phase and in many cases tends to reduce spontaneously, even considerably, in the first months
- It is often associated with anosognosia (unawareness of the disorder)
- It can be associated with attention disorders
- You can choose to work based on the type of aphasia or the level of impairment
- There are two keywords: repetition and self-monitoring
Aphasia has not only an emotional but also an economic cost for the patient and his family. Some people, for economic reasons, limit their rehabilitation possibilities, despite the evidence supporting the need for intensive and constant work. For this reason, since September 2020, all our apps can be used for free online in GameCenter Aphasia and our activity sheets are all available here: https://www.trainingcognitivo.it/le-nostre-schede-in-pdf-gratuite/