Introduction
Aphasia is a communication disorder which occur in the brain, blocking their language function such as reading, writing, speaking and understanding conversation. The combination of each level of disorders is called as Aphasia, it is likely to have extra hardship, for instance cognitive disorder. ( American Speech-Language-Hearing Association)
The cause is the damage in the area which controls language in the brain. In most cases, the damage is because of stroke(WebMD). The same website explained that aphasia does not impede the intelligence of the patients, as well as that it is first diagnosed by the doctor when treating stroke or brain damage, by neurological tests or asking the patients to do something which needs to understand to attain.
Ghaydaa, Taha, Al Sayed and Huda (2015) proved that Aphasia affect their personality with significantly higher score of depression and anxiety on people with Aphasia than without Aphasia after stroke.
It has a few different types, one of them is Broca Aphasia, that is non-fluent aphasia making people hard to speak although they can understand what other people talk to them, with degree depending on their severity. (The Internet Stroke Center. 2016) It is also noted in the website, in most cases, individuals with aphasia damaging the left of the brain, and right side of paralysis as it is controlled by left hemisphere. There are other kinds of aphasia, Wernicke aphasia, they can talk fluently but they have difficulty in understanding, because of this they are not aware that they do not comprehend what they speak and what others talk to them, and there is also global aphasia, which is the most serious case having all the difficulty. (The Internet Stroke Center. 2016)
In this project, severe Broca aphasia caused by stroke in chronic stage will be examined since as this secondary research is progressed, it has been revealed that this is difficult to make better.
The effectiveness of therapies does not only depend on the methods, but also on how intensively
It is introduced in G. Albyn’s paper that there are largely two groups of therapy, Impairment-based therapies and Communication-based therapies. The former sets the goal for improving their language function itself by training the area of the brain, proceeding step by step with usually with clinician and the latter focuses on making them communicate efficiently utilizing any strategies, this is also designed to have help from caregivers more easily. (G. Albyn (2011), American Speech-Language-Hearing Association and WebMD 2016)
General information about therapy and samothing like intensity wil be written heredee43w3
Melodic intonation therapy
MIT (Melodic Intonation Therapy) is treatment which makes use of music. Specialists have said that singing, applying melody and rhythm to words, can helps Aphasia patients to pronounce the words which they cannot do itself (Norton, Zipse, Marchina & Schlaug, 2009, and Ineke Van Der Meulen et al, 2016). MIT is widely regarded as treatment for non-fluent aphasia with a serious level which relatively has less information of way of recovery (Norton, Zipse, Marchina & Schlaug, 2009) and (Ineke Van Der Meulen et al, 2016). The former authors wrote in their paper that therapy stimulates the brain area in the right hemisphere having no injury, and also involving speaking ability. It is also explained in the paper that original method was outlined to start from elemental level which is only words or a few phrases, and gradually moving on to more difficult ones as they practice more, such as sentence often used in daily talk. These words are sung on only 2 pitches, with stressed sound to be higher and unstressed sound to be lower which is shown in the picture below, moreover the therapist taps the patient’s hand taking rhythm while they are humming so that it stimulates right hemisphere which has no damage and can work for left as well, and patients can build the image they are saying. Alternatively, some linguists administer 7-8 pitches on the words, for example, whilst accompanying with the piano.
The important point regarding this treatment is how therapists reduce the assistance to speak the word on the tone, as well as this point, this method requires further research in order to keep the improvement having made in the patients over a long period after stopping it because of the lack of durability of the effect. (Norton, Zipse, Marchina & Schlaug, 2009). The difficulty of lasting effectiveness was echoed by Ineke Van Der Meulen et al in 2016, based on their experiment comparing the effect in subacute aphasia and chronic aphasia, resulting that chronic aphasia showed only a short of effectiveness unlike subacute aphasia, whereas in both cases was observed that there were an increase in their ability relative to language, using. Although this therapy was originally planned for aphasia being affected by left hemisphere stroke since in many cases stroke inducing aphasia attacks the left hemisphere, an experiment was done to investigate how sufficiently MIT work on global Aphasia originating in right hemisphere stroke. (K. Leigh, Ashley, 2016). As a result, the treatment supported the patients as they acquired improved skill to express themselves in the right situation, therefore the authors concluded there is high possibility that it benefits people with right hemisphere stroke.
Computer-based therapy
Treatment which uses computer is so-called computer-based therapy. Therefore, it is difficult to define an established specific way. Palmer R et al, 2012, conducted a research which the patients of chronic aphasia were helped by volunteers who have already trained how to use the computer program(StepbyStep) which is a Home software and how to assist help them to be able to rehabilitate by themselves. This point was reiterated by Abi, Jane, and Stephanie, in 2016. It was reported the advantage that in addition to their 19% of positive change in word-finding ability, it is cost-efficient as there is less intervention making it expensive than other ways of treatment and they can do it on their own after the volunteer’s support, whereas the disadvantage is the improvement is small if the patients do not try hard as the frequency inevitably depends on them although it is also instructed as the plan, what is more, the desired result was rarely seen in further severe level of aphasia. (Palmer R et al, 2012). It seems the necessity of using computer also keep away people with most serious aphasia having cognitive problem from this treatment. Aphasia treatment does not only cover their functional disability, but also aim to obtain the better quality of life. (G. Albyn, 2011). In other words, there is the other way to approach to improvement on their communication skill. An example provided as another computer-based therapy whose goal is letting the patients interact with people by means of specifically gesture. (Abi, Jane, and Stephanie, 2016). It seems the necessity of using computer also keep away people with most serious aphasia having cognitive problem from this treatment with computers. However, according to Abi, Jane, and Stephanie (2016), participants having severe aphasia with comprehension and cognitive problems still completed the treatment introducing another computer tool, GeST, and they discovered improvement of using gesture. So this also suggest that it is possible for severe aphasia patient who has cognitive impairment to use computer tool.
Constraint-induced therapy
Stroke cause physical impairment to one side of their body as well. It is referred to by Aviva, this constraint-induced therapy stem from the treatment for this physical disability. She mentioned when applying to the physical movement, patients have to wear tools to restrict their hand or leg on the side which they can move without any hardship so that they cannot use their comfortable parts to move, consequently, this stops the damaged area of the brain get worse because of the loss of opportunities to work. In therapy for aphasia, they are not allowed to use other ways of communication such as gesture or writing. (Aviva). Friedemann Pulvermüller et al (2001) compared it with conventional treatment which means including naming, repetition, sentence completion, but does not focus on communication.
Communication-cased therapy has a wide range as半端
代替機能
In an article by Yusuke (2009), it was proved, by having an experiment on mice considering ethical issues,