Helga Johannsen-Horbach

Nonverbal communication as a compensative strategy for severely nonfluent aphasics?—A quantitative approach ☆

Seven severely nonfluent aphasics and one relative or close friend were investigated in an interview situation. The conversation was videotaped and analyzed for the use of nonverbal communication between aphasic and partner. The results indicate that the group of aphasics used significantly more frequently and for a significantly longer period of time nonverbal channels of communication than their healthy partners. The aphasic patients also used significantly fewer speech-focused movements and significantly more codified gestures. Nonverbal elements were more frequently used as speech substitutes by the group of aphasics.

Treatment of chronic global aphasia with a nonverbal communication system

Four chronic global aphasics were treated with Blissymbols (C. K. Bliss, 1965, Semantography-Blissymbolics, Sydney: Semantography Pub.). As soon as possible the therapeutic communication was based solely on the use of the symbols. Three patients seemed to benefit from therapy. In one case therapy had to be discontinued because of massive perseveration. In one patient expression of needs relied solely on the use of the symbols. In another, expressive speech could be restored to such an extent that communication by the use of symbols was discontinued.

Communicative skills in chronic and severe nonfluent aphasia

A diagnostic tool was developed for the investigation of communicative skills in nonfluent aphasic patients suffering from moderate or severe language deficits. Communicative skills and neurolinguistic deficits were assessed in 20 patients suffering from Brocas or global aphasia. Comparative data analysis revealed remarkably low correlations between communicative and neurolinguistic deficits. In nonfluent aphasic patients with severe linguistic impairment communicative abilities and non- and paralinguistic compensatory efforts and skills accounted for their efficient performance.

Computers in aphasia therapy: Effects and side‐effects

We review published studies on the use of computers in aphasia therapy. Computer‐based treatment seems attractive, especially as it may allow for massed practice. We discuss possible side‐effects. Aphasia rehabilitation must aim at a reduction of handicap. At least one published study described an improvement in functional communication after treatment with a comprehensive programme that included both therapist‐delivered speech‐language therapy and home computer training. It cannot be decided to what extent functional communication‐orientation of the programme, computer use, intensity of treatment, or even other factors contributed to the positive effect, as no control group was included. A randomised controlled trial with adequate control groups and adequate, handicap‐oriented outcome measurements is warranted to evaluate the effectiveness of the computer component and its effect size.

Empathy and aphasia rehabilitation-are there contradictory requirements of treatment and psychological support?

Abstract In the target article of this ‘Clinical Forum’ Brumfitt rightly points out that aphasia should not be merely interpreted as a linguistic disorder but also as an illness that affects the premorbidly acquired identity and that confronts the aphasic patient with the task to develop a new concept of his/her self. She quotes a number of (not representative) self reports of patients, who had recovered from aphasia, and clinical observations to show that the language disorder results in ‘a major personal change in the life of the aphasic person and a major loss and adjustment problem’. This can hardly be disputed. More specifically, however, Brumfitt claims that the aphasic person has lost his/her previous self due to the effects of his/her illness and that he/she is further impaired to maintain and re-acquire the sense of self by an inabiGty to talk to himself/herself.

Psychosocial Aspects on the Treatment of Adult Aphasics and Their Families: A Group Approach in Germany

Chronic aphasia results in considerable psychosocial changes and stress, both for the affected person and his or her relatives and for those close to them (Artes & Hoops, 1976; Bowling, 1977; Herrmann & Wallesch, 1989; Kinsella & Duffy, 1978, 1979). According to Matsumoto, Whisnant, Kurland, and Okasaki, (1973), fewer than 10% of aphasic stroke patients are professionally reintegrated, in comparison to one third of all stroke victims. Early retirement leads to loss of income and social status as well as to a restriction of social contacts. These changes affect both patients and their relatives. Within the family, social roles change and family members—in most instances wives—are faced with problems and tasks that were previously the aphasic person’s responsibility (e.g., monetary matters). In addition, relatives encounter changes and impairments in the patient’s mental and social capacities: Lack of endurance, concentration, and spontaneity; aggressiveness; resignation; irritability; cognitive impairment; depression; and sometimes confusion (for details, see Herrmann & Wallesch, 1989).