Treatment of Writing in Aphasia
Treatment of Writing in Aphasia
When an individual has aphasia, verbal output is often no longer sufficient for communication. Because of this, other modalities of communication are often explored. "Speech" therapy for aphasic patients often does not include speech activities at all, but rather focuses on a modality with which they will experience more success, and which will facilitate their communication in functional situations. Promoting Aphasic Communicative Effectiveness (PACE) is a multi-modality approach to therapy that encourages aphasics to use any means available to express themselves. One communication modality that can be included in this therapy approach is writing. Writing can pose some problems for aphasics, however. Often following a left hemisphere stroke, a patient is forced to write with the non-dominant left hand due to right sided weakness or paralysis. For this reason, aphasic patients are sometimes reluctant to try writing as a form of communication. A way to compensate for this is to have the patient write in block letters rather than attempting to write in cursive, as block letters are much easier to produce and decipher. Another complication that can get in the way of writing therapy is the possibility of agraphia or alexia, or a combination of the two. These disorders can sometimes be seen in addition to aphasia. Also, sometimes a patient with aphasia will make some of the same errors in writing as they make in speaking, (i.e. telegraphic speech, jargon, paraphasias) and so their writing will not be any easier to understand than their speech. Depending on where the lesion is located, spelling can also be a major stumbling block to success with a writing treatment. In some cases it may be necessary to work on sound to letter correspondences before working on writing words or sentences. If spelling problems persist, a possible solution to be explored is a keyboarding device either that accepts spelling errors, or that
When an individual has aphasia, verbal output is often no longer sufficient for communication. Because of this, other modalities of communication are often explored. "Speech" therapy for aphasic patients often does not include speech activities at all, but rather focuses on a modality with which they will experience more success, and which will facilitate their communication in functional situations. Promoting Aphasic Communicative Effectiveness (PACE) is a multi-modality approach to therapy that encourages aphasics to use any means available to express themselves. One communication modality that can be included in this therapy approach is writing. Writing can pose some problems for aphasics, however. Often following a left hemisphere stroke, a patient is forced to write with the non-dominant left hand due to right sided weakness or paralysis. For this reason, aphasic patients are sometimes reluctant to try writing as a form of communication. A way to compensate for this is to have the patient write in block letters rather than attempting to write in cursive, as block letters are much easier to produce and decipher. Another complication that can get in the way of writing therapy is the possibility of agraphia or alexia, or a combination of the two. These disorders can sometimes be seen in addition to aphasia. Also, sometimes a patient with aphasia will make some of the same errors in writing as they make in speaking, (i.e. telegraphic speech, jargon, paraphasias) and so their writing will not be any easier to understand than their speech. Depending on where the lesion is located, spelling can also be a major stumbling block to success with a writing treatment. In some cases it may be necessary to work on sound to letter correspondences before working on writing words or sentences. If spelling problems persist, a possible solution to be explored is a keyboarding device either that accepts spelling errors, or that
References: Beeson, P.M. (1999). Treating acquired writing impairment: strengthening graphemic representations. Aphasiology, 13, 767-785. Beeson, P.M., Hirsch, F.M., & Rewega, M.A. (2002). Successful single-word writing treatment: Experimental analyses of four cases. Aphasiology, 16, 473-491. Beeson, P. M., Rising, K., & Volk, J. (2003). Writing treatment for severe aphasia: Who benefits? Journal of Speech, Language, and Hearing Research, 5, 1038-1061 Ferrand, C.T. & Bloom, R.L. (1997). Introduction to organic and neurogenic disorders of communication: Current scope of practice Robson, J. et al. (2001.) Enhancing communication in jargon aphasia: A small group study of writing therapy