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Volume 43 Number 3, May/June 2006
Pages 323 — 336

Abstract - Treatability of different components of aphasia-Insights from a case study

Diane L. Kendall, PhD;1-2* Stephen E. Nadeau, MD;2-4 Tim Conway, PhD;1,5 Renee H. Fuller, MA, CCC-SLP;6 Alonso Riestra, MD;7 Leslie J. Gonzalez Rothi, PhD1-2,4

1Department of Veterans Affairs (VA) Rehabilitation Research and Development Brain Rehabilitation Research Center, Malcom Randall VA Medical Center (VAMC), Gainesville, FL; 2Department of Neurology, University of Florida, Gainesville, FL; 3McKnight Brain Institute, University of Florida, Gainesville, FL; 4Geriatric Research, Education, and Clinical Center, Malcom Randall VAMC, Gainesville, FL; 5Department of Clinical and Health Psychology, University of Florida, Gainesville, FL; 6Cardinal Hill Rehabilitation Hospital, Lexington, KY; 7Department of Neurology, Instituto Mexicano de Neurociencias (Mexican Institute of Neurosciences), Huixquilucan, México
Abstract — In this phase I clinical rehabilitation study, we investigated the effects of phonological rehabilitation for alexia and aphasia in an individual 54 years after a left-hemisphere ischemic infarction. In the context of a single-subject design, we studied whether treatment would improve phonological processing, reading, and generalization to untreated behaviors. While results showed a lack of generalization to real-word reading aloud, improvement was present in phonological processing, language function (Western Aphasia Battery Aphasia Quotient, Boston Naming Test, Reading Comprehension Battery for Aphasia), and auditory processing (Revised Token Test). Improvement in the lexical-semantic system was attributed to informal forced-use language treatment. We concluded that phonological therapies are unlikely to be successful unless a minimum initial level of phonological sequence knowledge exists; therapies that pressure subjects to use verbal communication can achieve clinically important gains in communicative ability that generalize to untreated behaviors. This study also demonstrates the importance of a careful analysis of the patient's language ability before a therapeutic strategy is chosen.
Key words: alexia, aphasia, chronic, constraint-induced language therapy, language function, nonword reading aloud, phonological processing, real-word reading aloud, rehabilitation, stroke, verbal communication.

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