Rehabilitation of the afasic patient in speech therapy

Aphasias are considered to be neurological linguistic disorders in which the comprehension and/or expression of oral and/or written language is compromised, thus having a significant potential impact on the quality of life of an individual and his / her family. Although much studied in its neurophysiological mechanism, aphasia is not always discussed in terms of rehabilitation. Therefore, this article aims to discuss the scientific production in speech therapy on the rehabilitation of aphasia. For this purpose, an Integrative Review of Literature was carried out, covering the period from 2000 to 2021 on the Scielo and BVS data platforms of articles available in full and in the Portuguese language, using as a descriptor the unitermo "aphasia", in which the articles found were submitted to the relevance tests I and II, in which the final sample made only those that passed the established criteria. A total of 236 articles were found on the Scielo platform, with only 29 discussing rehabilitation and only 5 on speech therapy. In the BVS platform, 98.901 articles were found, but only 86 were discussing deaf aphasia and were available, none of which addressed speech therapy rehabilitation. The electronic search reached a total of 5 relevant articles that included the theme of speech and hearing rehabilitation to the aphasic patient, all of them being from the Scielo platform. Thus, scientific scarcity on the subject of aphasia becomes evident, and it is necessary to invest in production that encapsulate the therapeutic behavior of the speech-language pathologist. As afasias são consideradas distúrbios linguísticos de cunho neurológico em que a compreensão e/ou expressão da linguagem oral e/ou escrita encontra-se comprometida, tendo desta maneira um potencial significativo de impacto na qualidade de vida de um indivíduo e sua família. Embora muito estudada em seu mecanismo neurofisiológico, as afasias nem sempre são discutidas sob o aspecto de reabilitação. Diante disso, este artigo objetiva discutir sobre a produção cientifica em fonoaudiologia sobre a reabilitação da afasia. Para tanto, foi realizada uma Revisão Integrativa da Literatura, contemplando o período de 2000 a 2021 nas plataformas de dados Scielo e BVS de artigos disponíveis na íntegra e no idioma em português, utilizando como descritor o unitermo “afasia”, em que os artigos encontrados foram submetidos aos testes de relevância I e II, em que fizeram a amostra final apenas aqueles que passaram pelos critérios estabelecidos. Foram encontrados na plataforma Scielo o total de 236 artigos, sendo que apenas 29 discutiam sobre reabilitação e apenas 5 sobre terapia fonoaudiológica. Na plataforma BVS foram encontrados 98.901 artigos, porém apenas 86 discutiam sobre afasia de fato e estavam disponíveis, sendo que nenhum abordava a reabilitação fonoaudiológica. A busca eletrônica alcançou o total de 5 artigos relevantes que contemplassem a temática de reabilitação fonoaudiológica ao paciente afásico, sendo todos da plataforma Scielo. Assim, torna-se evidente a escassez científica sobre o tema de afasia, sendo necessário investimentos para produção que embase a conduta terapêutica do profissional fonoaudiólogo.

The Preassessment Process for English Learners With Potential Language Impairment

This chapter presents the case of Tanveer, a first-grade boy from an Urdu-speaking immigrant family from Pakistan. He is in the public schools and has been struggling academically since kindergarten. This chapter discusses the preassessment process and interventions that took place before Tanveer underwent a full special education evaluation, including testing by a speech-language pathologist for the possible presence of an underlying language impairment. (Note: this author personally worked with this child, and this is a true story with some details changed for confidentiality.) This chapter shows how even before formal special education testing commenced, conducting an extensive preassessment process helped to greatly increase the accuracy of the formal evaluation, eventual diagnosis, and intervention provided for Tanveer.

Factors Influencing Aphasia Assessment for Bilingual Adults

This chapter provides a brief overview of stroke, aphasia, and aphasia assessment. Additionally, it considers various issues associated with the standardized assessment of aphasia, including problems related to cultural and linguistic biases. The chapter also includes information on working with people who are bilingual, as well as working with interpreters. A hypothetical case study is presented as a teaching avenue to discuss these topics in greater length. This section contains details regarding how both cultural and linguistic barriers associated with the assessment of the patient's aphasia may have influenced the intervention provided by the speech-language pathologist (SLP). Medical terminology and procedures related to stroke intervention are also discussed as it relates to the SLP's plan of care.

Intervention Services for a Child With Multiple Disabilities

This chapter will focus on providing intervention services for an eight-year-old African-American female, Dawn, with multiple disabilities. Dawn has been diagnosed with Down syndrome, a comorbid diagnosis of an intellectual disability, and exhibits behavior problems at home and school. In this scenario, she has been evaluated within the school system to determine eligibility for services, and the speech-language pathologist needs to develop intervention goals and select therapy strategies to provide appropriate services. While both parents are involved in the child's care, the family does not have permanent housing and moves frequently. Information from actual cases has been incorporated into this chapter.

A Case of Paradoxical Vocal Fold Movement Due to Psychological Causes

Paradoxical vocal fold movement (PVFM) is a dystonic laryngeal disorder characterized by involuntary vocal fold adduction during inspiration and/or expiration. PVFM is uncommon and may aggravate airway obstruction. And patients with PVFM have a specific etiology; therefore, treatment must be individualized and given immediately. We present a case of 63-year-old male presenting with intermittent dyspnea. After multidisciplinary workup, we presumed psychogenic PVFM and evaluated with speech-language pathologist and psychologist. In this report, we describe a rare case of psychogenic PVFM patient.

Management of intractable chronic cough during awake craniotomy: illustrative case

BACKGROUND Chronic cough is a common but challenging clinical condition that can adversely affect the safety of awake surgical endeavors such as awake craniotomy (AC). This case lesson highlighted a patient with severe refractory chronic cough undergoing AC for resection of a recurrent left frontal, insula, anterior temporal anaplastic ependymoma of the eloquent cortex. OBSERVATIONS The patient was successfully managed using a multifaceted medical treatment regimen combined with preoperative and intraoperative cough suppression therapy with a speech-language pathologist. The patient coughed only once intraoperatively and had a positive outcome. LESSONS Chronic cough is often multifactorial and requires a multifaceted treatment approach. Despite this challenge, select patients can successfully be navigated through AC with appropriate treatment for their condition. A review of neurogenic cough and modern treatments, which were used in this patient and would be helpful to neurologists or neurosurgeons, are also discussed.

The Effect of Tongue-Tie Release on Speech Articulation and Intelligibility

Objective The relationship between ankyloglossia and speech is controversial. The objective of this study was to determine the effect of tongue-tie release on speech articulation and intelligibility. Methods A prospective cohort study was conducted. Pediatric patients (>2 years of age) being referred for speech concerns due to ankyloglossia were assessed by a pediatric otolaryngologist, and speech articulation was formally assessed by a speech language pathologist using the Goldman-Fristoe Test of Articulation 2 (GFTA-2). Patients then underwent a tongue-tie release procedure in clinic. After 1 month, speech articulation was reassessed with GFTA-2. Audio-recordings of sessions were evaluated by independent reviewers to assess speech intelligibility before and after tongue-tie release. Results Twenty-five participants were included (mean age 3.7 years; 20 boys). The most common speech errors identified were phonological substitutions (80%) and gliding errors (56%). Seven children (28%) had abnormal lingual-alveolar and interdental sounds. Most speech sound errors (87.9%) were age/developmentally appropriate. GFTA-2 standard scores before and after tongue-tie release were 85.61 (SD 9.75) and 87.54 (SD 10.21), respectively, (P=.5). Mean intelligibility scores before and after tongue-tie release were 3.15 (SD .22) and 3.21 (SD .31), respectively, (P=.43). Conclusion The majority of children being referred for speech concerns thought to be due to ankyloglossia had age-appropriate speech errors at presentation. Ankyloglossia was not associated with isolated tongue mobility related speech articulation errors in a consistent manner, and there was no benefit of tongue-tie release in improving speech articulation or intelligibility.