Aphasia: Types, Assessment, and Analysis of a Case Study

A Report on Aphasia
A REPORT ON APHASIA
Introduction
Aphasia is clinically defined by the National Aphasia Association as the “impairment
of language, affecting the production or comprehension of speech and the ability to read or
write, that is caused by damage to the areas of the brain that control the said abilities
(National Aphasia Association, 2018). In a person with aphasia, auditory comprehension, one
or many of the communication modalities, such as verbal expression, reading and writing,
and functional communication are affected. Depending on the severity of impact and the area
of brain affected, aphasia is classified into various types, which divides the symptoms into
various categories.
According to the most widely accepted “Boston’s Classification”, Aphasia is
categorized into eight types (Mesulam, Wieneke, Rogalski, Cobia, Thompson, & Weintraub,
2009). One, Broca’s Aphasia (Expressive Aphasia), where the Broca’s area in the frontal lobe
of the brain responsible for speech comprehension and production is affected, thus the person
has issues in comprehending and repeating speech. Two, Wernicke’s Aphasia (Receptive
Aphasia), where the Wernicke ’s area in the temporal lobe of the brain that is responsible for
speech comprehension is affected and the person has severe issues in comprehending speech.
Three, Conduction Aphasia where the arcuate fasciculus that connect the Broca’s and
Wernicke’s areas are affected, thus though there is a good level of speech comprehension,
there is poor speech production. Four, Mixed transcortical Aphasia, where the areas that
control speech and communication are isolated from the rest of the brain, and there is both
impaired comprehension and expression. The person is unable to comprehend the speech and
start a new conversation, but is able to repeat the said words. Five, Transcortical Motor
Aphasia where, the frontal lobe of the language dominant hemisphere of the brain is affected,
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A Report on Aphasia
thus though there is a good level of speech production, the speech comprehension is affected.
Six, Transcortical Sensory Aphasia, where, the area near the Wernicke’s area in the temporal
lobe is affected, thus the person’s comprehension and speech production is affected, while
repetition is intact. Seven, Global Aphasia, where all the speech and language processing
areas of the brain are affected, which leads to poor comprehension, speech production, and
repetition of the individual. Eight, Anomic Aphasia, where parts of the parietal/temporal lobe
of the brain are affected, which leads to the person presenting with difficulty in retrieval of
words, usually names from memory.
Assessment of Aphasia is usually a difficult process, as it involves testing the
components of language and comprehension in the affected people, which might be
ambiguous. The four components of communication, namely verbal expression, reading and
writing, and functional communication are assessed by the use of different assessment scales
and indices (Whitworth, Webster, & Howard, 2014). The Boston Diagnostic Aphasia
Examination, the Boston Naming Test, the Western Aphasia Battery, the Comprehensive
Aphasia test, the Psycholinguistic Assessments of Language Processing in Aphasia, are some
of the common tools used in the assessment of aphasia.
In this report, the background information of the patient in the case study (David) is
provided, along with a detailed analysis of the type of disorder faced by the patient,
impairments, and the standardized assessment measures of David’s condition is made. A
comparison of the standardized assessment and the functional assessment is also done.
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A Report on Aphasia
Background Information
The assessment was made in January 2016. The patient David was a 71 year old man.
He had suffered from stroke involving the embolic infarct of the left Middle Cerebral Artery
in June 2008. The stroke was secondary to his pre-existing condition of infective
endocarditis. At the time of the stroke, he presented with a complete left hemiplegia with
total inability to speak. Presently, David is unable to use his right arm, and is unable to speak,
but he is able to walk. David is a married person who lives along with his wife. He used to be
a typesetter prior to his stroke, and is presently retired. David reads books and information on
the internet, and goes for walking with his dog. He is right handed, and is a monolingual
English speaker. David has a normal corrected vision, and an unimpaired hearing. He is a
regular participant of researches on Aphasia, but has not benefitted from any aphasia
therapies.
Analysis and Interpretation of client data
David was assessed for his aphasia by four different clinical assessment tools and
scales. His communication abilities and the resultant observation from the assessments are
described below.
The Western Aphasia Battery (Revised) Test
The Western Aphasia Battery (Revised) Test was performed and its four components
were assessed (Hula, 2010). In the component spontaneous speech, David was able to
respond to almost all basic conversations and questions. He was able to describe the picture
in short incomplete sentences, and lacked the fluency to complete the sentence, with poor
sentence construction and disjointed words. Auditory and verbal comprehension was assessed
by giving a set of yes-no questions, in which David answered almost all questions correctly,
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