The Multi-Facets Of Aphasia: A General Orientation To The Disorder

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McMahon, Maureen

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1982-04-01

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The communication of our thoughts, viewpoints, and emotions are synonymous with being human. By interacting and identifying with other humans through a mutually symbolic language code, man expresses ideas about self and world. This is possible because humans possess a dynamic center, the human brain, to control, reason, and formulate their perceptions and thoughts. "By means of complex cerebral processes, people attach meaning to symbols, combine symbols to represent impressions, and understand other's speech, thinking, and ideas" (U. S. Department of Health, Education and Welfare, 1979, p. 2). These processes, carried out by the human brain, control man's higher mental, motor, and sensory functions as well as playing an important role in speech and language comprehension and production. Within this communication, the transmission of information is enhanced by the means of gestures, facial expressions, and other non-verbal modalities. It is through these modalities that humans reveal their motives and character, in addition to the general information they desire to transmit. "What is needed to analytically learn from communication encounters is a system for listening beyond what is said, to how it is said, and what it does" (Larsen, 1976, p. 7) . This point becomes even more significant as humans engage in communication encounters with those individuals handicapped in the communication skills. It will be those adults, experiencing damage to the cerebral hemispheres from any number of etiologies, on which this paper is focused. This language disturbance, termed aphasia, is an W immensely complex condition usually caused by a lesion in the language dominant cerebral hemisphere. Authors formulating hypotheses about aphasia date back to the time of Hippocrates. He believed disturbances in speech and language functioning were associated with lesions in the brain (Sessler, 1981, p. 206). The effects of these lesions resulted in the disruption of communication ability; therefore, not only is language impaired, but understanding of the spoken word, reading, writing, and arithmetic abilities may be disrupted as well. In addition, depending on the location and the extent to which the cerebral damage involves the language dominant hemisphere, the degree of impairment varies across the aphasic population. Essentially, the reduction within each of these language skills is seen in the overall pattern of aphasic impairment demonstrated by each individual (Cohen, 1971, p. 2). According to Jon Eisonson (1967), these aphasic impairments are disruptions of an individual's verbal habits as well as other patterns of communicative behavior. The most severely reduced are the processes which require a "transition from inner symbolization into a conventional, interpersonal linguistic system" (U. S. Dept. of HEW, 1967, p. 36). It is the use of the conventional language formulation which is damaged and less often the aphasic individual's cognitive capabilities, knowledge, or intelligence. Although there are copious definitions of aphasia, the writer considers the following statement by Schuell, Jenkins, * and Jimenez-Pabon (.197 5) to incorporate the major characteristics encompassing aphasia. They define aphasia as a "reduction of available language that crosses all language modalities and may or may not be complicated by perceptual or sensorimotor involvement, by various forms of dysarthria, or by other sequelae of brain damage" (p. 3). The purpose of this paper is to explore the previously established fundamental principles presented in the literature concerning aphasia. Hopefully, this will demonstrate the necessary background underlying this disorder as well as developing a better understanding of the aphasic individual. Certain assumptions are utilized with aphasic individuals; therefore, an understanding of the principles and behavioral changes surrounding aphasia allows a clearer path toward intervention and rehabilitation. Although theories are formulated illustrating the skill and behavior changes manifested through aphasia's occurrence, we cannot neglect the fact that it is the individual with unique, personal characteristics and qualities upon which we base our concern. Each person, depending on his personality. experiences, and education brings an unlimited set of circumstances that have been disfigured through brain injury into panorama. The focus of concern among individuals responsible for a patient's recovery develops from an appreciation of the extensive range of varying language and non-language deficits which affect each individual. It is the writer's intent to address the nature and extent of aphasia in the following pages, hopefully remaining mindful of the uniquely human aspects of those who suffer from this disorder. In addition, the brevity of presentation from which these previously attained insights are derived must be acknowledged. As mentioned before, aphasia is an immensely complex area with the current state of the art of treatment still dependent on further research, not only with the disorder of aphasia, but extensive research in the area of neurology as well.The communication of our thoughts, viewpoints, and emotions are synonymous with being human. By interacting and identifying with other humans through a mutually symbolic language code, man expresses ideas about self and world. This is possible because humans possess a dynamic center, the human brain, to control, reason, and formulate their perceptions and thoughts. "By means of complex cerebral processes, people attach meaning to symbols, combine symbols to represent impressions, and understand other's speech, thinking, and ideas" (U. S. Department of Health, Education and Welfare, 1979, p. 2). These processes, carried out by the human brain, control man's higher mental, motor, and sensory functions as well as playing an important role in speech and language comprehension and production. Within this communication, the transmission of information is enhanced by the means of gestures, facial expressions, and other non-verbal modalities. It is through these modalities that humans reveal their motives and character, in addition to the general information they desire to transmit. "What is needed to analytically learn from communication encounters is a system for listening beyond what is said, to how it is said, and what it does" (Larsen, 1976, p. 7) . This point becomes even more significant as humans engage in communication encounters with those individuals handicapped in the communication skills. It will be those adults, experiencing damage to the cerebral hemispheres from any number of etiologies, on which this paper is focused. This language disturbance, termed aphasia, is an W immensely complex condition usually caused by a lesion in the language dominant cerebral hemisphere. Authors formulating hypotheses about aphasia date back to the time of Hippocrates. He believed disturbances in speech and language functioning were associated with lesions in the brain (Sessler, 1981, p. 206). The effects of these lesions resulted in the disruption of communication ability; therefore, not only is language impaired, but understanding of the spoken word, reading, writing, and arithmetic abilities may be disrupted as well. In addition, depending on the location and the extent to which the cerebral damage involves the language dominant hemisphere, the degree of impairment varies across the aphasic population. Essentially, the reduction within each of these language skills is seen in the overall pattern of aphasic impairment demonstrated by each individual (Cohen, 1971, p. 2). According to Jon Eisonson (1967), these aphasic impairments are disruptions of an individual's verbal habits as well as other patterns of communicative behavior. The most severely reduced are the processes which require a "transition from inner symbolization into a conventional, interpersonal linguistic system" (U. S. Dept. of HEW, 1967, p. 36). It is the use of the conventional language formulation which is damaged and less often the aphasic individual's cognitive capabilities, knowledge, or intelligence. Although there are copious definitions of aphasia, the writer considers the following statement by Schuell, Jenkins, * and Jimenez-Pabon (.197 5) to incorporate the major characteristics encompassing aphasia. They define aphasia as a "reduction of available language that crosses all language modalities and may or may not be complicated by perceptual or sensorimotor involvement, by various forms of dysarthria, or by other sequelae of brain damage" (p. 3). The purpose of this paper is to explore the previously established fundamental principles presented in the literature concerning aphasia. Hopefully, this will demonstrate the necessary background underlying this disorder as well as developing a better understanding of the aphasic individual. Certain assumptions are utilized with aphasic individuals; therefore, an understanding of the principles and behavioral changes surrounding aphasia allows a clearer path toward intervention and rehabilitation. Although theories are formulated illustrating the skill and behavior changes manifested through aphasia's occurrence, we cannot neglect the fact that it is the individual with unique, personal characteristics and qualities upon which we base our concern. Each person, depending on his personality. experiences, and education brings an unlimited set of circumstances that have been disfigured through brain injury into panorama. The focus of concern among individuals responsible for a patient's recovery develops from an appreciation of the extensive range of varying language and non-language deficits which affect each individual. It is the writer's intent to address the nature and extent of aphasia in the following pages, hopefully remaining mindful of the uniquely human aspects of those who suffer from this disorder. In addition, the brevity of presentation from which these previously attained insights are derived must be acknowledged. As mentioned before, aphasia is an immensely complex area with the current state of the art of treatment still dependent on further research, not only with the disorder of aphasia, but extensive research in the area of neurology as well.

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