Broca's Aphasia with apraxia-1

Georgia: 33 years old, 6 months after stroke, Broca’s aphasia and apraxia, 6 week session

  • At the beginning , she said a few single words and short automatic phrases (“I don’t know”) due to severe apraxia.
  • She had an Ipad and Iphone that she could use almost independently to answer questions
  • She rarely tried to speak, wanting to use her phone instead
  • She wanted to return to work soon and  speak in sentences

This client was a good candidate for intensive therapy because of age, relatively good understanding, able to easily use technology, supportive family and friends, and the most important part of all—motivation to improve.

Goal:  Say 15+ different 1-3 words/phrases 

  • We started with key functional words/phrases such as “diet coke”, “water”, “bathroom”, “hungry”, “please”, etc.
  • Halfway through, she was consistently saying more than 15 unique, single words in a session
  • She said several 2-4 word utterances with assistance (e.g., “help me, please”)
  • By the end of the program, she  spoke spontaneously 50-80% of the time
  • In social conversations, she said 1-3 words independently, allowing quicker responses and a natural conversational rhythm.

Goal 2:  Sequence (pronounce)  1-3 syllables words/phrases clearly and accurately

  • At the beginning , she repeated simple one and two-syllable words accurately (nose, snowball),
  • Speech was difficult to understand for longer words/phrases due to her apraxia of speech.
  • By the second week , Georgia said 2-3 syllable words with 94% accuracy
  • At the final week, she said 1-3 words at a time independently or with little assistance.

Her aphasia test score for speaking, understanding and repeating went from 32 to 45.7, a gain of 13.7 points. Her reading comprehension score went up 55%, and her caregiver rated improvements from 19%-46% in the areas of getting attention, recalling and saying names of people, and in participating in a group discussion about herself.

 Summary of Treatment

  • To increase speaking independence, we worked directly on her apraxia.
  • This client did a fairly good job of writing down the word that she couldn’t say during conversation, but needed help to then say it.
  • With apraxia, the first sound of a word is usually the most difficult to do without looking at someone else saying it first.

Georgia returned to The Aphasia Center for another 4 weeks 2 weeks later to continue her treatment.