Global aphasia with apraxia

Age: 71

Time Since Stroke: 1 month

Roger had just been released from inpatient rehab. Since he didn’t have physical issues, his insurance company would not let him stay for speech therapy. A retired businessman, he had a severe global aphasia so that he couldn’t communicate with his friends or family.

Problems:

  • No usable or clear speech
  • Very little understanding of speech or writing
  • Visual deficits
  • Family and client were told by doctor that he would be fine within a year
  • Cooperative but easily discouraged

Assessment: no writing or reading at all. He could only make some sounds similar to “whee haw”. He had severe deficits in all language areas, he was pleasant but clueless about his condition. He often covered up his lack of understanding by laughing and nodding his head. He could say a word less than 20% of the time. Written cues weren’t helpful to him and he couldn’t copy his name or other words.

Treatment: 6 weeks

Roger had to start at the beginning, relearning reading, speaking, and understanding. We focused on basic communication.

Results: When answering questions about himself, his accuracy increased to 95% from around 10% initially. He had a vocabulary of about 5 words independently, and another 20 words that he needed some help to express. Testing showed a 30% increase in naming and a 26% increase in repeating words and phrases. His writing increased by 33% and copying by 50%.