Aphasia is an acquired communication disorder that affects the ability of a person to speak and understand spoken language. The purpose of the Aphatar project is to create a virtual clinician that will help suffers of aphasia improve their speech in common scenarios. The project will gauge the interaction and quality of this virtual clinician against those of a real clinician. Aphatar will be created using three major systems: (1) KINECT for audio and visual recording, audio input, and future work in reading the client's emotional state using the KINECT 3D Camera system, (2) The Olympus Speech Recognition System, provided by Carnegie-Mellon University which will accept the audio input of the user and translate it from speech to text then provide spoken feedback to the user, and (3) the Avatar display system, which will provide the graphical interface for the former, allowing the user to see the avatar and interact with it. / Computer and Information Science

This study was divided into two parts. Study 1 examined the spoken language production of neurologically healthy adults (NHA) in selective and divided attention conditions during a story retell task. NHA participant groups consisted of 21 younger (26–54), 19 older (55–69), and 20 elderly (70–85) adults. Study 2 investigated how the language production of four people with aphasia (PWA) compared to their respective NHA group. All participants retold stories in a silent baseline condition, three background noise conditions (cocktail party, conversation, phone call), and one dual-task condition (tone discrimination). Language production measures (speech rate, disfluent verbalizations, language efficiency, lexical diversity, lexical-phonological errors), tone-discrimination accuracy and response time, and perceived effort and stress were compared across groups and conditions. Results of Study 1 revealed that the language of elderly adults was significantly less efficient and had more disfluent verbalizations than that of both younger and older adults, and the language of older adults was significantly less efficient and had more disfluent verbalizations than that of younger adults. The tone discrimination accuracy and response time of elderly adults was significantly lower than that of younger adults. Older and elderly adults showed greater levels of perceived stress than younger adults. Across groups, lexical diversity decreased and lexical-phonological errors and disfluent verbalizations increased during the dual-task and phone call conditions. Costs to tone discrimination accuracy, response time, perceived effort, and perceived stress were found in the dual-task condition across groups. These findings suggest that some, but not all, measures of spoken language production are impacted by aging, and that selective and divided attention interferes with spoken language production for NHA. Results of Study 2 show that the four PWA were distinguished from their respective NHA adult group for all dependent variables in at least one condition. Percent lexical-phonological errors, percent disfluent verbalizations, and speech rate were the dependent variables that distinguished PWA from NHA the most. However, the language production, tone-discrimination response, perceived effort, and perceived stress of each PWA were unique to the individual. These findings suggest that lexical-phonological errors, percent disfluent verbalizations, and speech rate may be useful measures for discerning individuals with mild aphasia from NHA speakers in a variety of conditions.

The psychosocial needs of couples impacted by aphasia are often unmet. Sixty-one marriage and family therapists' (MFTs) experiences, perceived knowledge, confidence, comfort, and barriers in working with couples impacted by aphasia, and their interactions with speech-language pathologists (SLPs) were investigated using survey methodology. All MFTs were licensed, practicing in the US, and had at least 3 years of experience. Participants completed the following in order: (a) a pre-intervention survey, (b) one of two intervention conditions, and (c) a post-intervention survey. Twenty-eight respondents were randomly assigned to an education-alone intervention and 33 respondents were assigned to an education plus Relationship-Centered Communication Partner Training program (RC-CPT). The results of the present study suggest that MFTs who participated in this survey consider providing therapy to couples impacted by aphasia to fall within their scope of practice and already feel comfortable with various skills needed to provide therapy to this population. Aphasia education alone and education plus RC-CPT can both improve MFTs' knowledge, confidence, and comfort in working with couples impacted by aphasia but being shown a model of RC-CPT likely helped MFTs better visualize therapy, which bolstered changes in respondents' perceptions. Future development of RC-CPT should prioritize MFT involvement as collaborators and consultants. Continuing education courses and interprofessional collaboration are needed to better address the psychosocial needs of people with aphasia (PWA) from an interdisciplinary perspective.

Bakgrund: Kommunikationssvårigheter uppstår när hjärnan skadas och beroende på skadans lokalisation kan symtom uppstå som afasi. I Sverige drabbades mellan 7000 och 10 000 personen av afasi år 2021. Kommunikation är en grundläggande förutsättning för en god omvårdnad. Därför är det i stor vikt att sjuksköterskor är pålästa och förstår vikten av kommunikation och olika kommunikationssätt under samtalet, för att kunna säkerställa en god omvårdnad samt främja personcentreradvård för patienter med afasi. Syfte: Att belysa sjuksköterskors erfarenheter av att kommunicera med patienter med afasi. Metod: En kvalitativ litteraturstudie baserad på tio vetenskapliga artiklar med kvalitativ ansats. Data analyserades utifrån Popenoes analysmetod i tre huvudsteg. Resultat: Tre huvudkategorier och sex underkategorier identifierades. Huvudkategorierna var:känslomässiga reaktioner, hinder i kommunikationen, förutsättningar för en effektiv kommunikation. Underkategorierna var: känslor av frustration och missnöjdhet, känslor av skuld och ansvar, tidspress, kunskapsbrist, tidens betydelse, strategier och metoder. Slutsats: Sjuksköterskor upplevde att kommunikationen med patienter med afasi är en stor utmaning. Detta innebär att sjuksköterskor upplevde känslor av frustration när de kommunicerade med patienter med afasi, eftersom både sjuksköterskor och patienter behövde tid för att kommunicera och att förstå varandra. Ytterligare bristande i kunskap om olika kommunikationshjälpmedel var en faktor som hindrade sjuksköterskor att ha en effektiv kommunikation med patienter med afasi. För att kunna kommunicera på ett effektivt sätt med patienter med afasi samt att främja personcentrerad vård krävs att sjuksköterskor avsätter tillräckligt med tid att sitta ner hos patienten, ökar sin kunskap om olika kommunikationsstrategier och metoder. / Background: Communication difficulties occurs when the brain is damaged and depending on the location of the injury, the symptoms occur and lead to aphasia. In Sweden, between 7,000 and 10,000 people were affected by aphasia in 2021. Communication is a basic competence for a good nursing care. That’s why it is important that nurses are well informed and understand the significance of communication and various communication methods during interactions between nurses and patients with aphasia. This is essential to ensure a good quality of health care and promote person- centred care for patients with aphasia. Aim: Is to illuminate nurses experience of communicating with patients with aphasia. Method: A qualitative literature study based on ten scientific qualitative articles. The data analysed using Popenoe analysing method in three main steps. Result: Three main categories and six subcategories were identified: The main categories were: Emotional reactions, obstacles in communication, opportunities for effective communication. The subcategories were: feeling of frustration and dissatisfaction, feeling of guilt and responsibility, time pressure, lack of knowledge, the importance of time, strategies and methods. Conclusion: Nurses experienced that communication with patients with aphasia was a great challenge. The findings showed that communication with this group of patients was frustrated because both, the nurse and the patient need time to communicate and understand each other’s messages. Lack of knowledge about different communication facilities was a factor that hindered communication with these patients. To communicate effectively with patients with aphasia and promote their individual care required from nurses to give enough time to sit with patient, increase their knowledge about different communication strategies and methods, and treat each patient as a unique individual with their own needs.

Background: Aphasia is an acquired language disorder, usually due to stroke, that affects the social functioning and the quality of life of the person with aphasia as well as the quality of life of his or her family and caregivers. Traditional aphasia therapy has tended to focus on decontextualized tasks and discrete elements of language functioning. The Life Participation Approach to Aphasia (LPAA) focuses on the collaborative nature of communication and addresses communication within personally relevant contexts. Joint decision-making is one type of social interaction that occurs frequently between married couples and has received considerable attention in the literature. To date, no study has investigated how married couples affected by aphasia collaboratively make decisions. Aim: The present study aims to provide foundational information on joint decision-making by married couples affected by aphasia. Methods and Procedures: Fourteen married couples in which one of the spouses had aphasia volunteered to participate in the study. A variety of assessment measures were administered to the participants with aphasia to characterize their speech and language deficits and all participants were administered a non-verbal reasoning test and a marital quality scale. The primary task of interest in this study involved a joint decision-making activity in which spouses were read two hypothetical ‘survival-type’ scenarios and were given a list of items for each scenario. The spouses were instructed to decide on six items and then rank their selected items in order of importance in terms of their value in helping them survive the scenarios. Participants’ interactions were audio- and video-recorded, and their verbal communication transcribed verbatim. The participants’ communicative interactions were coded for speech functions and analyzed by comparing differences in communication behaviors between the spouses with and without aphasia. Results: Findings showed that participants with and without aphasia utilized a variety of speech functions but that the participants with aphasia made far fewer attempts to persuade their spouse to agree with them and that the spouses without aphasia tended to dominate the interaction, resulting in an imbalance of power in the decision-making process. Despite the differences in communication behaviors, both groups of spouses were supportive of the ideas suggested by their significant other and conflicts were typically resolved quickly. Conclusion: Findings from this study revealed potential discrepancies in the balance of power between the spouses with and without aphasia in decision-making communication. Suggestions are provided for tailoring interventions and guiding future research in joint decision-making in couples affected by aphasia.

Abstract Background: Individuals with nonfluent aphasia may have significant difficulties with functional spoken communication tasks in their daily life. Aphasia treatment held in a group setting may provide an enriched communicative context wherein the requirements of spoken language are similar to those within functional day-to-day communicative situations. Thus engaging in a spoken language activity in a group setting may directly target generalization of trained skills to those required in real-life, social communication situations. The present study is concerned with an aphasia group treatment that requires focused practice of spoken language during a social-functional communication task. Intensive Language Action Therapy (ILAT) has demonstrated positive communication outcomes in some individuals with chronic aphasia. However, it remains to be seen which clinical measures best index outcomes for ILAT. The purpose of the current study was to determine the effectiveness of ILAT in individuals with nonfluent aphasia by exploring multiple, potential ILAT outcomes. The outcomes included change in performance on assessments of directly trained spoken social-functional communication abilities (proximal outcomes), untrained social-functional communication abilities and language abilities (primary outcomes), and cognitive-communication abilities (secondary outcome). Additionally, the project aimed to explore the participants' perceptions of ILAT (secondary outcome). Methods and Procedures: ILAT was implemented with four individuals with nonfluent aphasia, using a single-subject multiple baseline design. The treatment was conducted daily for 10 consecutive week days, totaling 25 hours of treatment. Treatment probes (i.e., using trained and untrained picture cards and an unrelated control-task of nonword repetition), a pre/post assessment battery, and a post-treatment survey/interview were administered to assess performance on the treatment task, generalization to other potential ILAT outcomes, and participants' perceptions. Outcomes & Results: Increased accuracy was observed for trained and untrained items. However, two of the four participants were not able to reach a criteria determined a priori for treatment performance. Performance on items that were untrained resulted in some improvements in performance for all participants. Three of the four participants demonstrated small effect sizes in response to ILAT. One participant who demonstrated a medium effect size in response to ILAT also demonstrated a clinical significant change in discourse abilities, a measure of spoken social-functional communication abilities. All participants demonstrated improvements on at least one primary outcomes measure. Two participants, however, demonstrated a decline. All participants, however, perceived a positive experience with ILAT on a qualitative posttreatment survey/interview. Conclusions: Patterns were found between skills directly trained during ILAT, proximal outcomes, and performance on primary and secondary outcome measures of language, social-functional communication, and cognitive-communication, meant to assess generalization of trained skills to similar or potentially related untrained skills. A substantial amount of change (e.g., at least a medium effect size) on proximal outcome measures may be required in order for improvements to occur in primary and secondary outcome measures. Participants' perceptions of a positive treatment experience associated with the ILAT program further supports the value of the treatment. Future research should aim to further examine the influence of ILAT treatment components and participants' characteristics.

Η παρούσα εργασία εστιάζει στον τρόπο επεξεργασίας των σύνθετων λέξεων της Νέας Ελληνικής (ΝΕ) στην Πρωτοπαθή Προοδευτική Αφασία με αγραμματικό λόγο (ΠΠΑ-α). Οι μέχρι τώρα έρευνες επικεντρώνονται κυρίως σε κλινικές περι- πτώσεις αφασίας από κάποια εστιακή εγκεφαλική βλάβη (ΕΑ), ενώ η ΠΠΑ δεν έχει μελετηθεί ως προς το ζήτημα αυτό τόσο στη ΝΕ όσο και διαγλωσσικά. Στόχο, λοι- πόν, της συγκεκριμένης εργασίας αποτελεί η εξέταση του κατά πόσο ελληνόφωνοι ασθενείς με ΠΠΑ-α παρουσιάζουν ελλείμματα στην κατονομασία σύνθετων λέξεων. Μέθοδος: Διεξαγωγή πειράματος κατονομασίας μέσω ορισμού (naming on definition task), το οποίο αφορά την κατονομασία σύνθετων λέξεων της ΝΕ. Συμμετέχοντες: 2 ΠΠΑ-α ασθενείς (ο πρώτος σε πιο πρώιμο στάδιο της ΠΠΑ-α σε σχέση με το δεύτερο) και 2 άτομα που συνιστούν την ομάδα ελέγχου (controls). Πειραματικό υλικό: 71 σύνθετα της ΝΕ, 45 υποτακτικά (π.χ. μολυβοθήκη, μαυροπί- νακας, σιγοτραγουδώ), 15 παρατακτικά (π.χ. αλατοπίπερο, βορειοδυτικός) και 11 εξωκεντρικά (π.χ. κοκκινομάλλης, κακόγουστος).Υποθέσεις: Σύμφωνα με τα πορίσματα της τρέχουσας βιβλιογραφίας, ασθενείς με αγραμματικού τύπου ΕΑ και ΠΠΑ-α εμφανίζουν παρόμοια επίδοση σε πειράματα που ελέγχουν τη μορφοσύνταξη (Thompson et al.). Έτσι, αναμένεται να έχουν εξί- σου παρόμοια επίδοση και όσον αφορά την επεξεργασία συνθέτων, αφού η σύνθεση αποτελεί μία αμιγώς μορφολογική διαδικασία. Βάσει του παραπάνω παραλληλι- σμού, υποθέτουμε πως οι ΠΠΑ-α ασθενείς θα κατονομάζουν ευκολότερα τα σημα- σιολογικά διαφανή σύνθετα (πρώτη υπόθεση), θα διατηρούν τη γνώση της δομής του συνθέτου (δεύτερη υπόθεση), θα διατηρούν τα όρια των επιμέρους συστατικών σε πιθανά λάθη υποκατάστασης ή παράλειψης (τρίτη υπόθεση), και θα προβαίνουν σε ανάκληση του συνθέτου μέσω τεμαχισμού στα επιμέρους συστατικά του (τέταρτηυπόθεση). Τέλος, αν το συστατικό-κεφαλή έχει κάποιο βασικό ρόλο στη διαδικασία της κατονομασίας, αναμένονται συστηματικά περισσότερα λάθη σε αυτό το συστα- τικό (πέμπτη υπόθεση). Ακόμη, στο επίκεντρο του ενδιαφέροντος βρίσκονται και κάποια επιπλέον ερωτήματα που αφορούν το αν και κατά πόσο υπάρχει όντως σύ- γκλιση μεταξύ της ΠΠΑ-α και της ΕΑ-α στην κατονομασία σύνθετων λέξεων, το αν υπάρχει συσχέτιση μεταξύ του είδους/αριθμού των λαθών και του τύπου συνθέτου και το αν υφίστανται πρόβλημα με συστατικά συγκεκριμένης γραμματικής κατηγο- ρίας. Αποτελέσματα: Τα αποτελέσματα του πειράματος ανέδειξαν σημαντικές διαφορές στην επίδοση των δύο ασθενών. Ειδικότερα, ο πρώτος ασθενης είχε περισσότερα λάθη υποκατάστασης, τα οποία σηματοδοτούν επίγνωση της σύνθετης δομής και ανάκληση του συνθέτου μέσω τεμαχισμού στα επιμέρους συστατικά του. Αντίθετα, η δεύτερη ασθενής είχε περισσότερα λάθη περίφρασης και απάντησης με μία λέξη- λέξημα, ενώ ο στόχος ήταν η απάντηση με σύνθετη λέξη. Έτσι, τα λάθη της δεύ- τερης ασθενούς παραπέμπουν σε μη επίγνωση της σύνθετης δομής και σε μία πιο ολιστική διαδικασία ανάκλησης του συνθέτου. Τέλος, τα περισσότερα λάθη και των δύο ασθενών έγιναν σε υποτακτικά σύνθετα της γραμματικής κατηγορίας του ονό- ματος, ενώ δεν εντοπίστηκε επίδραση τόσο της σημασιολογικής διαφάνειας όσο και της μορφολογικής κεφαλής. Συμπεράσματα: Από την ανάλυση των αποτελεσμάτων γίνεται σαφές πως το στά- διο της διαταραχής καθορίζει και το είδος των γλωσσικών ελλειμμάτων. Συγκεκρι- μένα, στα πρώιμα στάδια της ΠΠΑ-α εμφανίζονται γλωσσικά ελλείμματα τα οποία συγκλίνουν με αυτά της ΕΑ-α, ενώ σε μετέπειτα στάδια η ικανότητα κατονομασίας πλήττεται σοβαρά διαμορφώνοντας ένα ιδιαίτερο κλινικό προφίλ, το οποίο δεν φαί- νεται να συγκλίνει ξεκάθαρα με κάποιον άλλο παθολογικό πληθυσμό. Αναλυτικό- τερα, στα αρχικά στάδια το πρόβλημα εδράζεται στην ενεργοποίηση της φωνολο- γικής μορφής της λέξης, ενώ οι μορφολογικοί κανόνες φαίνεται ότι διατηρούνται (γνώση της σύνθετης δομής, ορίων των συστατικών). Αντίθετα, σε μετέπειτα στά- δια το πρόβλημα εντοπίζεται στην ενεργοποίηση τόσο της φωνολογικής όσο και της μορφολογικής δομής του συνθέτου. Σε ό,τι αφορά τα υποτακτικά σύνθετα, η αυξη- μένη δυσκολία που δημιουργούν μπορεί να συσχετιστεί με τη λειτουργική σχέση των επιμέρους συστατικών τους. Εν κατακλείδι, η παρούσα εργασία αποτελεί μία πρώτη προσπάθεια μελέτης της σύνθεσης στην ΠΠΑ-α. Η ανάλυση των αποτελεσμάτων έφερε στο φως μία σειρά από γλωσσικά ελλείμματα, τα οποία αναμένεται να ελεγχθούν σε μεγαλύτερο δείγμα ΠΠΑ-α ασθενών για τον καθορισμό ασφαλέστερων συμπερασμάτων. / The present study is focused on the agrammatic variant of Primary Progressive Aphasia (PPA-a), which is a language impairment caused by neurodegenerative disease and characterized by difficulties in processing the grammatical aspects of speech (Mesulam, 2013). PPA-a has not examined about the grammatical deficits in Modern Greek (MG). Therefore, the aim of the present study is to examine if the Greek-speaking individuals with PPA-a have problems in naming compound words in MG. Procedure: Naming definition task of compound words in MG. Participants: Two patients with PPA-a (the first patient is in earlier stage of the disease than the other patient). Stimulus set: 71 compounds in MG, 45 subordinate compounds (e.g. [molivo’θici]>pencil case, [mavro’pinakas]>blackboard), 15 coordinate compounds (e.g. [alato’pipero]>salt and pepper, [vorioδiti’kos]>northwest) and 11 exocentric compounds (e.g. [kokkino’malis]>redhead, [ka’koγustos]>vulgar/tasteless). Hypotheses: According to the recent bibliography, agrammatic patients caused by stroke (StrAgr) and PPA-a patients have common performance in tasks which examine the morphosyntax (Thompson et al. 2013). So, PPA-a is expected to have the same deficits with StrAgr in naming compounds, given that compounding is a pure morphological procedure. Specifically, we expected compound effect, semantic transparency effect and lexical access through decomposition. Results: The error analysis showed differences in the performance of the two patients respect to the stage of the disease. Specifically, in the early stage substitution errors were occurred, supporting compound effect and a view of lexical access through decomposition. On the contrary, noncomposed semantic paraphasias and single words errors were occurred mainly at a later stage , indicating a more holistic access. Finally, the most errors were in subordinate compounds, whereas no effect of headedness and semantic transparency were found. Discussion: The results produce clear evidence that the stage of the PPA-a can affect the kind of the linguistic deficits. Specifically, in the initial stages, the linguistic deficits resemble with those of StrAgr patients with problems in the activation of the phonological form of the compound, whereas the morphological rules are intact. On the other hand, the naming competence is more impaired and distinctly different from other pathological populations at a later stage. Specifically, there are problems in the activation of both the phonological and the morphological compound forms. Finally, the increased difficulty with subordinate compounds will be correlated with the grammatical relations holding between the constituents.

Every year, 12,000 people in Sweden are diagnosed with aphasia. Many people with aphasia supplement their logopedic treatment by participating in an aphasia group. Aphasia groups provide both social and linguistic stimulation. The aim of the present thesis was to study the social interaction between participants, and between participants and leaders in aphasia groups. In the present study, eleven persons with aphasia and four leaders participated divided into three aphasia groups. The groups were video recorded during sessions with a total of four sessions. Two hours of social interaction were recorded. The material was transcribed and analyzed according to Conversation Analytical principles. The study focuses specifically on the use of gestures and face-work. Both phenomena could be observed in all groups. The results of the present work showed that different gestures could enhance as well as reduce intelligibility. Individuals’ gesture use was consistent with their ability of expression, i.e. the better the expressive ability, the more acceptable and understandable gestures. Face-work that was analyzed in the present study showed that face-threatening as well as face-saving strategies occur in aphasia groups. / Varje år drabbas 12 000 personer i Sverige av afasi. Många kompletterar sin logopediska behandling genom att delta i afasigrupp. Afasigruppen ger både social och språklig stimulans. Syftet med föreliggande studie var att studera social interaktion mellan deltagare och mellan deltagare och ledare i afasigrupp.  I studien deltog elva personer och fyra ledare fördelat på tre afasigrupper. Grupperna filmades under pågående session. Sammanlagt filmades fyra tillfällen och totalt cirka två timmar social interaktion. Materialet transkriberades och analyserades enligt samtalsanalytiska principer. I studien fokuseras särskilt på användandet av gester och fasadarbete (face). Båda kategorierna kunde iakttas i samtliga grupper. Resultatet i föreliggande arbete visade att olika gester kunde stärka förståeligheten och andra minska förståeligheten. Individernas gestanvändande stämde överens med deras uttrycksförmåga: Ju bättre uttrycksförmåga, desto mer vedertagna och lättförståeliga gester. Fasadarbete som analyserades i föreliggande studie visade att ansiktshotande så väl som ansiktsräddande strategier förekommer i afasigrupper.

Orientador: Rosana do Carmo Novaes Pinto / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Estudos da Linguagem / Made available in DSpace on 2018-08-13T12:43:32Z (GMT). No. of bitstreams: 1 Canoas-Andrade_Rosangela_M.pdf: 2122155 bytes, checksum: e41f3e8059727d732ec7dd6d0bd9d6f8 (MD5) Previous issue date: 2009 / Resumo: A Fonoaudiologia tradicional, com relação às alterações da linguagem, ainda sofre a forte influência teórica e metodológica dos discursos que circulam na área médica. As abordagens orgânicas são geralmente priorizadas, em detrimento de análises mais abrangentes dos fenômenos e, principalmente, dos sujeitos. Essa visão redutora, inevitavelmente, também é que vai dar as diretrizes para o acompanhamento terapêutico. Orientado pela abordagem teórica e metodológica da Neurolingüística Discursiva (ND), este trabalho apresenta um estudo longitudinal de um caso de Afasia Fluente Progressiva, para o qual contribuem o histórico neurológico - constituído por imagens tomográficas e laudos que revelam lesões em várias áreas cerebrais, em decorrência de AVCs focais e isquêmicos, clipagem de aneurismas e atrofias corticais e sub-corticais, além dos resultados de avaliações neuropsicológicas e as análises lingüísticas de episódios dialógicos. Os dados analisados foram obtidos em episódios dialógicos ocorridos nas sessões semanais do Grupo III do CCA (Centro de Convivência de Afásicos) e em sessões individuais de acompanhamento fonoaudiológico, durante as quais também foram desenvolvidas algumas atividades metalingüísticas, com o objetivo de respaldar nossas hipóteses sobre suas dificuldades lingüísticas e cognitivas. Trata-se de um caso que consideramos singular, pois revela os efeitos das práticas sociais e do exercício real com a linguagem, tanto no curso do desenvolvimento de sua afasia, como das alterações cognitivas. A instabilidade presente no caso de AJ, cujos enunciados às vezes em nada diferem da normalidade, outras vezes revelam dificuldades próprias de sua afasia e, em determinados momentos assemelham-se aos quadros iniciais de demência, contribui para a reflexão acerca da relação normal/patológico.Por fim, discute-se o impacto da abordagem da ND para a clínica fonoaudiológica, na avaliação da linguagem e, principalmente, no acompanhamento terapêutico de sujeitos afásicos ou com outras alterações lingüísticas e cognitivas / Abstract: The traditional Speech Therapy, when the focus is language alterations, is still strongly influenced by the theoretical and methodological discourses from the medical field. Organic approaches are usually privileged in comparison to other approaches, other possibilities of analysis of the phenomena and, especially, of the subjects. This reductionist view, inevitably, is the one that will provide the guidelines for language therapy. Guided by the theoretical and methodological approach of Discursive Neurolinguistics (ND), this research presents a longitudinal study of a case of Fluent Progressive Aphasia. We present the neurological history of the case - which consists of tomography images and reports, which reveal lesions in various brain areas, due to strokes - focal and ischemic, clipping of aneurysms and cortical & sub-cortical atrophies. We also present the results of neuropsychological assessments and the analysis of linguistic episodes. Data were obtained during episodes occurred in the weekly discussion of Group III of CCA (Centro de Convivência de Afásicos) and in individual sessions of speech therapy, during which some metalinguistic activities were developed, with the aim of supporting our hypothesis about his linguistic and cognitive difficulties. This is a case that we consider unique, because it shows the effects of social and linguistic practices on the development of aphasia and on the cognitive changes. The instability that characterizes the case contributes to the debate / Mestrado / Linguistica / Mestre em Linguística

Aphasia is defined as an acquired language impairment and is often caused by stroke. The impairment can affect the person in many ways depending on the severity, and lasting effects often have a negative impact on the persons participation and communication. Currently there are no national guidelines for aphasia following stroke containing named interventions. The purpose of our study is to compose an evidence-based summation of interventions for aphasia currently in use which specifically target grammatical and discourse impairment. A systematic literature search was conducted, and the included studies were assessed. This resulted in a summation of ten included interventions for treating grammatical and discourse impairment. Persistently, the studies were of poor quality, had a flawed design and had a low number of participants. The majority of the interventions were, in spite of the occasional substantial theoretical framework, considered to have insufficient evidence base. There is a need for more extensive, high-quality studies for speech-language pathologists to be able to carry out evidence-based therapy in accordance with the recently published national guidelines for stroke. / Afasi definieras som en förvärvad språkstörning och orsakas vanligen av stroke. Språkliga funktioner hos den drabbade kan påverkas i olika grad, där svårigheter ofta kvarstår och påverkar personens delaktighet och kommunikationsförmåga. Det saknas kliniska riktlinjer för afasibehandling innehållande specifika metoder. Denna studie syftade till att sammanställa befintliga behandlingsmetoder för grammatiska svårigheter och nedsatt diskursförmåga i ett evidensbaserat kunskapsunderlag. En systematisk litteratursökning genomfördes och de inkluderade studierna evidensgranskades. Detta resulterade i en sammanställning av tio metoder för behandling av grammatiska svårigheter och diskurs. Genomgående sågs låg studiekvalitet, bristande studiedesign och lågt deltagarantal hos de inkluderade studierna. Majoriteten av behandlingsmetoderna bedömdes ha otillräcklig evidens, även där en omfattande teoretisk bakgrund fanns att tillgå. Behovet av mer omfattande studier med hög kvalitet är nödvändigt för att logopeden ska kunna arbeta evidensbaserat samt följa Socialstyrelsens nationella riktlinjer gällande strokevård.