•Use yes u and Hnon questions rather!

than
11

open-ended questions.
•Praise all attempts to speak a.nd downplay
1

any errors,. Avoi d ins isting that that each,

1

word be produced perfectly.

•Engage in normal a.c tivities whenever
possible.
•Encourage indepen dence and avoid being
1

O'v erprot·ective.
. Keep your voice at a norma.l leve l. Do not speak
loudly unles.s the person asks you to do so.
• Keep communication simple, but adult~Don't
"talk down1" to th e pe rsor1 W'i th aphasia.
1
1

• Give the individlru al time to sp eak. Resis t the

1
1
1

urge to fi nish sentences or offer w,ords .

1

. Communicate with drawings, ge.stures, writin g, 1

and facial exp·ressio ns in addition to speech~

1

• Encourage th1e person to use drawings,

gestures, and wrlt:ing.
Points to remember while
communicating aphasic
• Get the p erson's attention before you start
1

speakin g.
1

• Maintain eye contact and watch the person's

body language and use of gesture~
1

• Minim11ize or eliminate background noise (TV,

radiof other peo ple) .
1

. Sjmplify your s,e1ntence structure and

e,mphasize k.ey words .
~ Reduce your rate of speech.
Impairment based therapies
► Constralnt--lnduced' Movement The~apy
1

• C'o nstraint induced language t lh erapy

1

• Melodlc Intonation Therapy (MIT)

► Tele-rehabllltatlon
-· Communication based therapies:
Commun icalion ori e nterd tireatm11 nt s ~ in ,pan~ ass,ist the perso n in
1

conveying messages and feelings with ,a ltemative means of communicating

1

Jn addition. an indtwidual is encouraged to use any remainfing1language

ability that succeeds i·n c,onveying messagesi The,re·f ore, communication~
based activities continua t 0 be parity 11 langua91-,bas 1d 1~ and are likely to
1

incorio0r1ate Impairment- based objectives Slrmultaneously.

1

These accom1painie:s
_COMENSATORY SliMTECIES
Constraint-Indu ced Movement
Th erapy
~ This therapy is modeled
after a physica I therapy for
paralysis
11
In1 which a patient
1s forced/ for exam1ple 1 to
use an im pa1ired side of the
body bee au se the 9 aod
side has been restricted ar 1

constrained I]

~ p ri nc;ip le to
In a,pplyi.ng ~his _ 1

commun u:at1on funct11ons a

perrson w,ith aphasia may be
co nstrained in usi·ng intact.
gesture in 0 rde r to cl ire ct
1

the individual to use

impaired spoken language.
TIME
• A seco1
nd, and p erhaps more well-known,
1 1 1

compo,n ent of this treatment is th,a t it is more

int·ens,ive than typical thera.py sche dul:es and
1

it lasts for a relatively short dluration. For

exam1plle,. the thera.p y m1ay be administered
for thre e hour,s dailly for two weeks
1
Me lodic Intonation Therapy (M lT) 1

Best candildat.es are palie1n'ts rw hose A1ud irory

Co1m prehensio1n rus berrer than rhei r verba~ expression ar1 d
1

verbal expressiion ~s severely impaired

Strate gies:
1

· Intonation pattern uses a range of 3=·4 notes

• Elements, include an exaggerated melody line composed
of at leas t: 2 sylliable.s.. The rhythm and point of s·tress
1

[h elp to convey rneani,:ng

· MIT is :sllower., simUlar to Chant Tallk jng
· Program Progresses to Longer svnt.actic units aJnd to 1

Clinician Question. Cl.ient Answer using progressively

faster me Icdic patterns.
1
Melodic Intonation Therapy
U se s m us ic. rh yt hm an d ph ra se s to su
p]JOrt speec,b reoovecy
T oo l: ,,e c NC \\'S MIT Vi de o ~1 rr A.ese_ar~'h

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are prov ided over the

~ Establl ishe d proc edu res
Inte rnet W ith web cameras so that the
1

ther apis t and pers,on with ap has,i a ca,n see

1

and hea,r each other.

MIT lp rQgnffl

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Communication based therapies:
~ Activities/Participation-Based
Treatment
. Augmentative and Alte.rnative Communi1cation (AAC)
1

T1reatment involving the use cf augmentative aids, such

as picture, and symbol communication boards a.n d electronic
devtces 1 to hel p individuals with ap1hasi1a express thermselves"
1

t MIMII

IIVi "ii ti

lJ • ~ - I
. Promoting Aphas i1cs ' Comm1unication
Effectivene ss (PACE)
1

A conversational treatment in which any

modality· can be used to com1mun 1
1
icate ide as
1
1

from one partner to the other. The client

and clinician talk.e equal t.u rns in1t lhe sender
and receiver roles, and this promotes
conversational participation.
• Oral Reading for Language in Aphasia.
(ORLA)
treatment using auditory, visual, and written
cues to assist the person with aphasia in
reading sentences aloud.
Constraint-Induced Language Therapy
Primary locus is on talking whilB avoiding the use of othar
communication strategies such as gesturing, drawing, Wriliing, ale.
Tool :, Cl Traln1lna Video
. Constraint i1nduced ianig uage the.ra.py
In CILT, a smal1 group o,f patien,ts with aphasia 'take
part in language activities in whi1ch they are
con1strained to verbal. responses that are •shaped
t owar d more e·xpans1ve utterances 0ver time. I1n
1 1

contrast to other aphasia treatment approaches

that promote the use of compensatory
communication modalities such as gestu.re,
drawing , ~Jir writing[I in CILT no compensatory
1
1

nonverbal communication strategies are a,1,owed

1

during t.he language activities. lffl1proved verba,

re.sponses _
are th~ goal of tre_atme~t. Furthermore,
trea_tment 1s provt ded on an 1ntens1ve schedule, up
1

1D~~elUJo~DBLdar.foLfl1 !L~clays per -w_ttek.

C o n v e r s a ti o n P a r tn e r T r a in in g
Su pp or ted Co nv ers ati on CPT R6 Ca rth
He lp s ·conversation
pa nn er " 10 understand
an d pr ac tic e
verbal/non-verbal
co m m un ic at io n ■
st rateg ias
1 h1 lp ':1/'w\Nw. a ph e Si a .a a h Ill') tlll.nl, lyfl pc VnrJ
Tools: Su ppon.~ng Communitldon L•fc Pa rt, cl ~t lu n

II
hU p 11b •IJ yll pbE~~g hU p !/ftJ ~t. Lyll 111 I 1.E9i
• Word Finding Treatment
. Response Elaborati1on Training (RET)
A type of ••1oase training" which works to impr0ve 1

llexical retrieval an d the n1umber o;f content words

1

produced by an i n divid1
1
ual with aphasia ( Conley &,
1

Coe I hot 2003.) ~Forward chaJining, Oi'r elaboration. of the.

client's utterances is used .
1

•
• Opposites Exerci.se
This e.x ercise helps with repairing
w·o rd-finding abil itie,s a.1nd
~rticu latio n. as we 11 as expanding • 11
tdf _I II L II . . .

limited concep·t s. For t 1h is

exercise• write down tin w~rds,
11
such as up.'' mad" and br1 · ht/11 1

Then. ask for th@ opposite of

word. Fo r instance, you would
1
the .....
ask, ·what is the oppos~te of up? 11
• --■ Ill• Ii. I
You would then1re1pfy with ■ 5ETID
11
d-o·w n. N Th"1s exercise ~ earn
increase I~ diffic1 4:1 lty 1_ w i tlh
concepts 1ncre~sing in complexity
as the sufferers tolerance
_
·• ..•
strengthens.
11 11
IF or i ns'tanc@ 1 try
fru,s tratio n a.n1d ·~ oy / 1
• ■a I I
.,......
• all11

• ■ca ti
 :J) Wilue 11 the mt ,
. Prep os~tion ExercJse
1

T f ' ,te
.l!~.9.n
1

..t1iitEt~"H• ...~..nmu",itcr.4~-
This exercise. uses two spoons
2) Where i.s the oat 1
and a baxJ. and he~ps .firm the
conrc e·pt or prepps1t1ons,. To
start 1 p lace the box. on a
1 1

surface and place both 3) Where is the cat ?

spoons an~here relative to ■ a■ .... ■ I ■■:t ■■ 111111111 II ■■ I: ■■ l':"■W• ■ 111131 ■■ II ■■ Cl iii ■■■■■, ■

the box, such as on the bo.x

and bes ide· it~ These spoons 4) Where is the cat 7
would not b e in the same
1
1

location. Then ask ,1~'Which

1
spoon Es on the. box?£ He 5) Wh~re ts the ca, 1
would th~en .reply by pi clki ng
up o,r po1_nt1ng at t~e s~9_0n. • • 91. ■■ •• I •• 1 lil'l lolli •• I l ■cf 1-ITTlll:f 11 1 IIJlfll l!lll!I I • • I ■■■ :ll

You can 1n1crease 'the d 1ff1culty 6) Whue i! t he mt1

by using mu lt 'i ple spoons.
FI ■lliS ■ :.t a:■Ill ■'r■ L,■ li l! ■ i i l!i hl!!I ,. ... lillJt t•• I • • 1 11 ■ I ll ■
Script Training
P ro m ot es .s pe ec h recovery by
re pe at i" 9
((0( sp ec ifi cl re le va nt ph ra se s fr om
prepared scripts

T o o l: Sc ri pt 1'ra1ning A pp RIC Apl1Mia Sc ri pt s

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