Many questions arise when we are faced with a family member or even ourselves experiencing communication loss after a cerebrovascular accident. This article provides essential guidelines for understanding the recovery process in individuals with Broca’s aphasia by addressing the impairment at its root, identifying its core characteristics, and developing an appropriate therapeutic intervention plan.
Characteristics of Broca’s Aphasia
Oral Expression
- Non-fluent. Impaired articulation, grammatical structure (word and sentence formation), prosody, and phrase length.
- Short and agrammatical expressions
- Poorly articulated speech
- Produced with great effort
- Phonetic and phonological impairments
- Impaired naming ability
- Impaired repetition
Auditory Comprehension
- Impaired at the morphosyntactic level
- Difficulty understanding sentences in the passive voice
- Difficulty understanding sentences that rely on grammatical elements
Reading and Writing
- Oral reading influenced by spontaneous speech ability
- Agrammatic reading
- Reading ability conditioned by spontaneous language production
- Writing with impaired grapheme selection (substitution of one letter for another)
- Impaired grapheme formation (letters exhibit irregular shapes)
- Syntactic simplification influenced by spontaneous language production
Rehabilitation Exercises for Broca’s Aphasia
Affected Area
The brain lesion associated with Broca’s aphasia is located in the dominant (typically left) hemisphere, specifically in the region known as Broca’s area. This corresponds to the posterior portion of the left inferior frontal gyrus, encompassing Brodmann areas 44 and 45.
Communication
Communication is attempted in a primitive manner, often through gestures or with the use of basic words or phrases.
Clinical Presentation of Broca’s Aphasia (each case is unique, depending on the patient’s characteristics)
- Buccofacial apraxia
- Hemiparesis
- Hemiplegia
- Impairment in reading and writing abilities
Therapeutic Period
- Speech and Language Therapy
- Psychopedagogy
- Other disciplines based on individual needs
Treatment Goals for Broca’s Aphasia
- Stimulate language and spontaneous speech production
- Target function words and grammatical connectors
- Increase verbal fluency
- Improve naming ability
- Improve written and oral repetition
- Enhance reading skills both aloud and silently
Therapeutic Exercises for Broca’s Aphasia
Oral language disinhibition exercises
- Exercises involving counting days of the week, months of the year, and numbers
- Description of objects in the room
- Intoning familiar melodies (popular songs)
- Sentence completion with missing familiar words
- Joint and reflexive repetition of words and phrases
Restoration of word pronunciation
- Presentation of visual cards depicting objects or actions
- The interlocutor articulates several short and simple sentences that include the target word from the previous visual card. The patient is then prompted to name the depicted objects
- Pronounce words both softly and loudly
- Classification of objects depicted in the visual cards according to specific characteristics
Rehabilitation of active vocabulary
- Describe the object, identify the corresponding visual card, and name it (the patient may also draw it)
- Identify objects by touch with eyes closed and name them (the patient may also draw them)
- Provide the patient with incomplete sentences to complete
- Name objects that belong to specific categories
Rehabilitation of expression pronunciation
- Phrase repetition supported by visual cards
- Compose sentences related to visual cards
- Reading of texts followed by associating elements from the visual cards with corresponding expressions
For phonetic-articulatory analysis of words
- Word analysis
- Identify the number of sounds in a word
- Identify the letters that correspond to the word
- Write the word
- Pronounce the word independently (from memory)
- Read the word
Aimed at articulation rehabilitation
- Imitation of articulatory postures in front of a mirror
- Pronounce the sound in various positions
- Record the patient so they can later listen and identify their pronunciation errors
- Repetition of simple words
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