Global aphasia. Characteristics

First of all, it is important to remember that global aphasia is the most severe form of aphasia, as all or most aspects of language are affected and impaired due to a brain injury.

It refers to patients who can produce few recognizable words and understand little or none of the spoken language. People with global aphasia cannot read or write. As with other milder forms of aphasia, patients may have their intellectual and cognitive abilities fully preserved.

Global aphasia is caused by damage to multiple areas of the brain that process language, including Wernicke’s and Broca’s areas. These brain regions are particularly important for understanding spoken language, accessing vocabulary, using grammar, and producing words and sentences.

Characteristics of global aphasia

Oral expression

• Oral expression.
• Mutism may be present, meaning a total absence of speech.
• Occasionally, stereotyped expressions or neologisms.
• Automatic language may be preserved.
• Naming is absent. It may be reduced to babbling or stereotyped utterances.

Auditory comprehension

• Severely impaired.
• Responses may be observed to high-frequency words and simple commands.
• Sometimes shows no signs of understanding that they are being spoken to.

Reading and writing

• Severe alexia and agraphia.

Rehabilitation exercises for global aphasia

Affected area

Brain lesion in the left (dominant) hemisphere near Broca’s area, Wernicke’s area, or both.

Communication

Communication is attempted in a primitive way, through gestures, and sometimes through basic phrases or primitive words.

Clinical presentation (each case is unique, depending on the patient’s characteristics)

• Motor disorders (hemiplegia)
• Sensory disorders (touch or vision)
• Dysarthria (articulation)
• Scanning speech (separated syllables)
• Acalculia
• Behavioral disturbances (depression, catastrophic reactions, indifference, anosognosia)
• Amnesia
• Epileptic seizures

Therapeutic period

• Speech and language therapy
• Educational psychology
• Other disciplines as needed

Treatment objectives

• Stimulate language and its spontaneous production
• Increase comprehension of frequent words
• Work on function and connector words
• Increase verbal fluency
• Improve naming skills
• Improve written and oral repetition
• Improvement in reading aloud and silently

Treatment exercises

• Use of pictograms to facilitate communication
• We will say different things the patient must do
• Have them point to objects in the room
• Ask questions so the patient can respond by nodding yes or no
• We will ask them to recite something automatic (already acquired)
• Sing well-known songs (such as “Happy Birthday”)
• We will say words and ask for their antonyms (accompanied by images and text)
• We will ask them to name objects around us
• We will describe an object
• We will work on word categories
• We will say three words and ask them to name what they have in common
• We will ask them to explain some drawings
• We will ask them to copy some simple numbers and letters
• We will ask them to write next to a drawing what they see in it
• We will ask them to write individual adjectives about themselves.
• We will say a word and ask them to make a sentence with it
• We will give a series of words for them to read aloud
• We will ask them to copy words written below their drawing
• We ask them to name in writing the contents of a picture sheet with drawings
• We will ask questions so they can respond in writing
• Give them short stories to read. These should be accompanied by images

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