Speech as One of the Most Important Functions Which a Normal Individual Possesses - Research Paper Example

ar Broca’s Area 11/6 Treatment in Broca’s Aphasia Introduction Speech is the one of the most important function which a normal individual possesses. Some nervous disorders directly affect this function thus making it difficult for the individual to speak. Broca’s aphasia in particular is the most important part of the brain which is involved in speech comprehension. The word Broca comes from a renowned French surgeon Prierre Paul Broca. Broca in 1861 found out an area in brain which seemed to be responsible for speech and language. Broca’s area is located in the premotor area which lies anterior to the primary motor cortex. Damage to the Broca’s area can cause severe aphasia or difficulty in speech. An element through which Broca’s aphasia can be treated is a technique known as the Response elaboration training. This essay would further discuss the etiology of Broca’s aphasia along with its option of treatment in adult patients (Guyton & Hall 2011; Fazio et al 2009). Etiology Aphasia generally describes a condition in which an individual has impaired language skills. It can occur due to damage to the regions of the brain which are responsible for language. Broca’s area is a non fluent type of aphasia which occurs in the frontal lobe of the brain. In this type of aphasia the individuals are not able to speak whole words or they have difficulty speaking them. In this type of aphasia some motor movements of the individual are also affected because the frontal lobe is also affected. Commonly aphasia occurs due to accidents which harm the structures in the brain, a tumor in the brain, infection of the brain and dementia. It is because of these problems that the sensory pathways do not transmit the signals properly and hence aphasia occurs (Guyton & Hall 2011; LaPointe 2005). Characteristics of Broca’s aphasia Broca’s aphasia is characterized by problems in speaking or writing language. It is also called motor aphasia, expressive aphasia or non-fluent aphasia. The individuals are not able to speak fluently and hence have difficulties in making up sentences. The individuals face difficulties when speaking up full words. The individuals are not able to make up sense with their sentences. For example individuals would just use two words such as ‘glass, table, where the individual tries to say that the glass is on the table. (Fazio, 2009). At first it was believed that Broca’s aphasia was only associated with language comprehension but recent research suggests that it also affects other portions of cognition through which individuals cannot perform and understand actions properly (Grafton et al 1996; Binkofski et al 1999). People with Broca’s aphasia usually do not have a problem in hearing whereas they may face problems when trying to understand things. Anomia is a term used for aphasics when they are not able to find the correct word to speak in a situation. Several other problems may occur along with the Broca’s aphasia which include apraxia, alexia and dysarthria (LaPointe 2005). Diagnosis The diagnosis of Broca’s aphasia is dependent on the lesion or accident suffered by the patient. The individual has to go through a variety of tests through which the neurologist can know as to what problem is the patient actually facing. Tests such as Boston Diagnostic Aphasia Examination, the Western Aphasia Battery, and possibly, the Porch Index of Speech Ability help to detect the level of aphasia that the person is actually going through (LaPointe 2005). Treatment Many treatment options are available to the patients suffering from Broca’s aphasia. In some of the cases it is also seen that the patient recovers from the injury by himself but in some cases intervention is necessary to make sure that the person speaks. The treatment options are recommended to the patients depending on their state of aphasia or the cause of aphasia. In other words the underlying cause of aphasia is the foremost factor which a surgeon should come to know. One important form of treatment is Response Elaboration Training which is discussed in the subsequent paragraphs (Rider et al 2008; Fazio et al 2009). Treatment –Response Elaboration Training Response Elaboration Training is a technique which can be used to treat aphasic patients. It has proved to be effective in many instances to improve the verbal communication skills of the aphasic patients. RET was designed for the specific purpose of treating individuals suffering from aphasia. The treatment option is quite specific when it comes to improving the language skills. The foremost problem that individuals with aphasia face is that they cannot form sentences or proper words when delivering their inner thoughts. This form of treatment emphasizes on these characteristics of the disorder to cure the individual. It basically targets to increase the number and length of utterances by the aphasic patients (Kearns 1985). Kearns has done research on the RET through which it has been found out that it plays a great role in increasing the content delivered by the patients. The utterances of the patients are analyzed through RET so that the progress of the patient is matched to the outcomes of RET (Fazio et al 2009; LaPointe 2005). A study done by Wambaough in 2001 showed that individuals who used RET regularly had an increased form of verbalizations. The participants selected in this study were divided into three groups. One group of the participants showed increased usage of nouns when describing pictures and personal narratives. Verbs and adverbs were told to the participants in accordance to the picture which was shown to them. This made them memorize the actions mentioned on the picture even more. The second group of participants were told personal experiences of the experimenter himself along with the description of the pictures. This type of RET was more successful than the previous one in which only the pictures were shown. Personal recount by the experimenter was very helpful in improving the treatment of the individuals. It was clearly seen that RET here was very beneficial for the aphasic patients in improving their skills of memorizing (Wambaugh et al 2001). Yet in another study done by Conley in 2003 it was seen that both the methods of RET and structured treatment were used. The forward chaining technique was used in this experiment similar to the one used in the RET ones. It was also found through this experiment that the methods of RET in curing the individuals were very successful. The content of words produced by the aphasic patients increased after the RET. Conley in his experiment also used semantic analysis along with the methods applied in RET. This experiment clearly showed that both these methods together can bring about a desirable result (Conley & Coelho 2003). Many on the other hand argue that RET is not that successful in curing patients with aphasia as is the semantic features analysis. To prove this a research was done by Rider in 2008 which used the methods of SFA to help people memorize the information which was needed by them. In other words it helped the aphasic patients to organize their memory in such a fashion that it was easier for them to retrieve (Rider et al 2008). It is believed that semantics work through a different pattern than RET. The subject is asked questions about a particular word that the subject is facing difficult to retrieve. To be specific the subject is asked about the semantic analysis of the word so that he can retrieve the word. This feature in another way helps to repair the damaged semantic connection of the word in the brain of the individual and thus it helps the individual to retrieve the word more easily the next time. However the research done solely on the basis of semantics did not prove to be that much successful as with the combination of semantics and RET (Rider et al 2008). The strategies that RET adopts are regarding the patient’s own building up processes. Spontaneous responses are the most expected results of RET through which the patient can able to know much more about the speech he is going to deliver. The aphasic patient through such a strategy can be able to grasp spontaneous topics so that he can memorize a broad range of words and sentences. At first these spontaneous responses through RET would not be successful enough to generate a proper answer from the patient but several tries can make the patient aware about the situation. Through repetition the individual can grasp as to what really is he lacking and may try to improve. The client may be able to utter a whole word if the utterance of his words is completed by the experimenter which is a strategy used in RET. RET applies the concepts of agrammatism when trying to improve the speech in aphasic patients suffering from frontal lobe disorders. By agrammatism here it is meant that the patient always tries to simplify his speech before he speaks and hence complex language would make it difficult for the patient to speak. RET basically targets the patients suffering from aphasia to link up their words properly. It does not go for smaller sentences but rather forces the patients to use their utterances as a supporting framework through which they can build up their sentences. RET presents a loose environment to the patients of aphasia through which they can develop skills in an open environment. The stimuli and responses are reduced in the environment so that the patient is given a broad set up where he can freely share whatever he has in his mind. It gives an opportunity to the patients of aphasia to go back in their past so that they can grab stuff from there and join them to correct their speech. RET applies methods through which the patient directs the line of treatment. It is the patient through which the context of the treatment is determined. RET forces the patient to speak up more and more and hence enhance his communication skills. Thus it is RET which gives a platform to the patient through which the patient can improve his linguistic pattern (LaPointe 2005; Kearns 1985). Conclusion RET has proved to be an effective form of treatment option when treating Broca’s aphasia. The strategies adopted by RET have been quite successful in improving the problems faced by these patient. Semantic featured experiments are also helpful like RET but experiments have yet not showed any significant improvement in the patients going through this feature. However if both the RET and Semantic featured experiment are administered together then a lot of improvement can be witnessed in the patients. Further research is however needed to improve the concepts of RET so that the aphasic patients do not have to face any difficulty when talking (LaPointe 2005; Kearns 1985). References Kearns, K.P. (1985). Response elaboration training for patient initiated utterances. In R.H. Brookshire (Ed.) Clinical Aphasiology (Minneapolis, MN: BRK) pp. 196±204 Kearns, K.P. (1997). Broca’s aphasia. In L.L. LaPointe (Ed.) Aphasia and related neurogenic language disorders 2nd edn. (New York: Thieme) pp. 1±41. Wambaugh, J., Martinez, A., & Alegre, M. (October 01, 2001). Qualitative changes following application of modified response elaboration training with apraxic-aphasic speakers. Aphasiology, 15, 965-976. Top of Form Conley, A., & Coelho, C. (January 01, 2003). Treatment of word retrieval impairment in chronic Brocas aphasia.Aphasiology, 17, 3, 203-211. Bottom of Form Top of Form Rider, J. D., Wright, H. H., Marshall, R. C., & Page, J. L. (January 01, 2008). Using Semantic Feature Analysis to Improve Contextual Discourse in Adults With Aphasia. American Journal of Speech-Language Pathology, 17, 2, 161. Bottom of Form Top of Form LaPointe, L. L. (2005). Aphasia and related neurogenic language disorders. New York: Thieme. Bottom of Form Top of Form Hall, J. E., & Guyton, A. C. (2011). Guyton and Hall textbook of medical physiology. Philadelphia, Pa: Saunders/Elsevier. Bottom of Form Top of Form Fazio, P., Cantagallo, A., Craighero, L., D’Ausilio, A., Roy, A. C., Pozzo, T., Calzolari, F., ... Fadiga, L. (January 01, 2009). Encoding of human action in Brocas area. Brain, 132, 7, 1980-1988. Read More