The case study of the augmentative and alternative communication (AAC) intervention in Broca's aphasia patients with AOS

초록

Objectives: Individuals with severe communication problems associated with non-fluent aphasia and concomitant apraxia of speech are often unable to perform daily communication. For these people, augmentative and alternative communication (AAC) can be challenging to participate in meaningful communication. The purpose of this study was to report the training process and functional effect of AAC in 3 cases with Broca’s aphasia. Method: Three patients (2 male and 1 female) with severe non-fluent aphasia participated in this study and all of them were recruited at the Korea University Anam Hospital. All participants presented severe Broca’s aphasia with accompanying apraxia of speech, characterized by limited verbal output. And their aphasia quotient (AQ) measured by Korean version of Western Aphasia Battery (K-WAB) were 16.2, 10.8 and 28.8, respectively. We trained them to use AAC program (MyTalkie) and observed their responses during the therapy session. Also the changes of communication effectiveness were obtained from their caregiver after training. Results: Case 1 received 8 treatment sessions, but he didn’t want to use AAC device and wanted to communicate through his speech alone. Case 2 and 3 performed 15 and 17 training session, respectively, but they had difficulty to operate AAC device due to limb apraxia and perseveration. We couldn’t observe communicative improvement by report of caregivers. However, AAC was helpful to communicate with therapist in therapy setting. Conclusion: Many people with aphasia have cognitive dysfunction and limb apraxia as well as the language impairment. For successful communication with AAC, it is important to check motivation of patient with aphasia and to evaluate cognitive function and apraxia for selection of adequate candidate for training. Also, clinicians should develop a proper strategy for training of AAC, communicative assessment tools, and specialized education program is need for the therapist.

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