What is the treatment approach for perception aphasia?

Treatment Approach for Perception Aphasia

Speech and language therapy should be provided as early as possible after stroke onset to maximize language recovery, with intensive therapy of at least 45 minutes daily for five days a week in the first few months after stroke. 1

Core Treatment Components

Early Intervention and Intensity

• Treatment for aphasia should be initiated as early as tolerated, ideally within the first 4 weeks post-stroke 1
• For acute phase patients (up to 6 weeks post-onset), provide language therapy sessions of 30-45 minutes, 2-3 days per week 1
• In the first few months, intensive therapy (at least 45 minutes daily for five days a week) is recommended 1
• For chronic aphasia (>6 months post-stroke), intensive therapy of at least 10 hours/week of therapist-led therapy (individual or group) for 3 weeks, plus 5+ hours/week of self-managed training is recommended 1

Therapeutic Approaches

• Speech and language therapy should focus on improving functional communication, reading comprehension, expressive language, and written language 1
• Alternative communication methods should be incorporated as appropriate:
  • Gesture, drawing, writing 1
  • Augmentative and alternative communication devices 1
  • Assistive technology for communication aids 1
• Computer-based treatments can supplement therapy provided by speech-language pathologists 1

Group and Conversation-Based Therapy

• Group therapy and conversation groups can supplement individual therapy during hospitalization and continue after discharge 1
• Community-based aphasia groups are beneficial across the continuum of care 1
• Conversational therapy focuses on using all available communicative resources (gestures, body movements, facial expressions, drawing) particularly beneficial for severe aphasia cases 2

Communication Partner Training

• Treatment should include training for communication partners (family members, caregivers) 1
• Supported conversation techniques should be taught to potential communication partners 1, 3
• Environmental barriers should be addressed through:
  • Training communication partners 1
  • Raising awareness about aphasia 1
  • Providing aphasia-friendly formats for information 1

Tailored Approach and Goal Setting

• Identify therapy goals and develop tailored intervention plans in collaboration with the patient and family/caregivers 1
• Goals should be regularly reviewed and updated 1
• Reassess goals and plans at appropriate intervals 1

Education and Support

• Provide aphasia-friendly information on health, aphasia, and social/community supports 1
• Explain the nature of the impairment to the patient, family/caregivers, and treating team 1
• Teach strategies and techniques to enhance communication 1
• Provide specific training for caregivers/family before discharge, including communication strategies 1

Advanced Treatment Options

• Recent advances include combining conversational therapy with noninvasive brain stimulation techniques like transcranial direct current stimulation 2, 4
• Pharmacotherapy options may be considered to augment behavioral therapy effectiveness, though still experimental 5, 4

Common Pitfalls and Caveats

• The relative effectiveness of different treatment approaches is not well established 1
• Time restrictions can challenge implementation of comprehensive communication approaches 3
• Goal-setting discrepancies between staff and patients with aphasia may occur 3
• Implementation of new communication approaches requires organizational support 3
• Special attention from trained healthcare interpreters may be needed for patients from culturally and linguistically diverse backgrounds 1