Wednesday, 21 November 2012

The Breakdown of Language

So the other day I was struck when I read an article on The Record about a stroke survivor with aphasia, Austin, who is determined to help other patients with language disorders. “If I’m going to be limited to what I can do personally, then I may as well try to help,” said Austin, whose life has radically changed by a stroke, motivating him to start a a support group for those suffering from devastating conditions. Aphasia is a communication difficulty that is acquired by many stroke survivors and its symptoms range from having difficulty naming words to being unable to speak, read or write. Austin was in his early 40s when he suffered from a stroke and his loss of communication abilities was serious. Although, with tremendous effort, he’s made improvement, he still struggles. “It’s like identity theft and I deal with it every day,” he said.

Austin came up with the concept of an Expressive CafĂ©, as the best way to help people to recover from aphasia. It’s a really cool way to get survivors together and have them engage in conversations.

Have a look at the following eye-opening winning video of the Brain Awareness Video Contest to have a better understanding of how Aphasia can affect someone: 

Treasure Hunt” by Shiree Heath, University of Queensland`, Australia

Austin mentions, “[Stroke survivors] are home alone with no social engagement and not a lot of opportunity to just get out to talk,” and it is inevitable that this may have an impact on the quality of life of people with aphasia. I have seen this first-hand, as an uncle of mine, previously a language professor in Morocco, suffered from a stroke many years ago and acquired chronic aphasia, which affected his social life and quality of life immensely. Today, he is in a state of severe depression, refusing to leave the house or to allow us to visit him.

I found this article by Dr. Katerina Hilari, a lecturer at City University London, who did an interesting study looking at the long-term effects of a stroke on the quality of life of people admitted to acute stroke units. She compared the outcomes of people with aphasia and people without aphasia and found that those with aphasia were more severely affected. To find out more about how they were affected, you can check out the paper for free here.

You may be wondering what ‘quality of life’ actually means for a person with aphasia, and how it is measured. Although there’s an increasing need for therapists to consider the patient’s quality of life in order to provide successful intervention, there is very little research focusing on the people with aphasia’s perception of their own quality of life. This also got me thinking, so I found this where, Dr Madeline Cruice and others took an interest in conceptualising people with chronic aphasia’s view of their quality of life. They found that the core factors for the quality of life of the participants were verbal communication, body functioning, and activities. Other aspects included home, health, personal outlook, and independence. These factors could either improve or deteriorate their quality of life. To learn more about this study, click here for open access.

So yeah, although people with aphasia’s speech may be compromised, it doesn’t mean that they have no means of communication at all. Many people have the misconception that communication is in the forms of speech only. However I think it’s really important to understand that, communication can occur in many forms and manners, such as facial expressions, body language, and gestures. It is natural for gestures to accompany speech even with people with typical speech and language (e.g. thumbs up). Evidence suggests language influences the type of gestures used. An interesting research has been conducted by Dr Lucy Dipper and others, investigating the co-speech gestures used by an English speaker with aphasia in comparison to five people without aphasia. The sample taken involved describing a Sylvester and Tweety Pie cartoon. To know more about what they found out click here for free access!



It amazes me how gestures can be so powerful in terms of communication that there are languages based solely on them, such as the British and American Sign Language. The British Sign Language (BSL) is the preferred language of many deaf people in the UK. An estimated number of 125,000 deaf adults and 20,000 children use BSL in the UK. It involves the use of gestures, facial expressions, body movements, and space to communicate. Two weeks ago, while I was having lunch with a friend in Westfield, I saw a deaf little girl with her hearing dad. I was very touched to see how naturally she was using sign language, as she was explaining what she wants in her sandwich using signs to her dad, who then translated it to the waitress.

Can you believe that BSL is so intricate, that it has its own system of complex grammar and phonology, which is defined by orientation, location, hand shape, motion and so on…What is even more fascinating is that although it may appear to be very different than spoken language, the child processes of phonological acquisition of BSL and speech development are similar. A single-case study was conducted on a deaf little girl, Gemma, and she was found to follow similar strategies of simplification to typical speech development. You must read this study in order to appreciate the common patterns of BSL acquisition and speech development, it blew my mind away! It is easily accessible for free here.

Across the course of my studies, I really started to see how having a communication deficit impacts on the quality of one’s life, not only adults but even children. It made me realize how blessed we are for all the typical things we take for granted.  Did you know that residents of youth offender institutions have been shown to have a higher than expected incidence of Language Impairment ? See here for a study which highlights the problem of undiagnosed speech and language problems in young offenders.

Specific Language Impairment (SLI) is a developmental disorder and is identified by atypical patterns of language development without a known cause. Although it’s known to be an early years disorder, evidence shows that it can continue into adulthood. Can you imagine the types of difficulties children and adults with SLI can face? Bullying, failure to express needs and emotions, and low self-esteem to name a few.

The effect of specific language impairment on one’s life down the line has not been investigated enough, therefore, Professor Gina Conti-Ramsden and Dr Nicola Botting compared the emotional health of adolescents with and without a history of SLI. They found a higher rate of anxiety and depression in adolescents with SLI, however, no direct link with language impairment was evident. To learn more about how they assessed this and the clinical implications of it, click here for the open access paper.

Anyway as you can see I’ve obviously had far too much free time on my hands this month, lots of interesting reading still to be done! Hope you guys enjoyed my first blog! 

See you next month!

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