Releasing the Constraints on Aphasia Therapy: The Positive Impact of Gesture and Multimodality Treatments

• Published in: American journal of speech-language pathology Vol. 22; no. 2; pp. S227 - S239
• Main Author: Rose, Miranda L
• Format: Journal Article
• Language: English
• Published: United States American Speech-Language-Hearing Association (ASHA) 01.05.2013; American Speech-Language-Hearing Association
• Subjects: Aphasia; Aphasia - physiopathology; Aphasia - therapy; Care and treatment; Communication; Comprehension; Cues; Evidence; Gesture; Gestures; Humans; Intermode Differences; Language; Language Processing; Language Therapy - methods; Learning Modalities; Models, Theoretical; Neural networks; Neuronal Plasticity - physiology; Nonverbal Communication; Nonverbal Communication - physiology; Oral Language; Recall (Psychology); Rehabilitation; Semantics; Semiotics; Speech; Speech - physiology; Speech Communication; Studies; Therapy; Verbal Communication; Writing Ability; Australia; aphasia treatment; constraint; multimodality; therapy; gesture
• ISSN: 1058-0360; 1558-9110
• DOI: 10.1044/1058-0360(2012/12-0091)

Purpose: There is a 40-year history of interest in the use of arm and hand gestures in treatments that target the reduction of aphasic linguistic impairment and compensatory methods of communication (Rose, 2006). Arguments for constraining aphasia treatment to the verbal modality have arisen from proponents of constraint-induced aphasia therapy (Pulvermuller et al., 2001). Confusion exists concerning the role of nonverbal treatments in treating people with aphasia. The central argument of this paper is that given the state of the empirical evidence and the strong theoretical accounts of modality interactions in human communication, gesture-based and multimodality aphasia treatments are at least as legitimate an option as constraint-based aphasia treatment. Method: Theoretical accounts of modality interactions in human communication and the gesture production abilities of individuals with aphasia that are harnessed in treatments are reviewed. The negative effects on word retrieval of restricting gesture production are also reviewed, and an overview of the neurological architecture subserving language processing is provided as rationale for multimodality treatments. The evidence for constrained and unconstrained treatments is critically reviewed. Conclusion: Together, these data suggest that constraint treatments and multimodality treatments are equally efficacious, and there is limited support for constraining client responses to the spoken modality. (Contains 3 tables and 2 figures.)