![]() Treatment approaches for aphasia may reflect the particular classification system the clinician prefers and include, but are not limited to, “traditional” approaches, “cognitive neurolinguistic” approaches, and/or “functional” approaches to aphasia intervention. There are a variety of aphasia classification systems that range from considering aphasia as a unitary disorder to classifying aphasia as discretely distinct syndromes. Reflecting this domain, the life participation approach to aphasia therapy considers the conversational partner as a key part of the treatment of aphasia. Lastly, the “participation” domain of the ICF classifies an individual’s participation in society and the effects of aphasia on social roles and life situations such as attending a book club or going to a community luncheon, for example. ![]() Aphasia treatment approaches that reflect this domain take into account the context and environment where communication occurs. Examples of activities that may be affected secondary to aphasia are talking on the telephone, asking for directions to a location, or sharing a story. The ICF domain labeled “activity” considers the life activities in which an individual engages and how the health condition affects an individual’s activities. Moreover, neurophysiological clinical interventions for aphasia such as the use of noninvasive brain stimulation as an adjuvant to behavioral treatment for aphasia fall under the body functions and structure or the impairment-focused domain of the ICF. With regard to aphasia, there are several impairment-based approaches to behavioral intervention that focus on areas such as word finding and grammar. In the ICF model, the “body functions and structure” domain classifies the health condition as impairment based, thus approaches to treatment that focus on the aphasia impairment reflect this domain. ![]() The international classification of functioning model (reprinted with permission from the World Health Organization) ![]() We will discuss current approaches to aphasia therapy in the context of the International Classification of Functioning Disability and Health (ICF), a biopsychosocial model of health and disease that promotes the consideration of health conditions among three domains of functioning: body functions and structure, activity, and participation. Current behavioral treatment strategies for aphasia, although beneficial in some cases, leave many stroke survivors with life-long disability. With age as a major risk factor for ischemic stroke, and aging of the US population, aphasia will become more common in the coming decades. Regardless of the classification used, for individuals with aphasia, some or all aspects of linguistic competence are impaired. Commonly defined as language impairment or loss, aphasia causes impairment of oral language production, language comprehension, and other associated linguistic communication skills potentially by modality (auditory, oral, visual, gestural), level of processing (phonology, morphology, syntax, semantics), or impairment in other cognitive domains relevant to functional communication (emotional communication, pragmatics, self-monitoring, theory of mind or perspective-taking, aesthetics, and humor). It affects approximately 1 million people in the USA today. Aphasia, a cognitive-linguistic disorder that is a frequent and often chronic cognitive consequence of stroke, results in detrimental effects on autonomy and health-related quality of life.
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