Case Study - Anomic Aphasia (Fluent, anomic variation)

Case Study

Fluent Aphasia

Age: 67

5 months (brain injury)


Problems

Client was a semi-retired physician specialist. Dr. Grant’s speech consisted of all real words, but incorrectly placed vocabulary. For example, when describing a photo of a man driving a car, the client said, “Except to say he does not have classroom, he should be able to find them breathing with that place”. Client frequently unaware that he was making these errors. When clinicians clarified with him, he would then substitute that word into his speech. For example, if asked “are you talking about a Chinese restaurant?”, he would say “yes, Chinese. The Chinese are performing sutures in the experiment with the Chinese”.

Client was not going to return to work. He was initially very apprehensive about intensive therapy because he did not like his previous speech therapy. However, after a few days he began to get up to arrive early each day. His previous speech therapist told his wife that he was inattentive and should get a prescription for ADD medication. We noted no issues with his attention.

Assessment

Using The Aphasia Center's testing protocols
  • Wrote 3-word sentences to dictation
  • Content words in spoken speech frequently substituted with incorrect words
  • No written or spoken naming of photos, no cues helped
  • Oral reading of complex sentences
  • Used no strategies to help himself or listener
  • Auditory comprehension moderately affected
  • Reading comprehension very poor

Treatment

The client attended a 4 week program with online therapy continuing.

He used My Aphasia Coach software daily.


Results

Before
After
Naming
32%
43%
Repetition
57%
64%
Picture Description
10%
Content: 12
WPM: 80
70%
Content: 59
WPM: 212
Listening to Messages
43%
77%
Paragraph Reading Multiple Choice
0%
57%
Block Design WAB
22%
100%

Outcome

  • Repeated up to 5-word sentences
  • Emerging awareness of speech errors, saying “that’s not right. What is the word?”
  • Reading comprehension for short sentences
  • Learned to use strategies to help him with naming and writing
  • Writing 8+ word sentences to dictation
  • Increased conversational speech accuracy from 50% to 70% (judged by ease of listener comprehension and word substitution)