Case Study - Broca's Aphasia with Apraxia

Case Study

Broca's Aphasia with Apraxia

Age: 58

Time since stroke: 18 months


Problems

Russell was a brilliant scientist and entrepreneur before his stroke. His severe aphasia and apraxia left him unmotivated. He’d been largely just watching tv for months. He desperately wanted to go back to his old life and didn’t believe he could get better. He didn’t want to try if it wasn’t perfect.

His wife didn’t disclose his depression before he began intensive therapy. Typically, once a client like this sees that they can make progress and learn strategies to cope with their current life, their mood can improve. He stopped his psychotropic medication during the first week, thinking he would be ‘cured’ by the treatment. He began taking it again during the 4th week with significant speech benefits.

After extensive counseling during his treatment, he agreed to participate fully in the program. Daily goals helped him see his progress more frequently and easily. His treatment focused largely on speech production and compensatory strategies to help him feel more success more quickly.

Assessment

Using WAB-R
  • Only independent speech was "no".
  • Severe apraxia
  • Strong family support
  • Relatively good cognitive skills
  • Poor reading and writing skills
  • Sometimes became angry at therapists when frustrated and shouted

Treatment

He completed a 6-week program

and My Aphasia Coach software homework daily.


Results

Amazingly, he made rapid progress once he chose to fully participate.
Before
After
Listening
65%
85%
Speech
23%
59%
Aphasia Quotient
24.2
74.8
Comprehension
55%
84%
Reading
30%
46%
Writing
20%
50%

Outcome

  • Said 2-3 word phrases 75% accurately and communicated verbally 50% of the day
  • He ordered his own lunch verbally with some help
  • He read short sentences aloud with 60% accuracy
  • He became more interested in treatment and excited about projects
  • Started an art business, creating beautiful abstract works