Case Study
Global aphasia with very severe apraxia
Age: 45
Time since stroke: 14 months
Problems
The father of three young children, Kory's lack of progress in therapy had affected the entire family. He would become angry and his children were afraid because they didn't understand him. His spouse had been told that he couldn't get better.His speech was limited to "guhbuh" and "buhbuh". Very severe apraxia meant that he could not form sounds purposefully or sequence mouth movements.
Assessment
Using The Aphasia Center's testing protocols
- Relatively good comprehension in context
- Some single word reading
- Could write his full name independently, otherwise copy-dependent
- Extremely motivated with a great sense of humor; always playing jokes on everyone at the office
Treatment
He completed a 8-week program with tDCS
and My Aphasia Coach software homework daily.
Results
Before
After
Words
0
55
Yes/No questions
40%
50%
Following commands
23%
35%
Outcome
- In the first week, he learned 8 phonemes (sounds) and 2 words with minimum to maximum help
- During the first three weeks, he added 25 new words and 9 new phonemes with max cues
- He began to say some words after seeing the word, learning 55 words with max to minimum help
- He said simple words independently during the day ("hi", "bye", "no", "coke")
- He also began to say 2-word sentences with maximum cueing, such as "go home" and "my coke"
- To his family's delight, he also learned to say his son's name