ALTERNATIVE FORMS OF COMMUNICATION AMONG PERSONS WITH APHASIA

Abstract

The aphasia is the most complicated and the most difficult form of disorder of speaking and language. Most often it appears as a consequence of a brain stroke. The occurrence of aphasias is in about one third of the patients suffering from a brain stroke in an acute phase, or from 21% to 24%, and there are data for even bigger frequency. In a certain number of patients the aphasia withdraws spontaneously, but in a bigger number of patients it takes over all four models of language activity; phoneme pronunciation, carrying out a discussion, writing a letter of a full text. It spreads from the automatic to the creative expression. The process of rehabilitation of the spoken communication at the persons with aphasia is complicated, multidisciplinary and long lasting.

Around the World, a big accent is placed on the use of methods and strategies of alternative communication methods (AAK) for the persons with aphasia. Although the augmentative and the AAK methods for the persons with aphasia are relatively novel in the speech therapy, their applicability deserves an attention as well as the fact that they are promising new paths for researching.
The master thesis is written on 104 pages, which include 35 tables and 48 graphics, as well as a glossary with 114 biographical units. The content is divided into introduction, grounding theory and methodology of research. The introduction shows the meaning and the necessity for research of alternative methods in the therapy and the treatment of persons with aphasia. The section with the theoretical grounds contains several mutually connected chapters (parts). In methodology of research section are described the subject of the research, the aim and the character of the research. Further the text contains the tasks, hypothesis, research variables, methods and techniques of the research, as well as the sample and the organization of the research. The end of the section consist the analysis and interpretation of the collected data, results of the research, discussion, verification of the hypothesis and conclusions. After the methodology section follows the section with future recommendations. The subject of the research is the analysis of the forms of AAK that the patients with Brokin's and Vernike's aphasia use in their everyday communication. The necessity of the forms of AAK can be used for developing and improving of the communicative abilities at the persons with aphasia. The aim of this research is to find the forms and strategies of AAK that will support and help in the communication of the persons with aphasia in the Municipality of Shtip. In the process of gathering quantitative data to follow the attitude of the respondents, there were constructed two sets of questionnaires for the needs of the research. The first instrument used in the research which was designed for the respondents suffering from aphasia had a goal to confirm the forms of AAK that they use in their everyday communication. The second instrument, designed for the medical personnel and the family members of the patients as respondents, had a goal to confirm the necessity of information and preparation for using the different forms and strategies of AAK at the persons with aphasia. For the needs of the research, subtests from the Boston diagnostic test for aphasias (BDAE) were used in the function of detecting deficit of language functions among the respondents suffering from Brokin's and Vernike's aphasia. The research included three groups of respondents. The first category of respondents included 30 patients between 34 and 75 years old, suffering from aphasia, a consequence of a brain stroke. Some of them were hospitalized in the national hospital WU-Neuropsychiatry in Shtip and others were staying at home. The subgroups in this group were designed by the type of aphasia the patients were diagnosed with and by the similarity of results received from the Boston diagnostic test for aphasias (BDAE). The second group included 30 members of the patients' families and the third group included 27 persons of the medical personnel employed in the physical therapy in Shtip. The research included patients that recovered from a brain stroke between 2009 and 2010, having at least four months being passed after the brain stroke and were in a phase of stabilization of the disease. The respondents, the members of their families and the medical personnel were questioned regarding the AAK, after which an evaluation of the effects of using the different forms of AAK was made. The descriptive statistics show the structure and the inferential statistic c²test analyzes the difference in the data between the categories, where this difference is considered as significant at level of p<0.05. The results of the research are given by a specific order. An important part of the results is dedicated to the analysis of the data conducted after examining the medical personnel regarding the possibility for communication and understanding the persons with Brokin's and Vernike's aphasia. At the end of this chapter are given the results conducted after examining the patients' caregivers. Special importance has the comparison of the results conducted from the persons with Brokin's and Vernike's aphasia, regarding their separate values for using the alternative forms and methods of communication. In the Discussion the results of the research are analyzed and they are compared against the results conducted by other authors. Then they are brought in connection with postulation of the possibility and the meaning that using alternative methods of communication in the rehabilitation of the patients suffering from aphasia has, as well as their integration in the family and the wider social setting. In accordance to the goals, the established hypothesis and the results from the research, certain conclusions are extracted of which we highlight the following:
1. There is a difference between the persons with Brokin's and Vernike's aphasia in using the forms of AAK. From the results could be concluded that the patients with Brokin's aphasia use fragments of the forms of AAK such as: pointing out by looking at things, drawing and relying on a support from a communicating partner, in the understanding of the verbal communication. The patients suffering from Vernike's aphasia use only the support of the partner for understanding the verbal communication.
2. The results from the research showed that all respondents (patients, medical personnel and family members) had a positive attitude regarding the necessity of preparation when using the forms and strategies of AAK.
3. After retesting made with a standardized set of tests (BDAE), improvement was discovered in the speech abilities of the persons suffering from Brokin's aphasia that used some fragments of the forms of AAK.