Treatability of different components of aphasia - insights from a case study.

In this phase I clinical rehabilitation study, we investigated the effects of phonological rehabilitation for alexia and aphasia in an individual 54 years after a left-hemisphere ischemic infarction. In the context of a single-subject design, we studied whether treatment would improve phonological processing, reading, and generalization to untreated behaviors. While results showed a lack of generalization to real-word reading aloud, improvement was present in phonological processing, language function (Western Aphasia Battery Aphasia Quotient, Boston Naming Test, Reading Comprehension Battery for Aphasia), and auditory processing (Revised Token Test). Improvement in the lexical-semantic system was attributed to informal forced-use language treatment. We concluded that phonological therapies are unlikely to be successful unless a minimum initial level of phonological sequence knowledge exists; therapies that pressure subjects to use verbal communication can achieve clinically important gains in communicative ability that generalize to untreated behaviors. This study also demonstrates the importance of a careful analysis of the patient's language ability before a therapeutic strategy is chosen.