Enhancing communication in jargon aphasia: a small group study of writing therapy

People with jargon aphasia have severely disordered and incomprehensible sp eech that may be resistant to therapeutic intervention. In this study, we t reated written output and examined whether it assisted communication for th ese clients. In stage one of the study, anagram sorting, delayed copying an d lexical decision tasks were used to investigate the residual knowledge of written words in a group of ten people with jargon aphasia. Evidence of th e presence of orthographic knowledge was taken as an indication that writin g might be a useful focus for therapy. This hypothesis was explored in stag e two with six clients. A personally useful vocabulary was selected for eac h, and copying, word completion and written picture-naming tasks were used in therapy to improve written production of these words. The clients made p rogress in written naming. However, they showed little change on a 'message ' assessment that tested their ability to use the written words to convey m essages. Stage three targeted communicative writing. Here, three of the cli ents received 'message therapy', which encouraged them to relate treated wo rds to functional messages and to communicate them to a partner. The client s improved on the message assessment and observation of their communication and reports from relatives suggested that they made functional use of writ ing in a range of communication settings.