Activities for the neuropsychological rehabilitation in patients with Broca’s aphasia

Language consists of the following elements for its communicative function:

• Expression: ability to formulate and communicate ideas in a coherent, grammatically correct manner.
• Naming: ability to name objects and persons.
• Repetition: ability to produce a word or phrase that is heard.
• Comprehension: ability to understand the meaning of words, texts, and ideas.

These elements of language can be affected by a brain injury, for example, following a traumatic brain injury or stroke. The most common disorder is aphasia, a disturbance of the production and/or comprehension of language.

What is Broca’s aphasia?

Broca’s aphasia, also known as efferent motor aphasia or non-fluent aphasia, results from damage to a part of the brain called Broca’s area and is characterized by difficulty in the production of speech—although comprehension generally remains intact—agrammatism, de-automatization of speech articulation (apraxia of speech), anomia, and repetitive language..

Symptoms of Broca’s aphasia

Difficulties are evident in spontaneous speech, dialogue or conversation. Sometimes, patients with Broca’s aphasia may simply become mute or semi-mute.

Neuropsychological rehabilitation of Broca’s aphasia

The platform NeuronUP has activities for the rehabilitation of Broca’s aphasia. Depending on the difficulties with verbal expression, the activities should be organized hierarchically in the following manner:

• Articulation and phonemic production.
• Repetition of words and phrases.
• Object naming.
• Oral and written production.

1. Articulation and phonemic production

For articulation and phonemic production, the therapist can use a mirror to perform orolingual and buccofacial exercises. These exercises involve performing movements with the mouth, lips and tongue, thus stimulating them, to later express the phoneme in isolation and, after that, within a word.

Orolingual-facial exercises:

• Stick the tongue in and out while keeping the mouth open.
• Move the tongue from right to left, touching the corners of the mouth.
• Move the tongue up and down while keeping the mouth open.
• Lick the upper and lower lips.
• Touch the hard and soft palate with the tongue.
• Bite down on the tongue while it is bent upwards or downwards.
• Clean teeth with the tongue in a circular motion.
• With the lips together, pucker or purse the lips as if you were kissing.
• Smile without showing teeth.

2.Repetition of words and phrases

NeuronUP has repetition activities that will make it easier for the therapist to find words or phrases for the patient.
Repetition exercises are conducted by taking into account the number of syllables in a word.

3. Object naming

In order to train naming at a basic level, pictures are presented and the patient should match the words to the objects.

Subsequently, the patient is shown the picture of an object and, with the help of phonological cues, is expected to name the object.
Naming to visual confrontation helps patients to match the real object or the picture of an object to its name.

4. Oral and written production

In order to train production using morphosyntax, it is important to give patients activities that allow them to form words from syllables, while taking the level of difficulty into account. Patients first begin with bisyllabic words; the number of syllables increase, and so does the word difficulty, in order to meet the set or desired goals. This will allow patients to reach more advanced levels, in which words are not formed by syllables but by individual letters.


Next, it is time to train the patient’s verbal expression through the morphosyntax of a sentence. The “re-learning” taking place here consists of placing the lexicon in the correct order to produce meaningful sentences. The sentences should contain a small number of words in order to increase the difficulty depending on the patient’s performance; as a compensatory technique, the therapist will ask questions such as who? what? how? what is he/she doing? for whom? etc.

The therapist could also show images in which an action is represented, to give the patient the opportunity to form a short sentence from the image.

Although comprehension in patients with Broca’s aphasia is generally preserved, in some occasions they may have mild morphosyntactic deficits, a reason why the following activities are recommended:

This activity includes auditory and visual modalities. In the auditory modality, the patient must listen attentively to a statement concerning the image and determine whether it is true or false; as a compensatory technique, the patient can listen to the audio as many times as needed.

Another activity to help stimulate morphosyntactic comprehension consists of reading a statement and answering the question that appears on the screen; the patient will be able to read the statement as many times as needed in order to respond correctly.

As patients improve comprehension, the level of difficulty can be increased with more complicated statements being presented to patients.

It is important that speech therapists work with patients individually, tailoring therapy to the needs and tastes of the individual, and taking their premorbid level of function into account.

NeuronUP as tool for therapists and patients

Computer-based activities are very useful tools for the application of techniques since they provide therapists with a greater variety of exercises, help them meet set goals and also allow patients to know and identify the level of difficulty being reached and the attainment of goals. They also allow patients to rate their performance according to their own perceptions and to enjoy some degree of independence when using the computer on their own, while stimulating other cognitive functions as well.

NeuronUP uses reinforcers to boost patient’s motivation which is undoubtedly an important if difficult to control factor in patients on occassions.

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