Introduction
For several decades, childhood Aphasia has been recognized as an acquired condition occurring in the childhood whereby children are unable to express themselves verbally. This condition is usually considered to be transient and is thought to cause non-fluent aphasia. Moreover, the causative lesion leading to this condition has been often found to be localized to the right hemisphere (Woods & Teuber, 2004).
Main Body
It was a historically widely held belief that most childhood aphasias are non-fluent, irrespective of the location of the insult to the brain but recent advancements in this arena have showed that it is possible for children to acquire a fluent type of aphasia (Dongen, Paquier, Creten, Borsel, & Catsman-Berrevoets, 2001). However, there still remain gaps in the knowledge regarding acquired aphasia in children and the question of whether the patterns of aphasia in children are similar to those reported in adults remained unanswered. Dongen et al., therefore undertook this study to determine the existence of the fluent/non-fluent dichotomy in children with aphasia, similar to that observed in adults and the presence of the rank order, similar to that observed in adults, in case a dichotomy does exist (Dongen, Paquier, Creten, Borsel, & Catsman-Berrevoets, 2001).
The study population was comprised of 24 children presenting with childhood aphasia with similar baseline demographic features. The etiology of aphasia differed amongst individuals and varied from trauma to neoplastic, vascular and infectious etiologies (Dongen, Paquier, Creten, Borsel, & Catsman-Berrevoets, 2001). The children were assessed for the presence of spontaneous speech at the initial assessment visit, within three weeks after the onset of aphasia. The interviews conducted for each child were audio taped and videotaped and the severity of aphasia was assessed and hence rated on the basis of 10 different speech characteristics (Dongen, Paquier, Creten, Borsel, & Catsman-Berrevoets, 2001). The rating method used was in accordance with that used previously by Kerschenstiener et al. in their study. The data thus obtained was entered in to a database and analyzed using a cluster analysis (two-means clustering) and exact p-values were calculated using Mann-Whitney U tests. The results revealed that a dichotomy does exist in the characteristics of aphasia among children and thus refutes the old claim that only non-fluent types of aphasias are present in children (Dongen, Paquier, Creten, Borsel, & Catsman-Berrevoets, 2001). Moreover, analysis of the rank order showed that the patterns of aphasia observed in the children in this study was similar to adults (Dongen, Paquier, Creten, Borsel, & Catsman-Berrevoets, 2001).
This study is unique in that it proves that in aphasias which occur once speech development has taken place, the clinical picture and patterns observed are similar to those seen in adults who become aphasic as a result of any etiology such as stroke (Dongen, Paquier, Creten, Borsel, & Catsman-Berrevoets, 2001). A limitation of this study was that borderline cases and cases whom displayed features which did not correspond to any particular feature on the Kerschenstiener et al. ranking system, such as those having jargon aphasia had to be excluded (Dongen, Paquier, Creten, Borsel, & Catsman-Berrevoets, 2001).
Conclusion
Till date, no pharmacological treatment exists for the management of childhood aphasia. The mainstay of treatment is speech therapy. Children with aphasia require rehabilitation techniques such as exercising of facial muscles and special education during which their speech is developed gradually by word repetition, memory improvement using flash cards, use of communication skills other than speech, teaching of sign language and other therapies aimed at improving memory and recall (Penn State Children’s Hospital, 2006). An alternative option for such children is to send them to normal schools instead of special schools, but to train the teachers and staff to pay special attention to the child and educate the child using cues and techniques similar to those used in special schools. During the rehabilitation phase, it is important to inform the parents that recovery would be gradual and thus, patience and cooperation on their part would be required.
References
Dongen, H. R., Paquier, P. F., Creten, W. L., Borsel, J. v., & Catsman-Berrevoets, C. E. (2001). Clinical Evaluation of Conversational Speech Fluency in the Acute Phase of Acquired Childhood Aphasia: Does aFluency/Nonfluency Dichotomy Exist? Journal of Child Neurology , 345-353.
Penn State Children’s Hospital. (2006). Acquired Childhood Aphasia. Web.
Woods, D. B., & Teuber, H.-L. (2004). Changing patterns of childhood aphasia. Annals of Neurology , 273-280.