Multifactorial processes in recovery from aphasia: developing the foundations for a multileveled framework

This paper develops the foundations for a framework of recovery from aphasia which attempts to integrate knowledge from several domains to form a basis for an approach to treatment as managed recovery. We still have a mainly operational appreciation of recovery derived from atheoretical group investigations using psychometric batteries and generic definitions of aphasia and a lack of clarity in the use of the terms restoration, compensation, and reorganization. There is a failure to appreciate the interrelation of different levels (e.g., neural, cognitive, behavioral) and the importance of different perceptions (e.g., patient, relative, clinician) in individual recovery. The multileveled framework may improve understanding of what underlies individual recovery and form a framework for mapping interactions between levels as a basis for intervention.