Rethinking aphasia therapy: a neuroscience perspective

This article explores how consideration of acquired speech and language disorders from the perspective of neuroscience permits new insights into the content and design of therapy for people with aphasia. Key proposals are that aspects of current therapies often neglect the sensory-motor components of speech and language processing, and the interconnectivity of sensory-perceptual and motor systems. Furthermore, current therapy regimes are often administered at too low an intensity to stimulate neural reorganization. Neuroscientific perspectives on learning are explored and in particular the issues of associationist learning, learned misuse, mirror neurone systems, and procedural and errorless learning. The value of use of computer programs in administering high intensity therapy is outlined and it is proposed that aphasia therapies can be enhanced if clinicians adopt an explicit neuroscientific rationale for intervention.