A thesis submitted in partial fulfilment of - Queen Margaret University

Chapter 6
Discussion of findings
6.1 INTRODUCTION
Not everyone with aphasia recovers to the same degree and many people retain
residual language impairments to varying degrees of severity (see section
2.4.1). While there are theories and models of language impairment such as the
cognitive neuropsychology approach (see section 2.9.3), currently there is no
model or theory of rehabilitation that explains what therapy is or describes the
process(es) involved in the restoration of the damaged language system (see
section 2.7). Therefore it is not possible to discern what approaches or tasks in
aphasia rehabilitation would be most successful at restoring particular language
functions. Such a model or theoretical account would identify the process of
therapeutic rehabilitation and highlight any constraints to the restitution of
language impairment. Additionally, it would identify those most likely to benefit
from language rehabilitation, thereby allowing more targeted allocation of limited
resources.
The development of a theory of rehabilitation would be a considerable
undertaking. A first step however would be to ascertain if therapeutic
interventions facilitate the accessing of previously known information rendered
inaccessible due to the impact of the stroke. It has been demonstrated that
cortical plasticity occurs during the learning process (see section 2.5.2) and has
also been observed during language rehabilitation (see section 2.5.5).
Therefore, the rehabilitation of aphasia could involve the process of new
learning, resulting in the creation of new neuronal connections for vocabulary
newly acquired (or re-acquired) during the therapeutic process. The two
processes (re-accessing information and laying down new representations
through learning) could also be occurring in tandem. Perhaps old memory traces
are re-accessed where possible and where cortical damage is too great for
restitution of particular neuronal patterns, a process of new learning might occur
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