A thesis submitted in partial fulfilment of - Queen Margaret University

of lesion are thought to be intrinsically linked with the initial severity of the
language impairment. A further impacting factor on recovery appears to be the
initial functional severity of a number of variables following the stroke. These
include the initial severity of aphasia, which appears to be the most strongly
supported impacting factor on recovery. Emotional disturbances following a
stroke (especially post-stroke depression) also impact upon the performance of
an individual and puts the person at risk of further cognitive difficulties. Cognitive
impairment (in particular, attention, memory and executive function) is a
complex factor that often co-exists with aphasia and can impact upon its
recovery.
The rehabilitation process also has a part to play in determining recovery of
language. As discussed, although aphasia therapy is considered to be
efficacious (see section 2.4.1) the process underpinning rehabilitation is not fully
understood. However, the intensity of rehabilitation and its timing are factors that
have been shown to impact upon the recovery process (see section 2.6.4). As
various efficacy studies have employed different methods for assessing initial
aphasia severity, different stimuli and therapy procedures for rehabilitation and
also various measures of outcome and recovery, it is not clear exactly what part
of the therapeutic process causes or facilitates the recovery of language
function. Even when people receive the same therapeutic intervention they do
not always appear to have the same outcomes (Best and Nickels, 2000). If
therapists are to adopt the best rehabilitation methods, eliminating ineffective
ones that promote maladaptive connections (Enderby and Emerson, 1995), the
processes underlying rehabilitation must be investigated.
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