Aphasia Research Project Targets Improved Reading, Writing Therapies

UA's speech-language pathology faculty who pioneer new treatments are among the top in the nation.
Jan. 13, 2009
Pelagie Beeson and Sarah Andersen (right) study brain neurology as it relates to aphasia, a disorder that results from stroke or brain injury and impairs a person's ability to talk, write and read.
Pelagie Beeson and Sarah Andersen (right) study brain neurology as it relates to aphasia, a disorder that results from stroke or brain injury and impairs a person's ability to talk, write and read.
An electronic spell checker helps some people with aphasia improve their conversation and spelling.
An electronic spell checker helps some people with aphasia improve their conversation and spelling.
Aphasia Research Project director Pelagie Beeson confers with Kindle Rising, a senior research specialist who is a key speech-language pathologist on the project.
Aphasia Research Project director Pelagie Beeson confers with Kindle Rising, a senior research specialist who is a key speech-language pathologist on the project.

Anyone can acquire aphasia.

Each year, another 100,000 people acquire aphasia, a condition that affects one million Americans.

Aphasia usually occurs suddenly, often as the result of a stroke or head injury, but it may also develop slowly, as in the case of a brain tumor or dementia. The disorder impairs the expression and understanding of language as well as reading and writing.

Researchers in The University of Arizona's Aphasia Research Project, assisted by volunteer participants, study how physical brain structure and speaking, reading and writing disorders are related.

They are discovering more effective treatments not only for those with speech problems, but for those with spelling and writing disorders, called "agraphia," those with reading disorders, called "alexia," and those with primary progressive aphasia, known as PPA.

The UA researchers who are at the cutting edge of understanding how communications abilities relate to the brain's physical condition also teach students who will help meet the nation's current shortage of, and growing demand for, speech-language pathologists.

As one measure of faculty quality, U.S. News and World Report ranked the UA's graduate program in speech-language pathology at 5th in the nation in 2009. The program has ranked among the 10 best U.S. speech-language pathology graduate programs for the past several years.

"Aphasia rehabilitation is typically directed toward the improvement of spoken language, but reading and spelling are also affected," said Aphasia Research Project director Pelagie Beeson, an associate professor in the UA speech, language and hearing sciences department and the UA neurology department.

"Less research has been accomplished regarding the nature and treatment of written language disorders, despite the fact that as a society, we increasingly depend on the written word," Beeson said.

"In some cases, reading and writing are the primary deficit after stroke. We are particularly interested in seeing such individuals," she added.

"We are also recruiting people who have progressive aphasia, which is a slow onset of language decline that is not a memory impairment, like Alzheimer's disease, but rather a specific impairment of language."

Regents' Professor Emerita Audrey Holland and Beeson started the Aphasia Research Project in 1991. The project is now funded with a $1.5 million grant awarded in 2005 and a $900,000 grant awarded in 2006, both from the National Institute on Deafness and other Communication Disorders, one of the National Institutes of Health.

Scientists currently with the Aphasia Research Project include Dr. Steven Rapcsak of the UA neurology department, senior research specialist Kindle Rising, doctoral candidates Maya Henry and Hyesuk Cho, post-doctoral fellow Esther Kim and research specialist Sarah Andersen. Several undergraduate and graduate students also are active in the project.

About 300 individuals have participated in the research, Beeson said. They include adults ages 40-80 who do not have aphasia and serve as healthy controls.

To date, more than 50 adults who have developed written-language impairments have participated in the Aphasia Research Project, Rising said. More than 30 have participated in behavioral treatment protocols developed to improve their written language capabilities.

All the volunteer participants complete a variety of language tests, and some undergo MRI brain scans. Researchers develop effective treatments based on the nature and severity of the problem determined by comprehensive testing.

"Our research is leading to better understanding of who is a good candidate for what specific treatment approach," Beeson said. "Every individual's response to treatment helps us get closer to understanding how and why certain therapies work, and who will be most helped by them."

People who develop primary progressive aphasia, or PPA, are another priority. This form of aphasia does not result from stroke or brain injury, Beeson said. It relates to several diseases, all of which result in cortical atrophy of neurons in the region of the brain that's critical for language.

The UA is one of the few places that works with PPA patients, whose language problems are different from those of Alzheimer's and stroke patients. Aphasia Research Project researcher and graduate student Maya Henry is currently conducting her doctoral dissertation research on the topic of primary progressive aphasia.

Henry is rapidly emerging as one of the national experts in treating progressive aphasia, Beeson noted.

"We've learned that written language can sometimes recover to a greater extent than spoken language," Beeson said. "Some individuals with limited ability to speak can relearn the spellings of words that are important to them, and then communicate by writing those words."

Another approach to improved reading and spelling is to retrain a patient in corresponding sounds and letters. Patients at another level work with a hand-held electronic speller, a device that gives them a choice of probable spellings for a particular spoken word.

All treatments are aimed to strengthen neural connections in the undamaged regions of the brain.