La Trobe University, Bundoora, Victoria, Australia.
Am J Speech Lang Pathol. 2013 May;22(2):S227-39. doi: 10.1044/1058-0360(2012/12-0091).
There is a 40-year history of interest in the use of arm and hand gestures in treatments that target the reduction of aphasic linguistic impairment and compensatory methods of communication (Rose, 2006). Arguments for constraining aphasia treatment to the verbal modality have arisen from proponents of constraint-induced aphasia therapy (Pulvermüller et al., 2001). Confusion exists concerning the role of nonverbal treatments in treating people with aphasia. The central argument of this paper is that given the state of the empirical evidence and the strong theoretical accounts of modality interactions in human communication, gesture-based and multimodality aphasia treatments are at least as legitimate an option as constraint-based aphasia treatment.
Theoretical accounts of modality interactions in human communication and the gesture production abilities of individuals with aphasia that are harnessed in treatments are reviewed. The negative effects on word retrieval of restricting gesture production are also reviewed, and an overview of the neurological architecture subserving language processing is provided as rationale for multimodality treatments. The evidence for constrained and unconstrained treatments is critically reviewed.
Together, these data suggest that constraint treatments and multimodality treatments are equally efficacious, and there is limited support for constraining client responses to the spoken modality.
在针对减少失语症语言障碍和补偿性交流方法的治疗中，手臂和手势的使用已经引起了 40 年的关注（Rose，2006）。从强制性失语症疗法的支持者（Pulvermüller 等人，2001）那里提出了将失语症治疗限制在口头模式的论点。关于非言语治疗在治疗失语症患者中的作用存在混淆。本文的核心论点是，鉴于经验证据的状况以及人类交流中模态相互作用的强有力的理论解释，基于手势和多模态的失语症治疗至少与基于约束的失语症治疗一样合理。
回顾了人类交流中模态相互作用的理论解释以及在治疗中利用的失语症患者的手势产生能力。还回顾了限制手势产生对单词检索的负面影响，并提供了语言处理的神经架构概述，作为多模态治疗的基础。批判性地回顾了约束和非约束治疗的证据。
这些数据表明，约束治疗和多模态治疗同样有效，并且限制患者对口语模式的反应的支持有限。
