Aphasia and Other Acquired Neurogenic Language Disorders: A Guide for Clinical Excellence

Second Edition

Brooke Hallowell

Details: 629 pages, 2-Color with Full-Color Insert, Softcover, 8.5" x 11"

ISBN13: 978-1-63550-159-9

© 2023 | Available

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Covering an array of evidence-based content, including aphasia, traumatic brain injury, dementia, and language in aging, Aphasia and Other Acquired Neurogenic Language Disorders: A Guide for Clinical Excellence, Second Edition is a must-have textbook for clinicians and students studying to be speech-language pathologists. This clinical guide strategically addresses scientific foundations, service delivery, international and multicultural perspectives, assessment, and treatment.

Organized to maximize adult learning, the book is adaptable for multiple pedagogic methods for classroom-based courses, independent study, and online learning. The second edition provides clinicians and students a clear pathway for quality and effectiveness in clinical practice.

New to the Second Edition

  • Expanded content to reflect important recent developments throughout, with findings from over 500 new studies
  • A thoroughly updated chapter on primary progressive aphasia and other neurodegenerative conditions
  • Enhanced and updated foci on cognitive-communicative challenges associated with dementia, traumatic brain injury, and right brain injury
  • Inclusion of additional voices of people with neurogenic conditions to highlight person-centered strengths and needs
  • Updated attention to culturally responsive terminology and content throughout to promote diversity, equity, and inclusion
  • Improved information flow based on reviewers’ feedback, while maintaining structure to ease transitions in course design for instructors who used the first edition
  • Many new images and illustrations to support learning
  • Abundant resources to encourage research collaboration and career development, and to promote supportive networks for people affected by neurogenic communication disorders
  • Expanded foci on evidence-based practice, practice-based evidence, participatory research, and implementation science

Key Features

  • A rigorous approach to the art and science of clinical practice, integrating diverse theoretical perspectives for a global readership
  • Guidance on advocacy, ethics, reimbursement, legal aspects, and counseling
  • An emphasis on person-centered, empowering approaches to maximize life participation
  • Extensive assessment resources and a process analysis approach for analyzing communicative performance and interpreting assessment results
  • How-to content on more than 50 intervention approaches
  • Diagrams, charts, illustrations, summary tables, a substantial glossary, a detailed index, and rich up-to-date references
  • Content design applying adult learning research to maximize deep learning
  • Systematic queries that enliven clear objectives for knowledge, skills/application, and values

PluralPlus Online Ancillary Materials

  • For instructors: PowerPoint Slides, Test Bank, Instructor's Guide, Class Activities
  • For students: Videos, Learning Activities, Chapter Queries, and Study Aids



“As we have come to expect from Dr. Hallowell, this is a thoroughly researched book, and an extremely important contribution to the literature on neurogenic communication disorders. Our profession is much the richer for it!”
—Audrey Holland, Ph.D., CCC-SLP, BC-ANCDS, Regents’ Professor Emerita of Speech, Language, and Hearing Sciences, The University of Arizona

“The best and most comprehensive book on aphasia ever published.”
—Darlene Williamson, MA, CCC-SLP, President of the National Aphasia Association and Founder of the Stroke Comeback Center

“This second edition provides an extremely wide knowledge base in the area of aphasia and other acquired neurogenic language disorders. It is the most in-depth book in the area of speech language pathology that I have seen. The website resources are fantastic.
The purpose of this book is to teach readers about body structure and function and give them more skills in assessing and treating clients. It will also help students and other practitioners identify the clients' goals and care for them when dealing with multicultural matters and evidence-based practice. These are worthy objectives that are enforced throughout this book.  
The book's table of contents is 18 pages long, covering the book's 33 chapters. The contents section is so detailed that one can only read one chapter at a time. However, each chapter holds a great amount of knowledge that will help readers come away with new information each time.
I was deeply impacted by the information I obtained from reading this book. The content is incredible, with many opportunities for learning during the "Learning and Reflection Activities." I was highly motivated to read at least a portion of each chapter in order to gain insight and to improve my own clinical skills.  
This book encourages students, faculty, and speech-language pathologists not only to read assignments, but also to review the book's areas of figures, tables, and first-hand experiences as they go out into the world in their internships and other professional experiences. The various activities are helpful. This book is one that every speech-language pathology student and every speech-language pathologist working in the field should have."

–Lorelei J. Peirson, MA, Biola University, from Doody’s Reviews (August 2022)

What Is Special About This Book?

About the Author

Section I. Welcome and Introduction

Chapter 1. Welcome to the Fantastic World of Research and Clinical Practice in Acquired  
Neurogenic Communication Disorders

What Are Acquired Cognitive-Linguistic Disorders?
Which Neurogenic Communication Disorders Are Not Acquired Language Disorders? 
What Is Clinical Aphasiology? 
What Is So Fantastic About the World of Neurogenic Communication Disorders? 
     We Work With Wonderful People and Become Part of Their Rich Life Stories 
     We Are Catalysts for Positive Change 
     We Enjoy Empowerment of Others Through Advocacy and Leadership 
     We Enjoy a Great Deal of Humor and Fascination 
     We Enjoy Fantastic Local and Worldwide Professional Networks 
     Our Work Is Multicultural and Multilingual 
     We Are Lifelong Learners 
     We Tap Into Our Most Scientific and Our Most Creative Selves at the Same Time 
     We Have Rich Career Opportunities 
What Disciplines Are Relevant to Aphasia and Related Disorders? 
What Is Known About the Incidence and Prevalence of Acquired Neurogenic  
          Language Disorders?
Where Do Aphasiologists Work? 
What Is the Career Outlook for Clinical Aphasiologists? 
Learning and Reflection Activities 

Chapter 2. Becoming the Ultimate Excellent Clinician 
What Makes a Clinician Truly Excellent? 
     What Can One Do to Become an Excellent Clinical Aphasiologist? 
     How Do the People We Serve Characterize What They Most Want? 
What Are Some Traits of People Who Are Perceived as Unhelpful Clinicians? 
What Content Is Important to Master? 
What Credentials Are Required for a Career as an Aphasiologist?
What Credentials May Aphasiologists Earn Beyond Their Basic Academic and  
          Clinical Credentials?
Is It Best to Specialize or Generalize? 
What Strategies Help Boost Career Development in Acquired Cognitive-Linguistic  
What Organizations Support Professional Information Sharing and Networking 
          Among Clinical Aphasiologists?
Learning and Reflection Activities 

Chapter 3. Writing and Talking About the People With Whom We Work 
What Is Important to Consider in Writing and Talking About People With 
           Neurogenic Cognitive-Linguistic Disorders?
      Person-First Language 
      Alternatives to the Word Patient
      People With Disabilities 
      Research Participants 
      Older People 
      Healthy Adults 
What Are Important Nuances in Terms We Use to Refer to People Who Care for
            People With Neurogenic Cognitive-Linguistic Disorders? 
What Is the Difference Between the Terms Therapy and Treatment ?
      Neurotypical People 
What Are Pros and Cons of Terms Used to Refer to SLPs? 
What Are the Preferred Terms When Referring to the Experts Who Work With 
          People Who Have Neurogenic Communication Challenges?
What Is Important to Keep in Mind Regarding Inclusive and Welcoming Language? 
What Other Terms Might Unintentionally Convey Negative Connotations? 
Why Are There Inconsistencies in the Prefixes Used in Terms for Characterizing 
           Neurogenic Symptoms, and What Is the Rationale for Varied Prefix Choices?
Learning and Reflection Activities 

Section II. Foundations for Considering Acquired Neurogenic Language Disorders

Chapter 4. Defining and Conceptualizing Aphasia 
What Is a Good Way to Define Aphasia? 
      Aphasia Is Acquired 
      Aphasia Has a Neurological Cause 
      Aphasia Affects Reception and Production of Language Across Modalities 
      Aphasia Is Not a Speech, Intellectual, Sensory, or Psychiatric Disorder 
How Have Established Aphasiologists Defined Aphasia? 
What Are the Primary Frameworks for Conceptualizing Aphasia? 
      Unidimensional Frameworks 
      Multidimensional Frameworks 
      Medical Frameworks 
      Cognitive Neuropsychological, Psycholinguistic, and Neurolinguistic Frameworks 
      Biopsychosocial Frameworks 
      Social Frameworks 
      Social Determinants of Health Frameworks 
     Other Historically Relevant Frameworks 
How Does One Choose a Preferred Framework for Conceptualizing Aphasia? 
How Are the Frameworks for Conceptualizing Aphasia Relevant to Other 
            Neurogenic Language Disorders?
Learning and Reflection Activities

Chapter 5. The WHO ICF, Human Rights Perspectives, and Life Participation Approaches 
What Is the WHO ICF? 
How Is the WHO ICF Relevant to Ethics and Human Rights? 
How Is the WHO ICF Specifically Relevant to Intervention and Research in 
How Is the WHO ICF Specifically Relevant to People With Neurogenic Language 
Learning and Reflection Activities 

Chapter 6. Etiologies of Acquired Neurogenic Language Disorders 
What Is a Stroke? 
What Are Stroke Risk Factors, and What Causes Stroke? 
What Are the Physiological Effects of Stroke? 
How Crucial Is Timing for Medical Treatment After a Stroke? 
How Is the Sudden Onset of Stroke Relevant to Supporting Patients and Families? 
What Is a Transient Ischemic Attack? 
What Is Hypoperfusion? 
What Can Be Done to Prevent Stroke? 
     Attending to Stroke Triggers 
What Is TBI? 
What Are Blast Injuries? 
What Are Concussion and Mild TBI? 
What Can Be Done to Prevent TBI? 
What Are Bacteria and Viruses? 
What Other Types of Infections Affect Cortical Function? 
What Is Neoplasm? 
What Is Toxemia? 
What Are Diabetes Mellitus and Diabetic Encephalopathy? 
What Is Metabolic Syndrome? 
What Other Metabolic Disorders Cause Encephalopathy? 
What Is Neurodegenerative Disease? 
What Is Dementia? 
What Is Mild Cognitive Impairment? 
What Is Primary Progressive Aphasia? 
What Are Some Special Challenges in Identifying Etiologies of Cognitive-Linguistic 
Learning and Reflection Activities 

Chapter 7. Neurophysiology and Neuropathology of Acquired Neurogenic 
Language Disorders
           What Should SLPs Know About Neuroanatomy and Neurophysiology Associated 
With Neurogenic Cognitive-Linguistic Disorders?
What Are Key Neurophysiological Principles Pertinent to Acquired 
            Cognitive-Linguistic Disorders?
     Specialization of Structure and Function 
     Interconnectivity Throughout the Brain 
     The Brain’s Plasticity 
What Is the Most Clinically Pertinent Knowledge an Aphasiologist Should Have 
            About the Blood Supply to the Brain?viii Aphasia and Other Acquired Neurogenic Language Disorders
What Factors Affect a Person’s Prognosis for Recovery From a Stroke or Brain Injury? 
Why Is It Important for Clinical Aphasiologists to Know About the Visual System? 
What Aspects of the Visual System Are Most Relevant to People With Neurogenic 
           Language Disorders?
     Anatomy and Physiology Associated With Visual Deficits 
How Are Visual Field Deficits Characterized? 
What Are Ocular Motor Deficits? 
What Are Visual Attention Deficits? 
What Are Higher-Level Visual Deficits? 
What Aspects of the Neurophysiology of Hearing Are Most Relevant to People 
          With Neurogenic Language Disorders?
Learning and Reflection Activities 
Supplemental Review of Neuroanatomy Related to Aphasiology 
Supplemental Review of Blood Supply to the Brain 
Supplemental Review of the Visual System 
Supplemental Review of the Auditory System 

Chapter 8. Neuroimaging and Other Neurodiagnostic Instrumentation 
What Are the Most Relevant Neuroimaging Techniques for Aphasiologists to 
          Know About?
     Computed Axial Tomography (CAT or CT) 
     Magnetic Resonance Imaging (MRI) 
     Single Photon Emission Computed Tomography (SPECT) 
     Cerebral Angiography 
What Other Neurodiagnostic Methods Are Important for Aphasiologists to 
          Know About?
     Electroencephalography (EEG) 
     Additional Methods
Learning and Reflection Activities 

Chapter 9. Aging, Which Is Not a Disorder, and Its Relevance to Aphasiology 
What Is Aging? 
What Are Key Theories About Aging That Are Especially Relevant to Cognition 
          and Communication?
What Is Aging Well? 
How Are Demographic Shifts in Aging Populations Relevant to Clinical 
What Are Normal Changes in the Brain as People Age? 
What Are Positive Aspects of the Aging Brain? 
     Word Finding 
     Syntactic Processing 
     Reading and Writing 
What Are General Guidelines for Differentiating Normal From Impaired 
          Language in Older Adults?
What Theories Have Been Proposed to Account for Cognitive-Linguistic Changes 
          With Aging?
     Resource Capacity Theories
     Working Memory Theories     
     Context-Processing Deficiency Theories 
     Signal Degradation Theories 
     Transmission Deficit Theories 
     Speed-of-Processing Theories 
     Inhibition Theories 
What Can Be Done to Ensure the Best Preservation of Language Abilities as
          People Age?
What Is Elderspeak, and How May We Raise Awareness About It? 
What Sensitivities Related to Ageism Are Important for Aphasiologists to 
Learning and Reflection Activities 

Section III. Features, Symptoms, and Syndromes in the Major Categories of
Cognitive-Linguistic Disorders

Chapter 10. Syndromes and Hallmark Characteristics of Aphasia 
How Are the Types of Aphasia Classified? 
What Are the Classic Syndromes of Aphasia, and What Are the Hallmark 
           Characteristics of Each?
     Expressive/Receptive, Nonfluent/Fluent, and Anterior/Posterior Dichotomies 
     Classic Aphasia Classification 
     Wernicke’s Aphasia 
     Broca’s Aphasia 
     Global Aphasia 
     Conduction Aphasia 
     Transcortical Sensory Aphasia 
     Transcortical Motor Aphasia 
     Mixed Transcortical Aphasia 
What Is Primary Progressive Aphasia? 
What Other Syndromes of Aphasia Are There, and What Are Their Characteristics? 
     Crossed Aphasia 
     Subcortical Aphasia
     Anomic Aphasia 
How Might Dyslexia and Dysgraphia Be Conceptualized as Symptoms Versus 
What Are Limitations of Classification Systems Based on Relating Function to 
          Neuroanatomical Structure?
Learning and Reflection Activities 

Chapter 11. Cognitive-Communicative Challenges Associated With Traumatic Brain Injury 
Why Is It Hard to Generalize About TBI Survivors? 
What Communication Symptoms Are Likely to Be Experienced by TBI Survivors 
What Are Special Challenges for War- and Terrorism-Related TBI Survivors?  
     Scope of Practice 
     Interdisciplinary Collaboration 
     Assessment Challenges 
What Are Special Challenges Faced by TBI Survivors in Health Care Contexts? 
What Special Economic Considerations Affect Clinical Work With TBI Survivors? 
Learning and Reflection Activities 

Chapter 12. Cognitive-Communicative Disorders Associated With Right Hemisphere 
What Is Right Hemisphere Syndrome? 
How May RHS Affect Communication and Life Participation? 
     Conversation, Discourse, Pragmatics 
     Combined Receptive and Expressive Challenges 
     Receptive Challenges 
     Expressive Challenges 
     Attention Deficits 
     Memory Challenges 
     Executive Function Challenges 
     Visual-Perceptual Impairments 
     Auditory-Perceptual Impairments 
     Reading and Writing Impairments 
What Are Special Challenges That SLPs Face in Serving People With RHS? 
     Underdiagnosis and Lack of Awareness of RHS 
     Symptom Classification 
     Identifying Neurological Structure-Function Relationships 
     Characterizing What Is Normal 
What Are Special Challenges Faced by People With RHS in Health Care Contexts? 
Learning and Reflection Activities 

Chapter 13. Cognitive-Communicative Disorders in Primary Progressive Aphasia 
and Dementia
What Neurodegenerative Conditions Most Commonly Affect Cognitive-Linguistic 
What Are General Types of Cognitive-Communicative Impairments in People 
           With MCI and Dementia?
What Communication Challenges Are Typically Associated With MCI and Dementia? 
What Symptoms Are Associated With Common Forms of Dementia? 
     Alzheimer’s Disease 
     Vascular Dementia 
     Dementia With Lewy Bodies (DLB) 
     Parkinson’s-Associated Dementia 
     Frontotemporal Dementia (FTD) 
     Huntington’s Disease 
     Korsakoff ’s Syndrome 
     Creutzfeldt-Jakob Disease 
     AIDS Dementia Complex 
What Are Symptoms of the Primary Forms of PPA? 
Is There Such a Thing as “Reversible” Dementia? 
What Are Implications of an Incorrect Diagnosis of Dementia? 
What Is the Role of the SLP in Working With People Who Have PPA and Dementia? 
Learning and Reflection Activities 

Section IV. Delivering Excellent Services

Chapter 14. Contexts for Providing Excellent Services 
What Do SLPs Who Specialize in Neurogenic Communication Disorders Do? 
     Clinical Intervention (Screening, Assessment, Treatment, Counseling, Educating) 
     Interprofessional Collaboration and Interdisciplinary Learning 
     Marketing, Negotiating Contracts, Billing, Recordkeeping, Documentation, 
          Scheduling and Coordinating Care, Quality Assurance, and Fundraising
     Leadership and Management 
     Teaching and Mentoring 
In What Types of Settings Do We Provide Clinical Services? 
     Rehabilitation Centers 
     Health Maintenance Organizations
     Skilled Nursing and Long-Term Care Facilities 
     Continuing Care Retirement Communities (CCRCs) 
     Home Health Agencies 
     Private Practice and Not-for-Profit Clinics 
     University-Based Clinics 
     Adult Day Care Centers 
     Aphasia Centers 
In What Ways May Services Be Provided at a Distance? 
With What Types of Teams Do Clinical Aphasiologists Engage? 
How Do SLPs Get Paid? 
Where Does the Money Come From to Pay for SLP Services? 
     Government-Sponsored Programs 
     Health Insurance 
     Private Pay 
     Mixed Funding Options 
     Philanthropic Donations 
How Do Service-Providing Agencies Get Paid? 
What Makes Services Provided by SLPs Reimbursable? 
     Effective Documentation Meeting All Requirements for Reimbursement 
     A Physician’s Order 
     Preauthorization for Services by the Third-Party Payer 
     Evidence That the Services Are Actually Covered by the Plan 
     Evidence of the Need for Skilled Services 
     Confirmation That the Methods Used Are Evidence Based 
     Documentation of the Life-Affecting Nature of Services 
     Evidence of Treatment Progress 
     Good Relationships With Decision Makers at Third-Party Payer Agencies
What Are the Primary Reasons for Which Reimbursements for SLP Services 
          Are Denied?
What Do We Do if We Are Denied Reimbursement for Our Services? 
How Do Health Care Finance and Cost-Control Systems Affect Clinical Services? 
What Are the Impacts of Health Care Cost Cutting and Cost Control on Services 
          for People With Neurogenic Communication Challenges?
Learning and Reflection Activities 

Chapter 15. Engaging Proactively in Advocacy and Legal and Ethical Concerns 
How May Clinicians and the People We Serve Promote Access to SLP Services and 
           Communication Support?
     Enhance Awareness of Communication as a Human Right 
     Raise Awareness About Neurogenic Communication Challenges and Ways to 
           Support People and Loved Ones Coping With Them
     Help Educate Professionals in Health Care Contexts 
     Encourage Referrals 
     Advocate for Reduced Medicalization of Communication Disabilities 
     Promote Community-Based Approaches 
     Expand Knowledge Translation 
How Are Human Rights, Morality, Ethics, and Law Relevant to Advocacy for
           People With Acquired Neurogenic Disorders of Language and Cognition?
What Is the Role of the SLP in Supporting the Rights of Individuals With Aphasia 
           and Related Disorders?
How Do SLPs Engage in Decisions Regarding Competence and Decision-Making? 
How Might Financial Conflicts of Interest Affect the Practice of Clinical 
Learning and Reflection Activities 

Chapter 16. Clinical Aphasiology Around the World 
What Global Trends Are Affecting the Incidence and Prevalence of Neurogenic 
            Communication Disorders?
      A Rapidly Expanding Aging Population 
      Ongoing Demographic Shifts 
Increasing and Disproportionate Incidence and Prevalence of Conditions That 
           Cause Neurogenic Communication Disorders
     Health Care and Prevention Infrastructure Challenges 
     Global Health Priorities Undermining Essential Values 
What Are Important Priorities for Global Capacity Building to Serve People With 
            Acquired Neurogenic Communication Disorders?
     Build Culturally Contextualized Academic and Clinical Programs 
     Expand Life Participation Approaches 
     Attend to Cultural Aspects of Health, Aging, and Disability That May Affect 
            Receptivity to Services
What Are Key Challenges to Enhancing Global Engagement in Acquired 
     Neurogenic Communication Disorders?
What Are Important Ethical Considerations for Aphasiologists Engaging in 
     Transnational Work?
Learning and Reflection Activities

Section V. Strategic and Meaningful Assessment
Chapter 17. Best Practices in Assessment 

Where and When Does Assessment Happen? 
     Assessment Happens Throughout Intervention 
     Treatment Begins the Moment Assessment Starts 
What Are the Purposes of Assessment? 
What Aspects of Assessment Are Truly Relevant to Actual Clinical Practice? 
What Are the Best Practices in Assessment of Acquired Neurogenic Language 
     Do Not Underestimate How Impactful Your Role Is 
     Focus on the Person 
     Keep the Person at the Center of the Process 
     Focus on Life Participation Goals From the Start 
     Focus on Strengths 
     Have a Clear Purpose 
     Ensure the Best Possible Assessment Conditions 
     Be Strategic in Setting the Location 
     Be Strategic About Timing 
     Include Others in the Process 
     Be Mindful of Multiple Perspectives on Real-Life Impacts of Communication 
     Speak Directly to the Person 
     Appreciate That Experts, Not Tests, Are What Determine Diagnoses 
     Attend to Cultural and Linguistic Differences 
Learning and Reflection Activities 

Chapter 18. Psychometrics of Assessment and Components of Assessment Processes 
What Psychometric Properties Should Be Addressed in Assessment Processes? 
What Are Potentially Confounding Factors? 
     Factors Related to Concomitant Challenges to Health and Well-Being 
     Test Design Factors 
     Assessment Context Factors 
     Interpersonal Factors 
What Is Entailed in Screening for Acquired Neurogenic Language Disorders? 
What Are the Typical Components of a Comprehensive Assessment Process? 
What Information Is Pertinent to Collect During the Case History? 
Learning and Reflection Activities 

Chapter 19. Problem-Solving Approaches to Differential Diagnosis and 
Confounding Factors
How Are Potentially Confounding Factors Relevant to Differential Diagnosis? 
What Are Important Potentially Confounding Factors in Language Assessment, 
            and How Do We Address Them?
     Intelligence, Literacy, and Education
     Visual Problems 
     Hearing Problems 
     Motor Challenges 
     Reading Problems 
     Dysgraphia and Other Writing Deficits 
     Problems of Awareness and Arousal 
     Attention Problems 
     Lack of Awareness of Deficits 
     Executive Function Deficits 
     Pragmatic Deficits 
     Memory Problems 
     Other Concomitant Cognitive and Linguistic Deficits 
     Depression and Other Mood Disorders 
     Emotional Lability 
     Other Challenges to Health and Well-Being 
How Does a Process Analysis Approach to Assessment Help Address Potentially   
          Confounding Factors?
Learning and Reflection Activities 

Chapter 20.  Tests, Scales, and Screening Instruments 
What Are the Most Important Factors in Selecting an Assessment Instrument? 
     What Is the Reason for Your Assessment? 
     Who, Specifically, Is Being Assessed? 
     Does It Provide an Appropriate Index of the Constructs You Wish to Assess? 
     Does the Tool Allow for Alternative Response Modes in Cases Where Clients May Have 
          Trouble With Traditional Response Modes? 
     Might Instructions and Tasks Involved Confound Results? 
     What Is the Quality of a Given Tool? 
     Is It Up to Date and Appropriate in Terms of Content? 
     Does the Tool Complement Your Own Preferences and Preferred Theoretical 
     How Practical Is the Tool Under Consideration? 
     Do Others on Your Rehabilitation Team Understand the Results You Report and  
           Your Interpretation of Them?
What Are the Most Important Factors in Evaluating Assessment Instruments? 
What Assessment Tools Are Available? 
Learning and Reflection Activities 

Chapter 21. Discourse and Conversation as Vital Aspects of Assessment
What Is Discourse? 
What Are General Categories, Types, or Genres of Discourse? 
What Is Conversational or Discourse Analysis? 
Why Is Discourse Sampling and Analysis Important?
     Discourse, Especially the Social Use of Language, Is Highly Relevant to Every  
          Type of Acquired Neurogenic Disorder
     Discourse Analysis Helps Determine Strengths and Weaknesses Not Evident   
          Through Other Forms of Assessment
     Discourse Analysis May Yield Critical Information for Differential Diagnosis 
     Discourse Analysis Is Vital to Treatment Planning 
     Discourse Analysis Is an Essential Aspect of Research 
What Are Key Strategies for Sampling Discourse? 
What Are Key Measures for Indexing Discourse Competence? 
What Are Best Practices in Interpreting Discourse Analysis Results? 
What Challenges Do Aphasiologists Face in Applying Discourse Analysis in 
           Clinical Practice and Research?
     Training and Mentorship 
     Equipment and Software 
     Clear Communication and Perceived Relevance 
     Replicability and Variability in the Evidence Base 
How May Aphasiologists Confront Challenges in Applying Discourse Analysis in  
           Clinical Practice and Research?
Learning and Reflection Activities 

Chapter 22.  Documenting Assessment Results and Considering Prognosis 
What Are Best Practices in Sharing Assessment Results With Adults Who   
           Have Acquired Cognitive-Linguistic Disorders and the People Who Care  
           About Them?
How Do We Best Make Judgments About Prognosis? 
What Are Best Practices for Reporting Assessment Results in Writing? 
What Information Is Typically Included in Assessment Reports? 
What Abbreviations Are Commonly Used in Clinical Reporting? 
Learning and Reflection Activities 

Section VI.  Theories and Best Practices in Intervention 
Chapter 23.  Best Practices in Intervention 

What Are the Best Practices in the Treatment of Neurogenic Language Disorders? 
     Embrace Communication as a Human Right 
     Recognize Assessment as an Ongoing Intervention Process 
     Be Person Centered 
     Include Family Members, Caregivers, and Others Whose Roles Are Relevant 
     Have a Clear Sense of Purpose and Goals 
     Engage Communication Partners Outside of the Client’s Immediate Circle of 
           Friends and Family
     Embrace Cultural and Linguistic Differences 
     Encourage Self-Coaching 
     Consider Optimal Timing 
     Consider Optimal Locations and Conditions 
     Focus on Functional Communication 
     Engage the Person Actively and Meaningfully in Goal Setting 
     Focus on Relevant Material 
     Focus on Strengths 
     Be an Interprofessional Team Player 
     Integrate Evidence-Based Practice With Practice-Based Evidence 
     Blend Art With Science 
     Encourage Aphasia-Friendly Communication 
     Attend to Behavioral Challenges That Impede Successful Interactions 
What Does the Excellent Clinical Aphasiologist Know About Evidence-Based  
Where Can We Find Pertinent Information to Support Evidence-Based Practice? 
How Does the Excellent Clinician Integrate Evidence-Based Practice With  
           Practice-Based Evidence?
How May Excellent Clinicians Support Knowledge Translation Through  
           Implementation and Systems Science?
Learning and Reflection Activities

Chapter 24.  Treatment Theories and Types of Treatment to Enhance Language and 
Cognition Across All People With Neurogenic Communication Challenges

What Are the Purposes of Treatment Methods? 
What Are the Mechanisms of Recovery After Stroke and Brain Injury? 
How May Behavioral Treatment Facilitate Brain Recovery? 
How May Pharmacological Agents Facilitate Brain Changes? 
How May Brain Stimulation Facilitate Brain Changes? 
What Other Types of Intervention May Facilitate Brain Changes? 
Can We Differentiate Spontaneous Recovery From Progress Made Through  
What Are the Optimal Times During Recovery to Initiate Treatment? 
What Is the Optimal Focus of Initial Treatment Soon After a Stroke or Brain Injury? 
     Focus on Communication Needs 
     Counsel and Share Information 
     Promote Rest 
     Consider the Balance of Compensatory With Restitutive Approaches 
     Consider Pros and Cons of Focusing on Attention 
What Is the Optimal Intensity and Duration of Treatment? 
What Is the Best Level of Complexity for Treatment Foci? 
What Other Treatment Parameters Are Important to Consider? 
How Might Intervention in Neurodegenerative Conditions Slow  
           Cognitive-Linguistic Decline?
What Is the Best Time to Initiate Treatment With People Who Have   
           Neurodegenerative Conditions?
Learning and Reflection Activities 

Section VII.  General Approaches to Treatment 
Chapter 25.  General Approaches for Enhancing Cognitive-Linguistic Abilities in 
Traumatic Brain Injury, Stroke Survivors, and People With Primary  
Progressive Aphasia and Dementia 

What Is Treatment Fidelity, and How Is It Relevant to Clinical Aphasiology? 
What General Social and Life Participation Approaches Are Applicable to Treatment?
     Life Participation Approach to Aphasia 
     Supported Communication 
What General Treatment Methods Fit Within Social and Life Participation Models? 
     Total Communication Approaches 
     Partner and Caregiver Training 
     Reciprocal Scaffolding 
     Workplace Immersion Programs 
     Aphasia Mentoring Programs 
     Toastmaster Programs 
     Humor as Therapy
     Online Games 
     Other Socially Focused Programs 
What General Cognitive Neuropsychological Approaches Are Applicable to  
What Is Cognitive Rehabilitation? 
What Is the Stimulation-Facilitation Approach? 
How May Group Treatment Be Implemented, and How Can It Help People With  
            Aphasia and Related Disorders?
How May AAC, Apps, and Software Be Used to Support Communication and Aid  
            in Treatment?
     Alternative and Augmentative Communications
What Are Intensive and Residential Aphasia Programs, and How Can They Help   
           People With Aphasia and Related Disorders?
Learning and Reflection Activities 

Chapter 26.  Facilitating Communication in People With Primary Progressive Aphasia  
and Dementia

What Are Special Service Delivery Challenges for Serving People With PPA and  
How Is Working With People Who Have PPA and Dementia Recognized as a  
           Component of the SLP’s Scope of Practice?
What SLP Services for People With Dementia Are Reimbursable? 
What Types of Direct Treatment May Help People With PPA and Dementia? 
What Are Important Approaches for Caregiver Coaching, Training, and Support? 
What Are Memory Books and Memory Wallets, and How Are They Implemented? 
What Is Spaced Retrieval Training, and How Is It Implemented? 
What Is the FOCUSED Program, and How Is It Implemented? 
What Are Montessori Approaches to Dementia Management?
What Are Additional Forms of Programming to Support People With PPA and  
In What Other Ways May Clinical Aphasiologists Professionally Support the  
            Communication Needs of People With PPA and Dementia and the People  
            Who Care About Them?
Learning and Reflection Activities 

Chapter 27.  Counseling and Life Coaching 
How Might an SLP Become an Effective Counselor and Coach? 
Is the SLP Working With Adults to Be a Counselor, Life Coach, or Both? 
What Are Important Considerations Related to Counseling and Scope of Practice?
How Might a Speech-Language Clinician Adopt a Counseling Mindset? 
How Does a Clinician Listen and Respond Empathetically and Compassionately? 
How Do We Promote a Positive Outlook Without Conveying a Pollyanna Attitude? 
How Might Multicultural Differences Affect Counseling and Coaching? 
How Might Counseling Moments Be Influenced by the Time Course of Recovery 
          and Intervention?
     Counseling Following a Traumatic Change 
     Counseling at the Start of Intervention 
     Counseling Related to Assessment Results and Sharing Prognosis 
     Counseling During Treatment 
     Counseling at Discharge 
How May Coaching Enhance Self-Advocacy? 
What Are Best Practices in Responding to Seemingly Misguided Statements? 
What Are Effective Ways to Address Emotional Lability During Clinical Interactions? 
What Is the Role of the SLP in Addressing Depression in People With Neurogenic 
     Communication Disorders?
How Can Communication Counseling Enhance End-of-Life Care? 
What Are Ways in Which Opportunities for Counseling Can Be Missed? 
How Might Some Aspects of Life Improve After Onset of an Acquired Neurogenic  
     Communication Disorder?
How May People With Acquired Communication Challenges Support One Another? 
What Are Some Helpful Information-Sharing Strategies and Resources? 
Learning and Reflection Activities 

Chapter 28.  Complementary and Integrative Approaches 
What Are Complementary and Integrative Approaches to Wellness? 
How Are Complementary and Integrative Approaches Relevant to Neurogenic   
           Disorders of Language and Cognition?
Why Is It Important for Clinical Aphasiologists to Learn About Complementary   
           and Integrative Approaches?
How Are Mind-Body Practices Relevant to People With Cognitive-Linguistic   
How Might Hypnosis and Visualization Be Relevant to People With Neurogenic  
           Communication Disorders?
What Are the Potential Roles of Religion and Spirituality in Acquired Neurogenic 
          Communication Disorders? 
How Might Natural Product Use Be Relevant to People With Cognitive-Linguistic 
Why Are Complementary and Integrative Approaches Increasing in Popularity? 
     Frustration With Current Options 
     Increasing Awareness 
     Expanded Funding 
     Increasing Evidence 
     Aggressive Marketing 
What Is the Status of the Evidence Base Supporting Alternative Approaches to  
          Improving Cognitive-Communicative Abilities?
How Might SLPs Support People Considering Complementary and Alternative  
          Approaches to Cognitive-Communicative Wellness?
Stay Within Your Scope of Practice 
Engage Only in Methods You Are Trained in and Competent to Carry Out 
Emphasize Complementary Over Alternative Approaches to Direct Intervention for 
          Communication and Cognition 
Keep an Open, Nonjudgmental Attitude and Appreciate Multicultural Differences 
Encourage Caution When Counseling People Considering Alternative and  
          Complementary Approaches
Learning and Reflection Activities

Section VIII.  Specific Treatment Approaches 
Chapter 29.  Specific Approaches for Promoting Compensatory Communication Strategies 

What Is Promoting Aphasics’ Communicative Effectiveness (PACE)?
On What Principles Is PACE Treatment Based? 
How Is PACE Treatment Implemented? 
What Is the Status of PACE in Terms of Evidence-Based Practice? 
What Is the Communicative Drawing Program? 
On What Principles Is CDP Based? 
How Is CDP Implemented? 
What Is the Status of the CDP in Terms of Evidence-Based Practice? 
What Is Back to the Drawing Board? 
On What Principles Is BDB Treatment Based? 
How Is BDB Implemented? 
What Is the Status of BDB in Terms of Evidence-Based Practice? 
What Is Visual Action Therapy? 
On What Principles Is VAT Treatment Based? 
How Is VAT Implemented? 
What Is the Status of VAT in Terms of Evidence-Based Practice? 
Learning and Reflection Activities 

Chapter 30.  Specific Approaches for Enhancing Expressive Language 
What Is Constraint-Induced Language Therapy? 
On What Principles Is CILT Based? 
How Is CILT Implemented? 
What Is the Status of CILT in Terms of Evidence-Based Practice? 
What Is Script Training?
On What Principles Is Script Training Based? 
How Is Script Training Implemented? 
What Is the Status of Script Training in Terms of Evidence-Based Practice? 
What Is Melodic Intonation Therapy? 
On What Principles Is MIT Based? 
How Is MIT Implemented?
     Level I
     Level II 
     Level III 
     Level IV 
What Is the Status of MIT in Terms of Evidence-Based Practice? 
What Is Voluntary Control of Involuntary Utterances? 
On What Principles Is VCIU Treatment Based? 
How Is VCIU Implemented? 
What Is the Status of VCIU in Terms of Evidence-Based Practice? 
What Is Response Elaboration Training? 
On What Principles Is RET Based? 
How Is RET Implemented? 
What Is the Status of RET in Terms of Evidence-Based Practice? 
What Is Treatment for Aphasic Perseveration? 
On What Principles Is TAP Based? 
How Is TAP Implemented? 
What Is the Status of TAP in Terms of Evidence-Based Practice? 
Learning and Reflection Activities 

Chapter 31.  Specific Approaches for Improving Word Finding and Lexical Processing 
What Are Cueing Hierarchies for the Treatment of Anomia? 
On What Principles Are Cueing Hierarchies for the Treatment of Anomia Based? 
How Is Cueing Hierarchy Treatment Implemented? 
What Is the Status of Cueing Hierarchies for the Treatment of Anomia in Terms of  
            Evidence-Based Practice?
What Is Semantic Feature Analysis? 
On What Principles Is SFA Treatment Based? 
How Is SFA Treatment Implemented? 
     Baseline Phase and Target Selection 
     Semantic Feature Analysis Chart Method 
     Graphic Organizer Method 
What Is the Status of SFA in Terms of Evidence-Based Practice? 
What Is Phonological Components Analysis? 
On What Principles Is PCA Treatment Based? 
How Is PCA Treatment Implemented? 
What Is the Status of PCA in Terms of Evidence-Based Practice? 
What Is Verb Network Strengthening Treatment? 
On What Principles Is VNeST Based? 
How Is VNeST Implemented? 
     Stimulus Selection and Creation 
     Generation of Agent-Patient Pairs 
     Wh- Questions About Agent-Patient Pairs 
     Semantic Judgments 
     Generation of Agent-Patient Pairs Again 
What Is the Status of VNeST in Terms of Evidence-Based Practice? 
What Is Verb as Core? 
On What Principles Is VAC Treatment Based? 
How Is VAC Treatment Implemented? 
What Is the Status of VAC in Terms of Evidence-Based Practice? 
Learning and Reflection Activities 

Chapter 32.  Specific Approaches for Improving Syntax 
What Is Treatment of Underlying Forms? 
On What Principles Is TUF Based? 
How Is TUF Implemented? 
     Ensuring Metalinguistic Awareness 
     Creating Noncanonical Sentences 
     Thematic Role Training 
What Is the Status of TUF in Terms of Evidence-Based Practice? 
What Is Mapping Therapy? 
On What Principles Is Mapping Therapy Based? 
How Is Mapping Therapy Implemented? 
What Is the Status of Mapping Therapy in Terms of Evidence-Based Practice? 
What Is the Sentence Production Program for Aphasia? 
On What Principles Is SPPA Treatment Based? 
How Is SPPA Implemented? 
What Is the Status of SPPA and HELPSS in Terms of Evidence-Based Practice? 
Learning and Reflection Activities 

Chapter 33.  Specific Approaches for Improving Reading and Writing 
What Are Basic Principles That Underlie Most Writing- and Reading-Focused  
           Programs for People With Aphasia?
What Is Copy and Recall Treatment? 
On What Principles Is CART Based? 
How Is CART Implemented? 
What Is the Status of CART in Terms of Evidence-Based Practice? 
What Is Anagram and Copy Treatment? 
On What Principle Is ACT Based? 
How Is ACT Implemented? 
What Is the Status of ACT in Terms of Evidence-Based Practice? 
What Is the Problem-Solving Approach? 
On What Principles Is the Problem-Solving Approach Based? 
How Is the Problem-Solving Approach Implemented? 
What Is the Status of the Problem-Solving Approach in Terms of Evidence-Based  
What Is Multiple Oral Rereading? 
On What Principles Is MOR Treatment Based? 
How Is MOR Implemented? 
What Is the Status of MOR in Terms of Evidence-Based Practice? 
What Is Oral Reading for Language in Aphasia? 
On What Principles Is ORLA Treatment Based? 
How Is ORLA Treatment Implemented? 
What Is the Status of ORLA in Terms of Evidence-Based Practice? 
Learning and Reflection Activities


Brooke Hallowell

Brooke Hallowell, PhD, CCC-SLP, brings to this book over 30 years of clinical, research, teaching, and advocacy experience to support adults with acquired neurogenic communication challenges. She serves on boards and committees of several national and international organizations, including Aphasia Access, the National Aphasia Association, the Academy of Neurologic Communication Disorders and Sciences, and the American Speech-Language-Hearing Association (ASHA). She is a founding representative of the Global Rehabilitation Alliance (GRA), an affiliate of the World Health Organization (WHO) in Geneva, Switzerland, and serves on the GRA’s advocacy committee. She is an active consultant to the WHO on guidance regarding rehabilitation related to COVID-19, and she chairs ASHA’s committee on ethics in global engagement. She is also an editorial board member and reviewer for many scholarly journals and granting agencies.

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