Acquired Childhood Aphasia
What is it?
Acquired childhood aphasia is a child's partial or total loss of
the ability to understand words and use language because of a brain
injury. Acquired means that it occurs after the child has begun
developing language skills. One form of acquired childhood aphasia
is called Landau-Kleffner syndrome (LKS), or acquired epileptiform
aphasia.
Who gets it?
Aphasia can occur in children who have experienced head trauma,
an infection (such as encephalitis), a brain tumor, cerebrovascular
accidents (stroke), or other brain disorders. Researchers have found
no connection between aphasia and age, gender, or race. However,
Landau-Kleffner syndrome (LKS) is usually seen in children between
the ages of 3 and 7.
What causes it?
To understand what causes aphasia, it helps to know a little bit
about the structure of the brain. The main portion of the brain, the
cerebrum, is divided into halves called the left and right
hemispheres. The cerebrum is further divided into lobes-the frontal,
parietal, occipital, and temporal. In most people, language control
is located in the left hemisphere of the brain, called the language
dominant area of the brain. It is here that we store information
about word meaning, how to formulate spoken and written language,
and how and when to use words properly. So, damage to the left
hemisphere most often results in the symptoms of aphasia. However,
research has shown that many left-handed people have language areas
in both the left and right hemispheres of the brain. These people
can develop aphasia from damage to either side of the brain. The
types of language skills that are lost or impaired depends upon the
area of the brain that is injured.
What are the symptoms?
Aphasia affects one or more of a person's language functions.
These could include speech, naming, and repetition, which is called
expressive language; hearing comprehension, which is called
receptive language; reading; and writing. Injuries that cause
aphasia can also affect the child's motor speech abilities, such as
swallowing and the ability to formulate speech sounds. In children,
aphasia symptoms can begin with speech delays and progress to the
loss of communication skills in all areas. The symptoms of aphasia
may be temporary or permanent, depending upon the amount of brain
damage. Landau-Kleffner syndrome (LKS) affects the parts of the
brain that control speech and comprehension. Children with LKS
usually develop normally, but lose the ability to speak and
understand what others are saying with no apparent cause. Some
children with LKS also have seizures.
How is it diagnosed?
Any time a child suffers a stroke or any type of brain injury, he
or she is assessed for any effects on language skills. Your doctor
may refer your child to a registered speech and language pathologist
or neuropsychologist who will perform a comprehensive speech and
language skills assessment. The pathologist will use age-appropriate
materials to test your child's expressive and receptive language.
Test results are used to pinpoint the area of the brain that has
been injured and to develop a speech therapy program best suited to
your child. Magnetic resonance imaging (MRI) and computed tomography
scans (CT) are also helpful in mapping the area of the brain that is
affected and to diagnose a brain tumor. Landau-Kleffner syndrome can
be difficult to diagnose because its symptoms are similar to many
other neurological disorders, such as autism, attention deficit
disorder, and mental retardation. It is diagnosed when a sudden or
gradual development of aphasia is accompanied by an abnormal
electro-encephalogram (EEG).
What is the treatment?
The primary treatment for most causes of aphasia is speech
therapy, which is begun as soon as the child's condition allows.
There are no drugs available to cure or treat aphasia. The speech
therapist works with the child to strengthen his or her remaining
language skills and to find ways to compensate for the skills that
have been lost. Techniques might include exercising the facial
muscles, repetition of words, using flash cards to improve memory of
object names, using pictures of objects and activities to
communicate with others, completing reading and writing exercises in
workbooks, learning sign language, and using computer programs to
aid in speech, hearing, and reading comprehension, as well as
recall. Surgery is only used to treat the cause of aphasia, such as
to reduce pressure from a brain tumor or to reduce swelling from
head trauma. Recovery from aphasia depends upon the severity of the
brain injury, with aphasia from head injury resulting in the best
prognosis and aphasia from damage to both sides of the brain having
the worst. Research has shown that the undamaged right hemisphere of
the brain can help with recovery when only the left hemisphere is
damaged. Treatment for Landau-Kleffner syndrome (LKS) includes
anticonvulsant medications (where seizures are a symptom) and
corticosteroids, as well as speech therapy. One rather controversial
treatment that has been used to treat LKS is called multiple subpial
transection. It involves severing the pathways of the brain where
there is abnormal electrical activity.
Self-care tips
The types of events that cause aphasia, such as stroke and head
injury, are difficult to predict or prevent. For this reason, there
are no guidelines for preventing aphasia. However, individual and
family commitment to a physician-guided speech therapy program can
result in full to partial recovery.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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