Glossary - Terms and Definitions

This page is here because it can be really difficult to understand information you might find about stroke and aphasia. This page can be used as a quick reference for family, caregivers, and people with aphasia to understand unfamiliar terms. We hope this is useful!

 

These definitions have been borrowed from a variety of sources. The symbol at the end of each definition indicates its source as follows:

* - https://www.aphasiatoolbox.com/glossary

# - https://www.aphasia.org/aphasia-definitions/

~ - https://tactustherapy.com/speech-therapy-terms-defined/

** - https://www.strokengine.ca/en/glossary/

Agraphia - an acquired problem with writing and spelling. *

Alexia - acquired difficulty reading printed language.  *

Alzheimer’s Disease – The most common type of dementia, often recognized by declining short-term memory in the early stages. Like all dementias, people with Alzheimer’s get worse over time as it is a degenerative condition. ~

Amnesia - a problem remembering persons, places or events. *

Anomia – An expressive language impairment that makes it difficult to recall words and names. Anomia is a common and frustrating part of most types of aphasia. ~

Anomic Aphasia -This term is applied to persons who are left with a persistent inability to supply the words for the very things they want to talk about-particularly the significant nouns and verbs. As a result their speech, while fluent in grammatical form and output is full of vague circumlocutions and expressions of frustration. They understand speech well, and in most cases, read adequately. Difficulty finding words is as evident in writing as in speech. #

Anosognosia - a lack of awareness or recognition of one's disabilities or impairments.  People may have anosognosia following a stroke or traumatic brain injury. This may be confused with learned non-attention or learned helplessness. *

Aphasia – An acquired language disorder caused by damage to the language centers of the brain. Aphasia can impact auditory comprehension, verbal expression, reading, writing, and use of symbols. It does not affect intelligence. ~

Apraxia - a disorder of programming body movements.  When it affects speech (often referred to as apraxia of speech), it makes it difficult for a person to program and coordinate speech muscle movements to say words.  It may also impair the ability to initiate voicing or sequence sounds into syllables.  It is important to recognize that apraxia may affect other body movement (arm; leg; vocal folds; swallowing; head shake/nod, etc).  *

Articulation – The movement of the tongue, lips, and jaw to make speech sounds. Articulation is one part of the whole speech process that includes respiration, phonation, articulation, resonance, and prosody. Articulation problems are common after a stroke or brain injury as part of dysarthria. ~

ASHA – The American Speech-Language-Hearing Association is the organization that certifies Speech-Language Pathologists in the United States. The annual ASHA convention is held every year in November in various locations around the country, featuring continuing education and an exhibit hall  for 10,000-14,000 attending speech pathologists, audiologists, and students. ~

Assessment – The evaluation phase of therapy in which a speech therapist determines whether an impairment exists, the degree and nature of the impairment, and sets the direction for therapy, usually with a written report summarizing the findings. Assessments may include formal or standardized tests or may be informal, consisting of an interview or a variety of non-standardized tasks. Many assessments include a combination of formal and informal measures.

Assistive Device - Assistive devices are any piece of equipment that you use to make your daily activities easier to perform. **

Ataxia - a disorder that involves a lack of muscle coordination during voluntary movements such as walking or picking up objects. Ataxia can affect speech movement and coordination, resulting in ataxic dysarthria. *

Attention - involves the way we attend to and process information present in our surroundings. Attention could be of the following nature: Focused attention - active attention to one thing; being able to focus. Sustained attention - ongoing attention to a stimulus; sustaining attention long enough to practice. Selective attention -  the ability to avoid distractions;  being able to overcome distractibility; . Alternating attention - the ability to shift focus from one task to another; to attend to speech then to text then back to speech. Divided attention -   the ability to attend to more than one task;  to remember words while organizing them into a sentence. *

Auditory Comprehension – Understanding words through listening. Auditory comprehension is often impaired in aphasia. It can be relatively in-tact for single words or simple sentences, but impaired for complex sentences, grammatical words, or when there are background distractions. ~

Augmentative and Alternative Communication (AAC) – Communication methods used by a person with a communication disorder. to enhance or replace spoken or written communication. AAC can be unaided or aided by a device or communication tool, and can be low-tech (paper or equivalent) or high-tech (computer, smartphone, or dedicated device). ~

Blocked Practice - Blocked practice involves practicing one specific type of movement over and over again until you get it right.  **

Broca's Aphasia - Individuals with Broca’s aphasia have trouble speaking fluently but their comprehension can be relatively preserved. This type of aphasia is also known as non-fluent or expressive aphasia. Patients have difficulty producing grammatical sentences and their speech is limited mainly to short utterances. Producing the right sounds or finding the right words is often a laborious process. Some persons have more difficulty using verbs than using nouns.

Caregiver – A person who provides care for a person with a disability. A caregiver can be a spouse, sibling, parent, or friend as well as a paid caregiver hired to care for a person. Also called a carer or care partner. ~

Cerebrovascular Accident (CVA) – The medical term for a stroke. A stroke occurs when the blood supply to the brain is blocked (ischemic stroke) or ruptures (hemorrhagic). ~

Circumlocution – Literally talking around a word, a method of describing a concept. Circumlocution is a strategy used by people with anomia, as well as a common characteristic of aphasic speech. ~

Cognition – The mental processes related to knowledge, including awareness, attention, perception, reasoning, memory, language, and judgement. ~

Cognitive Flexibility - the ability to adapt thinking to new and unexpected happenings, including the ability to consider a variety of solutions to a problem or to come up with multiple ways to interpret an event. *

Cognitive-Communication – Cognition as it relates to communication. Disorders of cognition often have a negative effect on communication. ~

Cohesion - the links that hold a conversation, statement or narrative together.   They guide listeners or conversational partners and show how parts of a story or conversation relate to each other. *

Communication Disorder – Any disorder that impairs communication. Communication disorders may affect speech (speech-sound disorder, articulation disorder, motor speech disorder, apraxia of speech), language (aphasia, expressive language disorder), pragmatics (autism, frontal head injury), fluency (stuttering), literacy (dyslexia, agraphia, alexia), cognition (dyscalculia, dementia),  or voice. ~

Communication – The transmission of  a message from a sender to a recipient through a medium (e.g. verbal, non-verbal, written). ~

Compensatory Strategy – A method of carrying out a task when the easiest or most direct method of achieving the goal is impaired. Example: Describing a word is a compensatory word-finding strategy that can be used when a person cannot think of the exact word; using this strategy may result in the listener guessing the word, thereby compensating for the word finding deficit. A person must remember to use the strategy for it to work. Compensatory strategies used for cognition, language, speech, and swallowing and are frequently taught in speech therapy. ~

Comprehension – Understanding. Auditory comprehension is understanding through listening. Reading comprehension is understanding written words. Comprehension Therapy is an app designed to work on auditory and reading comprehension of single words. Reading Therapy is an app meant to be used for reading comprehension at the phrase and sentence levels. Answering Therapy targets the understanding of questions.

Cue – An auditory, visual, or tactile message that prompts a person to say or do something. Cues are given in speech therapy to help a person find a word, produce a sound, remember something, or use a compensatory strategy. Also referred to as a hint or prompt. ~

Cueing Hierarchy – A set of cues arranged in an order from most helpful to least helpful. ~

Decoding - the process through which meaning is extracted from written letters. Decoding is essential to reading. *

Degenerative Disease – A medical condition that gets worse, or progresses, over time. Often speech therapy for people with degenerative disorders will focus on teaching strategies that can be used by the person or family as skills deteriorate. Dementia, Parkinson’s, ALS, cancer, and PPA are progressive conditions that can affect communication. ~

Deglutition – A scientific word for swallowing, or passing something from the mouth into the stomach via the throat and esophagus. Disorders of deglutition are called dysphagia. ~

Dementia – An umbrella term for a set of degenerative brain disorders that often affect memory and thinking skills first, before impacting language, emotions, and motivation. Alzheimer’s, Lewy body, frontotemporal, and primary progressive aphasia are all types of dementia. See also Alzheimer’s. ~

Dietitian - These professionals provide a myriad of services: assessment of nutritional status and requirements; collaborative assessments and management of swallowing disorders, implementation of appropriate diet plans; risk factor modification; patient and family education. **

Discourse -  a unit of written or spoken language longer than a single sentence.  Obviously, this is an essential skill in communicative situations such as conversation, giving directions and sharing feelings.  *

Dysarthrias - a group of motor speech disorders resulting from damage to the brain or nervous system, which leads to abnormalities in the muscle movements for speech. This includes muscle strength and tone, range of motion, speed and precision of movement. People with dysarthria may have difficulty being understood by others, because of disturbances in their speech, which may affect articulation, voice, rhythm, resonance, and breathing in various ways. *

Dysfluency - a breakdown or blockage in the smooth forward flow of speech. *

Dyslexia - a learning disorder distinguished by impaired ability to recognize and comprehend written words. *

Dysphagia – Impaired swallowing. Dysphagia is common after a stroke, but also occurs from other neurological conditions or physical damage to the mouth, throat, or esophagus. Speech-language pathologists are experts in the diagnosis and treatment of oral and pharyngeal dysphagia. Exercises, modified diets, and strategies may be recommended after a clinical/bedside or instrumental assessment. ~

Echolalia - immediate or delayed pathological repetition of words previously spoken by others. *

Engagement - mutual and purposeful social interaction and conversation.  Important in optimal recovery is the active initiation of conversation by the person with aphasia. *

Evidence-Based Practice (EBP) – An approach to clinical practice that values research and evidence of efficacy above tradition when making treatment decisions. Evidence exists along a hierarchy of strength, from clinical expertise and case studies to randomized controlled trials and meta-analyses. ~

Executive Functioning – The term for the overall management of tasks, including planning, reasoning, monitoring, adjusting, problem solving, and evaluating. This is the highest level of cognitive functioning and often impaired in brain injury survivors. ~

Focused attention - active attention to one thing; being able to focus.

Formative Assessment - an ongoing (minute-by-minute; day-by-day) assessment, observation and review used to maximize the positive effect of client practice and aphasia treatment.  Speech-language pathologists can use formative assessment to keep individual aphasia treatment programs fresh and effective, based on changes in a client's performance. *

Frontal Lobe – One of the four lobes of the brain, located at the front of the skull behind the forehead. The frontal lobe is associated with executive functioning, decision making, self control, and problem solving. It is frequently damaged in brain injuries caused by motor vehicle collisions. ~

Generalization – The process of a skill learned in therapy being used in a broader context. Also known as carry-over or transfer. ~

Global Aphasia - This is the most severe form of aphasia, and is applied to patients who can produce few recognizable words and understand little or no spoken language. Persons with Global Aphasia can neither read nor write. Global aphasia may often be seen immediately after the patient has suffered a stroke and it may rapidly improve if the damage has not been too extensive. However, with greater brain damage, severe and lasting disability may result. #

Grapheme - the smallest unit in a writing system capable of causing a contrast in meaning, including letters and punctuation marks. *

Hemianoposia - a disorder characterized by blindness or decreased vision in half of the visual field of one or both eyes. This often is associated with stroke. *

Hemiparesis - weakness on one side of the body. *

Hemiplegia - a paralysis of one side of the body as a result of stroke or other neurological injury. *

Inference - drawing a logical conclusion from evidence, facts or circumstances.  *

Instrumental Activities of Daily Living (IADL) - Complex tasks that involve social or societal issues (shopping, bill paying, cooking, housework, etc.) that are done on a regular basis. **

Intonation – The rise and fall of pitch in the voice during speech. A component of prosody. ~

IPA - the acronym for International Phonetic Alphabet. The IPA has an internationally recognized form for representing the pronunciation of various speech sounds.  *

Jargon – Non-words produced by a person with aphasia, usually fluent aphasia, that sound like real words and are produced with appropriate intonation. Also, terminology specific to a profession, like most words on this list. ~

Language – A system for communicating. The words and rules for combining them understood by a community; can be spoken or written. English, Spanish, and American Sign Language are three examples of languages. ~

Learned helplessness - the condition of a person who has learned to rely on others for help and will avoid taking steps to help him or herself, even though he/she may be capable of doing so. Often, after a stroke or brain injury, people may believe that they are not capable of doing things independently and therefore, rely on family or caregivers to do things for them. See also Learned Non-attention. *

Learned non-attention - the condition of a person who either not sure where to focus his/her attention or had has developed set responses or maladaptive point of focus.  This problem can of course impair, or even preclude, adequate aphasia recovery.  *

Lexicon - the entire collection of all the words a person knows. Aphasia makes it difficult for a person to access and use his/her lexicon. *

Life Participation Approach to Aphasia (LPAA) – A philosophy or model of service delivery for aphasia therapy that expands the focus from only addressing the language impairment to also include the person, their environment, and their participation in activities to more fully impact quality of life. ~

Logorrhea - excessive wordiness.  The uncontrollable intention to continue a dialogue with lack of awareness of its impact on conversational partner.  Similar to press of speech but tendency to stay on a topic rather than drift from topic to topic. *

Mental processes -  the cognitive operations involved when a person thinks and remembers. Some thought functions considered to be mental processes include attention, memory, problem solving, decision making, and producing and understanding language. Aphasia treatment should target appropriate mental processes to maximize aphasia recovery. Your speech pathologist can explain to you what your mental process targets are and why they were chosen. *

Motor Speech Disorders - speech disorders caused by neurological impairment, which result in disturbances in the ability to plan, program, control, and execute speech. Motor speech disorders include dysarthrias and apraxia of speech. *

Naming – The process of saying what you see. The ability to name objects or actions is frequently impaired in people with aphasia and dementia. ~

Neglect – A neurological condition that results in a person being unaware of things that appear on one side of their visual field, even though their eyes are fine. Left neglect is more common than right neglect, though both are possible. ~

Neurogenic - controlled by or arising from the nervous system. *

Neurologist – A medical doctor specialized in disorders of the nervous system (brain, spinal cord, and peripheral nerves). ~

Occupational Therapy (OT) – A field of therapy that rehabilitates people with physical or mental illness through the performance of everyday tasks. Occupational Therapists often focus on the upper extremity (arm and hand), wheelchair mobility, activities of daily living, and visual-spatial skills in the rehab setting. ~

Paraphasia -  the production of unintended syllables, words, or phrases by people with aphasia. *

Parkinson’s Disease – A progressive or degenerative medical condition that affects movement by impacting the dopamine systems in the brain.  People with Parkinson’s Disease, or Parkinsonian symptoms, can have speech and swallowing problems that can be helped by speech therapy. ~

Perseveration - the inappropriate repeating of a sound, word or phrase instead of the intended item. This is a common problem associated with aphasia. When treated as a problem of focused and alternating attention, perseveration can be quite responsive to change. *

Phonagnosia - an impairment in the recognition of familiar voices. *

Phonation – Sound made when air vibrates the vocal folds in the larynx to produce speech. In some motor speech disorders, phonation is absent, impaired, or mis-timed. ~

Phonemes – The sounds that are distinct in a language. The word “cat” has 3 phonemes: k + æ + t. Phonemes can be written using the International Phonetic Alphabet, or IPA. ~

Phonology - the study of the way that sounds are used in a language and the rules for pronouncing certain words.

Physical Therapy (PT) – A field of therapy that rehabilitates people with physical impairments through exercise, massage, heat, or other treatments that are not surgery or medication. Physical Therapists often focus on transfer skills (e.g. moving from bed to chair), walking, and climbing stairs in a rehabilitation setting. ~

Plateau - a term used by some rehabilitation specialists and medical staff, that indicates that a person with aphasia is no longer expected to make progress. The PWA may be told to expect a plateau after a certain period of time.  *

Pragmatics – The social use of language, including tone of voice, taking turns in a conversation, providing context to a story, and using words appropriate to the audience or situation. Pragmatic skills are often impaired after a brain injury or a stroke on the right side of the brain. ~

Primary Progressive Aphasia -  a dementia that results in a progressive loss of language abilities, while memory is relatively preserved. *

Procedural Memory - knowledge of how to perform skills and actions (i.e., procedures) such as driving a car, using a cell phone or keyboarding.  *

Prosody - the rhythm, stress and intonation patterns of a person's speech. People use prosody to express important elements during conversations such as intent, emphasis, sarcasm, importance of the message and attitude. A person with aphasia often also has problems with prosody either as part of the speech/language impairment (aprosodia) or as a secondary outcome of the efforts to speak (struggle, robotic speech, mental resource allocation issues). *

PWA - an acronym meaning "person/people with aphasia". *

Screen Literacy - a person’s ability to successfully interact with everyday technology.  This is a critical skill in today’s world and might include using a cell phone, an ATM, a TV remote, or a gas pump.  *

Semantic Feature Analysis (SFA) – An evidence-based method of naming therapy that entails describing something in a systematic way. Detailing the color, size, shape, function, category, smell, taste, feeling, etc of an object or action is a communication strategy, a prompt to retrieve the word, and a restorative exercise. ~

Semantics - the meaning of a word, phrase, clause, or sentence, as opposed to its syntactic construction. It is also a branch of linguistics concerned with the study of meanings of words. *

Speech and Language Therapist (SLT or SALT) – The same as a Speech-Language Pathologist. This title is used for professionals who are trained to evaluate and treat communication and swallowing disorders. ~

Speech Therapy – The treatment of communication and swallowing disorders. ~

Speech – The expression of language through articulated sounds. Speech consists of respiration, phonation, articulation, resonance, and prosody. Disorders of speech may include problems with any of these areas, including fluency (stuttering or stammering) and voice. ~

Speech-Language Pathologist (SLP) – The official title given to professionals who are trained to evaluate and treat communication and swallowing disorders.  The term ‘Speech-Language Pathologist’ is meant to better reflect the scope of practice of professionals commonly referred to as ‘speech therapists.’ In the US and Canada, entry-level education to qualify to be a SLP is a Master’s degree. ~

Stimulus -1. something that elicits an action or response;  2. an object that is recognized by the senses.  In aphasia practice, it is usually a printed or spoken syllable, word or sentence. *

Strategy – A plan for achieving a goal. People with communication and swallowing disorders may benefit from using strategies to do the tasks that have become difficult for them. See also Compensatory Strategy. ~

Stroke – An event inside the brain in which there is a sudden loss of function, also known as a brain attack or cerebrovascular attack (CVA). A stroke occurs when a part of the brain is deprived of the oxygen it needs to function properly. ~

Syllable - a part of a word or a whole word that is produces with one, uninterrupted sound.   It is the smallest portion of speech.    We speak in syllables.  It is absolutely critical for maximizing recovery of speech that a person with aphasia reconnect his/her ability to mentally recognize and manipulate,  and to produce syllables.  See syllabification. *

Synonyms - different words that share a meaning (e.g., elated and ecstatic). *

Syntax - the rules and principles that govern the sentence structure of a language. *

Telepractice -  also referred to as tele-rehabilitation, may be defined is the provision of treatment services at a distance.  Rather than being a substitute for face-to-face sessions, telepractice is a new, proven system for providing aphasia treatment to PWA all over the world.  It is critical to not only use tools and activities designed to exploit neuroplasticity, but to also that take advantage of technology when using telepractice. *

Tele-rehabilitation - also referred to as Telepractice, may be defined is the provision of treatment services at a distance.  Rather than being a substitute for face-to-face sessions, telepractice is a new, proven system for providing aphasia treatment to PWA all over the world.  It is critical to not only use tools and activities designed to exploit neuroplasticity, but to also that take advantage of technology when using telepractice.  *

Traumatic Brain Injury (TBI) –  A jolt or blow to the head or a penetrating head injury that disrupts the normal functioning of the brain. ~

Verbal Memory - Verbal Memory is a term used in cognitive psychology that refers to memory of words and other abstractions involving language. *

Vernacular - the language or dialect of a country; the everyday language of ordinary people. *

Visual Field Cut - also known as hemianopsia or visual field loss. This is a partial or complete loss of vision in the peripheral fields range of vision.  A person with this condition may have trouble seeing things out of the corner of his/her eyes, may bump into things or people, or may lose his/her place when reading.  It is important to clearly differentiate this condition from visual inattention or neglect. *

Visual Field - the entire area that can be seen when the eye is directed forward, including the peripheral vision. *

Visual Neglect - also termed visual inattention or visual spatial neglect. This refers to a decreased awareness of the field of view.  There may also be sensory and perceptual involvement. *

Wernicke’s Aphasia – A type of fluent aphasia with poor auditory comprehension and jargon speech. ~

Working Memory - the brain’s capacity to hold information active until we need to use it for some purpose. *