L. S. Vygotsky's psychology and theory of learning applied to the rehabilitation of aphasia: A developmental and systemic view

Abstract

Background: Learning and relearning are essential aspects in the rehabilitation of aphasia, and yet it is not at all clear what learning is in aphasia. The need for new views, clearer definitions and discussions of learning has been expressed repeatedly. In aphasiological literature learning is mostly interpreted according to a behaviouristic paradigm. In other fields, however, L. S. Vygotsky's different philosophy and theory of learning have been applied widely, even if the Soviet political ban delayed the spreading and application of his ingenious work over 50 years.

Aims: This paper introduces basic Vygotskyan ideas, theories, and concepts and suggests the application of his views of learning to the rehabilitation of aphasia. Before A.R. Luria's most well-known research concerning the head-injured victims of the Second World War, he had worked in many other fields of psychology with Vygotsky and A. N. Leontiev. These three, Vygotsky as their theoretical leader, had as their endeavour to reform the science of psychology. Luria's aphasiological theories were, in fact, a continuation of the earlier achievements of the new cultural historical psychology they had created.

To Vygotsky a developmental method was basic to all psychological research. He argued that higher human, culturally mediated psychological functions can be understood only by considering how they occur in the development of both the human species and in human individuals: learning is essentially development. The interpretation of the higher mental functions as highly interactive systems was to Vygotsky equally important. Word meanings and signs are the link between thinking and language and form the centre in connection to which all other higher mental processes are organized as complex, interacting systems.

Main contribution: The clinical application of Vygotskyan psychology to the rehabilitation of aphasia is presented here condensed to what is called developmental and systemic rehabilitation. These aspects may actually appeal to experienced clinicians as something very natural. What is new is a set of theoretical explanations for phenomena that we often see in clinical work.

Conclusions: The developmental and systemic interpretation of learning can generate new insights for organizing everyday clinical work with each client into a logical and consequent progression in which the language, cognitive, psychological, and communicative functions are considered and united into interactive systems and a coherent course of therapy.

Keywords:

• Aphasia
• Learning
• Rehabilitation
• Development
• Systems approach
• Theory of therapy.

Notes

Audrey Holland's earlier kind encouragement, and valuable comments by Chris Code, Anu Klippi, Klaus Helkama, Anna-Maija Korpijaakko-Huuhka and Jaakko Virkkunen on earlier drafts of this paper are thankfully acknowledged.

¹ The name of the three generations of Leontievs in Russian psychology and psycholinguistics has also been written in English translations as “Leontyev” and “Leont'ev”. To avoid confusion, the form “Leontiev” is used throughout the text.

² The problems of interpretation and translation of Vygotskyan concepts into English have been discussed by Glick (1997), Kozulin (1986b, 1990), Minick (1987), van der Veer (1997), van der Veer and Valsiner (1994), and Wertsch (1981).

³ Note the difference of the meaning of the word hierarchy in systems-thinking as compared to the often used meaning of the word in aphasia therapy literature as the order of used therapeutic procedures, not in clear dependency relations.