Adaptation in aphasia: revisiting language evidence

ABSTRACT

Background: Humans adapt to constantly changing internal and external conditions to meet survival needs. Persons with aphasia (PWA) are faced with changes in their physiological, cognitive, and affective state. They usually have physiological impairments in the frontal or temporal areas, which can lead to cognitive problems such as limited working memory, inefficient executive function, and lapse of attention. These problems have negative impacts on their language. Most PWA also experience long-term social anxiety, pressure, and other negative feelings caused by their illness. According to adaptation theory, symptoms such as omission and disfluency are not caused by deficits in language knowledge but by adaptive behaviours that PWA produce because of certain communicative purposes or the severity of aphasia.

Aims: The purpose of this paper is to review the theories and facts concerning the adaptive language behaviours of PWA and to attempt to account for the features, motivations, and principles of their strategic, adaptive language.

Main Contribution: To adapt to the heterogeneous concomitant cognitive and psychological impairment induced by aphasia, PWA must maximise their expression by efficiently exploiting their resources (i.e., performing normal communication in the most effortless way) following the principle of economy, which is a basic human cognitive principle. PWA employ several strategies to maintain crucial information and avoid effortful, less necessary language elements. They sometimes seek non-verbal strategies to compensate for what cannot be expressed. In this way, PWA are able to transmit information and simultaneously avoid embarrassment caused by erroneous language.

Conclusions: This type of economic language use can be observed in phonology, morphology, syntax, and other levels of language. PWA’s adaptation should be taken into consideration when considering their language, so that it can be differentiated from language disorders caused by other cognitive impairments or competence loss. Sometimes language deficits are only symptoms of adaption rather than the result of impairments. Psychosocial interventions should be included in recovery programmes so that PWA can adapt in a more positive way and make full use of their language potential.

KEYWORDS:

• Aphasia
• adaptation
• principle of economy

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by The National Social Science Fund of China [14BYY065].