The use of spontaneous gesture by aphasic patients

Abstract

In order to determine the extent to which aphasic patients are able to use hand gestures in their spontaneous communication, informally structured 20-minute interviews were conducted with three Wernicke's aphasics, four Broca's aphasics and five non-neurologically impaired control subjects. The study has been designed to overcome some of the methodological problems inherent in existing research, notably; (1) the classification of subjects according to the type of aphasia present, (2) the analysis of representative samples of naturally occurring conversation, (3) the use of a well-defined and reliable system of gesture classification, and (4) the interpretation of results based on formal statistical analyses. Overall, it was found that there were significant differences between the three groups in their use of hand gestures. The results of the study indicate that hand gestures are used most by Broca's aphasics and least by non-aphasic controls. Batons, ideographs and deictic movements were associated predominantly with Broca's aphasics, while both Wernicke's and Broca's aphasics used kinetographs significantly more than the non-neurologically impaired comparison group. The results are discussed in terms of the model of communication favoured by Cicone et al. (1979) which considers that expressive communication is governed by a ‘central organizer’ which initiates and controls the clarity and complexity of both speech and gesture. Based on the differential usage of gestures by the Wernicke's and Broca's aphasics, different approaches to the problem of remediation in aphasia are considered.