Constraint-Induced Aphasia Therapy
The Constraint-Induced Aphasia Therapy (CIAT, dt. "Restriction-induced aphasia therapy") is an on neuroscience reasoned considerations form of therapy , patients with acquired language disorder ( aphasia to help) to recover their language skills. The therapy was developed analogously to Constraint-Induced Movement Therapy (CIMT), a therapy for people with acquired movement disorders.
Aphasia
Aphasias are caused by damage to parts of the brain , which in most cases is caused by an insufficient supply of oxygen as a result of a stroke. The lesions in the brain cause speech disorders. In about 40-60 percent of patients this damage persists for life; H. the aphasia becomes chronic. While until a few years ago it was assumed that there was no chance of improvement for these patients, new forms of therapy, above all the CIAT, have shown that the neuroplasticity of the brain allows an improvement in language ability under certain conditions.
The Constraint-Induced Movement Therapy
CIMT (also Forced Use Therapy ) was largely developed by the psychologist Edward Taub . Taub discovered that monkeys that were severed the nerve tracts of an arm (so-called deafferentation) put it back into use if they were prevented from using their still healthy arm (hence the constraint in the name of therapy). From this he and others developed the CIMT.
Neuroscientific Considerations
It is believed that the monkeys first try to use the deafferented arm, but soon give up due to failures. Taub referred to this as learned non-use . To overcome this, he prevented the monkeys from using their sound arm for long periods of time. This principle was transferred to the CIAT.
The three principles of Constraint-Induced Aphasia Therapy
The CIAT is based on the fact that during therapy the patients are prevented from communicating , for example by means of gestures or onomatopoeia ( constraint ), and are thus forced to use language. By means of shaping , i.e. a slow but steady increase in the degree of difficulty of the tasks, the patient's abilities should grow.
CIAT is based on three principles:
- massed practice principle (principle of frequent practice),
- behavioral relevance principle (principle of behavioral relevance ),
- focusing principle (principle of focusing).
The first principle says that the therapy should be carried out as often and as long as possible. As trivial as this may sound, this principle is a novelty, as it was sometimes even assumed before that aphasia therapy itself made no sense. The second principle assumes that relearning language skills is best achieved when it is done in a relevant context. The third principle is intended to ensure that patients do not avoid difficult communication situations, as otherwise a learned non-use would occur, which must be prevented.
literature
- F. Bross: Neuroscience and Aphasia Therapy: The Constraint-Induced Aphasia Therapy (CIAT). (PDF; 835 kB). In: Helikon. A Multidisciplinary Online Journal. 1, 2010, pp. 124-142.
- F. Pulvermüller, ML Berthier: Aphasia Therapy on a Neuroscience Basis. In: Aphasiology. 22 (6), 2008, pp. 563-599.
- Edward Taub: Motor behavior following deafferentiation in the developing and motorically mature monkey. In: R. Herman, S. Grillner, HJ Ralston, PSG Stein, D. Stuart (Eds.): Neural Control of locomotion. New York 1976, pp. 675-705.
- Individual proof
