‘Aphasia’ is the generic term used to describe the common range of language impairments that can follow mainly left hemisphere brain damage. Neurological damage can also cause a range of communication problems that do not directly affect such ‘straight’ linguistic aspects of language, such as right hemisphere language impairments, impairments to the planning component of speech production (apraxias of speech) and dysarthria (i.e. articulation impairment). To distinguish aphasia from other language impairments accompanying brain damage, aphasia can be described in terms of disorders of the core components of a linguistic model; features like lexical semantics, syntax, morphology and phonology. This chapter will outline what we know about the recovery from, psychosocial adjustment to and therapy for, aphasia.

Recovery

Most research into recovery from aphasia has been without reference to any theoretical model. Group studies have shown that most aphasic people make some recovery, yet most studies have used operational definitions, based on a group's improved performance on a test battery (Basso, 1992; Code, 2001) (see ‘Neuropsychological assessment’).

Such operational definitions, e.g. change in an overall score or aphasia quotient on a psychometric battery, are used widely but do not help to improve understanding of the cognitive processes underlying recovery. One hypothesis (e.g. Le Vere, 1980) is that recovery is best seen as neural sparing and distinguishes between ‘losses’ which simply cannot be recovered, and behavioural deficits which are the result of attempts to shift control to undamaged neural systems. Real recovery requires the sparing of the underlying neural tissue.