Cognitive Approaches to Aphasia Treatment: Application of the Cognition of Language to Aphasia Intervention

Cognition consists of the mental processes and activities that are used for perceiving, remembering, thinking, and understanding. Because language is a tool for accomplishing these behaviors, it is essential to cognition and is a part of our higher mental processes. Language processing, therefore, represents the embodiment of human cognition and is not simply the result of an interaction with cognition (as is suggested by accounts that attempt to separate language and cognition).

Information processing models have been important for describing language. Such models generally describe language processing in terms of stores that are activated when they are attended to, which, in turn, is determined by a central executive that responds to the priorities and/or goals of the processor. These models often focus on (1) the influence of attention in selecting and sustaining language inputs and outputs especially under conditions that compete for attention, (2) the role of short-term stores for activating and maintaining language representations, (3) the functions of working memory and its subsystems (especially the phonological loop and episodic buffer) for controlled processing of complex language, and (4) the storage and retrieval of language representations (e.g., semantic, phonologic) in long-term (permanent) memory.

Aphasia, as well as most acquired language disorders, is among the larger array of cognitive disorders and generally results from impairments to the processes described previously, processes that are fundamental to language itself. As clinical aphasiology has come to increasingly describe aphasia in terms of human information processing, it has not been unexpected that treatment approaches for aphasia have targeted for intervention, or at least described the outcomes of intervention, in terms of their influence on these cognitive processes.

This issue of Seminars provides a comprehensive overview of contemporary aphasia treatment from the perspective of information processing theory. In the first article, Peach and colleagues describe a treatment approach that exploits language tasks to improve attention. The next two articles by Minkina et al and Salis et al review the evidence regarding treatment for verbal short-term memory deficits and provide recommendations for improving language production and comprehension through the use of this approach. Henderson and coworkers describe the role of working memory, specifically the episodic buffer, in discourse and offer a treatment approach for discourse deficits following aphasia. Finally, Boyle and Madden and colleagues address the organization of semantic and phonological knowledge in long-term memory and describe methods for targeting these representations to improve lexical access and sentence production. All in all, the articles demonstrate how cognitive theory, especially with regard to the psychology of language, can be applied to develop new interventions for aphasia. We hope the reader will find these articles to be enriching and to provide new insights regarding the cognition of language and aphasia rehabilitation.