Aphasia 97Therapy for a patient with aphasia must be tailored to his or her communication strengths
and weaknesses. Generally, the most intact modes of communication are used to help improve the
more impaired ones. For example, if reading is a strong modality, a clinician may use it to improve
the expressive recall of words by having the patient read aloud. The patient’s level of motivation,
family support, learning abilities, and psychological status must also be considered. Many work-
books, tapes, computer programs, f lash cards, and other commercial therapeutic materials are
available for aphasia therapy. In addition, there are drills and exercises for aphasia- related reading,
writing, arithmetic, auditory comprehension, and verbal expression disorders. Aphasia therapies
should be based on scientific princi ples, but often there is a paucity of clinically relevant research
available to clinicians. Tanner and Sciacca (2008) propose that when evidence- based research is
unavailable, logical clinical syllogisms (deductive logic) can be used by the clinician for the treat-
ment of aphasia.
Case Study 5-1: A 44- Year- Old Man With
Traumatically Induced Jargon Aphasia and Denial-Projection
Roy’s meteoric climb up the corporate ladder was legendary in the investment banking world.
He was born in Detroit and spent his early years on its mean streets fending off temptation and
crime. His caring parents, dedicated teachers, and an uncle who preached the power of educa-
tion sparked him to achieve his potential. With the help of scholarships and student loans, Roy
graduated from a prestigious business college with a master’s degree in business administration
and landed a job at one of Detroit’s most aggressive international investment banks. He prided
himself on giving his family the good life, as well as a strong religion and a stable home. Roy was
more than a businessman; he was a family man. On weekends, he visited and cared for his el derly
parents. After dinner, he met several of his buddies at the neighborhood pool hall for a few games
and a couple of beers.
On this par tic u lar Saturday night, the pool hall was packed with the usual neighborhood
crowd, drinking, boasting, laughing, and listening to loud music. Roy walked through the smoke-
filled bar area to the pool tables at the rear of the room where his two longtime friends were already
locked in a close game, challenged the winner, and laid his $5 bet on the edge of the pool table. He
noticed two strangers admiring the custom- made cue he had brought and the cash in his wallet.
Roy was on his game that night and won nearly $500 from his friends and the two strangers.
At first, Roy tempered his playing by missing a few easy shots, using a sloppy bridge, and pulling
bad En glish. After a few beers, the games became more intense, and the betting increased. Late that
night, Roy’s friends left, and he and one of the strangers continued the game. Just before 2:00 a.m.
the last game was played, and Roy won a hefty bet. He then unscrewed his cue, placed it carefully
in its case, bid the stranger farewell, and started the short walk to his parents’ home and his car.
No one knows what happened next. The police report listed him as the victim of aggravated
assault, robbery, and attempted hom i cide. He was found lying unconscious on the sidewalk with
his head bleeding profusely. The police detectives believed he had been assaulted with a blunt
object, possibly the thick end of a cue stick. His wallet, minus credit cards and cash, was in a dump-
ster next to an adjacent bar, and his cue stick was nowhere to be found. The primary suspects, the
strangers in the pool hall, were never apprehended. Several days later, in Roy’s hospital room, the
detectives interviewed him about the crime. They learned little about the suspects but a lot about
jargon aphasia.