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When speech and language therapist first started working with people with stroke-related aphasia, they employed a general stimulation approach, the same with every patient they met. In the '70s this changed, and a more tailored approach was developed whereby therapists would identify the specific area of language breakdown such as word meanings (semantics) or word retrieval (lexical access) and target this specific area in therapy. Over time it became obvious that this approach did not work for everyone, and despite remaining relevant, other complimentary therapy approaches have been developed including conversation therapy. This article describes an approach to conversation therapy, whereby the speech and language therapy employs a multimodal approach to engage a person in conversation activities with the aim of increasing a person with aphasia’s participation in a natural conversation. The authors highlight that in recent years, transcranial direct current stimulation (tDCS) has offered another method of stimulating language recovery. The authors report that there is research that has demonstrated its effect not only on naming but also on conversation therapy. The field of aphasia therapy is a quickly expanding area and incorporates many different therapeutic approaches, as highlighted by the diversity of conversation therapies, the majority of which (not discussed here) work with both the person with aphasia and their communication partners. Offering a breadth of therapy options is important for any speech and language therapist, and exploring the potential of tDCS as a viable option for NHS therapists will take some time.

Conversation Therapy in Aphasia: From Behavioural Intervention to Neuromodulation.
Marangolo P, Pisano F.
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Anna Volkmer

UCL, London, UK.

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