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Introduction
Honorary Research Professor in the Department of Psychology, University of Exeter, UK. I am semi-retired, but still engaged in research in aphasia, apraxia, calculation, psychosocial impact of aphasia and the role of aphasia in the evolution of language and speech. Current projects include evaluation of peer support programmes for stroke survivors, group singing Intervention to Improve wellbeing for aphasic people, and investigation into the international public awareness of aphasia.
Current institution
Additional affiliations
October 1979 - June 1980
January 1982 - June 1992
December 1997 - present
Publications
Publications (212)
Apraxia of speech (AOS) is a common condition resulting from brain damage causing impairments to speech planning and programming that is distinct from aphasia and dysarthria. Following a stroke, AOS is most often seen as a part of nonfluent Broca’s aphasia. Recovery and dissolution of speech in stroke induced apraxia of speech (sAOS) and progressiv...
The choices of who we thought might make a good or bad speech-language pathologist/therapist in the late 1980s in the UK.
Background: Stylistic differences in language use, as described by sociolinguists, have also been shown to occur in disordered speech and language. In this article, we describe apraxia of speech, and compare stroke-induced and progressive forms of this neurogenic disorder. Method: Audio recordings were made of a client, CS, who had progressive apra...
Background: Stylistic differences in language use, as described by sociolinguists, have also been shown to occur in disordered speech and language. In this article, we describe apraxia of speech, and compare stroke-induced and progressive forms of this neurogenic disorder. Method: Audio recordings were made of a client, CS, who had progressive apra...
Community-based peer support groups for stroke survivors are common in the United Kingdom and aim to support rehabilitation. This study of 260 stroke survivors across 118 groups nationally used an online survey format, completed on average 3 months into the pandemic. Analysis of both quantitative and open-ended responses provided insights into how...
Purpose: Aphasia has a negative impact on a person’s quality of life (QOL). The Stroke Aphasia Quality of Life-39 scale (SAQOL-39) is a widely-used measure of health-related quality of life (HRQOL) developed for people with aphasia that has been translated into several languages. Its psychometric properties have been examined not only in English, b...
Background: Apraxia of speech (AOS) has been central in aphasiology for over 200 years. It has generated theoretical and clinical controversy and contributed significantly to the development of knowledge of how speech is formulated and generated by the brain.
Main Contribution: This short review introduces theoretical, experimental and clinical stu...
Abstract
The aim of this paper is to develop further the idea that symptoms that emerge in speech and language processing following brain damage can make a contribution to discussions of the early evolution of language. These diverse impairments are called aphasia, and this
paper proposes that the recovery of a nonfluent aphasia syndrome following...
The term aphasia is commonly used with the language impairments that develop in a range of dementias and other progressive conditions. The term also includes what is most often called apraxia of speech, sometimes called motor aphasia or aphemia: impairments in the fluent production of speech arising from damage to the mechanisms controlling the pla...
Objectives
Pilot feasibility randomised controlled trial (RCT) for the singing groups for people with aphasia (SPA) intervention to assess: (1) the acceptability and feasibility of participant recruitment, randomisation and allocation concealment; (2) retention rates; (3) variance of continuous outcome measures; (4) outcome measure completion and p...
Background: The services provided and the financial support for research into a health condition is influenced by public awareness of a
health condition. There has been a wide range of surveys of the public’s and health professional’s awareness of aphasia throughout the world
to gauge levels of awareness. Findings confirm that awareness of aphasia...
Background: The services provided and the financial support for research into a health condition is influenced by public awareness of a health condition. There has been a wide range of surveys of the public’s and health professional’s awareness of aphasia throughout the world to gauge levels of awareness. Findings confirm that awareness of aphasia...
The Inpatient Functional Communication Interview: Screening, Assessment, and Intervention (IFCI: SAI) is a set of four resources for speech-language pathologists (SLPs) and other health-care professionals working in acute and rehabilitation hospitals. It has been developed so healthcare professionals can identify and support patients who have diffi...
Purpose
The aims of this systematic review are to provide a critical overview of short-term memory (STM) and working memory (WM) treatments in stroke aphasia and to systematically evaluate the internal and external validity of STM/WM treatments.
Method
A systematic search was conducted in February 2014 and then updated in December 2016 using 13 el...
Any communication disorder has significant negative effects on the lives of people with the condition. Research shows, however, that acquired aphasia has a more devastating impact on individuals with the condition and their families than any other condition, including cancer and Alzheimer’s disease. Aphasia is a disorder in the use of language expr...
Aphasia is a linguistic disorder that affects the understanding and productive use of verbal symbols in the spoken and/or written modalities. Historically, aphasia was viewed as a memory disorder. For example, Paul Broca’s classification of aphasia included verbal amnesia where patients had forgotten the meaning of words. Modern studies on aphasia...
Many qualities define human beings, but emotions are central to what humans are as a species and as individuals, and emotional responses to social events make up a large chunk of human lives. This entry first defines psychosocial life and then examines the negative impact of aphasia on the psychosocial lives of people living with a devastating disa...
vestigations of neurodegenerative disorders may reveal functional relationships in the cognitive system. C.S. was a 63-year-old right-handed man with Pick's disease with a range of progressive impairments including nonfluent aphasia, limb, oculomotor, bucco-facial and speech apraxia but mostly intact intelligence, perception, orientation, memory, s...
This was a conference keynote address for the International Aphasia Rehabilitation Conference, University of Aveiro, Portugal, September 2018.
Introduction
The singing for people with aphasia (SPA) intervention aims to improve quality of life and well-being for people with poststroke aphasia. A definitive randomised controlled trial (RCT) is required to assess the clinical and cost effectiveness of SPA. The purpose of this pilot study is to assess the feasibility of such a definitive tria...
MS: APH-AB 18-189
Aphasia is not a Disorder of Language: Discuss
Chris Code
Department of Psychology
University of Exeter, UK
Contact: c.f.s.code@exeter.ac.uk
Background. Since Trousseau (1864) introduced the term aphasia to describe the communication impairments that follow brain damage, aphasia has been seen as a disorder of language. Before 1...
A setting which presents special challenges for interpreter-mediated communication is the speech pathology clinic, particularly when the encounter involves the assessment of a condition known as aphasia. Drawing on a corpus of five interpreter-mediated assessments of aphasia in speakers of a range of languages (Cantonese, Greek, Tagalog and Vietnam...
Presentation prepared for Aphasia United Conference 2017
A four-volumed collection of pre-published significant papers and chapters on the topic of aphasia.
We suggest that a clue to understanding much of Samual Beckett’s writing lies in his use of ‘aphasic’ language and illustrate this with reference to excerpts from his work and aphasic symptoms..
Purpose:
Public awareness of aphasia has been surveyed in a number of countries revealing that it is universally low. We report results of surveys in the Balkan countries Serbia and Montenegro and compare results with data from Croatia and Slovenia.
Methods:
Convenience surveys of the general public were conducted in public places like shopping...
This article explores the relationship between automatic and involuntary language in the work of Samuel Beckett and late nineteenth-century neurological conceptions of language that emerged from aphasiology. Using the work of John Hughlings Jackson alongside contemporary neuroscientific research, we explore the significance of the lexical and affec...
Objectives
The study sought to identify key design features that could be used to create a new framework for group-based health interventions. We designed and tested the first session of a group intervention for stroke survivors with aphasia which was aimed at nurturing new psychological connections between group members.
Setting
The intervention...
Aspects of sonority have been examined in terms of natural language,
and of typical and disordered phonological development (see many
of the chapters in this collection), though comparatively few studies have
looked at sonority in relation to the speech patterns found in acquired neurogenic
disorders. In this chapter we review some of the studies t...
Background:
It has been suggested that public awareness of aphasia is vital for extending services, research support, social inclusion and targeted raising of awareness. Earlier studies show that knowledge of aphasia varies across a range of variables, but is very low compared with other conditions.
Aims:
To report a series of surveys of public...
Investigations of neurodegenerative disorders may reveal functional relationships in the cognitive system. C.S. was a 63-year-old right-handed man with post-mortem confirmed Pick's disease with a range of progressive impairments including non-fluent aphasia, speech, limb, oculomotor, and buccofacial apraxia, but mostly intact intelligence, percepti...
Platform Presentation
Background
The evolutionist Herbert Spenser introduced the idea of ‘dissolution’, which he described as the reverse of evolution. The notion was utilised by Hughlings Jackson (1932) as a crucial component of his model of the CNS with particular reference to aphasia. Luria (1974) also used the term to describe language breakdo...
Background:
Aphasia following stroke refers to impairments that affect the comprehension and expression of spoken and/or written language, and co-occurring cognitive deficits are common. In this paper we focus on short-term and working memory impairments that impact on the ability to retain and manipulate auditory-verbal information. Evidence from...
Purpose:
Despite the relatively high prevalence of aphasia, research indicates that, world-wide, public awareness of aphasia is lacking. Of the surveys that have been conducted internationally, none has studied the Canadian public's awareness of aphasia. The purpose of the present survey was to assess public awareness and basic knowledge of aphasi...
Aims
1. To identify STM/WM treatments in stroke aphasia through a systematic review of relevant literature.
2. To appraise the evidence-base for STM/WM treatments for stroke aphasia.
The English evolutionary psychologist Herbert Spenser introduced the idea of ‘dissolution’, which he described as the reverse process to evolution. The notion was utilised by ‘the father of English neurology’ John Hughlings Jackson (1932) as a crucial component of his model of the evolution of the central nervous system (CNS) with particular refere...
‘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 th...
Recent research into nonfluent forms of primary progressive aphasia and progressive apraxia of speech has highlighted the importance of speech rate as a diagnostic feature. We describe detailed investigation and comparison of speech rate (latencies and utterance length in single word/nonword production and speech rate in connected speech) on a rang...
We review the research which has examined people's perceptions of likely psychosocial adjustment to aphasia. People's perceptions differ depending on whether they have aphasia themselves, are related closely to a person with aphasia or they work with the aphasic person in a professional capacity. In addition, people differ in what they perceive are...
Background: It has been suggested that public awareness of aphasia is vital for extending services, research support, social inclusion and targeted raising of awareness. Earlier studies show that knowledge of aphasia varies across a range of variables, but is very low compared with other conditions. Aims: To report a series of surveys of public awa...
This article explores the relationship between automatic and involuntary language in the work of Samuel Beckett and late nineteenth-century neurological conceptions of language that emerged from aphasiology. Using the work of John Hughlings Jackson alongside contemporary neuroscientific research, we explore the significance of the lexical and affec...
Survey of public awareness of aphasia, conducted in Kerala, India. Survey was based on international survey of public awareness of aphasia designed by Chris Code and colleagues (Simmons-Mackie, N., Code, C., Armstrong, E., Stiegler, L., & Elman, R. J. (2002). What is aphasia? Results of an international survey. Aphasiology, 16, 837-848.) Results of...
Background: In the first issue of the first volume of Aphasiology in 1987, Robert Marshall contributed the first Clinical Forum Target Article entitled Reapportioning time for aphasia rehabilitation: A point of view (Marshall, 1987a27.
Marshall , R. C. 1987a. Reapportioning time for aphasia rehabilitation: A point of view. Aphasiology, 1: 59–73. [...
We describe an analysis of speech errors on a confrontation naming task in a man with progressive speech degeneration of 10-year duration from Pick's disease. C.S. had a progressive non-fluent aphasia together with a motor speech impairment and early assessment indicated some naming impairments. There was also an absence of significant phonological...
This paper briefly explores the relevance of patterns of related symptoms of nonfluent aphasia arising from left inferior frontal brain damage for the evolution of speech, language and gesture. I discuss aphasic lexical speech automatisms (LSAs) and their resolution with recovery into agrammatism with apraxia of speech and draw parallels between th...
Providing a quality service for people with aphasia is a primary goal of speech-language pathologists working with neurogenic communication disorders. This paper reviews what is known about the incidence and prevalence of aphasia and what services are provided for people with aphasia. On the basis of the stroke data, the incidence of aphasia in the...
In many parts of the world, speech-language pathologists (SLPs) are frequently called upon to assess aphasia in bilingual speakers, or in speakers of languages of which they have little or no knowledge. One of the strategies that SLPs employ in these situations is to involve an interpreter in the assessment process. Three authentic interpreter-medi...
The Psycholinguistic Assessments of Language Processing Abilities (PALPA) is a battery of tests designed to assess language processing abilities in individuals with acquired aphasia. Published in 1992, the battery was well-received by both clinicians and researchers, yet no revised version has been published to date. In this paper, we examine conte...
What Is Aphasia?The Incidence and Prevalence of AphasiaSome HistoryThe Features of AphasiaRecoveryTherapyPsychosocial and Emotional Response to AphasiaReferences
We examined the outcome of a 1-month intensive treatment block for people with chronic aphasia. The selected participants were eight chronically impaired people (mean months post-onset [MPO], 34). We conducted pre-and post-treatment assessments using the English-language version of the Aachen Aphasia Test (EAAT) and the Communicative Effectiveness...
We examined the outcome of a 1-month intensive treatment block for people with chronic aphasia. The selected participants were eight chronically impaired people (mean months post-onset [MPO], 34). We conducted pre- and post-treatment assessments using the English-language version of the Aachen Aphasia Test (EAAT) and the Communicative Effectiveness...
Speech pathologists have reported assessing and treating patients with the human immunodeficiency virus (HIV) but there has been little research into the nature or frequency of such communication or swallowing disorders. All speech pathologists with adult patients in the State of New South Wales, Australia, were surveyed about their exposure to pat...
We describe the investigation of speech automatisms in a man with progressive nonfluent aphasia and apraxias. Occurrence of the automatisms yes and right, were analysed across a range of speech tasks varying in length, propositionality, lexical and articulatory complexity, whether tasks engaged internal generation or external triggering and articul...
Questions
Questions (3)
Progressive neurogenic stuttering?
I'm looking for a good English translation of Paul Broca's 1861 paper. Can anyone direct me to one? A PDF would be wonderful.
Broca, P. (1861b) Remarques sur le siège de la faculté du langage articulé, suivies d'une observation d'aphémie (perte de la parole). Bulletins et memoires de la Société Anatomique de Paris, XXXVI, 330-357.
The reason for my question is given a) the wealth of research demonstrating that a large range of aphasic symptoms can be (partially?) explained in terms of impairments of STM/working memory, executive deficits (eg, inhibition, attention), praxic impairments (eg, apraxia of speech), perceptual impairments (eg, aspects of anomia), and b) the acknowledge dependence of language processing on memory (mainly STM/WM), praxis/action (programming of articulation), executive functions: 'language' is impossible without these 'horizontal' cognitive functions.
