Aprosodia: Types And Symptoms Of This Language Deficit

This speech deficit appears in many cases of people with autism or brain injuries.

Woman talking on the phone.

Speech has its rhythm and its times. When we speak we do not just drop an idea without more, but we separate the words, we give more emphasis to some than others and we structure our speech. We pause and give it an intonation and a melody that make communication a flow of information understandable in various aspects. This stems from a host of aspects, including emotionality and a sense of rhythm.

Prosody can be trained and a greater wealth and skill in it tends to be acquired as we learn. But some people, for different reasons, either fail to achieve this learning or, although they do, lose it as a result of some type of brain injury. These people have aprosodia, a speech phenomenon that can lead to communication difficulties. Let’s see what it is.

What is aprosodia?

Aprosodia is considered a deficit or inability to understand and / or produce changes in the tone of the voice, rhythm or intonation. It is an alteration of one of the main paraverbal aspects of language, that is, one of the elements that allow the acoustics of the message we provide to vary and that can have various effects on the message itself.

Taking into account that prosody allows giving the information emotional meaning, qualifying or even implying the opposite of what is expressed, and also makes the message much more understandable for the receiver, we can consider that a person with aprosodia will show an inability to reflect their emotions in their voice, regulate the tone of voice or control the timing and rhythms of speech, making their speech much more difficult to interpret.

Your message will turn out much flatter, not knowing exactly what you want to emphasize unless you explicitly state it. Ultimately, the speech of someone with aprosodia tends to be monotonous and neutral. In some cases, words or phrases may not be separated well, making understanding even more difficult.

It will also have greater difficulty or even it may be difficult for you to understand elements such as the voice changes of other people and what it may imply regarding the message. There may be difficulties in capturing emotions. But we are not dealing with subjects who lack the ability to express their thoughts or who do not have emotions.

Nor are they people who have to have any intellectual deficit or a neurodevelopmental disorder (although it is common in some of them). They simply are not able to impress upon their language the intonation, rhythm, and emotional meaning that other people do.

As a problem that affects communication, it can have different effects on the life of those who suffer from it. Although in itself it does not usually suppose a serious limitation that prevents social participation or the performance of any action, the person can be seen as cold and strange. Her way of expressing herself can lead to misunderstandings and discussions, which can cause some type of social rejection or even some difficulty at work. It is likely that an avoidance on the part of the affected person to initiate or maintain conversations appears.

Types of aprosodia

Not all subjects with aprosodia have the same difficulties. In fact, at the time the concept was proposed, the existence of different typologies was also proposed depending on the affected brain location. Taking this aspect into account, we can find different types, but three main types stand out.

1. Sensory aprosodia

In this type of aprosodia the problem occurs at the level of understanding. The subject has severe difficulties when it comes to understanding and processing the changes in rhythms and intonation of others, and it may be difficult for him to recognize the emotions of the recipients.

2. Motor aprosodia

In this type of aprosodia the problem is fundamentally of expression: as we have said previously, the subject has a monotonous language and lacks emotionality, not being able to modulate the voice correctly so that it offers information beyond the content of the message in question and / or or not controlling the rhythm. They also frequently present some mutism, facial stiffness and lack of gesticulation.

3. Mixed aprosodia

In this case, the two previous types of difficulties occur together.

What are your causes?

The causes of aprosodia can be multiple, but can usually be found in the presence of neurological disorders or lesions.

The different investigations carried out indicate that these lesions are generally found in the temporal and parietal lobes of the right hemisphere of the brain, linked to emotional expression and the use of rhythm. Specifically, the damage is especially correspond with Broca and Wernicke of said hemisphere. It is a very common disorder in the clinical population, especially in those who have some type of aphasic problem.

These injuries can occur for multiple conditions. It is common to appear with head trauma, cerebrovascular accidents or neurodegenerative processes such as dementia (for example, it is common in dementias caused by Alzheimer’s and Parkinson’s disease).

It is also common and very characteristic of subjects with disorder spectrum of the autism. Likewise, aprosodia appears associated with the consumption of substances such as alcohol, as in subjects with dependence on said substance or those with fetal alcohol syndrome. Finally, it can appear in mental disorders such as schizophrenia, or in some cases in people who have experienced severe trauma.

Possible treatments

The aprosodia approach is usually multidisciplinary. It should be borne in mind that in most cases we are talking about the consequence of a brain injury, so what has caused it must be taken into account in the first place.

One of the main strategies is to apply speech therapy techniques and treatment through modeling and techniques based on imitation in order to reduce their communication limitations. Biofeedback is also frequently used, especially in the motor type. Working on emotional expression through various avenues can also be very helpful. Psychoeducation and information are also important so that the person and the environment can understand what is happening and know how to take it and understand it.

Bibliographic references:

  • Ardila, A .; Arocho, JL; Labos, E. & Rodríguez, W. (2015). Neuropsychology Dictionary.
  • Leon, SA & Rodríguez, AD (sf). Aprosodia and Its Treatment. American Speech Language Hearing Association. Florida.
  • Stringer, AY (1996). Treatment of motor aprosodia with pitch biofeedback and expression modeling. Brain Inj., 10, 583-590.
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