O The Natural Course of Aphasia

When aphasia has persisted for several months, a complete recovery to a premorbid level of communication function is unlikely. The temporal course of aphasia from its sudden onset, acute stage, and subsequent phases of recovery evolves along separate pathways depending on whether one is referring to the individual's communication skills, psychological state, social functioning, compensatory skill level, or level of adjustment.

In the period immediately following onset, a degree of natural recovery referred to as spontaneous recovery takes place in the majority of individuals. There is a lack of concensus as to how long this period lasts, ranging from 2 to 6 months postonset.

It is generally agreed that, with some exceptions, major improvements in communication occur in the first 12-24 months following onset. Gradual changes, however, have been reported for many years thereafter, especially in compensatory, alternative skills that are used more effectively over time.

Age, gender, education, and handedness do not appear to affect recovery. Comprehension tends to recover more than expressive communication. Some individuals recover many communication skills but are left with an anomia. Several studies report that for the more severe aphasias recovery of communication skills begins later than for the mild and moderately impaired.

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