I think we all know someone who gestures with gusto when speaking. These passionate communicators would be hard pressed to express themselves at all if they could not flail away with their hands or arms to illustrate their point of view! When a person suffers a brain injury due to stroke, traumatic brain injury, etc., expressive and/or receptive language skills may be negatively impacted. We call this disorder aphasia, an impairment of the ability to speak, write, and/or comprehend spoken or written words. Some degree of recovery may be expected in the months/years post-onset due to spontaneous healing and therapeutic interventions; however, sometimes aphasia persists. In these cases, gesture may serve as a primary means of communication while also helping to de-block verbal pathways.
I closed my last blog, AAC: Gesture, with the point that there is gesture and then there’s gesture. By this I mean that manual systems of communication may be structured and complex or informal and more transparent. There are a couple of ways that communicative gesture may be used by SLPs to help people with communication deficits. This post will focus on sign language.
Sign language is a language in every sense of the word. It is highly structured with its own grammar and syntax and is the preferred method of communication among many people who are deaf. I find it quite beautiful to watch individuals carry on fluent conversations in sign. It pleases my eye in much the same way I enjoy hearing my language spoken by non-native speakers. Sign language is rich and complex, but that very complexity discourages its use as a communication strategy for people with acquired or traumatic brain injury.
American Sign Language (ASL) is the version of sign language used in North America. Other countries have their own forms of sign, but I can’t stress enough that sign language is a language, just as English, Spanish, French, Russian, Mandarin, etc. are languages. Anyone who has tried to learn a second language later in life knows that it is not impossible, but it is a daunting task. Much motivation, repetition, and hard work are required for the average middle-aged brain to gain even a basic level of proficiency.
Now consider an adult brain with acquired or traumatic brain injury resulting in aphasia. Asking a person with aphasia – a language disorder – to learn a new language is a bit like expecting someone with a newly amputated leg to run a marathon. It’s possible for some to accomplish it after healing, strong motivation, hard training, and focused work to master use of an assistive prosthetic device, but not everyone can do it. Asking a person with a language disorder — and usually constrained by limited-to-no use of one hand — to learn a second, unfamiliar language such as ASL is probably not going to be very effective! Luckily, other gesture systems exist and can be employed in cases where sign language is not appropriate.
Please stay tuned because I have more to say on this topic! My next AAC-related blog will be titled AAC: …And Then There’s Gesture! It will highlight a less symbolic, more concrete, intuitive type of manual communication: Amer-Ind Gestural Code.
Cynthia Williams Bowen, MS, CCC-SLP owns Bowen Speech-Language Therapy, LLC in Clearwater, FL. Cyndee provides quality, creative, collaborative treatment to adults and adolescents with communication, swallowing, Parkinson’s, and related disorders.