Aprosodia: types and symptoms of this language deficit

Speech has its rhythm and its times. When we speak, we don't just drop an idea without further ado, 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 large number of aspects, including emotionality and a sense of rhythm.

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

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What is the aprosody?

The aprosodia is considered a deficit or inability to understand and/or produce changes in voice tonality, 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 be varied and that can have various effects on the message itself.

Bearing in mind that prosody makes it possible to give information emotional meaning, qualify or even imply the opposite of what is expressed, and also makes the message much more understandable to the receiver, we can consider that a person with aprosodia will show an inability to reflect his emotions in his voice, regulate the tone of voice or control the timing and rhythms of speech, resulting in his speech much more difficult to interpret.

Your message will be much flatter, not knowing exactly what you want to emphasize unless you explicitly indicate it. Definitely, the speech of someone suffering from aprosodia tends to be monotonous and neutral. In some cases, you may not separate words or phrases well, making comprehension even more difficult.

Likewise, it will be more difficult or even difficult for him to understand elements such as other people's voice changes and what it may imply regarding the message. There may be difficulties 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 no reason to have any intellectual deficit or a neurodevelopmental disorder (although it frequently appears in some of them). They are simply not able to print to their language of intonation, rhythm and emotional meaning that other people do.

As a problem that affects communication, it can have different effects on the life of the sufferer. Although in itself it does not usually imply a serious limitation that prevents social participation or the performance of any action, the person can be seen as cold and strange. Their way of expressing themselves can lead to misunderstandings and discussions, and can cause some kind of social rejection or even some difficulty at work. It is likely that an avoidance appears on the part of the affected person to start or maintain conversations.

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 typologies, but three main types stand out.

1. sensory aprosodia

In this type of aprosodia the problem occurs at the level of comprehension. The subject has severe difficulties when it comes to understand and process other people's rhythm and intonation changes, and it may be difficult for you to recognize the emotions of the recipients.

2. motor aprosodia

In this type of aprosody the problem is fundamentally one of expression: as we have said before, the subject has a monotonous language and lacks emotionality, not being able to modulate the voice correctly in such a way that it offers information beyond the content of the message in question and/or not controlling the rhythm. It is also frequent that they present a certain mutism, facial rigidity and lack of gesticulation.

3. mixed aprosodia

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

What are your causes?

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

The different investigations carried out indicate that these injuries would generally be 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 damages correspond especially to the Broca's area and the Wernicke's area 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 be caused by multiple conditions. It frequently appears after head trauma, cerebrovascular accidents or neurodegenerative processes such as dementia (for example, it is common in dementia caused by the disease of Alzheimer's and Parkinson's).

It is also common and very characteristic of subjects with spectrum disorder autism. Likewise, aprosodia appears associated with the consumption of substances such as alcohol, as in subjects with dependence on said substance or those subjects 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 approach to aprosodia is usually multidisciplinary. It must be taken into account that in most cases we are talking about the consequence of a brain lesion, so that it must be taken into account in the first place what has caused it.

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 communicative limitations. Biofeedback is also frequently used, especially in the motor type. Work on emotional expression through various pathways can also be very useful. Psychoeducation and information are also important so that the person and the environment can understand what is happening and know how to deal with it and understand it.

Bibliographic references:

• Ardila, A.; Arocho, J.L.; Labos, E. & Rodriguez, W. (2015). Dictionary of Neuropsychology.
• Leon, S.A. & Rodriguez, A.D. (s.f.). Aprosodia and Its Treatment. American Speech Language Hearing Association. Florida.
• Stringer, A. AND. (1996). Treatment of motor aprosodia with pitch biofeedback and expression modelling. Brain Inj., 10, 583-590.