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incidence accounts for more than two-thirds of the
global incidence of stroke (Suwanwela and
Poungvarin, 2016). According to the Ministry of
Health data, in Indonesia, stroke is also considered
to be the leading cause of death, with a stroke
prevalence of 12.1/1000 recorded in 2013. Thus, it
can be assumed that 4 out of 1000 Indonesians are at
risk of aphasia. Unfortunately, Neuro-rehabilitation
in Indonesia does not always include speech therapy.
This is true especially in smaller hospitals or more
remote areas where stroke is treated only with the
primary care of physicians. Often, stroke patients
may receive neither aphasia assessment nor
intervention.
The limited attention being paid by linguists to
clinical linguistics, especially language disorders of
stroke patients (especially in Indonesia) are the main
reason this research was conducted. Besides,
according to previous research, it was found that
there are language disorders suffered by people with
aphasia. However, there is no specific note about the
type of aphasia observed, and the linguistic disorders
discussed are still in general aspects. Therefore, the
objectives of the research are to analyse the types of
aphasia caused by ischemic stroke and their
modality language disorders.
2 APHASIA
Aphasian said can be defined as the loss or
impairment of language caused by brain damage. In
more depth, Goodglass and Kaplan (1972) define
aphasia as disturbance of any or all of the skills,
association and habits of spoken or written language,
produced by injury to certain brain areas which are
specialized for this function. Aphasia is labelled as
aphasic, namely a variety of limited disorder such as
“selective disorders of auditory comprehension,
object-naming, articulation, reading or repetition...”,
and these experts classify alexia with or without
agraphia among the aphasias. Schuell, Jenkins, and
Jumenez-Pabon (1964) require that aphasia be
reserved for language disorder crossing all
modalities – reading, writing, listening, speaking,
and gesturing.
Sinanović, et. al. (2011) states that there are
different definitions of aphasias, but the most widely
accepted neurologic and/or neuropsychological
definition is that aphasia is a loss or impairment of
verbal communication, which occurs as a
consequence of brain dysfunction. It manifests in
impairment of almost all verbal abilities, i.e.
abnormal verbal expression, difficulties in
understanding spoken or written language,
repetition, naming, reading and writing.
2.1 Types and Characteristics of
Aphasia
Apart from the broca’s and wernicke’s type of
aphasia, Ardila (2014) proposed diverse aphasia
classifications since Broca’s first description of a
language disorder associated with brain pathology
(Broca, 1863). There are, however, two most
influential aphasia classifications, that have
significantly guided the area during the last decades:
the Boston Group classification; and Luria’s aphasia
interpretation. The first one has been particularly
influential in the US and western European
countries; the second one has been mostly used in
eastern European countries and Latin America.
Boston Group classification represents a further
development of Wernicke’s ideas about brain
organization of language, and includes two basic
distinctions: (1) aphasias can be fluent or non-fluent;
and (2) aphasias can be cortical, subcortical, or
transcortical (e.g., Benson, 1979; Goodglass and
Kaplan, 1972). Nevertheless, this research uses the
classification stated by Benson (1979) that classifies
aphasia more in detail, into global aphasia, broca’s
aphasia, wernicke’s aphasia, anomic aphasia,
conduction aphasia, transcortical motor aphasia,
transcortical sensory aphasia, and mixed
transcortical aphasia.
Examination, diagnosis, and treatment on
aphasia patients resulted in the classification of
aphasia. Some systems use neurology criteria, in
which the location of brain injury becomes the
condition to classify aphasia. Other systems classify
aphasia based on the linguistic ability of the
disorder, namely The National Aphasia Association
in the United States of America classifies aphasia
into fluent and non-fluent. In fluent aphasia, also
called as Wernicke’s/posterior/sensory/receptive
aphasia, the language comprehension is very poor,
but fluent in their language. Fluent aphasia results in
long and unorganized utterances, good articulation
with the melody and supra-segmental characteristics
just like in normal utterances (these characteristics
may give the impression to the audience that fluent
aphasia possesses a good linguistic ability).
Non-fluent aphasia is also called as
broca’s/anterior/motor/expressive aphasia. People
with non-fluent aphasia may have difficulty in word
production, even though the comprehension is
relatively intact. In non-fluent aphasia, patients
challenge themselves to express utterances, unlike
Aphasia Types and Language Modality Disorder by Ischemic Stroke Patient
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