friends, the authorities, while shopping, and so on so that he or she can fulfill needs as independently as possible.
These two objectives tend to lead toward two approaches: a symptom-specific approach concerned with the details of the language deficit, and a "holistic" approach emphasizing the general setting of the patient's life. We promote an integrative therapy that combines the most important aspects of the two approaches ( Schädler, Seggewies, Willeke, Stachowiak, & Grassau, 1992). In most German clinical facilities, aphasic patients receive language therapy as well as coordinated neuropsychological and cognitive therapy, ergotherapy, psychotherapy, physiotherapy and work with social workers who assist them with lodging, social security, and occupational questions.
To assess the efficacy of aphasia therapy, we are thinking of using evaluation sheets as well as scales like those used to measure self-reliance and psychosocial situations of patients with brain trauma ( Truelle & Brooks, chapter 19, this volume) in addition to the specific language structural and modality related aphasia tests like the AAT. One focus will be on showing that computer-based techniques can be integrated as a supplementary form of therapy, and that they will in the long run offer good possibilities for long-term improvement for aphasic patients, especially in home training. In the meantime, we are working on interactive multimedia therapy programs containing videos with prototypical situations taken from daily life to promote the bond between computer-assisted training and daily living.
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