Aprosodia: challenges in pragmatic communication

Aprosodia: challenges in pragmatic communication

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When we start a conversation with someone, it follows a certain "rhythm" and frequency. Oral expression implies paralinguistic elements very important as they are: the intonation, stress, coarticulation and rhythm; all necessary for the conversation to flow naturally.


  • 1 What is prosody?
  • 2 What is aprosodia?
  • 3 Main types of aprosodia
  • 4 Aphasia & aprosodia
  • 5 Etiology and intervention
  • 6 7 Effective Communication Strategies for People with Aprosodia
  • 7 7 Intervention Strategies for People with Aprosodia

What is prosody?

Prosodias are paralinguistic elements, necessary within oral expression.

To talk about aprosodias, it is first important to know what prosody is. The "melody of a voice" depends on prosodic elements, because they are the ones who print “rhythm and emotion” to your words, giving them meaning, so they are also called 'emotional prosodias'. They also imply the ability to respect punctuation marks and make appropriate breaks in a conversation, the duration and intensity of a segment, the speed of the word's emission, as well as syllable segmentation. Each of these components makes the sender's message understandable to those who are listening to the 'speech', that is, to the 'receivers'.

Two main types of prosody can be distinguished: the 'intrinsic prosody', helps us differentiate an affirmative sentence from an interrogative, while the'intellectual prosody'helps give special meaning to words. Some alterations in prosody are: dysprosodia, hyperprosodia and aprosodia.

As in a score, it is important to respect the silences, the times and the tones to create a harmonious and understandable melody; The same happens with our voice and paralinguistic elements, within the communication process. Because it's not the same to say: "Let's eat children" with a cold and monotonous tone, How is it characteristic in people with aprosodia, that: “Let's eat, children! with an animated modulation; or: "I request employee, useless to present without references", which: "I request useless employee, to present without references".

As we can see, people with aprosodia can experience great challenges in their daily lives and in the interaction with others, due to their limitations to express themselves emotionally and effectively with their peers, the negative repercussions are significant in the life of these patients, because they complicate their socio-emotional, academic, work, professional and even love life, due to their limitations in the oral expression of language. For all the above and coupled with the feeling of helplessness, aprosodias tend to generate discrimination and social isolation, thus contributing to discouragement, frustration and mood disorders.

What is aprosodia?

Aprosodia is a neurological disorder that implies difficulties in communication and for express yourself in oral language, especially when trying to issue or understand variations in paralinguistic elements such as: tone, volume, accent, intonation or rhythm; same as they convey emotional intention and give meaning to oral language, It is associated with lesions in the non-dominant cerebral hemisphere.

The ability of a person to perceive, interpret and respond to the demands of social communication is limited in patients with aprosodia, this can be significantly disabling in individuals whose occupations depend on interpersonal communication or emotional expression, Stringer said: "A degree of social disability can be a consequence of being monotonous and inexpressive" (1996).

Theaprosodic disorders, essentially modify the effective communication of the person with their peers. Patients with aphasic lesions of the left hemisphere are usually more expressive that those individuals who present lesions in the right hemisphere. It has been observed, for example, in subjects suffering from cognitive impairment due to Alzheimer's or Parkinson's, to name a few, they used to be obviously less expressive (Buck and Duffy, 1980).

The major areas involved with the language that have been identified, have their location in the left hemisphere, in right-handed people.

But even more so propositional languagesince the affective language lies in the non-dominant hemisphere”.

Main types of aprosodia

Affective aprosodia: a subtype of aprosodia is considered as affective language disorder, due to the lack of emotional expression so characteristic. This condition often includes depressive symptoms. Therefore, it is of the utmost importance, that in the diagnosis of patients with brain lesions, identify signs and symptoms of a major depression, as it is common in patients with lesions in the right hemisphere.

Expressive aprosodia: The subjects may seem short, cold and monotonous, but they do not necessarily have concomitant mood disorders. This subtype of aprosodia, refers to the expression and the challenges they present to communicate effectively, since they lack intonation and emotion when speaking, the message they try to deliver does not reach the recipient or recipient in an appropriate way, sometimes due to physical limitations.

Comprehensive aprosodia: Refers to the difficulties of understanding that people who suffer from it, unable to properly process the paralinguistic elements of language.

Motor aprosodia: In this subtype, imitation and production of emotional prosody, as well as facial gestures, are compromised.

Aphasia & aprosodia

Roughly, aphasia is a brain injury that causes speech difficulties, it can mainly affect Broca's area and Wernicke's area. The clinical model of aphasia, specifically defines some affective language disorders, such as: transcortical, sensory, motor and global aprosodia among others.

Etiology and intervention

Aprosodia can manifest itself after a stroke, stroke or acute cerebrovascular disease.

The most common cause of aprosodia is due to a brain injury. The areas of the brain with damage are usually in the cerebral hemispheres: right or left, as well as in the right anterior and posterior region. Different tests are usually used for neurocognitive evaluation; The assessment instruments, for this condition measure: speech intelligibility, speech rhythm and communication efficiency ratio (CEC), among others.

The treatment depends a lot on the etiology, the affected regions and the characteristics of each patient; Well, depending on the type of brain injury, people can manifest: paralysis, stiffness or difficulty issuing facial gestures.

A multidisciplinary treatment is required, including different experts in neurosciences such as: neurologists, psychiatrists, psychologists, psychologists and speech therapists; to reinforce communication skills. With an appropriate protocol, you can model an appropriate joint for each situation. Even patients, who suffered severe head trauma, can improve their ability to communicate efficient responses, when their learning is constant and by enriching your environment.

7 Effective Communication Strategies for People with Aprosodia

  • Inhale deeply and emit syllables 'explosively'.
  • Exaggerate the pauses in a reading or speech.
  • Speak loudly but very slowly.
  • Underline certain syllables in a reading, so that you emphasize them when reading.
  • Use short and simple phrases.
  • Ask the person to repeat the messages, and then to express orally and clearly, if they have understood the information.
  • Provide them with tools for their emotional expression, it can be through technology or they can look for creative ways to help them express their emotions.

It is important to allow enough time for the person to respond and make written records of such information, as they serve to “measure” their improvement and set new goals within the therapeutic intervention.

7 Intervention Strategies for People with Aprosodia

  • Building a inclusive environment That stimulates your constant learning.
  • Cognitive neurorehabilitation: image description task, speech and language therapy, social skills learning, among others. The use of technology for these purposes, serves as a good assistant in cognitive training, as is the case of biofeedback, as well as other programs and applications developed for these purposes.
  • Cognitive-behavioral modification aimed at increasing the repertoire of positive social and oral expression skills.
  • Pragmatic skills learning.
  • Expression modeling improves the proper use of facial expressions.
  • Bioregulation and tone modulation.
  • Support groups for caregivers and people with aprosodia.

Burke et al. (2004) proposed that those subjects with aprosodia, whose damage is severe and cannot improve their communication skills through speech, can benefit from using a enhanced or alternative communication strategy (CPA).

The perseverance of patients and caregivers in a treatment well designed by health professionals, can help the affected person to have the ability to understand what is happening to them, and with that, have favorable results in their treatment, by assuming responsible attitudes and behaviors For your improvement. It is important that there is: motivation to achieve their goals, support and socio-emotional containment, as well as taking into account aspects of inclusion in the areas in which they operate daily.

Electronics references




Vallejo Ruiloba, J. (1992). Introduction to psychopathology and psychiatry. Mexico: Salvat.