Luria's approach to the restoration of speech in Aphasia and the International Classification of Functioning, Disability and Health (ICFDH)

Abstract

Background. Alexandria R. Luria's classic neurorehabilitation methods ("restorative learning") have now been successfully applied in clinical settings for more than seventy years. It is of interest how Luria's methods relate to contemporary strategic approaches to effective rehabilitation. One such framework is the International Classification of Functioning, Disability and Health (ICF)-a comprehensive WHO framework for measuring health and disability for diagnostic and rehabilitation purposes. Objective. To compare Luria's procedure of restorative learning in aphasia and the ICF. Such a comparison may facilitate the use of the ICF in the work of multidisciplinary rehabilitation teams for diagnosis, planning, implementation, and evaluation of rehabilitation programs. Design. A systematic comparison of ICF components with specific rehabilitation procedures developed by Luria aimed at speech understanding and production. Results. Luria's speech rehabilitation methods pertain to the ICF component "Body Functions and Structures". Specific correspondences between Luria's rehabilitation procedures and ICF categories are found, especially for afferent and efferent aphasias. For the aphasias related to speech understanding (sensory and semantic aphasia), such correspondences are rare. This reflects an insufficient differentiation in the understanding of higher cognitive functions in current neurorehabilitation. Luria's concern for patients' personality and social status is also explicated. Conclusion. Although Luria's "restorative learning" is realized within the ICF domain of "Body Functions and Structures", his approach also focuses on the rehabilitation of the personal and social status of the patient. This approach is an important condition for clinical and psychological rehabilitation in the ICF domains of "Activities" and "Participation".