In Aphasia and Related Neurogenic Language Disorders, 4th Ed. (Thieme), author Leonard LaPointe, PhD, CCC-SLP, acknowledges that as technology has changed since the book's first edition in 1990, so, too, has the field of speech-language pathology. For this, the latest edition of this quintessential book on aphasia, Dr. LaPointe has added chapters on its theoretical underpinnings, cultural and multi-linguistic issues, quality of life concerns, and a chapter on neurogenic disorders in the acute-care hospital setting.

"Gone," he notes, "are the chapters on selected subtypes of aphasia. We are grateful to the contributors of the previous editions, and we now welcome a new generation of experts on a wider array of topics."

Although Broca's, Wernicke's, conduction, transcortical, and global aphasia no longer get their own chapters, two contributing authors discuss various theories of aphasia, models, and classification in Chapter 3, bringing to light as they note, "the challenges imposed by theory and measurement." Though they acknowledge that no classification system to date satisfies the needs of every clinician and researcher, the authors present a concise overview of the foundation that serves as a common language throughout the field.

The book also presents full-color illustrations of the brain from the Thieme Atlas of Anatomy (Thieme, 2007) and chapter reviews, test questions, case studies and sidebars that further help organize the information presented. This way, readers can scan for particular areas of interest, or they can also choose to approach each chapter in depth.

The Mayo Clinic chimes in with a chapter fully devoted to Clinical Practice in Acute Care Hospital Settings and its challenges. The authors surmise that while it is especially important to address communication, it is often not the central concern in the initial hours following an acute CVA. Therefore, basic evaluation and education is preferred over impairment-related therapy. "Outcomes can be considered positive if patients and their families develop a practical understanding of patients' communication problems and probable evolution, develop some strategies for coping with them, and are prepared for the kinds of help that will be provided at the next level of care," according to the authors.

The chapter "Treatment Effectiveness and Evidence-Based Practice" goes beyond the age-old general question of "Is treatment beneficial?" when addressing the systematic ways in which clinicians and researchers can make evidence-based practice work. "The general process of evidence-based practice (EBP) becomes a deeply personal activity, a professional activity to be sure, but one that is driven by a personal choice leading to a result designed for an audience of two: a clinician and a client," the author writes.

Dr. LaPointe, a distinguished professor at Florida State University, recognizes that along with the teaching of speech-language science and theory comes first and foremost the knowledge of the basic human need to communicate. In addition to writing the chapter on brain anatomy, he authored Chapter 2, "Humanistic Basics," which looks at stages of illness from the point of view of those with communication disorders. Even in the face of chronic illness, there is a way to achieve more pleasure than pain, he notes, adding that "health care professionals have a responsibility to help ill people and their families on the journey to this state of relative equilibrium."

The final chapter delves into working with patients who have sustained traumatic brain, blast or multi-system injuries and subsequent cognitive issues. The author concludes that TBI "presents a formidable challenge to professionals called upon to help these persons regain meaning in their lives."

That theme is woven into each chapter, as authors present speech science along with its relevant meaning to the individual and clinician. While providing basic information regarding assessment and treatment, this book also touches upon more complex issues of communication, cultural concerns, and above all, quality of life.

Alice Rhein is on staff at St. John Providence Health System in Detroit, MI.