Management  

Most acute cases of aphasia recover some or most skills by participating in 
speech and language therapy  . Recovery and improvement can continue for years
after the stroke. After the onset of aphasia, there is approximately a six-
month period of spontaneous recovery; during this time, the brain is
attempting to recover and repair the damaged neurons. Improvement varies
widely, depending on the aphasia's cause, type, and severity. Recovery also
depends on the person's age, health, motivation,  handedness
 , and educational level.  [43]

Speech and language therapy that is higher intensity, higher dose or provided
over a long duration of time leads to significantly better functional
communication but people might be more likely to drop out of high intensity
treatment (up to 15 hours per week).  [94]  A total of 20–50 hours of speech
and language therapy is necessary for the best recovery. The most improvement
happens when 2–5 hours of therapy is provided each week over 4–5 days.
Recovery is further improved when besides the therapy people practice tasks at
home.  [95]  [96]  Speech and language therapy is also effective if it is 
delivered online through video  or by a family member who has been trained by a
professional therapist.  [95]  [96]

Recovery with therapy is also dependent on the recency of stroke and the age
of the person. Receiving therapy within a month after the stroke leads to the
greatest improvements. 3 or 6 months after the stroke more therapy will be
needed but symptoms can still be improved. People with aphasia who are younger
than 55 years are the most likely to improve but people older than 75 years
can still get better with therapy.  [95]  [96]

There is no one treatment proven to be effective for all types of aphasias.
The reason that there is no universal treatment for aphasia is because of the
nature of the disorder and the various ways it is presented. Aphasia is rarely
exhibited identically, implying that treatment needs to be catered
specifically to the individual. Studies have shown that, although there is no
consistency on treatment methodology in literature, there is a strong
indication that treatment, in general, has positive outcomes.  [97]  Therapy
for aphasia ranges from increasing functional communication to improving
speech accuracy, depending on the person's severity, needs and support of
family and friends.  [98]  Group therapy allows individuals to work on their
pragmatic and communication skills with other individuals with aphasia, which
are skills that may not often be addressed in individual one-on-one therapy
sessions. It can also help increase confidence and social skills in a
comfortable setting.  [9]  : 97

Evidence does not support the use of  transcranial direct current stimulation
 (tDCS) for improving aphasia after stroke. Moderate quality
evidence does indicate naming performance improvements for nouns but not verbs
using tDCS  [99]

Specific treatment techniques include the following:

* Copy and recall therapy (CART) – repetition and recall of targeted words within therapy may strengthen orthographic representations and improve single word reading, writing, and naming  [100]
* Visual communication therapy (VIC) – the use of index cards with symbols to represent various components of speech
* Visual action therapy (VAT) – typically treats individuals with global aphasia to train the use of hand gestures for specific items  [101]
* Functional communication treatment (FCT) – focuses on improving activities specific to functional tasks, social interaction, and self-expression
* Promoting aphasic's communicative effectiveness (PACE) – a means of encouraging normal interaction between people with aphasia and clinicians. In this kind of therapy, the focus is on pragmatic communication rather than treatment itself. People are asked to communicate a given message to their therapists by means of drawing, making hand gestures or even pointing to an object  [102]