Table 5.

Description of multiple-foci techniques.

Technique	Objective	Description	Results
Conventional Speech and Language Therapy.68	Improve verbal and non-verbal skills in communication.	Individualized tasks were used to improve speech and writing. These included: identifying picture/object, naming objects, recognizing the association between items, the facilitation of the expression of feelings and opinions and improving conversational skills. Patients were stimulated to use gestures and other means of nonverbal communication.	There was communicative improvement in all patients, being more evident in the first two weeks after injury, although progress has been observed in cases of aphasia in the 24 investigated weeks.
Intensive therapy for multiple language disorders.69	Improve the processing capacity of language, from word level to sentence level.	Steps: [a] use of computerized program to train reading. [b] reading, repetition and writing of nonwords. [c] use dictionary to identify verbs, read their meaning, copy, and review it. [d] retrieve the verbs and produce nouns as subjects and as direct objects. [e] narrate what is happening in a picture and what might happen next. [f] answer questions related to a sentence. [g] grammatical judgment. [h] activity of inference processing with reading.	The patient showed significant improvements in all language skills that were trained in an intensive and specific way.
Constraint-Induced Aphasia Therapy.70, 71	Understand and name oral language.	A pair of participants takes turns requesting a card with a picture that represents a specific semantic category. The other participant must select one of the pictures and name it. A visual barrier is placed between the pair of participants, only allowing them to see each other's eyes. Throughout the task, the degree of difficulty increases, ranging from single-word requests/responses to long sentences.	70Patients with significant improvement in language after the use of the technique but who then lost these gains in the follow-up, showed higher activation in the right hemisphere. Patients with significant improvement in language after the use of the technique and who kept these gains, showed activation in the left temporal lobe. Patients who did not show significant improvement in language had activation in the left parietal lobe. 71There was a decrease in the severity of aphasia, with improvement in the performance of the naming task and generalization in the effect of treatment.
Melodic Intonation Therapy.30, 32	Retrieve the propositional language for individuals with non-fluent aphasia.	Repetition of sentences with singing intonation and a gradual reduction of this intonation to a natural prosody.	30Patients who had a positive response to therapy showed brain activation in language areas of the left hemisphere. However, patients who had no improvement after therapy showed activation in areas of the right cerebral hemisphere.32There were an increase in the number of spoken words per minute and an increase in the number of fibers in the arcuate fasciculus in all participants after treatment.
Individual Musical Therapy.72	Elicit improvement in vocal quality, speech and discourse using melodic techniques.	The following tasks are performed: singing familiar songs, breathing between stressed syllables, segmented dynamic singing, speech aided by musicality, rhythmic speech, oral motor exercises, and vocal intonation.	Each patient benefitted differently for each form of treatment. The combination of strategies (e.g. auditory and visual, rhythm and melody) provided better patient response.
Animal-assisted Therapy (AAT).29	Develop the social skills of verbal and non- verbal communication in the presence of the dog and the handler.	Three experimental situations for the patient's way back from the speech therapy session to the ward were performed: [a] the employee accompanied the patient. [b] the dog accompanied the patient. [c] the handler and the dog followed the patient.	The presence of a therapy dog during the walk back to the ward resulted in benefits in communication, increasing the patient's verbal and nonverbal behaviors.
Rehabilitation with holistic approach.73	Facilitate the communicative skills of the patient from his potentialities.	Daily meetings with informal interviews, all recorded and transcribed for discourse analysis. The patient writes daily what comes to mind in a diary. The option for writing instead of speaking is suggested by the therapist, after asking the patient what the easiest way to express it is.	For the patient in question, the practice of the automatic writing helped in the search for words (increase in vocabulary), stimulating their potential.