Understanding Aphasia

What Is Aphasia?

Aphasia is a communication disorder that results from damage or injury to language parts of the brain.  It’s more common in older adults, particularly those who have had a stroke.

Aphasia gets in the way of a person’s ability to use or understand words. Aphasia does not impair the person’s intelligence. People who have aphasia may have difficulty speaking and finding the “right” words to complete their thoughts. They may also have problems understanding conversation, reading and comprehending written words, writing words, and using numbers.

What Causes Aphasia?

Aphasia is usually caused by a stroke or brain injury with damage to one or more parts of the brain that deal with language. According to the National Aphasia Association, about 25% to 40% of people who survive a stroke get aphasia.

Aphasia may also be caused by a brain tumor, brain infection, or even from dementia such as Alzheimer’s disease. In some cases, aphasia is a symptom of epilepsy or other neurological disorder.

Here are a Few of the Different Types of Aphasia

There are types of aphasia. Each type can cause impairment that varies from mild to severe. Common types of aphasia include the following:

  • Expressive aphasia (non-fluent): With expressive aphasia, the person knows what he or she wants to say, yet has difficulty communicating it to others. It doesn’t matter whether the person is trying to say or write what he or she is trying to communicate.
  • Primary progressive aphasia. Primary progressive aphasia is a rare disorder where people slowly lose their ability to talk, read, write, and comprehend what they hear in conversation over a period of time. With a stroke, aphasia may improve with proper therapy. There is no treatment to reverse primary progressive aphasia. People with primary progressive aphasia are able to communicate in ways other than speech. For instance, they might use gestures. And many benefit from a combination of speech therapy and medications.
  • Anomic aphasia. With anomic aphasia, the person has word-finding difficulties. This is called anomia. Because of the difficulties, the person struggles to find the right words for speaking and writing.
  • Receptive aphasia (fluent): With receptive aphasia, the person can hear a voice or read the print, but may not understand the meaning of the message. Oftentimes, someone with receptive aphasia takes language literally. Their own speech may be disturbed because they do not understand their own language.
  • Global aphasia. This is the most severe type of aphasia. It is often seen right after someone has a stroke. With global aphasia, the person has difficulty speaking and understanding words. In addition, the person is unable to read or write.

Aphasia may be mild or severe. With mild aphasia, the person may be able to converse, yet have trouble finding the right word or understanding complex conversations. Severe aphasia limits the person’s ability to communicate. The person may say little and may not participate in or understand any conversation.

Symptoms of Aphasia?

The specific symptoms and severity of aphasia vary depending on the location and extent of brain damage. Individuals with damage to the front part of the brain may have “choppy” or non-fluent speech. However, they can typically understand what people say fairly well. Those with damage to the posterior regions of the brain often have fluent speech—that is, the rate and rhythm of speech may sound normal. However, their speech may contain the wrong words or made-up words. They also typically have difficulty understanding what is spoken.

Additionally, all individuals with aphasia may also have one or more of the following problems:

  • Trouble speaking
  • Experience difficulty coming up with the words they want to say
  • Switch sounds within words (e.g., “wish dasher” for “dishwasher”)
  • Have difficulty putting words together to form sentences
  • Using strange or inappropriate words in conversation
  • Difficulty understanding language
  • Misunderstand what others say, especially when they speak fast (e.g., radio or television news) or in long sentences
  • Find it hard to understand speech in background noise or in group situations
  • Problems spelling and putting words together to write sentences
  • Difficulty understanding number concepts (e.g., telling time, counting money, adding/subtracting)

Some people with aphasia have problems understanding what others are saying. The problems occur particularly when the person is tired or in a crowded or loud environment. Aphasia does not affect thinking skills. But the person may have problems understanding written material and difficulties with handwriting. Some people have trouble using numbers or even doing simple calculations.

How Is Aphasia Diagnosed?

Usually, a doctor first diagnoses aphasia when treating a patient for a stroke, brain injury, or tumor. Using a series of neurological tests, the doctor may ask the person questions. The doctor may also issue specific commands and ask the person to name different items or objects. The results of these tests help the doctor determine if the person has aphasia. They also help determine the severity of the aphasia.

How Is Aphasia Treated?

Treatment for someone with aphasia depends on factors such as:

  • Age
  • Cause of brain injury
  • Type of aphasia
  • Position and size of the brain lesion

For instance, a person with aphasia may have a brain tumor that’s affecting the language center of the brain. Surgery to treat the brain tumor may also improve the aphasia.

A person with aphasia who has had a stroke may benefit from sessions with a speech-language pathologist. The therapist will meet regularly with the person to increase his or her ability to speak and communicate. The therapist will also teach the person ways to communicate that don’t involve speech. This will help the person compensate for language difficulties.

 

What can I do to communicate better with the person with aphasia?

  1. Get the person’s attention before you start speaking.
  2. Maintain eye contact and watch the person’s body language and use of gesture.
  3. Minimize or eliminate background noise (TV, radio, other people).
  4. Keep your voice at a normal level. Do not speak loudly unless the person asks you to do so.
  5. Keep communication simple, but adult. Don’t “talk down” to the person with aphasia.
  6. Simplify your sentence structure and emphasize key words.
  7. Reduce your rate of speech.
  8. Give the individual time to speak. Resist the urge to finish sentences or offer words.
  9. Communicate with drawings, gestures, writing, and facial expressions in addition to speech.
  10. Encourage the person to use drawings, gestures, and writing.
  11. Use “yes” and “no” questions rather than open-ended questions.
  12. Praise all attempts to speak and downplay any errors. Avoid insisting that that each word be produced perfectly.
  13. Engage in normal activities whenever possible.
  14. Encourage independence and avoid being overprotective.