Aphasia is a language disorder that negatively affects a person’s ability to talk, understand the spoken word and also their reading and writing. Originating from the Greek word “aphatos” which means speechless, aphasia is a symptom resultant of pre-existing brain damage, such as Alzheimer’s disease or stroke (with over 30% of stroke victims suffering aphasia to some degree).
Originally, aphasia was a term used only to describe complete impairment of the person’s communication and language.
At the time the term dysphasia was used to describe partial language impairment, but it has been frequently mistaken for a swallowing disorder, dysphagia. Because of this, the term aphasia has taken on the meaning of both degrees of language impairment.
There are three major kinds of aphasia. These are:
- Fluent aphasia
- Non-Fluent aphasia
- Global aphasia
What are the Signs and Symptoms of Aphasia?
A symptom is something the patient feels or reports, while a sign is something that other people, including the doctor detects. A headache may be an example of a symptom, while a rash may be an example of a sign.
As there are three types of aphasia, the symptoms can differ for each type. Details of these differences are:
Global aphasia – All parts of vocal and written interaction are affected. Both writing and reading is impaired, as well as speech and listening.
Fluent aphasia – Speech is hard/not possible to understand. The ability to speak is not impaired, but the words spoken make no sense.
Writing ability is usually effected in the same way, the writing is flowing but what is actually written is nonsense.
The person suffering from fluent aphasia may become annoyed and irritated if someone has trouble understanding them as they don’t always realize they have a language disorder.
As for understanding, people with fluent aphasia more commonly have problems with speech than writing.
Non-fluent aphasia – With this type, speech is slower and hesitant, the patient also struggles to get their words out. Sentences are rarely completed, and even though some words are missing, what they are saying can be made sense of. Again writing ability is usually the same as speech.
Someone with non-fluent aphasia has more problems with grammar than words alone. People with this kind of aphasia are more aware of their disorder and may get annoyed when they struggle with words.
The visible signs that can be noticed on someone with aphasia are weakness or paralysis on one side of the face or body.
Who has aphasia?
Anyone can acquire aphasia, including children, but most people who have aphasia are middle-aged or older. Men and women are equally affected. According to the National Aphasia Association, approximately 80,000 individuals acquire aphasia each year from strokes. About one million people in the United States currently have aphasia.
What causes aphasia?
Aphasia is caused by damage to one or more of the language areas of the brain. Many times, the cause of the brain injury is a stroke. A stroke occurs when blood is unable to reach a part of the brain. Brain cells die when they do not receive their normal supply of blood, which carries oxygen and important nutrients.
Other causes of brain injury are severe blows to the head, brain tumors, brain infections, and other conditions that affect the brain.
How is aphasia diagnosed?
Aphasia is usually first recognized by the physician who treats the person for his or her brain injury. Frequently this is a neurologist.
The physician typically performs tests that require the person to follow commands, answer questions, name objects, and carry on a conversation.
If the physician suspects aphasia, the patient is often referred to a speech-language pathologist, who performs a comprehensive examination of the person’s communication abilities.
The examination includes the person’s ability to speak, express ideas, converse socially, understand language, read, and write, as well as the ability to swallow and to use alternative and augmentative communication.
How is aphasia treated?
In some cases, a person will completely recover from aphasia without treatment.
This type of spontaneous recovery usually occurs following a type of stroke in which blood flow to the brain is temporarily interrupted but quickly restored, called a transient ischemic attack.
In these circumstances, language abilities may return in a few hours or a few days.
For most cases, however, language recovery is not as quick or as complete. While many people with aphasia experience partial spontaneous recovery, in which some language abilities return a few days to a month after the brain injury, some amount of aphasia typically remains.
In these instances, speech-language therapy is often helpful. Recovery usually continues over a two-year period. Many health professionals believe that the most effective treatment begins early in the recovery process.
Some of the factors that influence the amount of improvement include the cause of the brain damage, the area of the brain that was damaged, the extent of the brain injury, and the age and health of the individual.
Additional factors include motivation, handedness, and educational level.
Aphasia therapy aims to improve a person’s ability to communicate by helping him or her to use remaining language abilities, restore language abilities as much as possible, compensate for language problems, and learn other methods of communicating.
Individual therapy focuses on the specific needs of the person, while group therapy offers the opportunity to use new communication skills in a small-group setting. Stroke clubs, regional support groups formed by people who have had a stroke, are available in most major cities.
These clubs also offer the opportunity for people with aphasia to try new communication skills. In addition, stroke clubs can help a person and his or her family adjust to the life changes that accompany stroke and aphasia.
Family involvement is often a crucial component of aphasia treatment so that family members can learn the best way to communicate with their loved one.
How do you communicate with someone that has Aphasia?
The following are some tips on how to communicate with someone that has aphasia:
- Try to keep sentences short and simple and avoid questions that require a complicated answer.
- Do not change the subject of conversation too quickly.
- Minimise distracting background noises.
- When the person with aphasia is replying, try not to pressure them for a response and give them plenty of time to answer.
- Try not to correct their language as they may find this frustrating.
- Remember that their disorder is affecting the way they communicate, their tone may not necessarily reflect their mood.
- Try to keep a notepad/some paper and a pen to hand, this may help you or them to communicate.
What are the Complications associated with Aphasia?
Aphasia can have a negative effect on a number of aspects of life, as communication is fundamental to day to day living. It can affect things such as personal relationships and work and can result in the patient suffering frustration and distress.
All of these can contribute to heavy psychological stress which can then lead to depression. Research has proven this to be a common complication of aphasia with approximately 25% of people diagnosed suffering depression at some point.
It is advised that someone with aphasia suffering from depression go to support groups or see their doctor about treatment.
How can Aphasia be prevented?
With the main cause of aphasia being a stroke, taking measures to avoid having one would lower the risk of aphasia. Precautions that can be taken to reduce stroke risk are:
- regular exercise
- eating healthily
- monitoring and controlling blood pressure
- avoiding tobacco use
- keeping alcohol consumption low
- managing stress