What is Aphasia?

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Aphasia (uh-fay-zha), sometimes called dysphasia, is the loss of the ability to speak, to understand what someone else is saying, or both. It is a communication disorder that results when parts of the brain that contain language are damaged.

Aphasia affects different people in different ways. Someone with aphasia may have difficulty doing some or all of the following:

  • Understand what other people say
  • Use the right words to express a thought
  • Read
  • Write
  • Use gestures
  • Draw pictures
  • Use numbers or do math.

Aphasia varies in severity. Someone with a mild form called anomia usually just has trouble finding words during conversation. Someone whose language abilities are severely impaired, however, is said to have global aphasia.

Aphasia has nothing to do with intelligence. A person with aphasia is just as smart after the brain injury as before. He or she usually has coherent thoughts and meaningful ideas to share, but has trouble getting the words out.

Aphasia can occur alone or in combination with other conditions. These conditions include the following:

  • Dysarthria, or slurred speech
  • Apraxia, or inability to move the face and tongue muscles correctly to form words
  • Cognitive impairment.

What Causes Aphasia

Aphasia is usually caused by stroke. It may also be caused by a head injury, a brain tumour, or a neurological disease. Aphasia is typically caused by damage to the left hemisphere of the brain. This is the dominant hemisphere, or side of the brain responsible for language, in nearly all right-handed and most left-handed people. You might hear about damage to Broca’s area or Wernicke’s area, though aphasia can result from damage to other brain areas as well.

There is also one type of aphasia that is not caused by damage to the brain: Primary Progressive Aphasia (PPA). PPA is a degenerative disorder and a type of dementia that impairs language before other cognitive functions. While PPA will get worse over time, treatment is still effective in prolonging language abilities and should be started immediately after a diagnosis is received.

What You Might Notice

There are two main types of aphasia:

  • Fluent or receptive aphasia – difficulty understanding language as well as producing it
  • Non-fluent or expressive aphasia – difficulty producing language

A person with receptive aphasia often has trouble following directions, answering questions correctly, understanding the meanings of words and sentences, and following a conversation.

A person with expressive aphasia has difficulty coming out with the right words for what he or she wants to say. It may be hard for the person to say “yes” or “no” as intended, or to speak easily at a normal speed. He or she may even have trouble repeating what someone else says.

Many people have a combination of receptive and expressive aphasia, which might be called a mixed aphasia, or when it’s very severe, global aphasia.

There are other names for types of aphasia, depending on the relative strengths and weaknesses of listening, speaking, and repeating. Fluent aphasia may be called Wernicke’s, transcortical sensory, conduction, or anomic aphasia, while non-fluent aphasia may be called Broca’s, or transcortical motor aphasia. There are even subcortical aphasias caused by lesions deeper in the brain.

A person with aphasia may have a tendency to get stuck on the same words or ideas every time they come up. He or she may use made-up words, or actual words strung together in sentences that make no sense to anyone else. Some people with aphasia are still capable of swearing when they want to, so you may hear perfectly clear swear words while other words are less recognizable.

Aphasia can be a fluctuating condition. Sometimes the person is able to speak clearly in whole phrases, then lapse back into difficulty.

If You Have Aphasia

While you may have feelings of isolation, you are not alone. It is estimated that there are about two million people in the US living with aphasia – more than Parkinson’s disease.

Participating in speech-language therapy may help people with aphasia improve their communication skills. Meanwhile, here are a few tips many people with aphasia find helpful:

  • Minimize background noise. Turn off the TV and talk in a quiet room.
  • Think about what you want to say before you say it.
  • Use facial expressions, gestures, writing, and pointing to help get your message across.
  • Go easy on yourself.  You are trying your best, and talking is hard work for a person with aphasia.
  • Practice, practice, practice! Talk as much as you can.
  • If you can’t get a word out, try to describe it or think of another word that means the same.
  • Avoid important conversations when you are tired or emotional.
  • Join a support group for people with aphasia. You are not alone!

7 Ways To Help a Person with Aphasia

People with aphasia can still communicate, especially if they have a little help. Here are seven things you can do to make communication easier for them.

  1. Limit your conversations to one person at a time. Be sure your surroundings are quiet and free of distractions, so the person can hear and focus on you.
  2. Begin the conversation by telling the person what you want to talk about. Knowing the topic can help someone understand what you’re saying.
  3. Speak slowly and naturally. Don’t raise your voice. Use short, simple sentences, but be careful not to talk down to the person. When necessary, repeat yourself or rephrase your comments. Use facial expressions, gestures, and pointing to help make your meaning clear.
  4. As you proceed through a conversation, stop now and then to summarize what you’ve understood. Ask the person to indicate whether your understanding is accurate.
  5. Talk about familiar subjects. Family photos can help start or move a conversation forward. Ask yes-or-no questions, or give two or three choices in any question you ask.
  6. Encourage the person’s efforts to communicate, but admit when you don’t understand what he or she is trying to say. Don’t assume that you know what he or she means. It’s okay to offer help by guessing.
  7. Don’t make the person try to speak perfectly. Aphasia can be frustrating and tiring. Give the person plenty of time to express him or herself. If he or she makes several unsuccessful attempts to say something, offer to return to the idea later.

You can also download and print this card with information about an online aphasia support group and more tips for speaking with a person with aphasia.

Megan Sutton, MS RSLP, CCC-SLP (C) is a speech-language pathologist in Vancouver, Canada and co-founder of Tactus Therapy, a company that develops evidence-based speech therapy apps for adult communication, cognitive, and swallowing disorders. Megan earned a Master of Science degree in Speech-Language Pathology from Boston University after earning a B.A. in Linguistics from Rutgers University. She has worked passionately with adults with acquired communication and swallowing disorders for over 13 years in inpatient and outpatient settings, specializing in the assessment and treatment of aphasia. Visit her website for additional resources.

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