Aphasia

What Is Aphasia?

Aphasia is a communication disorder that makes it hard to use words. It can affect your speech, writing, and ability to understand language. Aphasia 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 communicate, but it doesn’t impair intelligence. People who have aphasia may have a hard time 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. People with aphasia may also repeat words or phrases.

Types of Aphasia

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

• Expressive aphasia (non-fluent). With expressive aphasia, the person knows what they want to say, yet has a hard time communicating it to others. It doesn't matter whether the person is trying to say or write what they are trying to communicate.
• 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.
• Anomic aphasia. With anomic aphasia, the person has a hard time finding words. This is called anomia. Because of the difficulties, the person struggles to find the right words for speaking and writing.
• 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 a hard time speaking and understanding words. In addition, the person can’t read or write. With a stroke, aphasia may improve with proper therapy.
• 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. There’s 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.

Symptoms of Aphasia

The main symptoms of aphasia include:

• Trouble speaking
• Struggling with finding the right term or word
• Using strange or wrong words in conversation
• Trouble understanding what other people say or following conversations
• Writing sentences that don’t make sense or trouble expressing yourself in writing
• Speaking in short sentences or phrases
• Using unrecognizable words

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. Serious aphasia makes the person less able to communicate. The person may say little and may not take part in or understand any conversation.

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 a hard time with handwriting. Some people have trouble using numbers or even doing simple calculations.

Causes of 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 dementia such as Alzheimer's disease. In some cases, aphasia is a symptom of epilepsy or another neurological disorder.

Diagnosing Aphasia

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 find out how severe the aphasia is.

Treatment for Aphasia

Treatment for someone with aphasia depends on things 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 help them speak and communicate better. The therapist will also teach the person ways to communicate that don't involve speech. This will help the person compensate for language difficulties.

Here are some tips from the National Stroke Association for someone with aphasia:

• Use props to help get the message across.
• Draw words or pictures on paper when trying to communicate.
• Speak slowly, and stay calm when talking.
• Carry a card to let strangers know you have aphasia and what aphasia means.

Tips for Communicating with Someone Who Has Aphasia

If someone you know has aphasia, these tips can help you communicate better:

• Get their attention before you say something.
• Keep eye contact.
• Pay attention to their body language.
• Talk where it’s quiet.
• Don’t talk louder. People with aphasia hear normally.
• Use simple words.
• Use shorter sentences and repeat important words.
• Talk slowly.
• Give them time to say something.
• Try drawings, gestures, writing, or facial expressions if words aren’t working.
• Ask them to draw, write, or point if they are having trouble.
• Ask yes-or-no questions.
• Let them make mistakes and try.

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