What is aphasia?
Aphasia is an acquired communication disorder that does not affect a person’s intellect. It can affect one or more language modalities such as: talking, reading, writing or understanding spoken language. The ability to read, write, speak or understand language can be lost or reduced. Without the ability to participate in conversation, friendships, relationships and many life activities can be affected.
Aphasia affects more than 2 million people in the United States. Aphasia is more prevalent than multiple sclerosis or Parkinson’s disease, although only 8% of the US has ever heard of it. (National Aphasia Association, 2016).
What causes aphasia?
Aphasia is an acquired disorder usually caused by a brain injury such as a stroke, head trauma, infection or brain tumor.
Type of aphasia
There are about seven different types of aphasia, which affect people in different ways. Some people have a “non fluent” type of aphasia, which usually is from an injury in the front of the brain. These individuals have more difficulty with producing words and sounds and it may be halting. There is also are “fluent” aphasia types, which usually result from damage to the back of the brain. They have longer sentences but they words may have less meaning.
Non-fluent types of aphasia:
Broca’s aphasia
Broca’s aphasia is when people find it very difficult to find and say the right words, although they probably know exactly what they want to say.
The person is non-fluent, able to understand, has difficulty repeating, and has word finding difficulties. They may also have problems with the” little” words such as “and, the” and using correct grammar such as verb tenses. They also may have apraxia of speech (motor sequencing difficulties) which makes it difficult to say sounds and repeat.
Transcortical Motor
The person is non-fluent, able to understand, able to repeat, has word finding difficulties.
Global aphasia
This is the most severe type of aphasia. Global aphasia usually affects all language modalities although intellect remains intact. The person is non-fluent, has difficulty understanding, has difficulty repeating, and has word finding difficulties. People with global aphasia may not be able to read, write or speak. They often can benefit from using a device or app to help them communicate.
Fluent types of aphasias:
Anomic
The person is fluent, able to understand, able to repeat, has word finding difficulties (known as anomia). This person is usually is able to talk in sentences, understand and write. They usually have trouble with saying or writing specific words or names of people.
Conduction
The person is fluent, able to understand, has difficulty repeating, and has word finding difficulties. This type of aphasia is characterized by very fluent speech and surprising inability to repeat back a word.
Transcortical Sensory
The person is fluent, has difficulty understanding, able to repeat, has word finding difficulties.
Wernicke’s
The person is fluent, has difficulty understanding, has difficulty repeating, and has word finding difficulties. Wernicke’s aphasia is when someone is able to speak and use long sentences, but what they say may not make sense. They may use words that are nonsense such as “shmooke”. They may not know that what they’re saying is wrong, so may get frustrated when people don’t understand them. They also may have difficulty with reading and writing.
Primary Progressive Aphasia
The final type of aphasia is Primary Progressive Aphasia. This type of aphasia is NOT due to a stroke or brain injury.
Primary progressive aphasia (PPA) is a progressive neurologic condition where language capabilities become slowly and progressively worse, leading to a gradual loss of the ability to:
- Read.
- Write.
- Speak.
- Understand what other people are saying.
Deterioration can happen slowly, over a period of years. The rate of decline is different from person to person. In the later stages of PPA, other thinking skills including memory, attention and behavior may be affected. It is important to get this diagnosed by someone who specializes in knowledge about primary progressive aphasia.
People with primary progressive aphasia may benefit during the course of their illness by acquiring new communication strategies from speech-language pathologists, therapy and learning communication strategies. Many people with PPA have also learned new ways to communicate through participation in Aphasia Community Groups, such as those offered at BRAC.
For more information and videos, visit the National Aphasia Association.
How is aphasia diagnosed?
Aphasia is usually first recognized by the doctor who treats the person for his or her brain injury. Most individuals will undergo a magnetic resonance imaging (MRI) or computed tomography (CT) scan to confirm the presence of a brain injury and to identify its location in the brain.
How to help someone with aphasia
People with aphasia are the same as they were before their injury and are competent and intelligent adults. Aphasia can affect both the ability to communicate verbally and through writing, and to understand the speech and writing of others. Aphasia changes the way in which we communicate with friends, families and coworkers. Although aphasia has no “cure”, individuals can improve over time, especially through speech therapy, participation in life and conversation. Therapy for aphasia should start at the onset of aphasia and continue in acute care, inpatient rehabilitation, and home health and outpatient settings.
At Brook’s rehabilitation we offer an incredible opportunity for people after they have been discharged from the hospital. The Brooks Aphasia Center offers two life participation aphasia programs including a community track and an intensive, comprehensive aphasia program.
The community track provides coordinated group activities to help reduce barriers to communication and increase confidence and socialization. Our members learn new skills which help them speak or write more effectively and enhance their quality of life.
The intensive, comprehensive aphasia program combines individualized, specialized therapy and immersive group rehabilitation for 5–30 hours per week for 6 weeks.
Both tracks begin with comprehensive assessments. They also include communication training for families and training to support the home or work environment. New skills and communication techniques are taught so members can re-engage in life’s activities and conversations again.
Tips to help with communication:
The following supported communication techniques will be helpful to increase communication:
To help get the message in clearly:
- Speak slowly with natural pitch/volume.
- Decrease background noise.
- Rephrase or simplify if needed.
- Ask yes/no questions if possible.
- Give written choices/key words.
- Draw or use pictures to help.
- Ask one question at a time. Wait. Listen.
To help get the message out:
- Allow time for them to respond.
- Encourage them to draw, write or use their phone to help.
- If they get stuck on a word, wait. Ask them if they want help.
- Try to give clues or describe a word before giving them the word.
- Write key words.
- Use humor and encourage them!