What is Aphasia?

According to the National Aphasia Association, aphasia is a communication disorder that affects over 2 million Americans. Nearly 180,000 acquire the disorder each year. Still many people have never heard of aphasia.

Aphasia is quite simply the loss of language. It is a common consequence of stroke, brain tumor, head injury, infection, or similar medical conditions. Each case of aphasia is different, as no two brains are the same and no two injuries can be identical.

Broca’s vs Wernicke’s Aphasia?

Although aphasia can be divided into many types, I wouldn't worry too much about labeling it. I find it more important to think about how the disorder manifests in each individual. There are two primary ways of thinking about aphasia: what one can understand, and what one can express.

· Receptive language (spoken language comprehension) refers to the ability to understand language, follow directions, make accurate choices. In its most severe form, some people are unable to answer simple yes/no questions.

· Expressive language (spoken language expression) refers to the ability to speak language, to string words together in a coherent and grammatical form. Many people associate expressive aphasia with word finding problems, but it can be more complex and is very frustrating.

Rarely do individuals with aphasia have purely one type or the other. Due to the proximity of the parts of the brain responsible for understanding and forming language, most people experience some degree of both expressive and receptive aphasia. In its most severe form, when both expressive and receptive language are profoundly affected, it is called “global aphasia.”

Aphasia, by definition, is a language impairment and does not suggest any other cognitive deficit. For example, thinking and reasoning skills are presumed to be intact unless there is a more complex medical condition also affecting these skills. Unfortunately, because the general public is not very familiar with aphasia, individuals with aphasia and their loved ones often have to combat the assumptions of a change in intelligence. Please help to dispel this myth.

Speech Language Pathologists (speech therapists) are the specialists who address language rehabilitation. Because, as mentioned above, each brain and aphasia presentation is unique, each course of aphasia therapy will be different and tailored to the individual’s unique need.

What to Expect in Aphasia Therapy

Therapy starts with an evaluation. This can be a formal battery of tests that are conducted to review all the different areas of strengths and weaknesses, or it can be an informal interview with the patient and family. A typical evaluation consists of some elements of each of these. {Side note: a good evaluation of language should also include reading and writing skills assessments, as this is also verbal communication.}

Once the language skills are analyzed by the speech pathologist, goals can be made. This part is important: Goals should be personal and meaningful. If a person is struggling with retrieving vocabulary (word finding), it is not enough to make a goal to name (or label) random objects in a room. Goals that are personalized will have greater impact and will result in greater success sooner. For example, a speech pathologist may focus first on regaining the ability to state the names of important family members and pets, objects he/she may use daily (toothbrush, coffee). A patient who has a personal goal to return to being the primary cook in the household, may need language goals that focus on vocabulary for the kitchen and meal planning. As the language skills improve, goals and therapy should also change and adapt.

Family Involvement is Important

Another important aspect of aphasia therapy is family/caregiver training. Family training can be helpful in identifying alternative ways to communicate while the person with aphasia is undergoing rehabilitation. Are there nonverbal ways to get the same message across? Sometimes by simply changing the way we ask a question we can give the person with aphasia more success. Oftentimes by giving a patient a hint (rather than the word), we facilitate faster recovery. There are many ways the family can support communication and reduce frustration. Sit in on your loved one’s sessions if you can. And be sure to ask the speech therapist how to keep the conversation going outside of the speech therapy sessions.

Nowadays, there are many computer-based games and applications that give additional practice for language recovery. Many are quite affordable and offer engaging functional language activities. Your speech therapist should be able to help in identifying which applications are best suited to each person’s specific language level and need. Just keep in mind that nothing replaces good ol’ conversation when it comes to language rehabilitation.

If you have more questions, reach out to Amplify Speech Therapy.