Aphasia

Have you ever come across a person who has had a stroke, a vehicular accident, or a brain surgery? Did the person have any difficulty with following instructions or expressing themselves? What were your observations?

Difficulties associated with communication following a brain injury can be difficult for both the person and their families.

A language difficulty caused by damage to the brain is known as Aphasia. Aphasia often affects everyday communication and living.

People with aphasia may have difficulty with following instructions, using gestures, talking, remembering words, reading and writing.

Causes of Aphasia

Causes of aphasia may include:

• Head injury such as a stroke (the most common)

• Tumour

• Infections in the brain

• Neurodegenerative diseases such as Alzheimer's disease and Dementia

Types of Aphasia

There are different types of aphasia. People are affected differently depending on the type of aphasia they have. The most common types are:

• Broca’s Aphasia (Non-fluent/expressive Aphasia) – People with Broca’s Aphasia have difficulty finding and saying the right words although they are likely to know what they want to say. It can be likened to having all the word categories jumbled up such that it becomes difficult to know where to go in the brain to find the right word. They often use single words or short sentences.

• Wernicke’s Aphasia (Fluent/receptive Aphasia) – People with Wernicke’s aphasia speak well and use long sentences, however, it is difficult to understand what they say as they often don’t make sense. They are usually unaware of their difficulty and may be frustrated when they are not understood.

• Anomic Aphasia – People with anomic aphasia have difficulty accessing the words they want to use to talk about things. There is difficulty finding words in both writing and speech.

• Global Aphasia – People with global aphasia have difficulties with both understanding and word production. It is considered to be the most severe type of aphasia as all language modalities are impaired i.e. understanding, speaking, reading and writing.

• Progressive Aphasia – This type of aphasia involves the language abilities of a person gradually becoming slow and deteriorating. This often leads to a gradual loss of the ability to understand what others say, speak, read and write. This is the type of aphasia the famous actor, Bruce Willis, was recently diagnosed with.

Treatment

Speech and language therapy (SLT) is one of the main interventions for aphasia. SLT aims at helping people with aphasia to communicate in the best possible way.

This may include helping them get their language back, using some other means of communication in addition to the few words they have following the aphasia, using another way of communication because they may not be able to use words again or using writing, gestures and others modes of communication to express themselves.

People with aphasia often describe how frustrating their language difficulty can be. SLT, therefore, helps in mitigating the frustration.

Without help, some people with aphasia get depressed. SLTs are allied health professionals trained to help persons with communication difficulties, including aphasia.

SLTs assess and provide intervention for persons with aphasia to improve their communication skills.

Helpful strategies

Few strategies to help when communicating with people with aphasia include:

• Use concrete or specific language when communicating with them. For example, if you want to tell them to do something in a day, saying “Morning and evening” is easier to understand than saying “twice a day.”

• Use simple language.

• Ask the person to repeat or try another approach if you don’t understand. For example, drawing, using pictures or gestures to check what they said. You can ask them ‘yes’ or ‘no’ questions to help you understand.

• If you ask a question, wait for the person to reply. Be patient. Don’t rush them.

• Engage them in conversation often. Do not ignore them.

Speech and Language Therapist/Clinical Tutor University of Ghana