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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 the language centers of the brain are damaged.
Aphasia affects different people in different ways. Someone with aphasia may have difficulty doing some or all of the following:
- Understanding what other people say
- Using the right words to express a thought
- Reading aloud or silently
- Writing or typing
- Using gestures
- Drawing pictures
- Using numbers or doing math.
Aphasia varies in severity. Someone with a mild form, called anomia, usually just has trouble finding words during a 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. They usually have coherent thoughts and meaningful ideas to share, but have trouble getting the words out.
Aphasia also impacts relationships and identity. Not being able to say what you want can have a devasting impact on your confidence and your participation in the world.
What Aphasia Is Not
There are many conditions that result in trouble communicating, but not all of them are aphasia.
Aphasia can occur alone or in combination with other communication impairments. These may include:
- Dysarthria – slurred or unclear speech
- Apraxia – inability to control the muscles used to form words
- Cognitive-communication impairment – a communication problem stemming from a thinking impairment rather than a language issue
Learn more about the different types of communication impairments that are commonly seen after a stroke.
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 3 main types of aphasia. Click through to the full articles to learn more about each type.
Fluent or receptive aphasia (Wernicke’s)
Difficulty understanding language, with effortless but error-filled speech.
People with fluent aphasia often have trouble following directions, answering questions correctly, understanding the meanings of words and sentences, and following a conversation. Their words are often not real words or unrelated to what they’re trying to say.
Non-fluent or expressive aphasia (Broca’s)
Difficulty producing language, with relatively strong understanding skills.
People with non-fluent aphasia have difficulty coming up with the right words for what they want to say. It may be hard for them to say “yes” or “no” as intended, or to speak easily at a normal speed. They may even have trouble repeating what someone else says.
Severe mixed aphasia (Global)
Extreme difficulty both understanding and producing language.
People with global aphasia are often able to say a few words or phrases, or may repeat the same word or phrase over and over. They may understand personally-relevant information, but have difficulty following more abstract ideas.
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. These names help to group symptoms together, but each person’s aphasia is unique.
A person with aphasia may have a tendency to get stuck on the same words or ideas every time they come up, called perseveration. They 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. This is typically based on how tired they are, their emotional state, or how automatic the exchange is.
If You Have Aphasia
While you may have feelings of isolation, you are not alone. It is estimated that there are more than 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.
- 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 feeling tired or emotional.
- Join a support group for people with aphasia. You are not alone!
- Practice, practice, practice! Talk as much as you can and do therapy exercises at home. Here’s a great app to start with for people with aphasia:
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.
- 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.
- Begin the conversation by telling the person what you want to talk about. Knowing the topic can help someone understand what you’re saying.
- 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.
- 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.
- 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.
- Encourage the person’s efforts to communicate, but admit when you don’t understand what they are trying to say. Don’t assume that you know what they mean. Ask if it’s okay to offer help by guessing.
- Don’t make the person try to speak perfectly. Aphasia can be frustrating and tiring. Give the person plenty of time to express themselves. If they make several unsuccessful attempts to say something, offer to return to the idea later.
Want more tips? Download 50 Things You Can Do Right Now to Help Your Loved One with Aphasia, a free PDF guide for care partners.
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