The Many Faces of Aphasia

The Many Faces of Aphasia
June is National Aphasia Awareness Month, which supports efforts to increase awareness of aphasia, a communication impairment caused by damage to the brain. According to the National Institute of Neurological Disorders and Stroke (NINDS), aphasia affects at least 1,000,000 people in the United States.
Aphasia is an acquired communication disorder that affects the ability to process language, the ability to speak and understand others. In the majority of cases, reading and writing is also affected. The impact aphasia has on communication fuels misconceptions that aphasia has an impact on a person’s intelligence. On the contrary, it has more to do with the ability to access ideas and thoughts through language that is disrupted, not the ideas themselves.

A stroke is the most common cause of aphasia and nearly 25-40% of stroke survivors have aphasia. Aphasia may result from a traumatic brain injury as well. Additionally, aphasia can come into play with a brain tumor, or other neurological causes. Aphasia occurs in people of all ages, but is most common among the elderly.

There is more than one type of aphasia and depends on the location of the brain injury and sections of communication centers affected. Global aphasia is the most significant type. People with global aphasia produce few recognizable words, have little understanding capacity and do not speak, read or write. Global aphasia may occur immediately after a stroke, however if the injury is minor, a speedy recovery is likely.

Broca’s aphasia, also called non-fluent aphasia, severely reduces speech to the point of short sentences and phrases that are no longer than four words. The person with Broca’s aphasia just might be able to understand speech fairly well and be able to read, but clear handle on, or access to vocabulary is limited.

There is also mixed non-fluent aphasia. People with this form of aphasia experience limited or labored speech, similar to Broca’s aphasia. However, they are also limited in how well they understand language. Beyond a simple elementary level, reading and writing is difficult.

Another type of aphasia is Wernicke’s aphasia, or fluent aphasia. People with this version of aphasia have frustrating difficulty with the meanings spoken words, but their own ability to produce discernible speech is not as highly affected. Still, common sentences do not hang together and irrelevant words may pepper the language in severe cases. Reading and writing are also affected.
In people living with anomic aphasia, there is a persistent inability to find words about the things they want to talk about, particularly nouns and verbs. Writing and speaking are sure areas that show evidence of this type. The ability to understand others’ speech is not impacted, but they themselves have difficulty putting words together.

A temporary version of aphasia is called transient aphasia. More than half of the individuals who initially show signs of aphasia recover completely within the first few days. If symptoms last longer than two or three months after a stroke, a complete recovery is not likely. Still, some patients may continue to improve over a period of years.

The National Aphasia Association suggests these tips for communicating with a person with aphasia:

1. Be sure you have the person's complete attention before trying to communicate with them.

2. During conversation, minimize or eliminate background noise. Turn off the television, radio, or step away from other people as much as possible.

3. Speak to the person in simple sentences without treating them like a juvenile. Try to speak carefully and at an easy pace without talking to them like they are a child. There’s no need to speak louder, but do enunciate words carefully. Be open to repeating a statement when necessary.

4. Encourage and try other ways of communicating, like writing, drawing, simple yes/no responses, choices, gestures, eye contact, facial expressions -- in addition to talking.

5. Be patient. Allow them have a reasonable amount of time to respond. Avoid speaking for the person with aphasia, except when necessary and ask permission before doing so. Look for eye and body language cues that it is okay to help them respond.

6. Praise all attempts to speak. Create a pleasant experience for speaking and provide stimulating conversation. Downplay errors and avoid frequent correcting. Please do not insist each word be pronounced correctly.

7. Continue normal activities, such as dinner with family, company, going out – as much as possible to build confidence and create more stimulation for language. Do not hide a loved one with aphasia away or ignore them. Instead, involve them as much as possible in the family decision-making and keep them informed of any major changes of events without stressing them out with minor details.

For more information about aphasia, these links below should provide some help.

You Should Also Read:
National Aphasia Association
The Aphasia Insitute of Canada
Picturing Aphasia Documentary

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