Aphasia is a condition that affects a person’s ability to communicate. It’s usually caused by damage to the left side of the brain, often from a stroke. People with aphasia may have difficulty speaking, understanding speech, reading, and writing. Aphasia can be frustrating and isolating, but with the right support, people with aphasia can regain some or all of their communication abilities. As a caregiver, family member, or friend of someone with aphasia, there are many things you can do to help.
What is aphasia?
Aphasia is an impairment of language abilities caused by brain damage. The damage usually occurs in the left side of the brain, which controls language for most people. This brain damage can be caused by a stroke, traumatic brain injury, brain tumor, or other neurological disease or disorder.
The severity of aphasia depends on the location and extent of the brain damage. Some common symptoms include:
– Difficulty finding the right words
– Using the wrong words without realizing it
– Having trouble understanding speech
– Speaking in short or incomplete sentences
– Making grammar mistakes when speaking or writing
– Having difficulty reading and writing
Aphasia only affects language abilities, not intelligence. People with aphasia are still just as smart as they were before the brain damage occurred. Aphasia can range from mild to severe. With therapy and support, many people can regain some or most of their language function over time.
Types of aphasia
There are several types of aphasia that can result depending on the location of brain damage:
Broca’s (non-fluent) aphasia
Damage to Broca’s area in the frontal lobe.
Symptoms:
– Speaking in short phrases, only a few words at a time
– Leaving out small connecting words like “is” or “the”
– Speaking slowly and with effort
– Unable to quickly retrieve vocabulary
– Understanding speech relatively well
Wernicke’s (fluent) aphasia
Damage to Wernicke’s area in the temporal lobe.
Symptoms:
– Speaking in long, complex sentences that don’t make sense
– Making up nonsense or incorrect words
– Having severe difficulty understanding speech
– Often unaware that speech is nonsensical
Global aphasia
Extensive damage to several areas of the brain that control language.
Symptoms:
– Severe difficulty producing speech
– Very limited vocabulary
– Very poor auditory and reading comprehension
– Often can only speak or understand a few words or phrases
Primary progressive aphasia
Gradual loss of language function over time, caused by neurodegenerative disease like Alzheimer’s or frontotemporal dementia.
Symptoms:
– Progressive difficulty finding words and naming objects
– Increasing trouble understanding complex sentences
– Eventually an inability to have conversations
How is aphasia diagnosed?
Aphasia is typically diagnosed by a speech-language pathologist (SLP) through a comprehensive evaluation of the person’s communication abilities. This includes:
– Observing speech and language during conversation
– Testing auditory comprehension by following commands or answering questions
– Evaluating reading and writing skills
– Assessing ability to name objects, repeat phrases, and carry on a conversation
The SLP analyzes the types of errors made to determine the severity and type of aphasia. Brain imaging like an MRI scan can reveal the location and extent of brain damage. A full medical history helps understand the cause and nature of the language impairment.
Treatment and therapy for aphasia
The main treatment for aphasia is speech and language therapy provided by a qualified SLP. The goals of therapy are to:
– Improve ability to communicate and be understood by others
– Practice language and communication skills
– Find alternate modes of communication if speaking is difficult
– Regain as much language function as possible
Therapy is tailored to each individual and focuses on their unique symptoms and challenges. Some common therapy techniques include:
Speech production practice
Exercises to improve word retrieval, sentence construction, pronunciation, and articulation. For example, repeating words and phrases, naming objects, reading sentences aloud.
Auditory comprehension training
Listening to speech and answering questions, following directions, identifying mistakes in sentences.
Reading and writing
Exercises to practice reading out loud, improve reading comprehension, spelling, handwriting, punctuation, grammar.
Communication tools
Using pictures, drawing, gestures,communication boards, and technology aids to facilitate communication.
Everyday conversation
Practice conversations and role play real-world situations to improve functional communication.
Aphasia therapy is most effective when it starts soon after the brain injury. The person should participate in intensive one-on-one therapy for several hours per week. Some amount of therapy and practice is often needed for a long period of time to regain language skills.
Ways family and friends can help
As a loved one of someone with aphasia, there are many things you can do at home to support their communication and create a helpful environment:
Be patient
Allow plenty of time for conversations. Don’t interrupt or finish words or sentences. Give encouragement using facial expressions, nods, and gestures.
Reduce distractions
Have conversations in quiet spaces without too much background noise from TV, radio, etc. This makes it easier to focus.
Use gestures and visual aids
Point or demonstrate what you mean through gestures, pictures, writing keywords, or showing objects. Visual aids can prompt ideas.
Ask questions that can be answered simply
Yes/no and choice questions are easiest. “Do you want water?” “Do you need a break?”
Repeat or rephrase if needed
Use simpler words and short sentences. Paraphrase what was said incorrectly. Verify you understand.
Treat the person with respect
Don’t infantilize them or speak as if they cannot understand. Include them in conversations.
Provide word retrieval prompts
If they are struggling to find a word, provide cues like the first letter or related words. But allow time to come up with it independently first.
Explore different communication methods
Try using drawings, writing, gesturing, communication boards, typing or technology aids if speaking is very difficult. Find what works best.
Practice daily communication
Incorporate language exercises and stimulation into everyday activities like reading, writing shopping lists, using communication cards, watching TV together.
Provide support with writing and technology
Help type messages on a computer or tablet, take dictation, check writing for errors, set up communication apps.
Join a support group
Find local aphasia or stroke/brain injury support groups. Connect with others experiencing similar challenges.
Remember your relationship
You have the same relationship, though communication has changed. Enjoy your time together through meaningful activities.
Coping strategies for living with aphasia
Aphasia can be isolating and frustrating to live with, but using effective coping strategies makes daily life easier. Some tips for someone with aphasia:
Carry a communication aid
Have a card, book, or device with commonly used words and phrases to point to or show others.
Alert others about aphasia
Explain the condition and best ways to communicate. Educate family, friends, coworkers, and medical providers.
Ask people to be patient
Let conversation partners know it may take longer to communicate. Tell them repetition and multiple modes may be needed.
Set up your environment
Reduce clutter, noise and distractions at home to minimize confusion and miscommunication.
Focus on one speaker at a time
Attending to multiple people is very difficult. Ask people to take turns talking.
Take advantage of technology
Use smart devices, apps, and computers to aid communication, prompt word finding, schedule activities, and more.
Try alternate communication methods
Use gestures, drawings, pointing, writing – whatever gets the message across. Be creative and flexible.
Ask for clarification
If you don’t understand something, request repetition, written keywords, gestures – don’t pretend you comprehend.
Avoid noisy, chaotic situations if possible
Crowds, background noise, and distractions make communication much more difficult. Opt for smaller groups in quiet settings.
Give yourself extra time
Rushing leads to frustration. Allow ample time for communicating, reading, writing, thinking through responses, understanding conversations.
Join an aphasia support group
Connecting with others experiencing the same challenges provides support, advice, and socialization.
Let some things go
Focus energy on the most important communication. Don’t get distressed over small mistakes or occasional misunderstandings.
When communication breaks down
Despite best efforts, there will likely be times when communication breaks down entirely. Tips for handling these situations:
– Stay calm and patient. Take a break if needed.
– Try again using a different communication strategy like writing or gesturing.
– See if another person can interpret what is being conveyed.
– Move on to another topic, then try coming back later.
– Schedule a therapy session to work through what led to the breakdown.
– Remember that this is part of the process – miscommunication will happen. The key is to keep trying different approaches.
– Focus on re-establishing mutual understanding, not “correcting” errors.
With creativity and problem-solving, find a way to get the point across successfully. Breakdowns are learning opportunities to strengthen your communication skills.
Conclusion
Aphasia presents daily challenges for communicating, but strong social support and therapy can help regain language function. As a loved one, provide patience, use communication aids, simplify your speech, and partner in therapy exercises. People with aphasia can utilize strategies like alerting others, using technology, and allowing extra response time. Though communication may look different, relationships can remain positive and fulfilling. With joint effort, motivation, and flexibility, it’s possible to adjust successfully to life with aphasia.