Aphasia

What is aphasia?

Aphasia is a neurological disorder caused by damage to the portions of the brain that are responsible for language. For most people, these are parts of the left side (hemisphere) of the brain. Primary signs of the disorder include difficulty in expressing oneself when speaking, trouble understanding speech, and difficulty with reading and writing. It is a common condition, with more than 140,000 Australians living with aphasia.

Aphasia is a brain condition that involves having difficulty with language and speech, but it does not affect intelligence. Aphasia usually occurs suddenly, often as the result of a stroke or head injury, but it may also develop slowly, as in the case of a brain tumour, infection, or dementia. The type and severity of language dysfunction depend on the precise location and extent of the damaged brain tissue.

Generally, aphasia can be divided into four broad categories:

1. Expressive aphasia involves difficulty in conveying thoughts through speech or writing. The patient knows what they want to say, but cannot find the words they need.
2. Receptive aphasia involves difficulty understanding spoken or written language. The patient hears the voice or sees the print but cannot make sense of the words.
3. Patients with anomic aphasia, the least severe form of aphasia, have difficulty in using the correct names for particular objects, people or places.
4. Global aphasia results from severe and extensive damage to the language areas of the brain. Patients lose almost all language function, both comprehension and expression. They cannot speak or understand speech, nor can they read or write.

Symptoms

Aphasia can cause difficulty with talking, understanding language, reading, writing and spelling, using gestures and numbers. Some symptoms that someone living with aphasia may experience include;

• Trouble retrieving the right words
• Speaking in short or fragmented sentences
• Mixing up sounds
• Experiencing difficulty understanding spoken messages, reading or writing

Treatment

In some instances, an individual will completely recover from aphasia without treatment. This type of “spontaneous recovery” usually occurs following a transient ischemic attack (TIA), a kind of stroke in which the blood flow to the brain is temporarily interrupted but quickly restored. While many individuals with aphasia also experience a period of partial spontaneous recovery (in which some language abilities return over a period of a few days to months after the brain injury), some amount of aphasia typically remains. In most cases, however, language therapy should begin as soon as possible and be tailored to the individual needs of the patient. Therapy strives to improve an individual’s ability to communicate by helping the person to use remaining abilities, to restore language abilities as much as possible, to compensate for language problems, and to learn other methods of communicating. Such therapy with a speech pathologist involves extensive exercises in which patients read, write, follow directions, and repeat what they hear. Computer-aided therapy may supplement standard language therapy.

Outlook

The outcome of aphasia is difficult to predict given the wide range of variability of the condition. Generally, people who are younger or have less extensive brain damage fare better. The location of the injury is also important and is another clue to prognosis. In general, patients tend to recover skills in language comprehension more completely than those skills involving expression.

Supporting someone with aphasia

If your friend or loved one is living with aphasia, there are practical ways you can help them communicate.

You can help them understand what you’re saying by:

• speaking slowly in short, clear sentences
• making eye contact
• repeating important words
• talking about one topic at a time
• choosing a quiet location and reducing background noise
• using pictures, emojis, gestures, drawings, physical objects (e.g. maps, calendars, communication charts) to support understanding

It’s important to remember that aphasia does not affect intelligence – you can speak naturally, at a normal volume, just a little bit slower than usual. Be patient and give them time to process what you’re saying and formulate a reply without trying to finish their sentences.

Aphasia is different for everyone. Different tips work better for different people depending on the type and severity of aphasia, and on personal preference.

For more in-depth information and tips on supporting communication, see the resources below.

Recent Research Grants

2013 – How does brain stimulation impact on language functions in patients with stroke? – Dr Marcus Meinzer – Read more >

Further Information and Support

• Australian Aphasia Association: https://aphasia.org.au/
• Get a free printable Aphasia ID card: https://aphasia.org.au/get-a-free-printable-aphasia-id-card/
• Aphasia Handbook (Stroke Foundation and AAA): https://strokefoundation.org.au/media/c3qjm2zw/sf1629_aphasia-booklet.pdf

Reviewed by Dr Laurie Miller, Clinical Neuropsychologist, Royal Prince Alfred Hospital, Camperdown.