Aphasia

• What is aphasia?
• What are some signs or symptoms of aphasia?
• How is aphasia diagnosed?
• What treatments are available for people with aphasia?
• What other organizations have information about aphasia?

What is aphasia?

Aphasia is a disorder resulting from damage to the areas of the brain responsible for language. Aphasia causes issues with speaking, listening, reading, and/or writing.

Damage to the left side of the brain causes aphasia for most right-handers and about half of left-handers. Individuals who experience damage to the right side of the brain may have further problems beyond speech and language.

Individuals with aphasia may also have other problems, such as dysarthria, apraxia, or swallowing problems.

What are some signs or symptoms of aphasia?

Some people with aphasia have issues with using words and sentences (expressive aphasia). Some individuals find it difficult to understand others (receptive aphasia). Some individuals with aphasia find it difficult both to use words and understand others (global aphasia).

Aphasia can result in issues with both spoken language (talking and understanding) and written language (reading and writing). Reading and writing are more often impaired than talking or understanding.

Aphasia may be mild or severe. The location of the damage to the brain determines the severity of difficulties in communication.

A Person With Mild Aphasia

• may be able to carry on normal conversations in various settings
• may have difficulty understanding long or complex language
• may have difficulty finding the words (called anomia) to express an idea or explain himself/herself (feeling as if the words are “on the tip of their tongue”)

A Person With Severe Aphasia

• may understand nothing that is said to him/her
• may say little or nothing at all
• may make approximate common phrases, such as “yes,” “no,” “hi,” and “thanks”

Characteristics of Expressive Aphasia

• Speaks only in single words (e.g., names of objects)
• Speaks in short, fragmented phrases
• Omits smaller words like “the,” “of,” and “and” (so message sounds like a telegram)
• Puts words in the wrong order
• Switches sounds and/or words (e.g., bed is called table or dishwasher a “wish dasher”)
• Makes up words (e.g., jargon)
• Strings together nonsense words and real words fluently but makes no sense

Characteristics of Receptive Aphasia

• Requires extra time to understand spoken messages (e.g., like translating a foreign language)
• Finds if very hard to follow fast speech (e.g., radio or television news)
• Misinterprets subtleties of language-takes the literal meaning of figurative speech (e.g., “it’s raining cats and dogs”)
• Is frustrating for the person with aphasia and for the listener—can lead to communication breakdown

Very often, a person with aphasia has both expressive and receptive difficulties to varying degrees.

How is aphasia diagnosed?

The speech-language pathologist (SLP) works in collaboration with the individual’s family and other professionals (doctors, nurses, neuropsychologists, occupational therapists, physical therapists, social workers) to attend to each of the individual’s needs. For example, an individual who has had a stroke often has physical problems, such as weakness on one side of the body, and requires the help of a physical or occupational therapist.

The SLP evaluates the individual to determine the type and severity of aphasia by evaluating the following areas of communication:
Speech

• Fluency, vocal quality, and loudness
• How clearly the person speaks
• Strength and coordination of the speech muscles (tongue, lips)

Understanding

• Understanding and use of vocabulary (semantics) and grammar (syntax)
• Understanding and answering both yes-no (e.g., Is your name Bob?) and Wh-questions (e.g., What do you do with a hammer?)
• Understanding extended speech-the person listens to a short story or factual passage and answers fact-based (the answers are in the passage) and inferential (the patient must arrive at a conclusion based on information gathered from the reading) questions about the material
• Ability to follow directions that increase in both length and complexity
• Ability to tell an extended story (language sample) both verbally and in written form

Expressing

• Can the person tell the steps needed to complete a task or can he or she tell a story, centering on a topic and chaining a sequence of events together?
• Can he or she describe the “plot” in an action picture?
• Is his or her narrative coherent or is it difficult to follow?
• Can the person recall the words he or she needs to express ideas?
• Is the person expressing himself or herself in complete sentences, telegraphic sentences or phrases, or single words?

Social Communication

• Social communication skills (pragmatic language)
• Ability to interpret or explain jokes, sarcastic comments, absurdities in stories or pictures (e.g., What is strange about a person using an umbrella on a sunny day?)
• Ability to initiate conversation, take turns during a discussion, and express thoughts clearly using a variety of words and sentences
• Ability to clarify or restate when his or her conversational partner does not understand

Reading and Writing

• Reading and writing of letters, words, phrases, sentences, and paragraphs

Other

• Swallowing (as needed)
• Ability to use an augmentative or alternative communication aid (as needed)

This information is gathered through both structured observations and formal tests.

What treatments are available for people with aphasia?

There is an array of treatment available for individuals with aphasia. The type of treatment is dependent on the needs and goals of the individual with aphasia. Computers or other published materials provide specialized programs. There are also more informal approaches that are available. A combination of both formal and informal tasks is the most appropriate for many individuals. One approach that can be used by some Speech Language Pathologists is the life participation approach to the treatment of aphasia. However, there are other treatments available.
What other organizations have information about aphasia?

Please be aware that the following list is not comprehensive, and does not necessarily imply endorsement from Premier Therapy Associates as to its content.

• Aphasia Hope
• National Aphasia Association
• Stroke Association
• Academy of Neurologic Communication Sciences and Disorders

See Also:

• Aphasia: Causes and Number
• Aphasia: Benefits of Speech-Language Pathology Services
• A Letter on Aphasia from a Concerned Son
• Family Adjustment to Aphasia
• Life Participation Approach to Aphasia