Updated: May 16
In recognition of speech and hearing month, we want to #communicateawareness about Aphasia, a common communication disorder that is often not clearly understood.
What is Aphasia?
Aphasia is a communication disorder that affects how a person expresses or understands language. Typically, aphasia is caused by a stroke or head injury that impacts the language areas of the brain. It can also be caused by brain tumors or certain brain disorders. A person with aphasia may find it difficult to talk, understand others, read, or write.
It is important to understand that aphasia affects language, not intelligence. People with aphasia are still competent and intelligent individuals. A person with aphasia knows exactly what they want to say, they just have difficulty translating those thoughts into language. If you have ever been in a foreign country where you can’t communicate, you know how frustrating this can be.
Types of Aphasia
Every brain is different, and every stroke experience is different. Aphasia also varies from person to person. Below are some common types of aphasia and how they may present.
Individuals with Broca’s aphasia, also called non-fluent aphasia, often have difficulty talking but can understand language. They may have difficulty finding words, use the wrong word, or use short sentences with a few words. For example, they may say “bread… kitchen…”. Depending on the severity, they may experience only minor difficulties finding the right word, or they may produce few or no words.
People with Wernicke’s aphasia, also called fluent aphasia, can produce speech easily but it may not make sense. They often have difficulty understanding what others say. They may use very long sentences that sound grammatically correct, but often don’t make sense. They may say, for example, “the man was by the airplane and he wanted a lake but then she wouldn’t give a banana so…”.
Global aphasia impacts all aspects of language including speaking, comprehension, reading and writing. Like individuals with Broca’s aphasia, people with global aphasia may have difficulty producing words. They may also struggle to understand those around them, much like people with Wernicke’s aphasia.
Primary Progressive Aphasia
Primary progressive aphasia is a rare brain disorder where the language part of the brain is slowly damaged. The condition becomes more severe over time whereas aphasia caused by a stroke or head injury will either stay the same or improve. Like other kinds of aphasia, primary progressive aphasia can affect both talking and understanding language.
Communication is essential to every aspect of life including work, healthcare, socializing with friends, family life, and even personal identity. When a person has aphasia, all these areas are impacted.
There are many communication strategies that can be used by the person with aphasia and their conversation partner to help make it easier to talk and understand each other. Below are some of the most common approaches based on the Supported Conversation for Adults with Aphasia (SCA TM) method.
Acknowledge competence. Aphasia can hide a person’s competence and make them appear to “know less”. It is important to show that you understand the person with aphasia knows more than they can say. It can also help to acknowledge if a situation is frustrating.
Get attention. Make sure you have your conversation partner’s attention before speaking. It also helps to have a conversation in a quiet place with minimal distractions.
Have natural conversation. Although you may find you need to use some of the “less natural” strategies listed below, it is important that the conversation itself is a typical, natural conversation. This means using appropriate language and tone, and talking about typical adult topics. Don’t “correct” their speech or make them repeat words.
Speak slowly. As appropriate, slow your rate of speech to ensure that your conversation partner understands you.
Give time. A person with aphasia may need a few more seconds to process and respond in a conversation. Be patient and wait. Don’t speak over your partner or complete their sentences.
Clarify. With any conversation, communication breakdowns can occur. A helpful way to make sure both partners understand each other is to clarify. You can do this by quickly summarizing what you understood your partner said and double checking that they understand what you are saying.
Ask closed questions. This can be helpful for anyone with aphasia, but especially people who have limited words. By asking yes/no questions or questions with choices on a paper, you provide an easier way for your conversation partner to respond.
Write keywords. Use a paper and pen to write down the “key” ideas in the conversation in order to better understand each other. It can also help keep the conversation on topic.
Use resources. Having pictures and objects can also help the conversation by having something concrete to maintain the conversation topic. You can be creative and use objects around the home, pictures on your phone or the internet.
Use humour. Conversation can be more difficult with a person with aphasia. It can take more effort by both conversation partners. Using humour is a fun and easy way to help ease tension.
Even when using the above strategies, breakdowns in communication can still happen. When this occurs, its okay to acknowledge that you are not understanding each other. You can always revisit the topic another time. What’s most important is showing your partner that you understand their competence and that you are making the effort to understand and speak with them.
Aphasia can be a lonely experience where people find that they are no longer able to socialize and have conversations. Using the above strategies, you can help bridge that gap and make conversation possible again.
Therapy for Aphasia
Before starting therapy, we conduct a thorough assessment to better understand your unique situation.
Treatment can vary from one individual to another, depending on the type of aphasia, your specific areas of concern, what your daily activities include and the people you interact with on a day-to-day basis.
Therapy can focus on improving or working towards recovery of impairment in specific areas and/or it can be aimed at providing you with ways to compensate for the difficulties you are having.
Sometimes therapy might include the use of an augmentative and alternative communication (AAC) system such as the use of an iPad, picture communication system using symbols or pictures, or a speech generating device. Therapy will be tailored to your individual situation and needs.