Types, Treatment and Challenges of Aphasia

[J.Adderton, BSN, MSN]

Quote

“Since so much of our identity is constructed through our social relationships, which rely so heavily on language, aphasia can obliterate that feeling of belonging”

― Debra Meyerson, Identity Theft: Rediscovering Ourselves After Stroke

The experience of aphasia is often described as imprisonment, loss of self, loneliness and a lack of presence in daily life. June is National Aphasia Month and an opportunity to learn more about this disorder that affects the ability to speak, read, write and listen.

What is Aphasia?

Aphasia is a communication disorder that impairs a person’s ability to communicate and understand others. Aphasia may also make it difficult to read, write, gesture or use numbers. However, aphasia does not affect a person’s intelligence. Someone with aphasia still has thoughts and ideas, however, it is difficult to communicate these through language. Head injury, infection, brain tumors or other neurological conditions can cause aphasia. However, the most common cause is stroke.

Facts and Figures

• About one-third of strokes result in aphasia
• At least 2,000,000 people in the U.S. live with aphasia
• It is more common than Parkinson’s disease, cerebral palsy or muscular dystrophy
• There is no medical cure
• Aphasia affects everyone differently
• Communication can improve overtime, especially with speech therapy
• Is most common among older population
• Occurs in people of all ages, gender, races and nationalities

Awareness Statistics

The National Aphasia Association conducted a survey on aphasia awareness in 2016. The survey found 84.5% of people have never heard of aphasia and 34.7% either have aphasia or know someone that does. Only 8.8 % of people surveyed have heard of aphasia and can identify it as a language disorder

Types of Aphasia

The types of aphasia depend on what language areas in the brain have been damaged.

Wernicke’s Aphasia (Receptive Aphasia)

This type affects the temporal lobe of the brain and characteristics include:

• Stringing together meaningless words to form long sentences
• Adding made-up or unnecessary words to sentences
• Being unaware of spoken mistakes
• Difficulty understanding speech

Example: “You know that sludder that you take to before and webster on together maybe.”

Broca’s Aphasia (Expressive Aphasia)

This is the most common type of aphasia and primarily affects the brain’s frontal lobe. Characteristics include:

• May accompany right-sided weakness or paralysis
• Knowing what they want to say but unable to express in sentence form
• Speaking in short phrases and omitting small words (i.e. is, and, the)
• Using words that are close to what they want to say, but not the exact word (i.e. using “dog” for “cat”)

Example: “Glasses aides table” for “My glasses and hearing aides are on the table.”

Global Aphasia

Global aphasia occurs with extensive damage to different language areas in the brain. Characteristics may include:

• Severe communication difficulties
• Very limited in ability to speak or comprehend language
• Repeating the same words or phrases over and over

Treatment For Aphasia

The brain has a tremendous ability to recover, therefore, people with aphasia often see dramatic improvements within the first few months. In fact, language improvements may occur even after long periods of time. However, many people have some difficulty after the recovery period. The goal of aphasia therapy is to use remaining language abilities to improve the ability to communicate. Learning new ways of communicating, such as gestures, pictographs and the use of electronic devices can significantly improve quality of life.

What Research is Being Done?

New types of speech-language therapies are being researched in both recent and chronic aphasia to identify new methods of helping with improving word retrieval and other aspects of speech. One of these methods is activities stimulating the mental representation of sounds, words and sentences for easier access and retrieval. Other research includes:

• Exploring drug therapies that affect chemical neurotransmitters in the brain to use in combination with speech-language therapy
• Using functional magnetic resonance imaging (MRI) to better understand language reorganization after a brain injury
• Studying the use of noninvasive brain stimulation in combination with speech language therapy to temporarily alter brain activity to help people re-learn language use.

Make the Effort to Connect

In recognition of Aphasia Awareness Month, take time to step up your ability to simplify your language, encourage communication and make a difference. Be sure to check out the National Aphasia Association’s website for tips and tools to help with communication and much more. The website is also a great resource for people with aphasia, as well as, family, friends and caregivers.

What have you done or plan to do for better communication with aphasic patients?

Additional Resource:

American Stroke Association Aphasia Education

American Stroke Association: Aphasia and Stroke