Aphasia

Aphasia is caused by brain damage, usually to the language centre of the brain (Broca’s or Wernicke’s area), and is the impairment of the ability to produce and/or understand language.

The severity of Aphasia depends on the area of damage and the extent of the damage. Aphasia might also be known as Dysphasia. Aphasia is the total loss of language and Dysphasia is the partial loss of language, however both terms are often used synonymously. Two types of language difficulty may be experienced after a stroke, these are comprehension and expression difficulties. Signs of Aphasia are word finding difficulties, difficulty understanding instructions, or any difficulties in the area of language, including reading or writing.

Different types of aphasia

Global Aphasia:  The patient is unable to speak or understand much.
Broca’s Aphasia: The patient is able to understand language, but cannot speak properly.
Wernicke’s Aphasia:  The patient cannot understand much language, and when speaking uses many nonsense words.

Symptoms of Aphasia

  1. Omission: where words are left out, words cannot be accessed or are partly left out.
  2. Commission: where incorrect words are used instead of the correct ones.
  3. Anomia: is word finding difficulties. If the person cannot locate the word, they often use another word, phrase or gesture, or they even talk around the word.
  4. Paraphasia: is when an incorrect word is used instead of the target word/s. This can be used through substitution, addition, or rearrangement of speech sounds.E.g. ‘pike’ is used instead of ‘pipe’.  As well as using a word that is closely related to the target word. E.g. ‘wife’ instead of ‘husband’.
  5. Circumlocutions: talking around or about the specific word they want to use. E.g. ‘I wear it right here’ (pointing to his wrist) ‘and I tell time with it’
  6. Agrammatism: involves inadequate sentence productions. Function words such as articles, verbs and prepositions are left out, but content words, such as nouns and verbs, are produced.
  7. Jargon: is often lengthy, fluent speech which sometimes makes little sense or no sense to the listener.

Causes of Aphasia

Aphasia is caused by a lesion or injury, which leaves an area of the brain unable to function as it had just moments before. The onset of aphasia is rapid. There are various causes of Aphasia:

Stroke: Strokes can be related to high blood pressure, high cholesterol, and hardening of the arteries. These conditions are increased by drinking, smoking, obesity and diabetes. A stroke is also known as a Cerobrovascular Accident (CVA).
Trauma: Brain injuries due to war have caused many cases of aphasia, head trauma such as closed-head trauma (motor vehicle accidents) or open-head trauma (gun-shot) can also cause aphasia.
Neoplasm’s: Are growths in the tissues of the brain and may produces aphasia, but are not as common as a stroke. The symptoms are general; such as a headache, poor concentration, and/or decreased concentration.
Combined with another disorder: Aphasia can occur with other types of illnesses. For example, multiple sclerosis, but it rarely causes aphasia until it has developed further. Aphasia may also be present in illnesses that come with old age, such as Alzheimer’s.

The speech therapist’s role in Aphasia

The speech therapist’s role is to improve the language disorder on a receptive (understanding) and expressive (use) level.

Comprehension

  • Understanding extended speech (For example;  a conversation)
  • Understanding questions
  • Following directions

Narrative Skills & Use of Language

  • The Speech Therapist teaches the person ways to make use of language skills to compensate for weaker skills. For example, some people may use techniques to express their ideas, such as using gestures (actions) and writing rather than with speaking.
  • To help the patient learn how to communicate effectively, the Speech Therapist may help the patient practice conversational skills with other persons with aphasia.

Literacy

The Speech Therapist helps the patient improve his or her reading and writing skills.

  • To help the patient compensate for the language disorder.
  • To help those in contact with the patient learn how to communicate with the patient.

The Speech Therapist also plays an important role in helping the patient communicate to the best of his or her ability, but it is also important for him/her to work together with the patient’s family and friends to reach this goal.

What types of activities can I do to help my family member who has Aphasia?

It is best to consult with your Speech Therapist to be guided as to the exact activities to complete with your family member. This is important as different patients will present on different levels or with different symptoms of Aphasia. Thus a therapy plan must be designed specifically for the patient. However, the following are general types of activities which can be attempted with the patient:

  • Phrases and songs which are familiar to you often help trigger speech, these should be said out loud. You can also try sequences such as counting and saying the days of the week or months of
    the year.
  • Place objects or pictures on the table and name them.
  • Think of words which fit into a specific category. For example:
    Food – egg, bread, apple                                              Book – page, title, cover
    Fruit – apple, pear, banana                                         Drive – car, wheel, keys
    Golf ball – round, white, small, hard
  • Describe an object or picture, then the patient must guess the item described. If this is to difficult, present the patient with pictures which they can choose from.
  • Try to name objects according to where they are found. For example: What do you find in a kitchen?
  • Play charades. One person thinks of a word and gives clues. The other person must then ask up to 20 questions to guess the right answer.
  • Go through sequencing activities/conversations. For example: What you did yesterday? What are your plans for today? What is needed to make coffee, a sandwich, build a house?
  • As you progress in your language ability, you must try and use the above-mentioned hints with more difficult topics like medical aids, your job, the news, etc.
  • Some of these activities will also assist in improving memory. You can also try making yourself to-do lists and pacing them in strategic places so you won’t forget what you have to do. Later on it won’t be necessary anymore!!!