This
information courtesy of the National Institute on
Deafness and Other Communication Disorders.
Aphasia Information
Who has aphasia?
Aphasia is a language disorder that results from damage
to portions of the brain that are responsible for language.
For most people, these are parts of the left side (hemisphere)
of the brain. 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 tumor.
The disorder impairs both the expression and understanding
of language as well as reading and writing. Aphasia
may co-occur with speech disorders such as dysarthria
or apraxia of speech, which also result from brain damage.
Who has aphasia?
Anyone can acquire aphasia, but most people who have
aphasia are in their middle to late years. Men and women
are equally affected. It is estimated that approximately
80,000 individuals acquire aphasia each year. About
one million persons in the United States currently have
aphasia.
What causes aphasia?
Aphasia is caused by damage to one or more of the language
areas of the brain. Many times, the cause of the brain
injury is a stroke. A stroke occurs when, for some reason,
blood is unable to reach a part of the brain. Brain
cells die when they do not receive their normal supply
of blood, which carries oxygen and important nutrients.
Other causes of brain injury are severe blows to the
head, brain tumors, brain infections, and other conditions
of the brain.
Individuals with Broca's aphasia have
damage to the frontal lobe of the brain. These individuals
frequently speak in short, meaningful phrases that are
produced with great effort. Broca's aphasia is thus
characterized as a nonfluent aphasia. Affected people
often omit small words such as "is," "and,"
and "the." For example, a person with Broca's
aphasia may say, "Walk dog" meaning, "I
will take the dog for a walk." The same sentence
could also mean "You take the dog for a walk,"
or "The dog walked out of the yard," depending
on the circumstances. Individuals with Broca's aphasia
are able to understand the speech of others to varying
degrees. Because of this, they are often aware of their
difficulties and can become easily frustrated by their
speaking problems. Individuals with Broca's aphasia
often have right-sided weakness or paralysis of the
arm and leg because the frontal lobe is also important
for body movement.
In contrast to Broca's aphasia, damage
to the temporal lobe may result in a fluent aphasia
that is called Wernicke's aphasia. Individuals with
Wernicke's aphasia may speak in long sentences that
have no meaning, add unnecessary words, and even create
new "words." For example, someone with Wernicke's
aphasia may say, "You know that smoodle pinkered
and that I want to get him round and take care of him
like you want before," meaning "The dog needs
to go out so I will take him for a walk." Individuals
with Wernicke's aphasia usually have great difficulty
understanding speech and are therefore often unaware
of their mistakes. These individuals usually have no
body weakness because their brain injury is not near
the parts of the brain that control movement.
A third type of aphasia, global aphasia,
results from damage to extensive portions of the language
areas of the brain. Individuals with global aphasia
have severe communication difficulties and may be extremely
limited in their ability to speak or comprehend language.
How is aphasia diagnosed?
Aphasia is usually first recognized by the physician
who treats the individual for his or her brain injury.
Frequently this is a neurologist. The physician typically
performs tests that require the individual to follow
commands, answer questions, name objects, and converse.
If the physician suspects aphasia, the individual is
often referred to a speech-language pathologist, who
performs a comprehensive examination of the person's
ability to understand, speak, read, and write.
How is aphasia treated?
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. In these circumstances, language abilities
may return in a few hours or a few days. For most cases
of aphasia, however, language recovery is not as quick
or as complete. 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 a month after the brain injury), some
amount of aphasia typically remains. In these instances,
speech-language therapy is often helpful. Recovery usually
continues over a 2-year period. Most people believe
that the most effective treatment begins early in the
recovery process. Some of the factors that influence
the amount of improvement include the cause of the brain
damage, the area of the brain that was damaged, the
extent of the brain injury, and the age and health of
the individual. Additional factors include motivation,
handedness, and educational level.
Aphasia 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. Treatment
may be offered in individual or group settings. Individual
therapy focuses on the specific needs of the person.
Group therapy offers the opportunity to use new communication
skills in a comfortable setting. Stroke clubs, which
are regional support groups formed by individuals who
have had a stroke, are available in most major cities.
These clubs also offer the opportunity for individuals
with aphasia to try new communication skills. In addition,
stroke clubs can help the individual and his or her
family adjust to the life changes that accompany stroke
and aphasia. Family involvement is often a crucial component
of aphasia treatment so that family members can learn
the best way to communicate with their loved one.
Family members are encouraged to:
Simplify language by using short, uncomplicated
sentences.
Repeat the content words or write down key words
to clarify meaning as needed.
Maintain a natural conversational manner appropriate
for an adult.
Minimize distractions, such as a blaring radio,
whenever possible.
Include the person with aphasia in conversations.
Ask for and value the opinion of the person with
aphasia, especially regarding family matters.
Encourage any type of communication, whether it
is speech, gesture, pointing, or drawing.
Avoid correcting the individual's speech.
Allow the individual plenty of time to talk.
Help the individual become involved outside the
home. Seek out support groups such as stroke clubs.
What research is being done
for aphasia?
Aphasia research is exploring new ways to evaluate and
treat aphasia as well as to further understanding of
the function of the brain. Brain imaging techniques
are helping to define brain function, determine the
severity of brain damage, and predict the severity of
the aphasia. These procedures include PET (positron
emission tomography), CT (computed tomography), and
MRI (magnetic resonance imaging) as well as the new
functional magnetic resonance (fMRI), which identifies
areas of the brain that are used during activities such
as speaking or listening. In-depth testing of the language
ability of individuals with the various aphasic syndromes
is helping to design effective treatment strategies.
The use of computers in aphasia treatment is being studied.
Promising new drugs administered shortly after some
types of stroke are being investigated as ways to reduce
the severity of aphasia.
The information contained in this
web site is not a substitute for medical advice or treatment.
Consultation with your doctor or health care professional is recommended.
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