Aphasia affects ability to communicate


Some people have heard of aphasia, but would be unable to define it or describe how someone with aphasia is able to communicate. It has been estimated that one million Americans or one in 250 people have acquired aphasia.

Aphasia may occur in persons of any age, sex or race. Vocation and education are not determining factors. A simple definition of aphasia is an acquired communication disorder that impairs an individual's ability to use language.

The primary symptom is an inability to express oneself when speaking, however, in some cases, reading and writing or understanding of speech can be the more impaired language modality.

The most frequent cause of aphasia is a stroke, although one can have a stroke without acquiring aphasia. Aphasia can also result from head injury, cerebral tumor or other neurological causes.

People who have aphasia can demonstrate different types of communication difficulties as well as varied severity of symptoms. Aphasia can be so severe as to make communication with the patient almost impossible, or it can be very mild. It may affect a single aspect of language use, such as the ability to retrieve names of objects, or the ability to put words together into sentences, or the ability to read.

More commonly, however, multiple aspects of communication are impaired, while some means remain accessible for a limited exchange of information.

Several types of aphasia exist. The three most common are Broca's aphasia, or expressive or non-fluent aphasia; Wernicke's aphasia or receptive or fluent aphasia; and global aphasia.

Broca's aphasia is characterized by reduced speech output and is often limited to short utterances of less than four words. Vocabulary access is limited and sound formation by persons with Broca's aphasia is often difficult and clumsy.

The person may understand speech relatively well and be able to read but is limited in writing. Broca's aphasia is often referred to as a non-fluent aphasia because of the halting and effortful quality of speech.

Wernicke's aphasia is referred to as fluent aphasia, although speech is far from normal. Sentences do not always have the correct grammar and irrelevant words intrude — sometimes to the point of jargon in severe cases. Reading and writing are often severely impaired.

Global aphasia is the most severe form of aphasia. Patients with global aphasia can produce few recognizable words and understand little or no spoken language. Global aphasics can neither read nor write.

Global aphasia may often be seen immediately after the patient has suffered a stroke and it may rapidly improve if the damage has not been too extensive. However, the greater brain damage, severe and lasting disability may result.

Speech and language therapy is often provided to persons with aphasia but does not guarantee a cure. The purpose of speech therapy is to help the patient to fully utilize remaining skills and to learn compensatory means of communication. Treatment of aphasia is most critical immediately after a stroke, and should be pursued to help maximize gains made in therapy.

Jane Anderson, MS/CCC-SLP, is a speech therapist and language pathologist with Ashland Health and Rehabilitation Services. Online resources to learn more about aphasia include www.aphasia.org, ww.aphasiahope.org and www.ash.org.

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