Aphasia is a language disorder caused by damage in a specific area of the brain that controls language expression and comprehension. Aphasia leaves a person unable to communicate effectively with others.
Many people have aphasia as a result of stroke. Both men and women are affected equally, and most people with aphasia are in middle to old age.
There are many types of aphasia. These are usually diagnosed based on which area of the language-dominant side of the brain is affected and the extent of the damage. For example:
Global aphasia is the result of damage to a large portion of the language-dominant side of the brain.
People with aphasia often have trouble with the 4 main ways people understand and use language.
These are:
Speaking problems are perhaps the most obvious, and people with aphasia may make mistakes with the words they use.
This could be sometimes using the wrong sounds in a word, choosing the wrong word, or putting words together incorrectly.Although aphasia affects a person’s ability to communicate, it doesn’t affect their intelligence.Aphasia can occur by itself or alongside other disorders, such as visual difficulties, mobility problems, limb weakness, and problems with memory or thinking skills.
Aphasia is often classified as “expressive” or “receptive”, depending on whether there are difficulties with understanding or expressing language, or both.But most people with aphasia have some trouble with their speaking, and will have a mixture of problems with writing, reading and perhaps listening. Symptoms can range widely from getting a few words mixed up to having difficulty with all forms of communication. Some people are unaware that their speech makes no sense and get frustrated when others don’t understand them.
Aphasia is caused by damage to parts of the brain responsible for understanding and producing language.
Common causes include:
Aphasia can affect people of all ages, but it’s most common in people over the age of 65. This is because strokes and progressive neurological conditions tend to affect older adults.
Speech and language therapy is the main type of treatment for people with aphasia. This aims to help restore some of your ability to communicate, as well as help you develop alternative ways of communicating, if necessary. You may receive speech and language therapy on an individual basis or in a group, depending on your needs and the service provided. An increasing number of computer-based applications are available to support people with aphasia. But it’s important to start using these with the assistance of a speech and language therapist
Complications of Aphasia
The challenges of living with aphasia can impact how a person feels and interacts with others.
In some cases, it can lead to:
isolation
anxiety
depression
If aphasia has been caused by a sudden brain injury, such as a stroke or severe head injury, symptoms usually develop straight after the injury.In cases where there’s gradual damage to the brain as a result of a condition that gets worse over time, such as dementia or a brain tumour, the symptoms may develop gradually.
Expressive Aphasia
Someone with expressive aphasia experiences difficulty communicating their thoughts, ideas and messages to others.
This may affect speech, writing, gestures or drawing, and causes problems with everyday tasks like using the telephone, writing an email, or speaking to family and friends.
People with expressive aphasia may have some of the following signs and symptoms:
slow and halting speech – with difficulty constructing a sentence
struggling to get certain words out – such as the names of objects, places or people
only using basic nouns and verbs – for example, “want drink” or “go town today”
spelling or grammatical errors
using a wrong but related word – such as saying “chair” instead of “table”
including nonsense words or their speech not making sense (speech-sound errors)
Receptive Aphasia
A person with receptive aphasia experiences difficulty understanding things they hear or read. They may also have difficulty interpreting gestures, drawings, numbers and pictures.
This can affect everyday activities such as reading an email, managing finances, having conversations, listening to the radio, or following TV programmes
People with receptive aphasia may have some of the following signs and symptoms:
Difficulty understanding what people say difficulty understanding written words misinterpreting the meaning of words, gestures, pictures or drawingsgiving responses that may not make sense if they’ve misunderstood questions or comments not being aware of their difficulties with understanding, or their own speech errors
Aphasia symptoms associated with dementia
People with the most common types of dementia, such as Alzheimer’s disease and vascular dementia, usually have a mild form of aphasia.This often involves problems finding words and can affect names, even of people they know well.It doesn’t mean they don’t recognise the person or don’t know who they are, they just can’t access the name or get mixed up.
Primary progressive Aphasia
This is a rare type of dementia, where language is heavily affected. As it’s a primary progressive condition, the symptoms get worse over time.Usually, the first problem people with primary progressive aphasia (PPA) notice is difficulty finding the right word or remembering somebody’s name.
Aphasia Treatment
The recommended treatment for aphasia is usually speech and language therapy. Sometimes aphasia improves on its own without treatment.
This treatment is carried out by a speech and language therapist (SLT). If you were admitted to hospital, there should be a speech and language therapy team there.
When you leave hospital, an SLT should be available through a community rehabilitation team or, after a stroke, an early supported discharge team.
For people with aphasia, speech and language therapy aims to:
Help restore as much of your speech and language as possible (reduce impairment)
Help you communicate to the best of your ability (increase activity and participation) find alternative ways of communicating (use compensatory strategies or aids) provide information to patients and their relatives about aphasia
How the therapy is carried out will depend on your circumstances.
An intensive course of speech and language therapy may be recommended for some people. This involves a number of sessions given in a shorter period of time.
But speech and language therapy can be exhausting, and an intensive course of treatment won’t be suitable for everyone.
For some people, shorter and less intensive sessions may be recommended.
Therapy may be individual sessions, in groups, or using technology such as computer programmes or apps.
For many people with aphasia caused by stroke, the most rapid changes are early on in the weeks and months after their stroke.
But improvements can continue to be seen many years, and even decades, later.
Assessment before Therapy
The treatment you receive will depend on your general health and the difficulties you have with your speech, language or social skills.
An assessment will be carried out before therapy begins so the therapist can identify which aspects of language you have the most difficulty with.
A therapist will talk to you and your family to try to determine whether your problems are related to understanding language or if you have problems expressing yourself.
The assessment will then focus on the areas that need to be targeted in therapy.
Other health problems that may impact your ability to communicate, such as hearing or sight problems, will also be taken into account.
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