Approximately every four minutes in the United States someone acquires aphasia, a devastating language disorder dramatically impacting conversational interaction (talking and understanding) as well as the ability to read and write.
Cause & Effects
Aphasia is usually due to stroke or traumatic brain injury. People with aphasia are often frustrated and confused because they can’t speak as well or understand things the way they did before aphasia.
According to the recently published Aphasia Access white paper, Aphasia in North America: A Comprehensive Report on Incidence, Causes and Impact, the latest numbers of people living with aphasia are staggering – resulting in 2.5 – 4 million Americans.*
Despite the language barriers aphasia creates, people with aphasia have their intelligence intact. Think of aphasia somewhat similar to trying to navigate conversations in a foreign country, not knowing the language. The language barrier would impact your ability to read, write, and speak. The language barrier would put you at risk of misunderstanding everyday interactions and challenge your ability to navigate environments that had no adaptations for communication-accessibility.
* Simmons-Mackie, N., (2018). Aphasia in North America: A Comprehensive Report on Incidence, Causes and Impact. Aphasia Access: Moorestown, NJ.
Aphasia is a widespread problem.
Aphasia is a family problem.
Aphasia is a public health problem.
Aphasia is a costly problem for individuals, healthcare, and society.
Aphasia Definition and Types
From a holistic framework, aphasia is defined as a language disorder that impacts conversational interaction (talking and understanding) as well as the ability to read and write. With the onset of aphasia, people not only experience problems communicating but also experience a host of secondary consequences that, without intervention, can significantly undermine relationships while limiting participation in activities and interactions of choice.
From Varieties and Special Features of Aphasia, the National Aphasia Association, retrieved from www.aphasia.org/aphasia-definitions.
Aphasia is an impairment of language, affecting the production or comprehension of speech and the ability to read or write. Aphasia is always due to injury to the brain – most commonly from a stroke, particularly in older individuals. But brain injuries resulting in aphasia may also arise from head trauma, from brain tumors, or from infections.
This is the most severe form of aphasia, and is applied to patients who can produce few recognizable words and understand little or no spoken language. Persons with Global Aphasia 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, with greater brain damage, severe and lasting disability may result.
Broca’s Aphasia (Non-Fluent Aphasia)
In this form of aphasia, speech output is severely reduced and is limited mainly to short utterances of less than four words. Vocabulary access is limited and the formation of sounds by persons with Broca’s aphasia is often laborious and clumsy. The person may understand speech relatively well and be able to read, but be limited in writing. Broca’s aphasia is often referred to as a ‘non fluent aphasia’ because of the halting and effortful quality of speech.
Mixed Non-Fluent Aphasia
This term is applied to patients who have sparse and effortful speech, resembling severe Broca’s aphasia. However, unlike persons with Broca’s aphasia, they remain limited in their comprehension of speech and do not read or write beyond an elementary level.
Wernicke’s Aphasia (Fluent Aphasia)
In this form of aphasia the ability to grasp the meaning of spoken words is chiefly impaired, while the ease of producing connected speech is not much affected. Therefore Wernicke’s aphasia is referred to as a ‘fluent aphasia.’ However, speech is far from normal. Sentences do not hang together and irrelevant words intrude-sometimes to the point of jargon, in severe cases. Reading and writing are often severely impaired.
This term is applied to persons who are left with a persistent inability to supply the words for the very things they want to talk about-particularly the significant nouns and verbs. As a result their speech, while fluent in grammatical form and output is full of vague circumlocutions and expressions of frustration. They understand speech well, and in most cases, read adequately. Difficulty finding words is as evident in writing as in speech.
Primary Progressive Aphasia
Primary Progressive Aphasia (PPA) is a neurological syndrome in which language capabilities become slowly and progressively impaired. Unlike other forms of aphasia that result from stroke or brain injury, PPA is caused by neurodegenerative diseases, such as Alzheimer’s Disease or Frontotemporal Lobar Degeneration. PPA results from deterioration of brain tissue important for speech and language. Although the first symptoms are problems with speech and language, other problems associated with the underlying disease, such as memory loss, often occur later.
In addition to the foregoing syndromes that are seen repeatedly by speech clinicians, there are many other possible combinations of deficits that do not exactly fit into these categories. Some of the components of a complex aphasia syndrome may also occur in isolation. This may be the case for disorders of reading (alexia) or disorders affecting both reading and writing (alexia and agraphia), following a stroke. Severe impairments of calculation often accompany aphasia, yet in some instances patients retain excellent calculation in spite of the loss of language.
Communication Tips for People with Aphasia
- Remember you are speaking with a competent person.
- Simplify your talking. Emphasize key words and main points. Offer choices. Write them down for easy reference later.
- Offer communication tools. Pen and paper. Visual aids.
- Accept and use all forms of communication. Gesture, drawing, writing, pictures, devices.
- Confirm understanding. Use Yes/No/Other questions. Restate. Summarize.
Did you know?
The Canadian estimated prevalence of aphasia ranges from 165,761 to a high of 384,861 people.
How To Confirm Understanding
Begin with this basic tool when helping a person with aphasia, a Yes/No/Other card
Host a Group Activity
Here’s a sample Communication Access Group Activity from our Resource Exchange
Know the Real-life Impacts of Aphasia
Here’s a one-page summary of Aphasia’s impact, perfect for media, grant applications, etc.