Did you know that more than 100,000 Canadians are living with aphasia today? Did you know that one in every three stroke survivors have aphasia? So…what exactly is aphasia?
Aphasia is an acquired language disorder that results from damage to the brain, typically in the left hemisphere region, which is associated with language. Although cerebral vascular events (i.e. stroke) are one of the most common causes of aphasia, it can also be a result of other neurological conditions that can cause damage to the brain, including traumatic brain injuries, dementia and brain tumours.
Aphasia is a language disorder, meaning it impacts how we communicate what we want to say and what we can understand. Aphasia might also co-occur with other communication disorders, such as speech disorders, which affect how we say something.
Language and the Brain
Important areas in the brain that are associated with language include:
Broca’s area in the left frontal lobe, which is associated with the production of language and the motor control of speech and articulation.
Wernicke’s area in the posterior superior temporal lobe, which is associated with the comprehension or processing of language.
The Perisylvian region is the area surrounding the sylvian fissure and is important for both language and speech.
What does Aphasia Affect?
Aphasia can affect any or all aspects of language, including:
Auditory comprehension of spoken language
Expression of spoken language
Reading
Writing
Often, people with aphasia have varying levels of difficulty with more than one of these aspects, and the level of severity can vary between them.
In addition to affecting a person’s ability to use and understand language, aphasia may also influence a person’s quality of life and decrease their participation in daily activities, such as social interactions, work, and community activities. Studies showed that aphasia can have a profound impact on people’s lives, including increased incidence of depression, reduced social activities and loss of contact with friends and community.
What Does Aphasia Look Like?
Aphasia can look very different from person to person; however, the hallmark sign of aphasia is anomia, or word-finding difficulties. People with aphasia may also have difficulty with the receptive (understanding) and expressive (producing) components of language:
Aphasia often co-occurs with written language difficulties, including reading (alexia) and writing (agraphia).
What Aphasia Might Look Like
Typical components of an aphasia assessment might include:
Case history - the clinician will go through the client’s medical history and information relevant to the client’s speech and language profile.
Interview - the clinician will conduct an informal interview to discuss topics such as: the client’s self-reported communication difficulties and how it might be affecting their daily functioning and/or ability to participate in activities; the client’s priorities and goals for treatment; the client’s communication demands and main communication partners.
Oral mechanism exam - an oral mechanism exam is an assessment of the structures that are involved with producing speech (e.g. lips, tongue, teeth, jaw, etc.).
Language assessment - the clinician will assess the different language areas: receptive (auditory comprehension); expressive (verbal expression); reading; and, writing.
What Treatment Might Look Like
Based on the client’s priorities and assessment results, specific therapy goals will be created in partnership with the client. Aphasia treatment can be direct or indirect. Usually a combination of both is recommended.
Direct treatment - the clinician works directly with the client, such as in individual sessions, or group sessions.
Indirect treatment - the clinician works on changing the environment to decrease the client’s overall communication difficulties. An example of an indirect treatment approach is teaching and coaching the client’s family members on how to support the person with aphasia.
What We Can Do To Help
Aphasia is a prevalent communication disorder. More than 100,000 Canadians are living with it today. Because communication disorders are often ‘hidden’ and less tangible than physical diseases, people often underestimate how much aphasia can impact a person’s quality of life.
We can support people with aphasia by using multi-modal communication. Think about the ways you can supplement or alter your verbal communication to make it more ‘aphasia-friendly’.
Use gestures
Speak slower
Speak in simpler phrases
Ask yes/no questions
Write down key words
Draw simple pictures
Living with aphasia? Print out the card below as a tool to help others understand how best to communicate with you.
CONTRIBUTED BY: Joyce C. Chan, Speech-Language Pathologist, MSc, R.SLP, S-LP(C) Provisional
We'd love to hear your feedback and questions - please comment on the post or email admin@synaptichealth.ca
References
ASHA. (2021). Aphasia. Retrieved February 12, 2021, from :https://www.asha.org/practice-portal/clinical-topics/aphasia/
Dickey, L., Kagan, A., Lindsay, M. P., Fang, J., Rowland, A., & Black, S. (2010). Incidence and profile of inpatient stroke-induced aphasia in Ontario, Canada. Archives of physical medicine and rehabilitation, 91(2), 196-202.
Spaccavento, S., Craca, A., Del Prete, M., Falcone, R., Colucci, A., Di Palma, A., & Loverre, A. (2014). Quality of life measurement and outcome in aphasia. Neuropsychiatric disease and treatment, 10, 27–37. https://doi.org/10.2147/NDT.S52357
Wilson SM, Eriksson DK, Schneck SM, Lucanie JM. A quick aphasia battery for efficient, reliable, and multidimensional assessment of language function. PLoS One 2018; 13(2): e0192773.