What is Aphasia?

Aphasia is a language disorder that is developed due to brain damage - often the result of a stroke, or accident in which the brain was affected. People who have aphasia may struggle understanding when others speak, verbalizing their own words, and have a hard time reading and writing.

Read more about brain injury.

Aphasia should not be confused with a lack of intelligence or memory. Aphasia affects the ability to form words, but not necessarily the ability to problem-solve or form judgement in a situation.

What Causes Aphasia?

Anyone is susceptible to developing aphasia, including children and young adults, though most people who develop the condition are middle-aged or elderly.

Stroke is the number one cause of aphasia, and it is estimated that nearly 80,000 individuals develop aphasia each year due to a stroke. 

Aphasia is caused by damage to the brain, primarily to one of the language areas of the brain. Various types of brain damage can occur from:

  • Stroke
  • Head injury
  • Brain tumors
  • Brain surgery
  • Trauma
  • Electric Shock
  • Toxins
  • Brain infections

Read more about brain injury.

Read more about strokes.

Types of Aphasia: 

There are two primary categories for aphasia: fluent and non-fluent, caused by damage to the temporal lobe or frontal lobe respectively. 

Fluent aphasia: also called Wernicke’s aphasia, is the result of damage to the side portion of the brain, or temporal lobe. This is most common on the left temporal lobe, but can also result from damage to the right side. 

Fluent aphasia results in speech filled with unnecessary or made-up words.

For example, someone with fluent aphasia may say, “I need to like you wanted and then doodle flat in the end.” This type of speech is incredibly hard to follow, but they are often unaware of the mistakes in their speech.

Non-fluent aphasia: also called Broca’s aphasia, is the result of damage to the brain’s frontal lobe. The frontal lobe of the brain affects motor movement as well, which means that non-fluent aphasia is often accompanied by right-side weakness of the arm or leg, or - in severe cases - paralysis of the right side.

Non-fluent aphasia results in shorter phrases of speech that will make sense, but take much effort for the person to produce.

Common words are often omitted, such as “the” or “and.” Instead of saying “I am walking to the grocery store” they may say “walk store.”

Those who have non-fluent aphasia often understand other’s speech, but they struggle with their own. Because they are often aware of their lack of speech, it can lead to much frustration. 

Symptoms of Aphasia:

The signs and symptoms of aphasia can be broken down based on the severity of the damage or type of aphasia. 

Symptoms of aphasia by type:

Expressive aphasia: 

  • Trouble using words or forming sentences
  • May speak in single words rather than full sentences
  • Omitting key words such as “the” and “of”
  • May reverse the order of words in sentences
  • Invents words, or mixes up the names for objects

Receptive aphasia: 

  • Trouble understanding others when they speak.
  • Takes longer to calculate what has been said, similar to translating a foreign language.
  • Misinterprets language by taking words or phrases literally.
  • Cannot follow if a person speaks too fast.

Global aphasia: 

  • Trouble with both forming words and and understanding others.
  • Includes signs of both expressive and receptive aphasia.

Levels of severity in aphasia include: 

Mild aphasia: 

  • Able to carry on a traditional conversation much of the time.
  • May struggle with difficult language when complex words are used.
  • Might have difficulty with finding the right word for an object or expression.

Severe aphasia: 

  • May struggle to understand anything said by others.
  • Commonly quieter, as speech is often a struggle.
  • Tendency to reduce responses to basic speech (yes, no, okay, thanks)

How Is Aphasia Diagnosed?

Since aphasia is caused by damage to the brain, it is often diagnosed by the physician who is treating the cause of the brain damage.

Specific tests are typically run following a brain injury that require the patient to follow simple commands to show comprehension, answer basic questions the patient should know the answer to, name objects found in the vicinity, and hold a general conversation with the physician. 

If aphasia is suspected, the patient will likely be referred to a speech-language specialist, or pathologist, who will then perform a more comprehensive exam surrounding the patient’s speech capabilities.

These more extensive tests will include the ability to read and write in addition to verbal speech abilities.

  • Speech fluency, strength and coordination.
  • Understanding and using vocabulary and grammar.
  • Using yes-no questions as well as what-where questions.
  • Ability to follow simple directions.
  • Coherency in a narrative.
  • Expression of complete sentences.
  • Interpret and explain stories from pictures.
  • Ability to initiate conversation and participate in a conversation.
  • Ability to read and write words and sentences.

Treatment For Aphasia:

It is possible to recover from aphasia without any treatment at all. This is more typical after a stroke, when the blood flow to the brain has been temporarily stopped and then restored. This type of aphasia is called a transient ischemic attack (TIA). 

However, in most cases the language does not recover completely. Speech therapy can assist the person who has aphasia by teaching the person to communicate with the remaining language skills, and to help restore language skills if possible. 

Tips for living with Aphasia:

A big part of living with aphasia is having support from family and friends. Simple ways family and friends can help include:

  • Keep sentences short and uncomplicated.
  • Repeat key words as needed.
  • Maintain a natural conversational manner that is age appropriate for the person with aphasia.
  • Encourage all types of communication to continue the therapy process.
  • Avoid correcting speech, but rather focus on asking for clarification.
  • Don’t interrupt the person speaking, but allow them the time they need to form words and sentences.
  • Encourage and help the person join support groups and communities outside of the house.
  • Learn to read body language to help open up types of communication.

Related Resource Pages on Band Back Together:

Stroke

How To Help A Friend With Chronic Illness

Body Language Resources

Brain Injury

Additional Resources:

National Aphasia Association offers comprehensive information about living with aphasia.

Adler Aphasia Center provides information for aphasia patients and their families or caregivers. 

American Speech Language Hearing Association offers information about aphasia and other language disorders. 

Speaking of Aphasia provides information on aphasia therapies.