What is Aphasia?
Aphasia, pronounced as Uh-Fay-Zhuh, is a disorder of language and cognition that is a direct result of a stroke or traumatic brain injury, which affects a person’s ability to communicate, as described by The National Aphasia Association.
We would like to begin by stating what Aphasia IS NOT:
Aphasia IS NOT a loss of a person’s intelligence.
Aphasia IS NOT a disease and is not contagious.
Aphasia IS NOT discriminating and can therefore affect people of all ages,
ethnicities, religions and professions.
Aphasia IS NOT visible, therefore, a person who is experiencing aphasia can’t
be singled out from somebody without aphasia.
Aphasia DOES NOT change the person, but their ability to communicate is will
often be different.
That stated, a more thorough description of aphasia will now be provided.
Aphasia usually occurs suddenly due to a stroke or other type of brain injury or brain tumor. Aphasia can be described as a disorder of language and cognition that results from damage to specific areas of the brain that control or support language, and the areas which are damaged will determine the type of problem that the person with aphasia will experience.
For instance, if the anterior (front) region of the brain is damaged, it is possible that the individual will experience difficulty with expressive language or formulating sentences, frequently referred to as expressive aphasia. Individuals with this type of aphasia will often know what they want to say but may have difficulty retrieving or finding the words to use to express themselves. Therefore, verbal expression may be limited to using a few words making it very difficult to be understood by others, often resulting in frustration and anxiety for the individual with aphasia, as well as their caregivers. This type of aphasia is also referred to as a non-fluent aphasia.
If the damage occurs in the posterior (back) region of the brain, the individual may what is commonly referred to as receptive aphasia. This means that the person may experience difficulty understanding what is being said to them, or may have difficulty following directions. Although, the individual may be able to speak in longer phrases or complete sentences, what they may be attempting to say may have limited or no meaning to them whatsoever. This occurs because the individual experiences a great deal of difficulty understanding verbal expression and is therefore unaware of their own verbal mistakes. This type of aphasia may also be referred to as fluent aphasia. Unlike individuals with expressive aphasia, individuals with receptive aphasia may not experience as much frustration because they may not realize that what they are saying may not be understood by others.
If multiple areas of the brain are affected then an individual may be experiencing a global aphasia. These individuals will often experience difficulty with speaking (expressive language) and understanding (receptive language), making communication extremely difficult if not impossible.
Aphasia disorders may also include difficulties with reading, writing, spelling as well as mathematical calculations, and may range in severity from mild to very severe.
How is Aphasia identified?
According to The National Aphasia Association greater than 2,000,000 individuals in the United States presently have aphasia. That calculates to approximately 1 in 250 people. There are about 80,000 to 100,000 new cases of aphasia each year, with the leading cause being stroke. Although aphasia cannot be cured, it can get better with the proper intervention.
Aphasia may be initially identified by a physician (most likely a neurologist) or a speech language pathologist who may be treating the individual for an emergent stroke or brain injury hospital admission. Once stabilized, the individual is followed by a speech language pathologist who will continue to evaluate for other possible stroke related disorders such as dysphagia (swallowing impairment), as well as for motor speech difficulties such as dysarthria (slurred speech), and/or apraxia of speech (difficulty forming the actual words).
How is Aphasia managed?
Individuals may experience limited spontaneous recovery following the stroke or brain injury as the brain begins to heal. Although rare, some individuals may experience total recovery from a stroke and not require any subsequent treatment. For those who do not recover fully, a program of speech and language therapy should be initiated immediately! The goal of therapy is to provide the opportunity for the individual to use residual abilities, to regain language and communicative abilities, and to improve areas of specific motor speech impairment such as dysarthria and/or apraxia of speech. In addition, compensatory strategies may be initially presented to assist to assist the individual in their ability to communicate more effectively in all aspects of their lives. Initially, therapy is most effective when provided on a one to one basis. However, as the individual improves, group therapy can be beneficial since it is designed to reinforce social language skills and will often provide emotional support from other members of the group who are also experiencing aphasia. When traditional therapy terminates, participation in social and communication groups are strongly recommended as these group experiences will often focus on functional and interesting activities which the individual could then caryover to his or her natural environment. In addition, these groups provide an opportunity for family and friends to learn how to more effectively communicate with their loved one who is struggling with aphasia and who is desperately trying to recapture some functional aspect of their life before aphasia.
What is The Life Participation Approach to Aphasia?
The “life participation approach to aphasia” (LPAA) is a consumer-driven service-delivery approach that supports individuals with aphasia and others affected by it in achieving their immediate and longer term life goals. It focuses on re-engagement in life, beginning with initial assessment and intervention, and continuing, after hospital discharge, until the consumer no longer elects to have communication support.
LPAA emphasizes that regardless of the stage of management, the attainment of re-engagement in life is dependent on strengthening daily participation in activities of choice. A highly supportive environment can lessen the consequences of aphasia on one’s life, whatever the language impairment. For more information on LPAA go to http://www.asha.org/public/speech/disorders/LPAA/