Aphasia is a disorder of communication that impairs a person’s ability to use and comprehend language. Aphasia is a symptom of brain damage and affects approximately one million Americans. Stroke is the leading cause of aphasia. One in four stroke survivors experience some form of language impairment after a stroke. Speech is primarily controlled by the Broca’s and Wernicke’s regions of the brain.

Strokes that damage the frontal and parietal lobes in the right hemisphere of the brain can cause a person to have difficulty expressing and processing language.

Symptoms

No two people experience aphasia the same way, with varying symptoms and severity.

Aphasia may make it difficult to:

• Speak
• Understand spoken language
• Read
• Write
• Use numbers and do calculations
• Use non-verbal gesturing

There are four main types of aphasia:

• Nonfluent describes a person who has a difficult time speaking, writing or finding specific words. Broca’s aphasia is a type of nonfluent aphasia.
• Fluent: The rate of speech may be normal, but the person may not make sense. He or she has difficulty reading or comprehending what others say. Wernicke’s aphasia is a type of fluent aphasia.
• Global is the most severe type. Patients produce few recognizable words and understand little or no spoken language.
• Anomic aphasia is the persistent inability to supply the words for the very things patients want to talk about—particularly the significant nouns and verbs.

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Treatment

A full recovery from aphasia is possible, but if symptoms persist long enough, usually more than six months, then a complete recovery becomes unlikely. Speech therapy is the most common treatment for aphasia. There are a variety of specific speech therapy exercises and techniques. A doctor can design an effective speech therapy plan based on the specific type and severity of aphasia.

Other types of therapy have also proven effective for some stroke survivors, including:

• Melodic intonation therapy sometimes allows stroke survivors to sing words they cannot speak.
• Art therapy
• Visual speech perception therapy focuses on associating pictures with words.
• Constraint-induced language therapy involves creating a scenario in which spoken verbal communication is the only available option, and other types of communication, such as visual cues from body language, are not possible.
• Group therapy and support groups

There are some non-invasive brain stimulation techniques that are considered non-traditional treatment options. Examples are transcranial magnetic stimulation and transcranial direct current stimulation. Some research has shown positive results, but these techniques are still relatively new and not widely used.

Some prescription medication can aid in the recovery of aphasia. Different medications target specific symptoms. Prescription medicine alone does not help recovery, but some medications, such as amphetamines, can increase the effectiveness of therapy.

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Management

Communication Tips

At Home Exercises

• Play word-based games, such as board games, cards and crossword puzzles.
• Cook a new recipe and read the ingredients.
• Write out a shopping list.
• Go out to eat, order off a menu and calculate the tip.
• Send out greeting cards to loved ones.

Returning to Work

Many people with aphasia are able to return to work, whether it is at their same job or a new job. Here are some considerations to keep in mind when looking into returning to work:

• Consider your limitations, such as hours or the speed in which you can complete certain tasks.
• Talk with your employer about new challenges you will face at work because of your aphasia. The Human Resources department is a good place to start.
• If you cannot return to your former job, a local vocational rehabilitation center can help you find opportunities that are seeking your strengths.
• A career counselor can also be helpful in identifying a career that fits your current level.

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More Resources

Publications

• Careliving Guide
• StrokeSmart™ magazine

Fact Sheets

• Coping With Emotions
• Thinking and Cognition

Multimedia

• iHOPE: Aphasia
  
• Living After Stroke: Returning to Work Post-Stroke

» Watch David's video, which chronicles his recovery over the past 15 years.

David Dow suffered a massive stroke while on a family vacation to Las Vegas. At 10 years old, he was left with his entire right side paralyzed and with global aphasia. He was unable to speak, read, write or understand what people were saying to him.