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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.
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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.
No matter which part of the brain the stroke affects, a stroke survivor
may experience aphasia. Cardioembolic strokes are caused by a blood clot in the
heart, leaving more stroke survivors with aphasia than any other type of
stroke does. Atrial fibrillation, which is an irregular heartbeat, is the biggest
risk factor for cardioembolic stroke. Therefore, people who have never had a
stroke but have atrial fibrillation are at risk to develop aphasia in the
event of a stroke.
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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
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If you have aphasia
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Use props to make conversation easier (photos, maps).
Draw or write things down on paper.
Stay calm. Take one idea at a time.
Show people what works best for you.
Take your time. Make phone calls or try talking only when you have plenty of time.
Create a communication book that includes words, pictures and symbols that are helpful.
Use the Internet to connect to people via email or to create a personal webpage.
Carry and show others a card or paper explaining what aphasia is and that you have it. Keep it in your purse or wallet.
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Talking to someone with aphasia
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Use props to make conversation easier (photos, maps).
Draw or write things down on paper.
Be patient. Take one idea at a time.
Speak simply, clearly and slowly.
Be sure the person with aphasia understood you.
Treat the person with aphasia as an intelligent adult; aphasia does not typically affect thinking skills.
Try different ways to get your message across.
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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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Content Updated: August 2012
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