Aphasia

Aphasia is a language disorder that impacts a person’s ability to participate in conversation and/or understand spoken language. Aphasia can also impact a person’s reading and writing abilities. Intelligence remains intact, but the ability to communicate is impaired. Approximately 80,000 individuals develop aphasia each year. Learn more about the disorder with the following frequently asked questions:

What causes aphasia?

Brain damage, most commonly due to a stroke or head injury, can cause aphasia. Usually, the damage occurs in the left side of the brain, where the primary, or dominant, language centers are located. Some people have language dominance on the right side of the brain, and damage to that side will cause aphasia.

What are some communication problems with aphasia?

The specific symptoms and severity of aphasia vary depending on the location and extent of brain damage. Patients may have "halting/choppy" or non-fluent speech, however they may understand what people say fairly well. Those with fluent speech may speak with normal rate, rhythm and speak in complete sentences, however their speech may contain the wrong or made-up words, and they may have difficulty with understanding.

Individuals with aphasia may have one or more of the following problems:

  • Difficulty producing language:
    • Experience difficulty coming up with the words they want to say.
    • Substitute the intended word with another word that may be related in meaning to the target (e.g., "chicken" for "fish") or unrelated (e.g., "radio" for "ball").
    • Switch sounds within words (e.g., "wish dasher" for "dishwasher").
    • Use made-up words (e.g., "frigilin" for "hamburger").
    • Have difficulty putting words together to form sentences.
    • String together made-up words and real words fluently, but without making sense.
  • Difficulty understanding language:
    • Misunderstand what others say, especially when they speak quickly (e.g., radio or television news) or in long sentences.
    • Find it hard to understand speech in group situations or when background noise is present.
    • Misinterpret jokes and take the literal meaning of figurative speech (e.g., "it's raining cats and dogs").
  • Difficulty reading and writing:
    • Difficulty reading forms, pamphlets, books, and other written material.
    • Problems spelling and putting words together to write sentences.
    • Difficulty understanding number concepts (e.g., telling time, counting money, adding/subtracting).

What can I do to communicate better with the person with aphasia?

  • Get the person's attention before you start speaking.
  • Maintain eye contact and watch the person’s body language and use of gesture.
  • Minimize or eliminate background noise (TV, radio, other people).
  • Keep your voice at a normal level. Do not speak loudly unless the person asks you to do so.
  • Keep communication simple, but adult. Don't "talk down" to the person with aphasia.
  • Simplify your sentence structure and emphasize key words.
  • Reduce your rate of speech.
  • Give the individual time to speak. Resist the urge to finish sentences or offer words.
  • Communicate with drawings, gestures, writing, and facial expressions in addition to speech.
  • Encourage the person to use drawings, gestures, and writing.
  • Use "yes" and "no" questions rather than open-ended questions.
  • Praise all attempts to speak and downplay any errors.
  • Avoid insisting that each word be produced perfectly.
  • Engage in normal activities whenever possible.
  • Encourage independence and avoid being overprotective.

What are Motor Speech Disorders?

  • Damage to the brain may also cause speech problems, including dysarthria and apraxia.
  • Dysarthria is a result of muscle weakness or problems coordinating muscle movements. Symptoms include slurred or irregular speech, weak or hoarse voice, altered nasal or vocal quality, or a combination of these which negatively impact a person’s intelligibility (ability to be understood).
  • Apraxia occurs when there is a disconnect from the signal from the brain to the muscles which produce speech. It can result in mixing up the order of sounds and words and sentences can be spoken differently each time. In severe cases, the person may not be able to produce sounds or words at all.

How does a Speech Language Pathologist help?

Speech Language Pathologists (SLP) at UM BWMC provide various services to people with aphasia depending on the person’s specific areas of difficulty which will be determined during an evaluation. The SLP uses a variety of treatment approaches that focus on improving language abilities in daily activities and social situations. The SLP may help to improve understanding and speaking and teach compensatory strategies which may include gesture, drawing or pointing.