Aphasia

TYPES

Expressive/Nonfluent/Broca’s Aphasia

• Associated with damage to the frontoparietal area of the brain.
• Defined as the inability to form and express words although the person knows what they want to say.
• The person struggles to get words out, speaks in short sentences, and may omit words especially small words such as “is” or “the”.
• Typically, the person can be understood by others.
• Someone with expressive aphasia is aware of the language challenge which results in frustration at not being able to speak fluently.
• This type of aphasia makes the person seem more impaired than they really are.
• Language is affected, not intelligence.
• Anxiety and social isolation may occur.

Receptive/Fluent/Wernicke’s Aphasia

• Associated with damage to the temporal lobe of the brain.
• The person speaks easily but may incorrectly use or make up words creating a jumble known as “word salad”.
• Receptive aphasia creates difficulty understanding what others are saying and the written word.
• Someone with receptive aphasia typically doesn’t realize that speech is not understood which may lead to frustration.

Global Aphasia

• The person has both expressive and receptive aphasia.
• The brain’s language centers are poorly functioning and significant communication issues are present.
• Understanding even simple words and phrases is severely limited.
• May repeat the same words or phrases over and over again.

Anomia

• Defined as the inability to find the correct word when speaking or writing.
• Often speak around a word to convey meaning.
• Listening and reading is unaffected.

Primary Progressive Aphasia

• Defined as the gradual loss of the ability to speak, read, write and comprehend.
• Occurs as communication and language areas of the brain shrink due to dementia.

CAUSES

• Stroke
• Head injury
• Dementia
• Brain tumor
• Infection

SYMPTOMS

• Difficulty naming familiar objects, places, or events.
• Difficulty finding the correct word when writing or speaking including mixing up the order of the words, substituting a word that doesn’t make sense, or making up words.
• Using great effort to produce a short sentence.
• Difficulty understanding what others are saying or following a conversation.
• Trouble reading or spelling.

DIAGNOSIS

• Physical exam with specific attention to the brain, heart and blood vessels.
• Assessment of language center
  • Naming objects
  • Participating in conversation
  • Repeating words or sentences
  • Following instructions
  • Answering questions about common subjects
  • Reading and writing
• CT of the head or MRI of the brain

TREATMENT

Speech therapy

• Goals
  • Restoring as much language as possible
  • Learning other ways to communicate such as gestures, pictures, props, or computer assisted technology.

Medication

• Medications to improve blood flow or enhance memory may be prescribed.

Strategies for the caregiver

• Have the attention of the person before starting a conversation, establishing good eye contact.
• Reduce background noise.
• Speak slowly in short, uncomplicated sentences using a normal volume.
• Avoid correcting the person’s speech or finishing their sentences. Suggesting a word being searched for may be helpful.
• Yes and no questions may be easier for the person to respond to rather than long, complicated responses.
• Writing key words and meanings may help convey the message.
• Encourage other communication techniques such as writing, gesturing, pointing, or drawing.
• Include the person in conversation whenever possible, providing extra time for responses, and continuing to value input.
• Caregiver(s) should participate in speech therapy sessions to learn helpful techniques for communication.

Research

• Research on noninvasive brain stimulation is being conducted using electric current to stimulate damaged brain cells.
• Medications to enhance communication between brain cells is ongoing.