What is Aphasia?
Aphasia is a language disorder that occurs when the part of the brain that is responsible for language becomes damaged. The damage usually happens to the left hemisphere of the brain and can happen quite quickly in cases such as head injury or stroke. Brain tumors can also cause aphasia, but the symptoms of these may only be seen gradually over a longer period of time.
Sufferers can also develop impairments in facial expressions and the understanding of language. They also have difficulty with reading and writing. A stroke is a very common cause of aphasia. A stroke occurs when brain cells die due to a lack of blood reaching the brain, resulting in a lack of vital nutrients and oxygen. Other causes of brain injury are brain infections and serious blows to the head.
There are three main types of aphasia. Sufferers of Broca's aphasia have had damage to the frontal lobe of the brain. They must make a great effort to talk and speech is usually in short, meaningful sentences. The person will often leave out short words such as "is" and "the". Broca's is characterized as non-fluent aphasia, due to the short length of sentences.
People with Broca's can usually understand the speech of others. They are also aware of their own speech and how others hear them. This can cause sufferers great frustration as they try to produce longer sentences. People with Broca's usually suffer from paralysis or weakness of the right arm or leg. This is because the frontal lobe of the brain is also responsible for movement of the body.
People who have had damage to the temporal lobe of the brain can suffer from Wernicke's aphasia. This is a fluent aphasia that results in the sufferer talking in long sentences which have no meaning. They add unnecessary words or often create new words. They are usually unaware of these mistakes, as they have great difficulty understanding speech. They also usually have no body weakness, as the temporal lobe is not needed for body movement.
A third type of aphasia is known as global aphasia. This results from damage to large parts of the brain. Sufferers have extreme difficulty communicating verbally and understanding language.
Aphasia usually occurs in the middle to later years of life. It can occur in both men and women. It is estimated that about 80,000 people are afflicted every year, and there are over 1 million sufferers in the United States. Some individuals recover completely without treatment, but a large amount of sufferers require treatment such as speech therapy. At the moment, there are also a large number of research studies being undertaken, as well new drugs available to help sufferers now and in the future.
What causes aphasia?
Aphasia is caused by damage to one or more of the language areas of the brain. Many times, the cause of the brain injury is a stroke. A stroke occurs when, for some reason, blood is unable to reach a part of the brain. Brain cells die when they do not receive their normal supply of blood, which carries oxygen and important nutrients. Other causes of brain injury are severe blows to the head, brain tumors, brain infections, and other conditions of the brain.
Individuals with Broca's aphasia have damage to the frontal lobe of the brain. These individuals frequently speak in short, meaningful phrases that are produced with great effort. Broca's aphasia is thus characterized as a nonfluent aphasia. Affected people often omit small words such as "is," "and," and "the." For example, a person with Broca's aphasia may say, "Walk dog" meaning, "I will take the dog for a walk." The same sentence could also mean "You take the dog for a walk," or "The dog walked out of the yard," depending on the circumstances. Individuals with Broca's aphasia are able to understand the speech of others to varying degrees. Because of this, they are often aware of their difficulties and can become easily frustrated by their speaking problems. Individuals with Broca's aphasia often have right-sided weakness or paralysis of the arm and leg because the frontal lobe is also important for body movement.
In contrast to Broca's aphasia, damage to the temporal lobe may result in a fluent aphasia that is called Wernicke's aphasia. Individuals with Wernicke's aphasia may speak in long sentences that have no meaning, add unnecessary words, and even create new "words." For example, someone with Wernicke's aphasia may say, "You know that smoodle pinkered and that I want to get him round and take care of him like you want before," meaning "The dog needs to go out so I will take him for a walk." Individuals with Wernicke's aphasia usually have great difficulty understanding speech and are therefore often unaware of their mistakes. These individuals usually have no body weakness because their brain injury is not near the parts of the brain that control movement.
A third type of aphasia, global aphasia, results from damage to extensive portions of the language areas of the brain. Individuals with global aphasia have severe communication difficulties and may be extremely limited in their ability to speak or comprehend language.
How is aphasia treated?
In some instances an individual will completely recover from aphasia without treatment. This type of "spontaneous recovery" usually occurs following a transient ischemic attack (TIA), a kind of stroke in which the blood flow to the brain is temporarily interrupted but quickly restored. In these circumstances, language abilities may return in a few hours or a few days. For most cases of aphasia, however, language recovery is not as quick or as complete. While many individuals with aphasia also experience a period of partial spontaneous recovery (in which some language abilities return over a period of a few days to a month after the brain injury), some amount of aphasia typically remains. In these instances, speech-language therapy is often helpful. Recovery usually continues over a 2-year period. Most people believe that the most effective treatment begins early in the recovery process. Some of the factors that influence the amount of improvement include the cause of the brain damage, the area of the brain that was damaged, the extent of the brain injury, and the age and health of the individual. Additional factors include motivation, handedness, and educational level.
Aphasia therapy strives to improve an individual's ability to communicate by helping the person to use remaining abilities, to restore language abilities as much as possible, to compensate for language problems, and to learn other methods of communicating. Treatment may be offered in individual or group settings. Individual therapy focuses on the specific needs of the person. Group therapy offers the opportunity to use new communication skills in a comfortable setting. Stroke clubs, which are regional support groups formed by individuals who have had a stroke, are available in most major cities. These clubs also offer the opportunity for individuals with aphasia to try new communication skills. In addition, stroke clubs can help the individual and his or her family adjust to the life changes that accompany stroke and aphasia. Family involvement is often a crucial component of aphasia treatment so that family members can learn the best way to communicate with their loved one.
Family members are encouraged to:
- Simplify language by using short, uncomplicated sentences.
- Repeat the content words or write down key words to clarify meaning as needed.
- Maintain a natural conversational manner appropriate for an adult.
- Minimize distractions, such as a blaring radio, whenever possible.
- Include the person with aphasia in conversations.
- Ask for and value the opinion of the person with aphasia, especially regarding family matters.
- Encourage any type of communication, whether it is speech, gesture, pointing, or drawing.
- Avoid correcting the individual's speech.
- Allow the individual plenty of time to talk.
- Help the individual become involved outside the home. Seek out support groups such as stroke clubs.