What is Aphasia?

Aphasia is a disruption or reduction of the abilities to use and /or understand language that can result from a stroke or head injury. This can involve speaking, writing, reading and listening.

Types of Aphasia

Receptive Aphasia is a reduction in the person’s ability to understand spoken and/or written words. The person’s hearing is still the same but the meaning of what they are hearing is unclear. The patient may still understand and respond to non-language information including gestures, situations, use of objects, facial expression, tone of voice and sequences of daily activities.  In addition, speech may be clear but lack meaning or be inappropriate.  Reading may also be affected.  Although the patient may see the words, the meaning may be only partially clear.  The degree of difficulty varies from person to person.

Expressive Aphasia is an impairment in the person’s ability to express thoughts verbally or in writing.  This can involve problems with thinking of names or the words you want to use, putting words together to describe something and/or repeating or saying nonsense words.  Again, the degree of difficulty will vary from being unable to say any words (totally nonverbal) to occasional difficulty thinking of a word.  Sometimes saying only parts of sentences is possible.

Usually a combination of receptive and expressive aphasia exists.

Aphasia is a language problem and does not decrease intelligence. Communication can be very frustrating because the person often knows what they want to say but they are unable to make themselves clear.  This is called word-finding difficulty.  This is somewhat like having a word on the “tip of your tongue” and the harder you try to think of it, the harder it

becomes to say.  Then we think of it hours or days later.  Sometimes, sound or word substitutions may occur as a result of efforts to come up with words.

For other patients, however, they may not be aware of the difficulty and may talk nonsensically or in jargon. Words have no meaning or do not fit the situation or follow any logical order.  This most often occurs with individuals who also have receptive aphasia.  Not only do they have difficulty understanding others, but they cannot monitor and correct their own speech.

In addition, some individuals may repeat their own words or phrases over and over.  They may get “stuck” and be unable to change topic.  This is called perseveration.

Another symptom of aphasia is echolalia where a person may repeat all or part of what another person has said.  This may be a word or a phrase.

How Long is the Recovery?

Recovery varies from person to person and is dependent on many factors. Recovery depends on the type and severity of the stroke, a person’s age, health, previous education and motivation. Depression can also be a factor in speed of recovery.  Support systems of family, friends and professionals can help to maximize recovery.  Most of the improvement following a stroke occurs in the first 6-8 months, but may continue well past one year. Therapy can facilitate recovery by teaching new strategies to help the person communicate easier and by helping to rebuild communication abilities. The importance of initiating therapy early cannot be overemphasized.  Early intervention can minimize frustration for the patient and their family and to help everyone maintain a positive outlook.

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