Aphasia

An Overview

Once the cause has been addressed, the main treatment for aphasia is speech and language therapy. The person with aphasia relearns and practices language skills and learns to use other ways to communicate. Family members often participate in the process, helping the person communicate.

Types of aphasia

Aphasia is often classified as “expressive” or “receptive”, depending on whether there are difficulties with understanding or expressing language, or both. Aphasia usually occurs suddenly, often following a stroke or head injury, but it may also develop slowly, as the result of a brain tumor or a progressive neurological disease. The disorder impairs the expression and understanding of language as well as reading and writing. Aphasia may co-occur with speech disorders, such as dysarthria or apraxia of speech, which also result from brain damage.

Expressive aphasia

Someone with expressive aphasia experiences difficulty communicating their thoughts, ideas and messages to others.
This may affect speech, writing, gestures or drawing, and causes problems with everyday tasks like using the telephone, writing an email, or speaking to family and friends.
People with expressive aphasia may have some of the following signs and symptoms:
• slow and halting speech – with difficulty constructing a sentence
• struggling to get certain words out – such as the names of objects, places or people
• only using basic nouns and verbs – for example, “want drink” or “go town today”
• spelling or grammatical errors

Receptive aphasia

A person with receptive aphasia experiences difficulty understanding things they hear or read. They may also have difficulty interpreting gestures, drawings, numbers and pictures.
This can affect everyday activities such as reading an email, managing finances, having conversations, listening to the radio, or following TV programmes.
People with receptive aphasia may have some of the following signs and symptoms:
• difficulty understanding what people say
• difficulty understanding written words
• misinterpreting the meaning of words, gestures, pictures or drawings

But most people with aphasia have some trouble with their speaking, and will have a mixture of problems with writing, reading and perhaps listening.

Symptoms for Aphasia

Symptoms can range widely from getting a few words mixed up to having difficulty with all forms of communication.
• Speak in short or incomplete sentences
• Speak in sentences that don’t make sense
• Substitute one word for another or one sound for another
• Speak unrecognizable words
• Not understand other people’s conversation
• Write sentences that don’t make sense

Causes of Aphasia

Aphasia is caused by damage to one or more of the language areas of the brain. Most often, the cause of the brain injury is a stroke. A stroke occurs when a blood clot or a leaking or burst vessel cuts off blood flow to 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, gunshot wounds, brain infections, and progressive neurological disorders, such as Alzheimer’s disease.

Diagnosing Aphasia

Aphasia is usually diagnosed after tests carried out by a clinician – either a speech and language therapist or a doctor. They can also help arrange treatment if necessary.
These tests often involve simple exercises, such as asking a person to name objects in the room, repeat words and sentences, and read and write. If the physician suspects aphasia, the patient is usually referred to a speech-language pathologist, who performs a comprehensive examination of the person’s communication abilities. The person’s ability to speak, express ideas, converse socially, understand language, and read and write are all assessed in detail.
The aim of these tests is to understand a person’s ability to:
• understand basic speech and grammar
• express words, phrases and sentences
• socially communicate – for example, hold a conversation or understand a joke
• read and write letters, words and sentences
• Repeat words and sentences
• Follow instructions
• Answer yes-no questions and respond to open-ended questions about common subjects
• Read and write

Treatment for  Aphasia

Aphasia therapy aims to improve a person’s ability to communicate by helping him or her to use remaining language abilities, restore language abilities as much as possible, and learn other ways of communicating, such as gestures, pictures, or use of electronic devices. Individual therapy focuses on the specific needs of the person, while group therapy offers the opportunity to use new communication skills in a small-group setting.
Recent technologies have provided new tools for people with aphasia
Speech and language therapy is the main type of treatment for people with aphasia.
This aims to help restore some of your ability to communicate, as well as help you develop alternative ways of communicating, if necessary.

You may receive speech and language therapy on an individual basis or in a group, depending on your needs and the service provided. An increasing number of computer-based applications are available to support people with aphasia.
But it’s important to start using these with the assistance of a speech and language therapist.
Starts early. Some studies have found that therapy is most effective when it begins soon after the brain injury.
Often works in groups. In a group setting, people with aphasia can try out their communication skills in a safe environment. Participants can practice initiating conversations, speaking in turn, clarifying misunderstandings and fixing conversations that have completely broken down.
May include use of computers. Using computer-assisted therapy can be especially helpful for relearning verbs and word sounds (phonemes).
Medications
Certain drugs are currently being studied for the treatment of aphasia. These include drugs that may improve blood flow to the brain, enhance the brain’s recovery ability or help replace depleted chemicals in the brain (neurotransmitters). Several medications, such as memantine (Namenda) and piracetam, have shown promise in small studies.

People with aphasia

If you have aphasia, the following tips may help you communicate with others:
• Carry a card explaining that you have aphasia and what aphasia is.
• Carry identification and information on how to contact significant others.
• Carry a pencil and a small pad of paper with you at all times.
• Use drawings, diagrams or photos as shortcuts.
• Use gestures or point to objects.

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