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Mar 196 min read

What is aphasia?

Losing one's ability to speak and communicate is overwhelming and can be frustrating for the individual and their family.

learning about what is aphasia acquired language disorder after stroke or brain injury

There are many different language disorders seen in our world today. Language disorders can significantly impact almost every area of an individual’s way of life. This is because communication is essential for human interaction, and without being effectively able to convey a message to another individual, one is at a severe disadvantage.


There are ways in which we, as individuals, can support those dealing with language impairments, and the first step is to educate ourselves. Therefore, this post intends to provide a brief description of what aphasia is and the impact of aphasia on social interactions. If you live in Edmonton, Alberta, check out our list of local resources and services for individuals with aphasia and other communication difficulties.


Aphasia is a language disorder

Aphasia means the absence of language.

Aphasia is an acquired language disorder caused by damage to the left side of the brain (Marshall, Lazar, & Mohr, 1998). When there is damage to the left side, the result will be impairments in speech expression and understanding of spoken language. In our brain we have two different hemispheres or ‘sides’ that each play a different role to control various functions in our body. These divisions are known as the right and left hemisphere. “In general, the left hemisphere controls speech, comprehension, arithmetic, and writing and the right hemisphere controls creativity, spatial ability, artistic, and musical skills” (Mayfield Clinic).These brain injuries can result from conditions like stroke, traumatic brain injury, brain tumours, or neurodegenerative diseases (Huy Kien Lei & Lui, 2023). 


Aphasia is seen as an umbrella term. The word aphasia means the absence of language. However, an aphasia diagnosis is more complicated. Within aphasia, there are two main categories: Receptive aphasia and expressive aphasia. Receptive aphasia is the inability of an individual to comprehend what is being said to them. However, individuals with receptive aphasia are often still capable of producing coherent sentences. Expressive aphasia is the opposite. Individuals with expressive aphasia have difficulties with initiating verbal expression and sometimes use poorly constructed word structure, such as missing, adding, or changing consonants (Whitaker, 2007). Typically, comprehension remains intact for those with expressive aphasia in comparison to those with receptive aphasia. Under these two subtypes, there are many additional variations of aphasia. 


What are symptoms of aphasia? What does aphasia look like?

Aphasia may not be recognized because it is considered a hidden disorder.

Patients with varying types of aphasia may have difficulty understanding or speaking words or sentences. (Huy Kien Lei & Lui, 2023). These symptoms depend on the specific type of aphasia one may have acquired. 


Here are some of the most prevalent symptoms of expressive and receptive aphasia:

Expressive Aphasia:

  • Speaking in short or incomplete sentences (choppy sentences) 

    • E.g., “I washroom” instead of  “ I need to use the washroom” 

  • Semantic paraphasias - Substituting one word for another 

    • E.g., saying “table” to mean “bed”, saying "bird” to mean “chicken” . 

  • Phonemic paraphasias - Substituting one sound for another:

    • E.g., “wish washer” for “dishwasher”. 

  • Having difficulty recalling words 

    • E.g., forgetting or needing a long time to find previously known words such as “stove”, “paperclip” 

(American Speech-Language-Hearing Association [ASHA], n.d). 


Receptive Aphasia:

  • Using Jargon: Speaking in words and sentences that don't make sense because of errors in sounds or meanings of words  (Rohrer, Rossor, & Warren, 2009). 

    • E.g., Instead of saying, “I’d like a cup of coffee”, the individual would say, “I lies a sup of cocoa”. ("Jargon Aphasia," n.d.). 

  • Limited awareness of their own verbal and/or written errors and using appropriate words. 

  • Not understanding other people's conversation

  • Not understanding what one reads

  • Writing sentences that don't make sense

  • Difficulty understanding complex grammar

    • E.g., passive sentences such as “The dog was chased by the cat” 

  • Difficulty with understanding figurative language such as metaphors, sarcasm, similes

(Mayo Clinic, n.d.) (American Speech-Language-Hearing  Association [ASHA], n.d).


How does having aphasia affect one's ability to socially interact?

At first glance, aphasia may not be recognized because it is considered a hidden disorder. This means that an outsider may not be able to discern any impairments in an individual because there are no visible signs indicating a physical limitation. For instance, we can readily attend to the needs of someone using a cane, signifying blindness, or a person in a wheelchair, indicating a mobility impairment, or even someone with a cochlear implant, suggesting difficulty in hearing. However, there are no physical indicators of impairment for an individual with aphasia. Consequently, in social interactions, one might become frustrated or impatient when dealing with someone with aphasia. “This frustration and lack of patience may contribute to a lack of motivation for participation and diminished self-esteem for the aphasic individual” (Garcia & Connor, 2011).


Individuals with aphasia may have difficulty understanding rapid speech; therefore, it is important to intentionally slow down your speech rate and make sure to articulate your words very clearly (Garcia & Connor, 2011). In our everyday experiences, we frequently encounter rapid speech, which can present comprehension challenges even for individuals without language impairments. So now imagine the added difficulty faced by individuals who have a language disorder. For example, imagine a person with aphasia standing in line at a busy grocery store. The cashier is handling multiple customers at a fast pace to keep the line moving efficiently. The person with aphasia may struggle to understand the cashier's questions due to the rapid pace of communication. Additionally, the person with aphasia may not hear the total of their purchase, which could cause confusion. They may also struggle to ask for clarification. As a result, they're holding back the line, and this takes a toll on their self-esteem because they are self-conscious of their impairments. This situation echoes the initial point that individuals with language impairments may feel reluctant to engage in basic activities like grocery shopping, causing them to slowly withdraw from social interaction. These individuals may benefit from strategies such as using a communication board as an alternative way to communicate their message more effectively.


Noisy environments also play a role in the ability of a person with aphasia to communicate effectively (Garcia & Connor, 2011). There are many different situations where background noise can affect one’s ability to effectively communicate. For example, at larger social gatherings where there are many people having conversations at one time, children may be running around screaming, or other infants may be crying; the television could be on at an increased volume, and on top of that, the overhead fan may be on. These distractions all contribute to a significantly decreased capability of an aphasic individual to properly hear the person they may be speaking to and comprehend what is being said to them.


People with aphasia communicate better when their communication partner is attentive and uses strategies to help them understand and get their message out. Here are "6 Tips to Talk to Someone with Aphasia" that takes accounts for their difficulties with understanding rapid speech and having conversations in noisy environments.


What do Speech Language Pathologist for Adults with Aphasia?

speech therapists and speech-language pathologists at Chatty Therapy Edmonton Alberta provides therapy for adults with aphasia

Speech-language pathologists (SLP) or speech therapists can help individuals with aphasia by assessing areas of strength and weaknesses and diagnosing language impairments. SLPs can provide therapy that helps individuals re-learn speech and language skills they have lost and leverage their strengths to develop other communication strategies. Treatment may look like repetitive practice, introducing alternative communication methods or environmental changes such as using pictures, simplified language and larger print. The goal of therapy is to help the individual participate in activities and social interactions that are meaningful and important to them. SLPs can also teach family members and caregivers how to support and work with their loved one with aphasia. 


This is just a brief introduction to aphasia. It's important to speak to a speech-language pathologist to ensure that the individual receives the support they need to compensate for their speech or comprehension loss. If you would like to learn how to talk to someone with aphasia, you can also check out our blog post here for "6 Tips to Talk to Someone with Aphasia".


References


 

 

Chatty Therapy is based in Edmonton, AB. We have wonderful speech-language pathologists who can help you support your loved-one with communication difficulties. Speech-language pathologists specialize in helping adults understand others and express themselves better. Click here to learn more about our services or book a free 15-minute consultation.


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