Aphasia: Symptoms, diagnosis, and learning to communicate again

Aphasia is a language disorder that can affect a person’s use of language. It can impact their ability to speak, to understand, to read and to write, but not necessarily all of these. It often happens as the result of a stroke.

Aphasia can happen as a result of brain damage linked to Alzheimer’s disease or stroke. The challenges that the person will face depend on which parts of the brain are affected. Studies suggest that between 9 percent and 62 percent of people who have a stroke experience some degree of aphasia.

In the past, aphasia referred only to a complete impairment of the person’s communication and language, while dysphasia was used to describe partial language impairment.

However, because there was confusion between dysphasia and dysphagia, a swallowing disorder, aphasia is now used for all degrees of impairment.

Types and symptoms

There are several kinds of aphasia.

[speech therapy after stroke for aphasia]
Stroke can lead to aphasia, a loss of the ability to communicate.

Fluent aphasia or Wernicke’s aphasia: The person finds it difficult to understand the meaning of spoken words, but they can produce connected speech. However, the speech may be incoherent, with irrelevant words intruding. Reading and writing may be difficult.

Non-Fluent aphasia, or Broca’s aphasia: Speech production is often short, and described as halting and effortful. It is hard to access words, and formation of sounds may be difficult. Writing may be affected, but the ability to read and understand often remains intact.

Global aphasia: This affects all aspects of language. The person may be able to say a few recognizable, words but they cannot understand speech or read and write.

Anomic aphasia: The person may produce grammatically accurate language, but they have difficulty naming objects and words, so they may talk around the word as they try to explain themselves. Listening and reading may remain intact.

The person with aphasia will normally have noticeable difficulty with their use of speech and language. They may become frustrated at their inability to express themselves.

However, the type of difficulty will be different according to the type of aphasia they have.

Weakness or paralysis on one or both sides of the face or body can also make speech production or writing more difficult. The muscles used to breathe or swallow can be affected, and this has an impact on the production of sounds.

[brain damage and depression with aphasia]
Damage from stroke or Alzheimer’s can lead to aphasia.

Damage can result from:

Stroke

Traumatic brain injury

Epilepsy

Migraine

Brain tumor

Alzheimer’s

Parkinson’s

The type of aphasia depends on which part of the brain is damaged.

Global aphasia happens when there is widespread damage right through the language center, fluent aphasia normally results from damage to the temporal lobe, or the side of brain, and
non-fluent aphasia happens when there is damage to the frontal lobe, or the front of the brain.

Diagnosis

As many people have aphasia after a stroke, a speech-language pathologist will conduct an evaluation to diagnosis aphasia soon after the event.

Some basic exercises that can help assess the patient’s language skills include:

Naming objects that begin with a certain letter

Reading or writing

Holding a conversation

Understanding directions and commands

The Boston Diagnostic Aphasia Examination test incorporates exercises that extensively evaluate the patient’s language skills.

A comprehensive diagnosis will also include a Computerized Tomography (CT) or Magnetic Resonance Imaging (MRI) scan to determine the location and degree of brain damage that has caused the aphasia.

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