Possibly one of the most important aspects of being human is the ability to communicate with one another in order to share information, express thoughts and emotions, and to learn. Imagine how frustrating it must be to understand what is being said around you, yet to be unable to react and respond in a manner that is intelligible to those around you – to be unable to share and to participate in human exchanges. That is precisely what people with aphasia endure every day.
Aphasia is a language disorder that results from damage to the speech centers and pathways in the brain. At any given time, approximately 1 million people in the United States have aphasia. While anyone can acquire aphasia, it most commonly occurs in the middle to later years of life, affecting men and women equally. People of all races and nationalities are subject to the possibility of acquiring this condition. Aphasia can impair the ability to express language verbally and in writing, and can also affect the understanding of both the written and the spoken word.
The most frequent cause of aphasia is stroke, but any injury to the brain can cause the disorder. About 2/3 of the cases of aphasia are the result of stroke, which accounts for about 80,000 new cases annually. The remaining 1/3 of the cases are due to brain damage from a head injury, brain infection, or a tumor. Consequently, aphasia usually has a sudden onset, except in situations such as a brain tumor, where the impairment progresses over time.
There are several different types of aphasia, determined by the location of the damage to the brain. A large number of people with aphasia also have weakness or paralysis of the right side, especially the right arm or leg. This is because the left side of the brain is predominantly responsible for speech, and it also controls the movements on the right side of the body. Symptoms can range from mild to severe, affecting just a single aspect of language use, such as the ability to remember the names of objects, or they can be so severe as to render communication almost impossible.
While there is no cure for aphasia, approximately ½ of those who initially show signs of aphasia recover completely within the first few hours or days following the injury to the brain. This is known as transient aphasia. In some cases, such as a brain tumor or a hematoma, surgery can be successful where relieving pressure to the affected area of the brain is in order. But the vast majority of cases of aphasia occur from a stroke, which can, by the way, occur in young people and children as well as older adults. Following a stroke, if the symptoms persist beyond the first 2 or 3 months, complete recovery is unlikely. To whatever extent recovery is possible, the process can take up to 2 years. At least a minimum of 1 year of speech therapy is required to increase language function.
The speech professional will make a determination as to the extent of the damage to the brain and what the remaining abilities might be. Speech therapy will help the victim to restore language abilities as much as possible, to fully utilize remaining skills, and to learn com-pensatory and alternate means of communication. The speech therapist also will assist both the individual and family members in understanding and adjusting to long-term effects of aphasia.
Not surprisingly, a recent study of people with aphasia revealed that 90% of the participants felt isolated, and 70% felt that other people avoided contact with them because of the difficulty communicating. Because many people are fully aware of their problem and their limitations, they are often frustrated and angry, while their family members and friends feel helpless, guilty, and unprepared for the sudden emotional, physical, and psychological changes that have been thrust upon them. Considerable support and hard work are required in order for the person with aphasia to resume living a normal life.
Some suggestions should be kept in mind when communicating with a person with aphasia. It is important to remember the person inside is still the same, even if the ability to communicate is impaired, so talking with the person should remain as normal as possible. Continue to speak as you would to any adult, and avoid the temptation to talk as you would to a child. The following tips should further facilitate communication with an aphasic person:
1. Minimize or eliminate background noise as much as possible, and keep
the atmosphere relaxed.
2. Make sure you have the person’s attention before communicating.
3. Keep your own communication simple, but adult. Reduce your own
rate of speech, emphasize key words, simplify sentence structure, and
maintain your voice at a normal volume level.
4. Repeat statements as necessary, and enhance communication with
gestures and visual aids when possible.
5. Confirm that you are being understood by asking simple questions.
6. Avoid speaking for the person with aphasia; when absolutely necessary
to do so, ask for permission first.
7. Give the aphasic person time to talk and respond, really listen, and offer undivided attention and encouragement.
8. Engage in humor.
9. Continue normal routines to the extent possible, involving the person with
aphasia to participate fully in conversations, activities, and decision-making.
Although people with aphasia have difficulty expressing themselves, they often retain their memory of situations, appointments, people in their lives, and general knowledge. Learning to communicate again can be a slow, arduous process, but is absolutely necessary to reduce the sense of isolation and maintain as normal a life as possible. For additional information about aphasia and available resources, contact the National Aphasia Association at 1-800-922-4622.