The Free Press, Mankato, MN

June 1, 2013

National Aphasia Awareness: Putting the disorder into words

Sarah Krenik-Hoffmann Speech-language pathologist
The Mankato Free Press

---- — “It’s on the tip of my tongue” is a phrase everyone has said time and time again. Sometimes it’s hard to find that word you’re looking for – whether it’s someone’s name, a common object or something else. But for people with a disorder called aphasia, it’s as if their brain’s “word cabinet” falls over and mixes all of their words around, resulting in varying levels and forms of language comprehension and expression impairment.

June is National Aphasia Awareness Month, making this a perfect opportunity for you to learn more about the condition, its causes and how it’s treated.

1. Causes

A stroke and its subsequent brain damage is the most common cause of aphasia. A stroke results from the bursting or blockage of blood vessels supplying the brain. This creates a reduction of blood flow to the brain, which deprives the brain of essential nutrients and oxygen needed to support brain cell life.

Aphasia can also surface due to a brain tumor, infection or degenerative disease. There is always an underlying cause of aphasia and this determines the severity of language difficulties.

Temporary aphasia can appear during a migraine, seizure or transient ischemic attack (TIA or mini-stroke). Anyone who experiences a TIA is at an elevated risk for a full-blown stroke in the near future.

2. Symptoms

A person who is affected by aphasia may:

n Use words or sentences that don’t make sense

n Speak in brief or incomplete sentences

n Experience difficulty understanding conversations

n Have trouble writing coherent sentences

Seek medical help immediately if you or a loved one experiences these symptoms. A form of aphasia can be the first sign of stroke.

3. Types

Aphasia presents itself in three different ways. Your health care provider may classify aphasia as:

n Broca’s (nonfluent) aphasia. People with this form of aphasia speak in short sentences with missing words and have difficulty getting words out. Broca’s aphasia is often very frustrating for sufferers as most of them are aware of their communication difficulties.

n Wernicke (fluent) aphasia. Fluent aphasia refers to individuals who communicate in long sentences that are hard to understand or contain incomprehensible, unneeded or incorrect words. Most people with fluent aphasia don’t realize they have a communication disorder.

n Global aphasia. This is the most severe form of aphasia. It causes major comprehension and expression disabilities.

4. Testing for aphasia

A common initial test from health care providers to determine the cause of aphasia is a computerized tomography (CT) scan or magnetic resonance imaging (MRI) test. Aside from that, testing for aphasia usually involves exercises and observations to gauge your ability to:

n Have a conversation

n Follow directions

n Repeat words and sentences

n Explain a situation as depicted on paper

n Read and write

5. Treatment and coping

Speech-language therapy is the most common form of treatment for aphasia, and this comes after the underlying cause of aphasia has been addressed. Early intervention and timely treatment is imperative for achieving maximum results.

A speech-language pathologist works with aphasic patients to regain as many previous language skills as possible or, with certain diseases and conditions, to maintain their current level of communication ability. Patients commonly work in a hierarchical fashion, meaning that they start with simple exercises and work their way up. (i.e. Speaking, reading or writing single words, then progressing to full sentences, then a paragraph and so on.)

In terms of coping, family and friends can make adjustments to simplify conversations and ensure comprehension. In turn, this keeps people with aphasia included and eases some apprehension they may have about communication. Those with aphasia may also choose to use images and gestures to help them communicate.

Additionally, there are stroke and aphasia support groups to aid in the healing and coping process.

Aphasia is a challenging communication disorder that creates many obstacles for patients and their families. Fortunately, raising awareness about the condition, its underlying causes and treatment options can help to reduce the effects aphasia has on many lives.

Sarah Krenik-Hoffmann is a Mayo Clinic Health System speech-language pathologist.

For more information, please go to mayoclinichealthsystem.org.