Hello friends! I’ve been in hibernation for the past month thanks to the polar vortex, which seems to be affecting everyone outside of California (is Winter over yet?). Today was finally a gorgeous 60 degrees, so I ventured outside of my blanket burrito to write about something that has been a huge part of my semester so far: Aphasia.
Aphasia is a communication disorder that affects over 1 million people in the United States, with over 80,000 new cases every year. Aphasia is more common than ALS and Cerebral Palsy combined, and yet most people have never heard of it unless someone close to them has been affected by it. Aphasia can be caused by strokes, traumatic brain injuries, tumors, or brain infections that damage (usually) the left side of the brain. In most humans, language is predominantly localized in the left hemisphere of the brain (although some individuals, especially left handed people, may have right hemisphere localization). These language areas of the brain communicate with each other and other areas in the right hemisphere to help us comprehend language, produce speech, read, and write. Damage to any of these areas can lead to devastating losses in communication ability.
There are many different types of aphasia depending on the site of lesion in the brain, but I’ll name just a few.
- Broca’s Aphasia primarily affects language production. Individuals may have some impairments in comprehending complex language, but they understand language fairly well. However, they have a lot of difficulty producing language. Speech is characterized by extreme effort, word finding difficulties, and short sentences or single word output only.
- Wernicke’s Aphasia affects both comprehension and language output (although differently from Broca’s Aphasia). Individuals with Wernicke’s have severely reduced language comprehension, and although they produce fluent speech, their language output is usually nonsensical and may be characterized by jargon and made up words (to a foreign language speaker, the output may sound completely fluent, but to a native speaker, the output would have little or no meaning). These individuals are also usually unaware that they are not comprehending or producing intelligible language.
- Global Aphasia – a very severe form of aphasia where comprehension and language output are very severely impacted and the individual may only produce grunts or be completely mute.
- Other forms affect naming ability, occur in the absence of trauma as a progressive neurological disease, etc.
- Aphasia affects ALL modalities of language, not just verbal output and auditory input. Individuals with aphasia also have deficits in reading, writing, and sometimes math.
- Since every brain is a little different, symptoms and severity of aphasia in each person can vary greatly.
- Aphasia does NOT affect intelligence. Many individuals with aphasia describe their language difficulties as having a disconnect between getting the words from their brain to their mouth. The information is all still there, just more difficult to access.
- Aphasia can be devastating to an individual and loved ones – the loss of the ability to communicate can be extremely frustrating and may feel like a “loss of self”. Caregivers, friends, support groups, and medical professionals play a huge role in improving quality of life and working towards improvement.
- Language abilities CAN improve over time through intensive therapy and commitment to practice. Language can continue to improve even years after the onset of aphasia.
The reason I chose to write about aphasia is because this semester I’m taking a wonderful class on aphasia classification, diagnosis, and treatment, and one of my clinical placements is in Aphasia Group. Aphasia Group is run through the Pi Beta Phi Rehabilitation center at Vanderbilt and has been meeting for 10 years. All of its members have some form and severity of aphasia and some have been attending for 10 years while others are new this semester. Aphasia Group serves as a wonderful support group as well as an avenue for social interaction and language practice with some therapy thrown in. Every Thursday, I work with these individuals from 10-4:30 helping them navigate computers, participate in a book club, discuss current events, and work on their comprehension, speaking, reading, writing, and overall communication. The goal is to help them develop strategies to get around their language deficits. I was initially extremely nervous to work with adults since I’ve only had experience working with children, but the last two weeks have been incredible. It is a long, tiring day to constantly try to be an effective communication partner, but the members are so positive, upbeat, patient, and committed to improvement, which makes my job so rewarding and educational.
I think it’s so important that people learn more about aphasia, because there’s a very high chance that at some point you will encounter a grandparent, parent, sibling, or friend who acquires aphasia after a stroke or an accident. Individuals with aphasia still have a lot to say, but they need your support, patience, and understanding.
If you’re interested in learning more, these are some great websites: