Aphasia

Causes of aphasia

Aphasia is caused by damage to the areas of the brain involved in communication and language.

There are a number of ways in which our brains can be damaged. These include stroke, where a blood clot, or bleeding in the brain stops blood reaching parts of the brain. Approximately one third of people develop aphasia following a stroke.

Head injuries caused by driving and sports related accidents can also cause brain injury, as can brain tumours and some types of dementia.

Related: What is dementia?

Related: Stroke symptoms

Symptoms of aphasia

People with this condition have difficulty expressing themselves, so they have problems communicating what they’re thinking and how they’re feeling, to those around them. This is known as expressive aphasia.

The symptoms of aphasia can vary a great deal, from very mild, where it makes only a small difference to the person who has it, to severe.

Aphasia can make it difficult to speak, write, draw and make gestures. It can also cause problems doing things that most of us take for granted, like sending an email, or talking on the phone.

It may affect only one area of communication, such as being able to read, or to find the right words for familiar objects. However, it is more likely to affect more than one means of communication.

How aphasia affects communication

Some people who have aphasia tend to have trouble making clear sentences. Their speech can be reduced to simple sentences that are shorter than they would normally be. They may also use the wrong words – for instance, window instead of door.

This can progress to having trouble understanding familiar and complicated words.  And people with aphasia may find it increasingly difficult to say what they mean, and to express themselves clearly.

Receptive aphasia

People who have receptive aphasia, have problems understanding the information they receive. This means that they are likely to have trouble making sense of what they hear – in conversation, or on television or the radio. They may also find it difficult to understand anything that’s written down – in a letter, for instance, or in emails.

Aphasia is usually different for everyone who has this condition, with people having different sets of symptoms to different degrees. There are also different forms of aphasia, as well as expressive and receptive.

Wernicke’s aphasia

For instance, with Wernicke’s aphasia, the person affected may say something that, listening to their speech pattern, sounds as if it should be normal, but doesn’t have any clear meaning.

Broca’s aphasia

Broca’s aphasia (also known as non-fluent aphasia) describes the condition where the person with aphasia isn’t able to speak a great deal and will usually only be able to speak in short bursts. They may understand what other people are saying reasonably well, and may be able to read.

Anomic aphasia

People with Anomic aphasia usually understand what other people are saying, and can often read reasonably well. However, they find it difficult to find the right words – usually nouns and verbs – to convey what they want to say.

Primary Progressive Aphasia

Primary Progressive Aphasia (PPA) is a degenerative brain condition that is caused by continuing deterioration of the brain in the areas that govern speech and language. With primary progressive aphasia the problems with language start off slowly, and become progressively worse.

Global aphasia

Global aphasia is the term used for the most severe form of aphasia, often seen following straight after a stroke. It means that the person will be able to say few, or no words, and may understand hardly any or no spoken words. This condition may improve after a stroke, depending on the amount of damage to the brain. However, where the stroke has caused a lot of brain damage, recovery may be limited.

Treatment for aphasia

The recommended treatment for aphasia is speech and language therapy (SLT). If your aphasia has been brought on by an accident, stroke, or other medical condition, and you are admitted to hospital for treatment, you may be assessed by the speech and language team (SLT) there.

Related: How a speech and language therapist can improve your or a loved one's communication

If this doesn’t happen, ask your GP to refer you to your local speech and language team (or you may be able to get in touch with them yourself, without a referral from your GP).

It is usually best to start speech and language therapy as soon as you can after aphasia starts. The most noticeable recovery happens in the first six months for most people. However, improvement can carry on for some years.

Your SLT team will start by assessing you, to find out which aspects of language and communication have been most affected. They will focus your treatment on these areas, using a range of techniques.

These may include matching words to pictures, sorting picture cards into different piles, and electronic communication aids. The therapist may also use group therapy sessions.

The therapist will also work with the people closest to the person with aphasia, giving them advice and training. This will mean that that they can help at home, with practising exercises, and encouraging other ways to communicate, such as writing and drawing.

Aphasia charities and voluntary organisations may also offer help. These include Aphasia Alliance, Connect – the communication disability network and Speakeasy.