Aphasia

What is Aphasia?

Aphasia is an acquired form of language or speech impairment. Aphasia affects a person’s ability to speak, communicate correct words and names, and/ or their ability to read and write.1

Aphasia can be a symptom of all forms of TBI, and the severity may differ depending on a number of factors. These factors include:

  • where on the head the person was hit
  • the location of any secondary impact on the brain
  • how severe the impact was.

Aphasia doesn’t affect the intelligence of a person, but rather their ability to access words and thoughts.

 

Aphasia following TBI

Aphasia is more commonly associated with severe TBI, rather than mild to moderate TBI.2 Aphasia occurs when the brain’s language centres have been impacted by the injury.

Depending on the severity of the injury, the resulting aphasia may be permanent or it could be a temporary symptom.

Types of Aphasia after TBI

The four most common types of Aphasia which may be associated with TBI are3:

Broca’s Aphasia (Expressive Aphasia)
Wernicke’s Aphasia (Receptive Aphasia)
Anomic Aphasia (Amnesic Aphasia)
Global Aphasia

Broca’s Aphasia

Broca’s Aphasia is caused by injury to the front regions of the left hemisphere of the brain, otherwise known as Broca’s area. Broca’s Aphasia is commonly referred to as non-fluent or expressive aphasia.4

People with Broca’s Aphasia have trouble forming sentences, leave out connecting words, and use words which are close to the intended word e.g. hand clock for watch.

Wernicke’s Aphasia

Wernicke’s Aphasia occurs when posterior temporal regions of the brain are damaged. Wernicke’s Aphasia is also known as receptive or fluent aphasia.4

Wernicke’s Aphasia can be characterised by a reading and writing impairment. People with Wernicke’s Aphasia use words which don’t make sense, use the wrong word or a made up word, and may string sentences together which do not make sense.

Anomic Aphasia

Anomic Aphasia is the least severe form of aphasia.4

People with Anomic Aphasia can understand speech, and are able to read well. However, while they are generally fluent, their own speech and writing suffers. For example, they will be unable to provide the correct noun or verb which they would like to talk about.

Global Aphasia

Global Aphasia is the most serious form of aphasia and affects extensive parts of the left hemisphere of the brain. Global Aphasia is caused by injuries to multiple parts of the brain including both Broca’s and Wernicke’s areas.4

People with Global Aphasia are not only unable to read or write, but they have difficulty in both forming and understanding words and sentences. While there is some chance for improvement, the greater the injury to the brain, the more likely it is that these will be long lasting or permanent side-effects.

 

Communicating with aphasia patients 

Although people with aphasia may have reduced scope to communicate, they will still understand the majority of what you are trying to say so it’s important to make sure you still communicate with them as an adult. Don’t speak to them as though they are any less intelligent or in a patronising tone.

The Aphasia Institute in Toronto, Canada has three tips for communicating with people with aphasia.5

These are:

  • Get the message in
  • Get the message out
  • Verify.

In order to get the message in you may have to rethink the way in which you communicate with patients suffering from aphasia.

  • Shorten your sentences
  • Ask yes or no questions
  • Write down key words
  • Use photographs
  • Use expression and hand gestures
  • Communicate one idea at a time
  • Look at the person when you are talking to them so they can see your expression and you can judge whether they understand your message.

In order to help the patient get their message across there are also a number of things you can do to help the conversation.

  • Ask yes or no questions
  • Give the person time to answer
  • Don’t finish their sentences as this can be frustrating for them
  • Ask the person to draw an image or write a keyword if they can.

Finally, it’s important to make sure you’re both on the same page. Repeat the key message and ask the patient to confirm if that is correct with a yes or no answer.

If you or someone you love has aphasia it can be frustrating for both the person experiencing the condition and those trying to communicate with them. See your GP if you need help dealing with the symptoms of aphasia. The Australian Aphasia Association also hosts community groups which may be of help.

 

References

  1. Marini et al., 2014 Cognitive correlates of narrative impairment in moderate traumatic brain injury Neuropsychologia, 64 (2014), pp. 282-288
  2. GIL, M. COHEN, C. KORN, Z. GROSWASSER(1996) Vocational outcome of aphasic patients following severe traumatic brain injury, Brain Injury, 10:1, 39-46, DOI: 10.1080/026990596124700
  3. The Aphasia Institute, Toronto, Canada: aphasia.ca