June is National Aphasia Awareness Month

As a skilled therapist, devote some time this month to understand the different aphasia types, causes and treatment options.

Aphasia is the loss of language ability including the incapacity to understand or articulate speech as well as a loss of ability read or write. Aphasia is actually a symptom of a greater underlying problem, and is typically seen in patients with brain injury. However, there are various aphasia types, each related to the underlying cause of the speech and comprehension problems.

Aphasia Types & Definitions:

1. Primary progressive aphasia (PPA). Language difficulty that develops gradually. This is seen in patients with a gradual degeneration of brain cells as in the instance of dementia or Alzheimer's. It may also be related to stroke, brain tumor, infection or head injury.

2. Temporary aphasia. This is a transient episode of aphasia, which occurs in patients with severe migraines, TIAs (transient ischemic stroke) or seizures.

The types of aphasia are further broken down into 3 groups:

• Nonfluent aphasia (Broca aphasia). Results from damage to the frontal regions of the left hemisphere of the brain. Symptoms include verbal apraxia (difficulty saying words correctly and consistently), repetitive speech, good auditory comprehension but with difficulties following directions, and aggramatic speech (speech pattern with simplified formation of sentences such as “want drink” or "go store" similar to the speech pattern of a toddler, excluding words such as “the”.) Patients with Broca aphasia are often aware of their own communication difficulties and, therefore, experience frustration with their limitations.
• Fluent aphasia (Wernicke aphasia). Results from damage to the posterior portion of the left side of the brain. This type of aphasia is named “fluent” because these patients can fluently speak; however, they typically communicate via long sentences that are incomprehensible and unrecognizable. They regularly use neologisms (made-up words). These patients have poor auditory processing and often do not even realize that others cannot understand what they are saying. In addition, they cannot repeat what they have said or what others say to them.
• Global aphasia. The most debilitating of the aphasia types. Results from damage to the frontal and posterior regions of the left hemisphere of the brain. The effect is severe disability with almost a total loss of all forms of communication (speech, reading, writing) as well as comprehension.

Aphasia Treatment Considerations for Therapists:

1. When a patient has aphasia, it is important to remember the distinction between language and intelligence. Aphasia does not necessarily equate to a loss of intellect. Rather, the problem is rooted in an inability to communicate. Thus, be sure to maintain an appropriate manner for conversation with an adult.
2. Also, remember to use short, uncomplicated sentences and repeat words or write down words as needed. Do not correct the patient’s speech.
3. Goals of treatment will differ from patient to patient, and range from complete restoration of language impairments to providing the necessary resources to compensate for long-lasting language barriers. Regardless of the treatment goals, be sure to use positive reinforcement and reassure the patient as treatment progresses. For patients with higher treatment goals, express encouragement with any demonstration of language proficiency or treatment progression, whether communication occurs via speech, gestures, writing, or drawing.
4. The health professional should be considerate of the patient’s family members and friends. Be sure to educate caregivers about the specific language disorder, treatment plan, prognosis, and community resources. Don’t forget to show regard for the patient’s opinion and include him or her in the conversation with family members.

To learn more about specific therapy protocols for the various aphasia types, refer to the following resources below:

• The Aphasia Practice Coach Program
• ASHA: Aphasia
• National Aphasia Association: Aphasia Therapy Guide
• National Stroke Association: Aphasia

Source: CEU360.com

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