What Is Aphasia/Dysphasia?

Aphasia and dysphasia are terms that are interchangeably used to describe a condition that has resulted from damage to areas of the brain responsible for producing and understanding language.

Dysphasia is being abandoned by some doctors as people may confuse it with Dysphagia. But you might still hear it being used to describe your loved ones condition.

Aphasia can also be used to emphasis a more sever form of the condition where by the person loses their ability to speak and has comprehension difficulties. For the purpose of this blog I will only use the term aphasia.

Aphasia is an acquired language disorder and a hidden disability, mainly affecting people over sixty five. People with aphasia have problems with language. Writing or speaking as well as understanding it for some. There are multiple types of aphasia depending on the area of the brain that has been damaged.

The three most common types are:

• Broca’s aphasia’ also called ‘Expressive’ or ‘Motor’ aphasia which affects the person’s ability to speak. The person can only manage to string a number of words together but they can still be generally understood.
• Wernicke’s aphasia also called ‘Receptive’ or ‘Sensory’ aphasia. The person can speak but what they say doesn’t make sense or includes nonsense words. People with this type are not aware that they are not making sense and can become very frustrated and angry as a result.
• Global aphasia which is a combination of the two. A person with this type has difficulty with all forms of communications including speaking, writing, and understanding others.

Symptoms

People with aphasia may experience difficulties using or comprehending speech, writing or reading. Symptoms will depend on the location and severity of acquired brain injury.

Speaking symptoms include:

1. struggling to find words (anomia)
2. speaking slowly or with great difficulty
3. speaking in single words or short fragments
4. omitting small words, such as articles and prepositions (telegraphic speech)
5. making grammatical errors
6. mixing up word order
7. substituting words or sounds
8. using nonsensical words
9. speaking fluently but without meaning

Comprehension symptoms include:

1. struggling to understand speech
2. taking extra time to understand speech
3. giving incorrect answers to simple questions
4. having difficulty understanding complex grammar
5. having difficulty understanding fast speech
6. misinterpreting meaning (for instance, taking figurative language literally)
7. lacking awareness of errors

Causes

Aphasia usually occurs in the over 65’s, as the causes are most prevalent in this age group. But it can occur at any stage of life following an acquired brain injury of some kind. The most common triggers are:

• Stroke
• Brain Tumour
• Seizures
• Infections
• Migraines
• Severe Brain Injury
• Dementia

Diagnoses

Aphasia will often appear suddenly following an acquired head injury. But if it occurs without obvious cause you should seek immediate medical help from your GP or A & E. It may be a sign of a mild stroke or brain tumour.

For most people you will be diagnosed after one of the causes listed above and will most likely be attending hospital at the time. The consultant will usually recommend some tests:

1. A physical exam, including blood tests.
2. A neurological exam.
3. Other tests of abilities such as reflexes, strength, and feeling.
4. An MRI scan.
5. A speech-language evaluation.

Treatment

Speech and language therapy (SLT) is the main type of treatment for people with aphasia. The aim of SLT is:

1. To help the person to relearn any communication skills that have been lost or damaged (if this is possible)
2. To make the best use of the person’s remaining communication abilities
3. Helping the person to find new ways of communicating
4. Provide alternatives methods to communicate such as sign language, technology, etc.

Some treatment is also using medication with SLT for example with Broca’s aphasia with good results.

For the best results treatment should start as soon as possible. But restoring full communication abilities isn’t always possible.

Complications Of Aphasia

Any type of brain injury comes with complications, particularly mental health conditions. These can include, but are not limited to: Depression, Anxiety, Aggression, Anger, Frustration, Crying or Laughing uncontrollably, Screaming for what might appear to be no apparent reason to you.

This can be so frustrating and upsetting for the person and their loved ones to deal with. So please be aware that you need patience with a loved one and help for yourself too. Remember depression can also be an early indicator for types of Dementia.

Communicating with someone who has Aphasia

These are just some suggestions and your speech and language therapist will have many more.

1. Have patience with them, allow them to time to communicate a response.
2. Keep distraction to a minimum, be aware of background noises.
3. Try and use closed questions, ones that require yes or no answers.
4. Use short, uncomplicated questions.
5. Use paper and pen if needed.
6. Do not finish their sentences for them.
7. Do not be patronising, if you don’t understand the person be honest.
8. Remember if they use short, abrupt sentences it can be upsetting for you, but how they speak to you doesn’t mean they don’t care about you.
9. Aphasia often make the person affected feel lonely and isolated, make sure you spend time with them and reassure them. Don’t exclude them from consultations about their treatment or speak for them when making treatment plans.

More Information And Support

Aphasia Ireland

Aphasia UK support

Headway UK

Headway Ireland

Carers Association Ireland

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