Aphasia

The process of language acquisition is often viewed as a natural process that develops in a person's early years and then continues to develop over time. It's not always plain sailing, though, and there are cases where a person may develop a communication disorder such as aphasia which can impact their ability to communicate with others.

Aphasia Aphasia

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Table of contents

    There are a few areas of aphasia you need to know about to understand the language disorder fully, which we'll learn about today. They are:

    • Causes of aphasia

    • Types of aphasia

    • Potential treatments

    • The difference between aphasia and other language disorders, such as dysphasia

    Aphasia Language Disorder

    Aphasia is a language disorder that can affect a person's ability to produce and interpret language. This means that the affected person may have difficulties speaking, interpreting language, reading, and writing. Aphasia can occur in people of all ages; however, it is more often seen in those over the age of 65 and those who have suffered trauma or neurological condition.

    The main cause of aphasia is damage to the brain's left hemisphere.

    The left hemisphere of the brain is the language center. This is where the production and comprehension of language, language-related sensations, and visual data are processed.

    Symptoms of Aphasia

    The main symptoms of aphasia can be seen in a person's difficulties in communication. This can be split into four main areas:

    • Reading

    • Writing

    • Speaking

    • Listening

    In each of these areas, a person with aphasia may have trouble with interpreting and producing language.

    A person with aphasia may have particular trouble with the production of spoken language and may produce the wrong speech sounds in words, use the wrong words, or miss words out completely.

    For example, someone with aphasia may say "call sh- sh-- -un- tomorrow" when they mean "I'll call Shaun tomorrow."

    Symptoms of aphasia can differ in different people. For example, one patient with aphasia may have difficulty interpreting spoken language, and another may have difficulty expressing what they want to say through speech.

    Good to know: when referring to people with aphasia, you can use the term 'patient.'

    Different Categories of Aphasia

    Aphasia can be referred to as either receptive or expressive.

    Receptive aphasia refers to cases where the patient has trouble receiving, interpreting, or understanding language.

    Expressive aphasia refers to cases where the patient has trouble expressing or producing language.

    Both of these types of aphasia can apply to written and spoken language and can appear either separately or together, with patients having varying degrees of difficulty with different areas of language communication.

    Effects of Aphasia

    The symptoms of aphasia can have a massive impact on a person's life and cause many adverse knock-on effects, such as:

    • Frustration when they can't express the words and ideas they want

    • Frustration and anxiety when they can't properly interpret what others are saying

    • Lack of confidence when speaking to others

    • Loneliness and withdrawal from society

    • Impatient family members or interlocutors when waiting to understand what a person with aphasia is saying

    • potentially depression caused by prolonged frustration, anxiety, and loneliness

    An interlocutor is someone who is part of a conversation or exchange of dialogue.

    Aphasia Lonely man StudySmarterFig 1. Someone suffering from aphasia can end up feeling anxious, frustrated, and lonely.

    Causes of Aphasia

    Earlier, we mentioned that the main cause of aphasia is damage to the left hemisphere of the brain. To understand this further, let's have a look at what the left hemisphere is responsible for.

    Left Hemisphere of the Brain

    The left hemisphere of the brain has four lobes (sections): the frontal lobe, the parietal lobe, the temporal lobe, and the occipital lobe.

    Aphasia Labelled brain StudySmarterFig 2. The temporal, frontal, parietal, and occipital lobes are in the left hemisphere of the brain

    Each of these lobes has a different set of functions and plays a part in a person's ability to use and interpret language. Let's have a look at the functions of each lobe:

    Lobe

    Functions

    Frontal lobeProblem-solving, judgment, planning, anticipation, speaking, expressing emotions, sexual behavior, self-awareness, self-monitoring, motor planning, personality, behavior control, organization, attention, concentration, and initiation.
    Parietal lobeTouch, taste and smell senses, differentiation, spatial perception, visual perception, maths skills, reading, and writing.
    Temporal lobeUnderstanding language, organization and sequencing, information retrieval, musical awareness, memory, hearing, learning, and feelings.
    Occipital lobeVisual reception, visual interpretation, and reading.

    Most, if not all, of these functions are used in language use and interpretation. If one of the lobes is damaged, some element of language ability will be lost or damaged.

    So, what causes damage to the left hemisphere?

    Causes of Left Hemisphere Damage

    There are four main causes of left hemisphere damage that can cause aphasia. These are stroke, head trauma, brain tumor, and progressive neurological conditions. We'll have a quick look over what each of these is.

    Stroke

    A stroke is caused when the blood supply to part of the brain is cut off, causing brain cells to die. This can cause permanent damage to the brain and damage to the language center of the brain (especially if the left hemisphere is the affected region). Strokes can affect people of any age, although they are more likely in people over 65.

    Head trauma

    A severe fall, impact injury or blow to the head can potentially cause serious brain damage. This is because it may lead to pressure being placed on the brain from bleeding or a clot. If this damage is on the left hemisphere of the brain, the patient's language abilities can be severely impacted. Brain damage sustained through a head trauma injury may be either permanent or temporary and can occur when a person is at any age.

    Brain tumor

    A brain tumor occurs when the growth of cells multiplies abnormally. Brain tumors can occur in people of any age; however, the risk of them developing increases as you get older. A brain tumor can impact any part of the brain and will mainly affect a person's language use and interpretation if it occurs in the left hemisphere.

    Progressive neurological condition

    Progressive neurological conditions are those that cause the brain to become damaged over time. As these conditions develop over time, they often only cause aphasia in older adults.

    Types of Aphasia

    Now that we understand what causes aphasia, let's look at the different types that can occur. Aphasia can present itself as three different types; Broca's Aphasia, Wernicke's Aphasia, and Global Aphasia.

    Broca's Aphasia

    Broca's aphasia occurs when there has been damage to the frontal lobe1. This affects a person's ability to speak and causes the following:

    • Broken, awkward-sounding speech

    • Problems with finding the right words

    • Incomplete utterances

    • Increased pauses

    A patient with Broca's aphasia will have a relatively good understanding of language and will be aware of what they are saying. This can make them feel frustrated as they understand what they want or need to say but are aware of their limitations and can't always produce the correct language when needed. A person with Broca's aphasia may sometimes produce fixed expressions or phrases perfectly when they are stored as a single unit in the brain (meaning the components don't need putting together).

    A Broca's aphasia patient may struggle with conversational speech but can answer direct questions with fixed phrases. Some examples of fixed phrases that may be easier to produce without hesitation or pauses are:

    • Mashed potato
    • Roast dinner
    • Sunday lunch
    • Pain in the neck
    • I'm fine
    • Nice weather

    Wernicke's Aphasia

    Wernicke's aphasia occurs when there is damage to the temporal lobe, affecting a person's hearing and understanding of language2. A person with Wernicke's aphasia may seem able to communicate normally at first, as they can usually still produce fluent spoken language.

    Wernicke's aphasia has the following effects:

    • Fluent spoken language

    • Lack of comprehension

    • Unrelated utterances

    • Confidence when speaking

    • Speaker is unaware of their condition

    • May echo what someone else has said

    • Speech often seems unrelated or jumbled

    A Wernicke's aphasia patient will often have very little understanding of what they're saying and how it relates to what someone else has said. Although someone with Wernicke's aphasia may appear to speak fluently, it can be very difficult for people to maintain a conversation as the subject or topics may seem very disjointed and random.

    Global Aphasia

    Global aphasia is the most severe type of aphasia a patient can experience. Global aphasia patients will have damage to the brain in multiple lobes and therefore display elements of both Broca's and Wernicke's aphasia. This means they will have difficulties with the production and interpretation of language3.

    Aphasia Globe StudySmarterFig 3. Global aphasia occurs when a person has difficulties in both using and interpreting language

    Aphasia Treatment

    There is no specific cure for aphasia; however, there are treatments available that can help a patient recover some (if not all) of their language ability. Some research into medications to treat aphasia has also been conducted; however, more research is needed before these medications can be viewed as solid treatments. The most common aphasia treatments include speech and language therapy or computer-based treatments.

    Speech and Language Therapy

    Speech and language therapy can help patients to recover some of their language skills through exercises such as imitating what others say. Speech therapists will tailor their form of treatment to each patient; patient interaction is crucial to find out where specifically a therapist can help4. Therapy can also help patients to learn new ways to communicate when they find that their speech is too severely impaired.

    Some different types of communication a person with aphasia may learn to use are:

    • sign language
    • drawings
    • picture note cards
    • hand gestures and pointing (may be more intuitive than sign language)

    Aphasia Sign language StudySmarterFig 4. Speech and language therapists can help aphasia patients to learn new ways to communicate

    Computer-Based Treatment

    Some computer-based treatments allow patients to practice and relearn the production of words and phrases. This is done on an action, observation, and imitation basis.

    Action: A patient may be presented with an image of a man digging so that they know what concept they are practicing the speech for.

    Observation: The patient will then be shown a video of someone else saying "digging" so they can see the motor functions and shape of the mouth.

    Imitation: The patient then imitates the word and movements of the mouth to produce the same word while watching the image of the man digging.

    Computer-based treatments such as this are usually carried out with the guidance of a speech and language therapist. Patients benefitting from this form of therapy can be seen to go from imitating the speech to anticipating it and producing the correct word or phrase before the video shows them.

    Aphasia vs. Dysphasia

    When carrying out your study of aphasia, you may also come across the term dysphasia.

    Dysphasia is a language disorder where a person's production and interpretation of speech is impacted by brain damage or disease.

    The term dysphasia comes from the Greek dus (difficult) and phatos (spoken), meaning "hard to utter."

    When the two terms are used separately, dysphasia is often used to refer to a partial loss of language, while aphasia refers to complete or more severe language loss. It is common for the term aphasia to be used as an umbrella term for all types of language loss caused by brain damage.

    Aphasia - Key takeaways

    • Aphasia is a language disorder that can affect a person's production and interpretation of language.
    • Aphasia is caused when damage is sustained to the left hemisphere of the brain through either stroke, head trauma, brain tumor, or a progressive neurological condition.
    • There are three types of aphasia: Broca's, Wernicke's, and Global.
      • Broca's Aphasia affects the speaker's production of language.
      • Wernicke's Aphasia affects the speaker's understanding and interpretation of language.
      • Global aphasia refers to a patient who has difficulties in both the understanding and production of language.
    • The effects of aphasia can be treated through speech therapy and computer-based treatments; however, there is no single cure.

    References

    1. J. M. S. Pearce. 2009. Broca's Aphasiacs. European Neurology. Volume 61. Issue 3.
    2. A. Hillis, R. Wityk, E. Tuffiash et. al. 2001. Hypoperfusion of Wernicke's area predicts severity of semantic deficit in acute stroke. Annals of Neurology. Volume 50, Issue 5.
    3. M. Alexander, M. Naeser, and C. Palumbo. 1987. Correlations of Subcorticalct Lesion Sites and Aphasia Profiles. Brain. Volume 110. Issue 4.
    4. U. S. Department of Health and Human Services. 1991. Aphasia Treatment: Current Approaches and Research Opportunities. Proceedings of a Workshop.
    Frequently Asked Questions about Aphasia

    What are the 3 types of aphasia?

    There are three types of aphasia: Broca's, Wernicke's, and global. Broca's occurs when the patient has difficulties in speaking and producing language. Wernicke's occurs when the patient has little or no comprehension of language. Global aphasia occurs when the patient has difficulties with both producing and interpreting language.

    What are the 4 causes of aphasia?

    There are four main causes of aphasia:

    • Stroke
    • Severe head trauma
    • Brain tumor
    • Progressive neurological condition


    All of these cause damage to the language center of the brain, causing aphasia.

    Is aphasia a language disorder?

    Aphasia is a language disorder that affects a person's ability to produce and interpret language.

    How long does aphasia take to heal?

    People who have aphasia can recover their language use completely, partially, or not at all. The time it takes to recover typical language use depends on each different case and on how much help (such as speech therapy) is available.

    What is the difference between dysphasia and aphasia?

    When the terms aphasia and dysphasia are used, aphasia refers to complete language loss, and dysphasia refers to partial language loss. Despite this, the term aphasia can be used as a cover-all to refer to both partial and complete language loss.

    Test your knowledge with multiple choice flashcards

    What is aphasia?

    Which side of the brain is damaged if someone has aphasia?

    Which of these isn't affected by aphasia?

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