Most people have never heard the term aphasia, unless a
close family member has it. Yet there are about twice as
many people with aphasia as there are sufferers of
Parkinson's.
Aphasia is an impairment of language, affecting the
production and comprehension of speech, and often the
ability to read and write. In other words, it is the
inability to express thoughts in words, or the inability to
understand words spoken by others.
Aphasia is always due to injury of the brain, most
frequently the result of a stroke, particularly in older
people. A stroke occurs when, for some reason, blood is
unable to reach a part of the brain. Brain cells die when
they do not receive their normal supply of oxygen, which is
carried in the blood. However, aphasia can also be caused by
infection or a brain tumor or any other injury to the
head.
For most right-handed people and also some who are left-
handed, aphasia is the result of injury to the left side of
the brain. There are three forms of aphasia, each varying in
severity. One is Broca's aphasia, which is the result
of damage to the front part of the left hemisphere of the
brain. The sufferer may understand speech very well and be
able to read, but his own speech output is severely limited
and he will not be able to string more than two or three
words together. He will speak very haltingly, with obvious
great effort. Furthermore, the melodic intonation which
characterizes normal speech is often absent, making the
patient sound much like a deaf person when he speaks.
Unfortunately, as the patient's comprehension is not usually
affected, he becomes very frustrated at his inability to
communicate.
The second type of aphasia is Wernicke's aphasia. This
is the result of damage to the back part of the left
hemisphere of the brain. The patient will have limited
comprehension, although he may speak quite fluently, with no
apparent difficulty. He will use whole sentences with
correct grammar but the words are jargon and quite
incomprehensible. To simplify the two disorders, Broca's
aphasia limits speech, while Wernicke's limits
comprehension.
The most severe form of aphasia is global aphasia
where most language areas of the brain are affected. In
global aphasia, patients understand very little or no spoken
language, and can hardly produce recognizable sounds. This
is often seen right after a patient has suffered a stroke
and may improve rapidly and spontaneously if the damage is
not too extensive.
Speech therapy is often provided for a person with aphasia
to help the patient utilize his remaining skills fully and
to learn compensatory means of communication. Most people
agree that the sooner therapy is begun after the injury, the
more chances there are of success. Constant hard work and
patience is needed on the part of the patient and the
patient's family to recover the use of normal speech. Not
surprisingly, children recover more quickly than adults, as
the swelling goes down, or the injury resolves itself, and
other parts of the brain take over.
Hashem gave us humans the ability to speak and the loss of
this ability is quite devastating to the sufferer and to the
family. It is heartbreaking to watch someone with Broca's
aphasia trying to communicate. Visitors and family should
refrain from correcting the patient and from trying to
complete the sentence for him. Give him plenty of time to
speak. A man once complained to me that people often
completed his sentences for him, either because they were
impatient or they wanted to be helpful, but it wasn't what
he wanted to say! Family should also simplify their language
by using short, uncomplicated sentences, although
maintaining a conversational manner appropriate to an
adult!
If an aphasic does not recover sufficiently from his
disorder even after the use of various techniques and
therapies, there is an interesting approach in the use of
alternative, augmentative communication. This is primarily
based on symbols and may be discussed in a future article.
