Aphasia is when a person has difficulty with their language or speech. It's usually caused by damage to the left side of the brain (for example, after a stroke).
Symptoms of aphasia
People with aphasia often have trouble with the 4 main ways people understand and use language.
These are:
- reading
- listening
- speaking
- typing or writing
Speaking problems are perhaps the most obvious, and people with aphasia may make mistakes with the words they use.
This could be sometimes using the wrong sounds in a word, choosing the wrong word, or putting words together incorrectly.
Although aphasia affects a person's ability to communicate, it doesn't affect their intelligence.
Aphasia can occur by itself or alongside other disorders, such as visual difficulties, mobility problems, limb weakness, and problems with memory or thinking skills.
Types of aphasia
Aphasia is often classified as "expressive" or "receptive", depending on whether there are difficulties with understanding or expressing language, or both.
But most people with aphasia have some trouble with their speaking, and will have a mixture of problems with writing, reading and perhaps listening.
Symptoms can range widely from getting a few words mixed up to having difficulty with all forms of communication.
Some people are unaware that their speech makes no sense and get frustrated when others don't understand them.
Causes of aphasia
Aphasia is caused by damage to parts of the brain responsible for understanding and producing language.
Common causes include:
- stroke – the most common cause of aphasia
- severe head injury
- brain tumour
- progressive neurological conditions – conditions that cause the brain and nervous system to become damaged over time, such as dementia
Aphasia can affect people of all ages, but it's most common in people over the age of 65. This is because strokes and progressive neurological conditions tend to affect older adults.
Diagnosing aphasia
Aphasia is usually diagnosed after tests carried out by a clinician – either a speech and language therapist or a doctor. They can also help arrange treatment if necessary.
These tests often involve simple exercises, such as asking a person to name objects in the room, repeat words and sentences, and read and write.
The aim of these tests is to understand a person's ability to:
- understand basic speech and grammar
- express words, phrases and sentences
- socially communicate – for example, hold a conversation or understand a joke
- read and write letters, words and sentences
Imaging techniques such as a CT scan or MRI scan can be used to assess brain damage.
Treating aphasia
Speech and language therapy is the main type of treatment for people with aphasia.
This aims to help restore some of your ability to communicate, as well as help you develop alternative ways of communicating, if necessary.
You may receive speech and language therapy on an individual basis or in a group, depending on your needs and the service provided.
An increasing number of computer-based applications are available to support people with aphasia.
But it's important to start using these with the assistance of a speech and language therapist.
How successful treatment is differs from person to person. Most people with aphasia make some degree of recovery, and some recover fully.
If the aphasia is caused by a one-off event, like a stroke, most patients recover to some degree with therapy. There's no evidence to suggest that recovery stops at a specific time after stroke.
But the chances of recovery is poorer for people with aphasia resulting from a progressive neurological condition.
Some people can still respond to therapy, but there are currently no good ways of reversing the ongoing injury to the brain.
When aphasia is caused by a progressive condition, treatment focuses on making the most of what people can still do and developing other ways of communicating to prepare for a time when speaking will be more difficult.
Complications of aphasia
The challenges of living with aphasia can impact how a person feels and interacts with others.
In some cases, it can lead to:
- isolation
- anxiety
- depression
If you're concerned about someone with aphasia, encourage them to discuss any problems with their GP or a member of their care team to access the relevant support.
If the person is unable to do this themselves, they may require someone to communicate on their behalf.
Symptoms-Aphasia
Aphasia affects everyone differently, but most people will have difficulty expressing themselves or understanding things they hear or read.
If aphasia has been caused by a sudden brain injury, such as a stroke or severe head injury, symptoms usually develop straight after the injury.
In cases where there's gradual damage to the brain as a result of a condition that gets worse over time, such as dementia or a brain tumour, the symptoms may develop gradually.
Expressive aphasia
Someone with expressive aphasia experiences difficulty communicating their thoughts, ideas and messages to others.
This may affect speech, writing, gestures or drawing, and causes problems with everyday tasks like using the telephone, writing an email, or speaking to family and friends.
People with expressive aphasia may have some of the following signs and symptoms:
- slow and halting speech – with difficulty constructing a sentence
- struggling to get certain words out – such as the names of objects, places or people
- only using basic nouns and verbs – for example, "want drink" or "go town today"
- spelling or grammatical errors
- using a wrong but related word – such as saying "chair" instead of "table"
- including nonsense words or their speech not making sense (speech-sound errors)
Receptive aphasia
A person with receptive aphasia experiences difficulty understanding things they hear or read. They may also have difficulty interpreting gestures, drawings, numbers and pictures.
This can affect everyday activities such as reading an email, managing finances, having conversations, listening to the radio, or following TV programmes.
People with receptive aphasia may have some of the following signs and symptoms:
- difficulty understanding what people say
- difficulty understanding written words
- misinterpreting the meaning of words, gestures, pictures or drawings
- giving responses that may not make sense if they've misunderstood questions or comments
- not being aware of their difficulties with understanding, or their own speech errors
Aphasia symptoms associated with dementia
People with the most common types of dementia, such as Alzheimer's disease and vascular dementia, usually have a mild form of aphasia.
This often involves problems finding words and can affect names, even of people they know well.
It doesn't mean they don't recognise the person or don't know who they are, they just can't access the name or get mixed up.
Primary progressive aphasia
This is a rare type of dementia, where language is heavily affected. As it's a primary progressive condition, the symptoms get worse over time.
Usually, the first problem people with primary progressive aphasia (PPA) notice is difficulty finding the right word or remembering somebody's name.
The problems gradually get worse, and can include:
- speech becoming hesitant and difficult, and making mistakes with the sounds of words or grammar
- speech becoming slow with short, simple sentences
- forgetting the meaning of complicated words, and later also simple ones, making it more difficult for them to understand other people
- speech becoming more vague and the person having difficulty being specific or clarifying what they're saying
- becoming less likely to join in with or start conversations
A person with PPA may also experience other symptoms later in their illness, including:
- changes in their personality and behaviour
- difficulties with memory and thinking – similar to Alzheimer's disease
- difficulties with movement – similar to Parkinson's disease