What Is Aphasia?

Aphasia is loss of the ability to understand or express speech that occurs after some types of brain injuries. This usually results from damage to the portions of the brain that are responsible for language. For many people, they locate on the left side of the brain.

Aphasia usually occurs suddenly, often following a stroke or brain injury, but it may also develop slowly as the result of a brain tumor or a progressive neurological disease. It affects the expression and understanding of language, as well as reading and writing.

There are different types of aphasia, and each has its own recovery process.

Types

Each type of aphasia can be temporary or permanent. For example, in the case of a transient ischemic stroke, a brief stroke-like attack, language effects may appear and disappear quickly.

Similarly, in an ischemic stroke, when a blood clot blocks or narrows an artery to the brain, if a clot can be removed or dissolved and blood flow is restored quickly, aphasia may reverse.

However, in cases of more severe strokes or traumatic head injuries, speech problems can be permanent.

Expressive Aphasia

Expressive aphasia usually occurs after an injury to the front lobes of the brain. It interferes with your ability to express yourself through language or writing. However, the ability to understand speech may be preserved. People with expressive aphasia may be able to read but not write.

This type of aphasia is also called Broca’s aphasia after Broca’s area. Broca’s area is in the left, frontal area of the brain and is responsible for your ability to speak.

When this area is damaged, your ability to form words may be temporarily or even permanently damaged. You may have trouble putting words together into full sentences and only be able to say short sentences.

While what you want to say will sound correct in your mind, it won’t come out right. You may remove words that are important to the sentence, like saying “I go store” instead of “I am going to the store.”

Receptive Aphasia

Receptive aphasia impacts your ability to understand or speak language in a meaningful way. This type of aphasia occurs when an area in the temporal lobes of the brain—on the sides of your head near the temple—called Wernicke’s area is affected. Therefore, this kind of aphasia is also called Wernicke’s aphasia.

With Wernicke’s aphasia, you may have trouble understanding words and stringing words together in a way that makes sense. You may speak using a random combination of real or made-up words like, “You know that smoodle pinkered and that I want to get him round and take care of him like you want before.”

This version of aphasia may be particularly frustrating because the person who is speaking usually isn’t aware of their language mistakes.

Global Aphasia

Global aphasia is the most severe form of aphasia. Large areas of the brain are damaged, and you may have trouble both understanding or producing any spoken or written words. If someone with global aphasia can speak or understand words at all, speech may consist of just a single repeated word. A person with global aphasia usually won’t be able to speak, write, or understand simple words or sentences.

Mixed Non-Fluent Aphasia

Mixed non-fluent aphasia is like a severe case of expressive aphasia. A person with this type of aphasia may try to speak, but produce very little understandable conversation. They may write at a very simple level and have difficulty understanding language.

Anomic Aphasia

Anomic aphasia occurs when someone can understand language and speak it fluently, but has periods of time when they can’t find the right words. Sometimes called “word finding problems,” anomic aphasia can be frustrating for both the person speaking and the person trying to understand them. It is common in people with Alzheimer’s disease.

Primary Progressive Aphasia

Primary progressive aphasia develops over time as a result of a neurologic disease that causes tissue damage progressively, like Alzheimer’s disease. It can result in problems understanding or speaking or writing language gradually.

Aphasia Symptoms

Aphasia symptoms vary based on the type and where the damage that is causing the aphasia is located in the brain.

Common symptoms include:

• Trouble finding the right word for what you want to say
• Using made-up words in place of the words you want to say
• Trouble reading or understanding spoken language
• Speaking in short, one-word sentences
• Repetitive language
• Not realizing the errors you are making in writing or speaking

Causes

Aphasia occurs when the areas of the brain that control speech and communication are damaged. This can be from a forceful injury or even a temporary delay in blood flow to the brain.

Stroke

About 25% to 40% of all aphasia cases occur after a stroke. A stroke occurs when a blood clot or a leaking or burst vessel cuts off blood flow to part of the brain. Brain cells die when they do not receive their normal supply of blood, which carries oxygen and important nutrients.

There are two kinds of stroke:

• Hemorrhagic stroke: A stroke caused by an aneurysm or bleed in the brain
• Ischemic stroke: A stroke caused by a clot or disruption of blood flow to an area of the brain

If treated quickly, brain damage from strokes can be minimized, and in time, therapy could help improve language problems.

Tumors

Brain tumors refer to any group of cells or tissues that are growing in a part of the brain where they don’t belong. There isn’t a lot of room to spare in the brain, so any extra cells or tissues can increase pressure in the brain and damage the area around it.

When a tumor grows, especially if it is growing in or near a part of the brain that controls communication, if can affect your ability to create or understand speech.

Traumatic Brain Injury

A traumatic brain injury is damage that occurs in your brain tissues after a head injury. Head injuries that can result in brain damage can occur from:

• Concussions
• Sports injuries
• Car accidents
• Falls

Traumatic head injuries can cause bleeding or damage tissue in any area of the brain, and speech may be affected depending on where the damage occurs and how extensive it is.

Brain Disorders

A number of neurologic conditions can cause progressive damage to brain tissues that control speech and communication, including:

• Alcoholism
• Amyotrophic lateral sclerosis
• Alzheimer’s disease
• Dementia
• Huntington’s disease
• Parkinson’s disease

Diagnosis

Diagnosis of aphasia usually occurs after you or people around you have noticed speech problems. If your doctor thinks you had a stroke or head injury, they will check your ability to use and understand language regularly.

If a speech problem does develop, your doctor may also order a computed tomography (CT) scan or magnetic resonance imaging (MRI) to confirm a brain injury and identify where damage has occurred in your brain. They also typically test your ability to understand and produce language, such as following commands, answering questions, naming objects, and carrying on a conversation.

If your doctor suspects aphasia, they will refer you to a speech-language pathologist, who will perform special tests to better understand your limitations. Your ability to speak, express ideas, converse socially, understand language, and read and write are all assessed in detail.

Treatments

People with aphasia often see dramatic improvements in their language and communication abilities in the first few months of recovery, even without treatment. But in many cases, some aphasia remains. Speech-language therapy is then recommended to help patients regain their ability to communicate.

A speech therapist will work with you to figure out what areas are impacted and ways you can overcome your speech difficulties, and help you use tools that can make up for any problems that can’t be improved. This may include using writing tools instead of speaking or even computer-assisted tools like apps that can help generate speech or clarify language.

Family involvement is often a crucial component of aphasia treatment because it enables family members to learn the best way to communicate with their loved one. Family members are encouraged to:

• Participate in therapy sessions, if possible
• Simplify language by using short, uncomplicated sentences
• Repeat words or write down key words to clarify meaning as needed
• Maintain a natural conversational manner appropriate for an adult
• Minimize distractions, such as a loud radio or TV, whenever possible
• Include the person with aphasia in conversations
• Ask for and value the opinion of the person with aphasia, especially regarding family matters
• Encourage any type of communication, whether it is speech, gesture, pointing, or drawing
• Avoid correcting the person’s speech
• Allow the person plenty of time to talk
• Help the person become involved outside the home by seeking out support groups

Prognosis

While some forms of aphasia may improve over time with therapy, most types of aphasia are permanent, progressive, or irreversible. However, speech therapy can give you tools to improve your communication. Family support can also create a safe environment for you to communicate and work on communication skills.

If your aphasia is being caused by a progressive disease like Alzheimer’s, there may be medications that can help slow the progression of the disease and in turn help with aphasia.

Coping

Aphasia can be a difficult condition to live with, both for the person with the speech problem and the people they need to communicate with. Some tips to help you and your loved ones communicate include:

• Reduce background noise when trying to talk
• Ask or use simple questions that can be answered with “yes” or “no”
• Use visual aids like pictures or letter boards
• Use hand gestures and body language which can help with understanding
• Offer clear choices when asking a question
• Speak clearly but use adult language
• Be patient
• Allow the person time to speak or understand what is being communicated

Summary

Aphasia causes difficulty understanding and creating speech in writing and speaking. It’s usually a result of a stroke in or an injury to parts of the brain responsible for language. Neurological diseases and brain tumors can also result in aphasia.

Frequently Asked Questions 

What are the different types of aphasia?

The different types of aphasia are mainly expressive and receptive. This means that you have trouble using or understanding written or spoken language. There are other subgroups of aphasia that combine features of expressive and receptive aphasia.

What is Broca’s aphasia?

Broca’s aphasia, also called expressive aphasia, makes it hard for you to say or write words in a way that makes sense to other people. You may leave words out or not use spoken language at all.

How do you communicate with someone who has aphasia?

The key to communicating with someone who has aphasia is to be patient. Tips for effective communication with someone who has aphasia include speaking in short, simple sentences, allowing extra time for the conversation, and not talking down to the person with baby talk.

What causes aphasia?

Aphasia is caused by some type of injury to the brain. This can include a stroke, traumatic injuries, brain tumors, and progressive neurological diseases. How your speech is affected depends on where the injury occurs and how bad the injury is.

What is the difference between aphasia and dysphasia?

Aphasia and dysphasia are both problems with using or understanding language. Dysphasia is usually less severe than aphasia. Dysphasia can be confused with dysphagia, a swallowing disorder.

A Word From Verywell

Aphasia is a communication disorder that can affect your ability to speak and understand language. It is usually caused by either an acute injury like a stroke or trauma, or a chronic, progressive disease like Alzheimer’s.

In many cases, aphasia is a permanent condition, but speech therapy can help offer tools to communicate in new ways. If you or a loved one has aphasia, consider attending therapy sessions together so you and those around you can help forge new communication pathways.