Aphasia (cont.)
How is aphasia diagnosed?
Aphasia is usually first recognized by the physician who treats the person for his or her brain injury. Frequently this is a neurologist. The physician typically performs tests that require the person to follow commands, answer questions, name objects, and carry on a conversation. If the physician suspects aphasia, the patient is often referred to a speech-language pathologist, who performs a comprehensive examination of the person's communication abilities. The examination includes the person's ability to speak, express ideas, converse socially, understand language, read, and write, as well as the ability to swallow and to use alternative and
argumentative communication.
How is aphasia treated?
In some cases, a person will completely recover from
aphasia without treatment. This type of spontaneous recovery usually occurs
following a type of stroke in which blood flow to the brain is temporarily
interrupted but quickly restored, called a transient ischemic attack. In these circumstances, language abilities may return in a few hours or a few days.
For most cases, however, language recovery is not as
quick or as complete. While many people with aphasia experience partial
spontaneous recovery, in which some language abilities return a few days to a
month after the brain injury, some amount of aphasia typically remains. In these
instances, speech-language therapy is often helpful. Recovery usually continues
over a two-year period. Many health professionals believe that the most
effective treatment begins early in the recovery process. Some of the factors
that influence the amount of improvement include the cause of the brain damage,
the area of the brain that was damaged, the extent of the brain injury, and the
age and health of the individual. Additional factors include motivation,
handedness, and educational level.
Aphasia therapy aims to improve a person's ability to communicate by helping him or her to use remaining language abilities, restore language abilities as much as possible, compensate for language problems, and learn other methods of communicating. Individual therapy focuses on the specific needs of the person, while group therapy offers the opportunity to use new communication skills in a small-group setting. Stroke clubs, regional support groups formed by people who have had a stroke, are available in most major cities. These clubs also offer the opportunity for people with aphasia to try new communication skills. In addition, stroke clubs can help a person and his or her family adjust to the life changes that accompany stroke and aphasia.
Family involvement is often a crucial component of aphasia treatment so that family members can learn the best way to communicate with their loved one.
Family members are encouraged to:
- Simplify language by using short, uncomplicated sentences.
- Repeat the content 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. Seek out support groups such as stroke clubs.
Other treatment approaches involve the use of computers to improve the language abilities of people with aphasia. Studies have shown that computer-assisted therapy can help people with aphasia retrieve certain parts of speech, such as the use of verbs. Computers can also provide an alternative system of communication for people with difficulty expressing language. Lastly, computers can help people who have problems perceiving the difference between phonemes (the sounds from which words are formed) by providing auditory discrimination exercises.
What research is being done for aphasia?
Scientists are attempting to reveal the underlying problems that cause certain symptoms of aphasia. The goal is to understand how injury to a particular part of the brain impairs a person's ability to convey and understand language. The results could be useful in treating various types of aphasia, since the treatment may change depending upon the cause of the language problem.
Other research is attempting to understand the parts of the language process that contribute to sentence comprehension and production and how these parts may break down in aphasia. In this way, it may be possible to pinpoint where the breakdown occurs and help in the development of more focused treatment programs.
Although different languages have many things in common when specific portions of the brain are injured, there are also differences. Scientists are trying to understand the common (or universal) symptoms of aphasia and the language-specific symptoms of the disorder. Other researchers are examining whether people with aphasia may still know their language but have difficulty accessing that knowledge. These studies may help with the development of tests and rehabilitation strategies that focus on specific characteristics of one language or multiple languages.
Researchers are exploring drug therapy as an experimental approach to treating aphasia. Some studies are testing how drugs can be used in combination with speech therapy to improve recovery of various language functions.
Researchers are also looking at how treatment of other cognitive deficits involving attention and memory can improve communication abilities.
To understand recovery processes in the brain, some researchers are using functional magnetic resonance imaging (fMRI) to better understand the human brain regions
involved in speaking and understanding language. This type of research may
improve understanding of how these areas reorganize after brain injury. The
results could have implications for both the basic understanding of brain
function and the diagnosis and treatment of neurological diseases.
SOURCE: National Institutes of Health,
National Institute on Deafness and
Other Communication Disorders
Last Editorial Review: 7/6/2009
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