What is Aphasia?

Aphasia is a communication impairment affecting the production or comprehension of speech and the ability to read or write. Aphasia is the result of an injury to the brain, most commonly from a stroke or head injury. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), there are an estimated 180,000 new cases of aphasia every year in the United States and as of 2015, there were approximately 1 million people in the United States living with aphasia.

Aphasia has a variety of causes including:

  • Stroke
    • Ischemic—caused by a blockage that disrupts blood flow to a region of the brain
    • Hemorrhagic—caused by a ruptured blood vessel that damages surrounding brain tissue
  • Traumatic brain injury
  • Brain tumors
  • Brain surgery
  • Brain infections
  • Progressive neurological diseases (e.g., dementia)

According to the American Speech-Language Hearing Association, common signs and symptoms of aphasia include the following:

  • Impairments in Spoken Language Comprehension
    • Having difficulty understanding spoken utterances
    • Requiring extra time to understand spoken messages
    • Providing unreliable answers to “yes/no” questions
    • Failing to understand complex grammar (e.g., “The dog was chased by the cat.”)
    • Finding it very hard to follow fast speech (e.g., radio or television news)
    • Misinterpreting subtleties of language (e.g., taking the literal meaning of figurative speech such as “It’s raining cats and dogs.”)
    • Lacking awareness of errors  
  • Impairments in Spoken Language Expression
    • Having difficulty finding words (anomia)
    • Speaking haltingly or with effort
    • Speaking in single words (e.g., names of objects)
    • Speaking in short, fragmented phrases
    • Omitting smaller words like the, of, and was (i.e., telegraphic speech)
    • Making grammatical errors
    • Putting words in the wrong order
    • Substituting sounds or words (e.g., “table” for bed; “wishdasher” for dishwasher)
    • Making up words (e.g., jargon)
    • Fluently stringing together nonsense words and real words, but leaving out or including an insufficient amount of relevant content
  • Impairments in Written Expression (Agraphia)
    • Having difficulty writing or copying letters, words, and sentences
    • Writing single words only
    • Substituting incorrect letters or words
    • Spelling or writing nonsense syllables or words
    • Writing run-on sentences that don’t make sense
    • Writing sentences with incorrect grammar
  • Impairments in Reading Comprehension (Alexia)
    • Having difficulty comprehending written material
    • Having difficulty recognizing some words by sight
    • Having the inability to sound out words
    • Substituting associated words for a word (e.g., “chair” for couch)
    • Having difficulty reading noncontent words (e.g., function words such as tofromthe)

An initial screening can be done by a family care provider to determine if an individual experiencing signs and symptoms of aphasia should be seen by a speech language pathologist. Once an individual is screened as having aphasia, a speech language pathologist will do a comprehensive language and communication assessment. This assessment will determine the severity of the aphasia as well as a long-term treatment plan

More information about aphasia can be found at www.asha.org.