What is Aphasia?
Aphasia is a language disorder resulting from damage to the language centers in the left hemisphere of the brain, caused by reasons such as brain trauma or degenerative diseases. Consequently, the patient’s abilities such as speaking, understanding spoken language, naming, repetition, reading, and writing are also impaired. Aphasias are generally seen in two forms: fluent and non-fluent aphasia.
What kind of problems does Aphasia cause?
Aphasia causes impairments in understanding what is said, speaking fluently and meaningfully, reading, and writing, without affecting the person’s intellectual level. The types of aphasia can differ according to the location and severity of the damage in the brain.
Among the complaints caused by aphasia are:
- Hesitation in speech (non-fluency),
- Inability to speak except for certain words,
- Agrammatic speech,
- Speech that is fluent but the content is meaningless,
- Mispronunciation of words or confusing them with a word of similar meaning while speaking (such as saying “plate” instead of “cup”),
- Inability to recall the intended word,
- Difficulty perceiving spoken language,
- Inappropriate repetition of a previously spoken word (perseveration),
- Difficulty perceiving what is read,
- Difficulty writing,
- Misspelling of words and inability to form sentences.
What are the types of Aphasia?
1. Fluent Aphasias
A. Wernicke’s Aphasia
The lesion may be within Wernicke’s area or the nearby temporal and parietal regions. This type of aphasia has two main components. The first is the impairment of written and spoken language comprehension. The second is the deficiency seen in speaking independent language. Patients with the second type generally cannot construct some words properly or place them appropriately in the sentence. In Wernicke’s aphasia, speech is fluent, with normal prosody, melody, and inflections, but it is meaningless in content.
B. Conduction Aphasia
The lesion is in the white matter pathway connecting the Broca’s and Wernicke’s areas (the arcuate fasciculus), and the most prominent feature is problems experienced with repetition. It is normally a type of fluent aphasia, but the more anterior the lesion, the more non-fluent the speech becomes.
C. Transcortical Sensory Aphasia
The lesion is located posterior to Wernicke’s area, at the intersection of the parietal and temporal regions. It is very similar to Wernicke’s aphasia, except for the preserved ability to repeat.
2. Non-Fluent Aphasias
A. Broca’s Aphasia
The lesion is in Broca’s area. Speech in Broca’s aphasia is non-fluent, agrammatic, and has a telegraphic style lacking prosody, melody, and inflections. The person understands what is said to them and can be aware of their errors.
B. Transcortical Motor Aphasia
In this type of aphasia, repetition and reading are preserved. Other than this, it is very similar to Broca’s aphasia. Dysarthria, caused by weakness of the oral organs, may be observed in patients with Broca’s and especially transcortical motor aphasia.
In this language disorder, the person cannot produce spontaneous speech, form words, or convey what they mean. However, they can repeat something if you ask them, without struggle. This language disorder usually occurs as a result of an impact anterior to Broca’s area.
C. Global Aphasia
This is the most common and severe type of aphasia. Patients with global aphasia neither understand what is spoken nor can they produce speech.
How is Aphasia treated?
Significant successes can be achieved in the treatment of aphasia today. Speech and language therapy plays a major role in aphasia rehabilitation. Starting speech and language therapy without delay after a diagnosis of aphasia is made will accelerate and increase the patient’s gains. Since rapid development occurs especially in the first 6–12 months, receiving therapy support during this period is highly beneficial.
A speech and language therapist organizes a session to evaluate the patient’s language and speech skills in detail. They may use standardized tests (e.g., ADD – Aphasia Language Assessment Test) or non-standardized tests during the assessment. During this evaluation, the patient’s speech, auditory discrimination, repetition, naming, reading, and writing are examined in detail. The purpose of language therapy for an aphasia patient is to attempt to restructure the language they acquired and lost, through treatment and training. Therapy is carried out in the form of stimulating the brain according to the patient’s weak language and cognitive areas and transferring the learned skills to real life.