Aphasia

Aphasia is a language impairment, caused by injury to the brain. This injury may be from stroke, head trauma, brain tumors or infections and is most common in older populations. Aphasia impacts multiple aspects of communication, such as the production and comprehension of speech as well as the ability to read and write.



Types of Aphasia

The type of aphasia, or patterns in the brain impacted, varies depending on fluency of speech, comprehension of audio and repetition of words or phrases. Aphasia shows damage to the left side of the brain, where language skills reside. Language systems include the sound of speech, grammatical structure and meaning. Damage to the right side would cause problems such as poor attention or memory.

Diagram Showing Types of Aphasia
Diagram Showing Types of Aphasia (image source: Aphasia.org)

Global aphasia remains the most severe form, while Anomic aphasia is the least inhibiting. Other common varieties include: Broca’s, Wernicke’s, mixed non-fluent and Primary Progressive. Unlike other forms, Primary Progressive aphasia slowly impairs and is one of many symptoms associated with underlying disease.

The brain damage which caused aphasia may cause other issues such as dysarthria (muscle weakness in the mouth), apraxia (trouble moving the mouth properly) or dysphagia (swallowing issues).

Aphasia is not a basic sensory system deficit (hearing, vision, touch) or a motor function one. If these problems are present they are circumstantial and are most likely due to advanced age.



How Does Aphasia Affect Communication?

Aphasia will affect the ability for reading comprehension and coherent speech to varying levels depending on the type and severity. The two broad categories of aphasia are Fluent and Non-Fluent. The following is a list of symptoms that may make aphasia recognizable in a patient:

Fluent: Speech may flow and sound natural, but the content is not understandable. ie. “The door walking open under rainbow and call the cat sunglasses.” (resembles a structured sentence of the English language but makes no actual sense).

  • Speaking in seemingly complete/structured sentences that make no logical sense
  • Adding extra unnecessary or made-up words to sentences
  • Being unaware of the mistakes in their speech
  • Having difficulty understanding language
  • Issues with repetition
  • Being unable to find the right word; using filler words


Non-Fluent: Sentence structure is choppy and there is difficulty with expression, but the message may still be understood. ie. “Pass phone desk there.”  (can be understood as “Pass the phone on the desk over there.”)

  • Thoughts are coherent; knows what they are trying to communicate
  • Others can usually be understood with little difficulty
  • Speech can be physically difficult
  • Short phrases often used in place of sentences
  • Delay in response time
  • Persistent repetition

The listed symptoms above are not attributed to any one type of aphasia per say, as different cases will see different manifestations of the impairment. There may be cases where an individual only experiences a few of the challenges listed, or where they experience different combinations of these issues.



Tips for Verbal Communication 

Verbal Communication with Aphasia (image source: The Aphasia Center)

When trying to engage in spoken communication with a person affected by aphasia, it is important to:

  • Get the attention of the person before speaking
  • Talk in a quiet space & keep your voice at an audible level
  • Use shorter sentences with key words
  • Ask simpler yes/no questions
  • Slow down speech
  • Give the person time to respond
  • Try drawings, gestures or facial expressions to help convey meaning


Tips for writing for understanding

Alternately, when attempting to communicate through writing it is pertinent to:

  • Accessibility Typography (image source: Mobile UX)

    Use larger fonts & short sentences

  • Use sans serif fonts (Arial, Comic Sans, Verdana etc.)
  • Leave lots of space between lines, at least 1.5 spacing
  • Avoid using block capitals
  • Use clear headings to highlight key points
  • Use bullet points, bolding and numbers instead of words (1 vs one)
  • Use pictures that relate, close by to the corresponding text

And in cases of longer documents, brief summaries at the beginning are helpful as well as an index or helpful words section. This relates to dividing the information into subsections based on topic, which is also helpful.

Serif vs Sans Serif (image source: Easil)

 


Citations:

 

Aphasia Definitions National Aphasia Association. mk0aphasiaorgnw068ec.kinstacdn.com/wp-content/uploads/2014/12/Aphasia-Definitions.pdf. 

“Aphasia Definitions.” National Aphasia Association, 20 June 2018, www.aphasia.org/aphasia-definitions/. 

“Aphasia.” American Speech-Language-Hearing Association, American Speech-Language-Hearing Association, www.asha.org/public/speech/disorders/aphasia/. 

“Designing Apps with Accessible Fonts.” Mobile UX, 22 Nov. 2020, www.mobileux.net/2019/06/24/designing-apps-with-accessible-fonts/. 

“Making Written Information Aphasia Friendly.” Specialist Speech and Language Therapy, www.specialist-speech-therapy.co.uk/aphasia-friendly-written-information.html. 

Tomkins, Connie A. Aphasias, sk.sagepub.com.ocadu.idm.oclc.org/reference/perception/n26.xml. 

“What Does It Mean to Have Expressive or Receptive Aphasia?” The Aphasia Center, 23 Oct. 2019, theaphasiacenter.com/2019/10/expressive-receptive-aphasia/. 

“What Is the Difference between Serif and Sans Serif Fonts.” Easil, 3 Sept. 2018, about.easil.com/support/serif-vs-sans-serif/.