Neurogenic Disorders

Patients with aphasia may have a variety of symptoms depending on the location of the injury within the language centers of the brain. A patient may have difficulty expressing themselves through speaking and/or writing, yet they may appear to understand all that is happening around them. They may experience apparent muscle weakness or muscle incoordination, which makes their speech and written language unintelligible. This can be highly frustrating for the aphasic and the person with whom he/she seeks to communicate. Another symptom may be difficulty understanding spoken and/or written language. The person with aphasia may be able to speak fluently, yet cannot comprehend what is said to them or what they read. The difficulties with communication may also appear in inappropriate use of words (the person speaks fluently but their words do not make sense), word-finding difficulties, repetition of the same word/words without meaning, omitting words during the speech, and misinterpreting absurdities/idioms/humor. Symptoms, as well as severity, are highly variable in patients with aphasia, therefore therapy and communication strategies should be highly individualized.

The speech-language pathologist (SLP) will assess each area of communication that the individual was able to use prior to the injury and will determine the strengths and weaknesses of his/her communication. For example, the SLP should evaluate his/her ability to speak, write, read, and listen, determine where the communication breaks down and help provide repair strategies through therapy. If the patient is able to read well but has a difficult time speaking intelligibly, the clinician can use the strength of reading to help the patient and family develop strategies for repairing communication breakdowns within the home. During speech and language therapy, the SLP may perform drills and exercises with the patient to strengthen specific language skills affected by the brain injury, teach ways to use strengths in communication to compensate for weaker language skills, teach vocational and daily functional activities to move the person back towards independence as needed, and teach the spouse/family to help patient use communication strategies learned in therapy at home/care facility.

Aphasia is often highly frustrating for the person as well as the family and friends around the person. It is important for the family to recognize that this person with aphasia no longer communicates as they did before the injury. The family should learn how they can facilitate/aid communication by writing, providing choices, speaking slowly, and above all, being patient. Educate those around the person about his/her communication problems and teach them how to communicate with him/her more effectively. Recognize that this person still needs to relate his/her wants and needs and still desires to communicate.