One of the most discernible effects that a stroke, a head injury or dementia has, is its effect on the ability of the survivor or patient to communicate. Communication as one of the ADLs (Activities of Daily Living) is important in how it relates to a person’s ability to be independent and to thrive. A person’s ability to communicate affects how they can have companionship, which is an essential part of being a person.
Aphasia and Dysphasia
When assessing a communication disturbance, medical staff differentiate between:
(a) speech disorders – physical difficulties affecting the complex process of pronunciation, and,
(b) language disorders – disruption of the semantic process in which thoughts and ideas become speech, and the syntactic process of forming appropriate sentences.
Dysphasia is a language impairment that is caused by damage to the brain, most often by stroke.
Aphasia is a difficulty to use and understand words, although the person’s intelligence is unaffected.
The National Aphasia Association provides figures: aphasia affects between 25% to 40% approximately of all stroke survivors.
Aphasia and dysphasia are often used interchangeably and the term ‘aphasia‘ is usually used to mean either of those terms, since they often co-exist.
How Aphasia affects the Brain and Speech
Aphasia causes brain damage in the part of the brain that controls speech and language. As a result, a sufferer has difficulty expressing himself by the spoken word, in writing or signing. There may also be disturbance of comprehension of speech or written language.
Aphasia can affect each sufferer in a different way. When a person cannot retrieve the right words from their internal dictionary, they can’t express their thoughts smoothly. Sometimes the difficulty in comprehending written words and writing words, extends to using numbers.
How are speech and language disorders diagnosed?
One of the ways a doctor will test for dysphasia will be to ask the patient to repeat or say complex phrases and tongue-twisters, to indicate the extent of their language and speech ability. They will also ask the patient questions, give specific instructions and ask the patient to name objects. This will enable the doctor to understand whether the patient has a speech or language disturbance and how severe it is.
Working Towards a Cure
Speech therapy with a speech-language pathologist is the main cure for aphasia, usually following a stroke. If there is more hope there is of recovery, the sessions will be more intense and closely spaced. The hope is, to recover what can be recovered while that part of the brain is healthy enough to adapt.
Communication with a Language Disorder
In the case of expressive dysphasia, there is a difficulty in forming words to make a meaningful sentence. With receptive dysphasia, the difficulty is in comprehending the words heard. When the conditions overlap, as is often the case, communication can be seriously impaired. Communication as one of the ADLs is precious, it is one of the things a person needs in order to be an independent person. People need to communicate in order to feel connected to society and thrive.
Often dysphasia co-exists with dysphagia, which is the inability to swallow anything, including saliva. Unfortunately, this affect communication as a whole, perhaps more than speech. The speaker has to overcome the physical and emotional difficulties and so do the listeners.
In such cases, in spite of the difficulties in communication as one of the ADLs, companionship is still incredibly important, since humans are social creatures. In a future article about Companionship for an Aphasia Sufferer we will share tips on ways to get around the communication challenges following a stroke.