According to the National Aphasia Association, over 2 million people in the United States live with aphasia, with nearly 180,000 Americans coming down with this condition yearly. (1)  Interestingly, despite the prevalence, most people have not heard of it and do not know what happens to someone with aphasia.

Aphasia is a speech and language impairment that affects your ability to speak, read, and even understand what others say. People who have aphasia are generally competent and retain their level of intelligence, however, communication may be mildly or severely difficult depending on the type and severity of the impairment. This piece explores all you need to know about aphasia, how it happens, and what happens after.

Key Takeaways

• Aphasia is a common speech and language disorder that often occurs following a stroke, traumatic brain injury, brain tumor, or degenerative disease such as Alzheimer’s.
• Aphasia primarily affects the dominant hemisphere, and for the majority of people, this is the left hemisphere.
• The region of the left hemisphere affected determines the type of aphasia an individual suffers and the symptoms they experience.
• Aphasia doesn’t have any effect on your intelligence, however, it may affect your job depending on the severity and type of aphasia, as well as your job description. It may also impact your ability to return to driving.

What Happens to Someone With Aphasia?

Have you ever had a family member or friend who suffered from a stroke or any other brain injury? Did you notice any odd changes in their speech?

Aphasia typically occurs after a stroke, traumatic brain injury, tumor, or other degenerative diseases. People primarily develop aphasia when their left hemisphere is affected. This area of the brain is responsible for language and speech processing, comprehension, and production in about 99% of right-handed individuals and most left-handed people. (2)

Within the left hemisphere, different areas are responsible for the various aspects of speech, and the symptoms a person experiences often depend on the affected area. Here are the main aspects of the left hemisphere responsible for your speech.

• Broca’s Area: Located at the inferior-frontal aspect of the left hemisphere, Broca’s area is responsible for speech and sentence formation. Injuries affecting this area will affect your ability to speak fluently.
• Wernicke’s Area: It is located in the posterior region of your left hemisphere and is responsible for processing written and spoken language. Individuals with damage to this area have difficulty processing spoken or written sentences.
• Arcuate Fasciculus: This consists of nerve bundles that form neural pathways connecting Broca’s and Wernicke’s areas. It is essential for language processing and is specifically responsible for speech repetition. (3)

What happens to an individual with aphasia generally depends on the area of the left hemisphere that is affected and the extent of damage. However, it is crucial to note that beyond the symptoms, these people may experience frustration and depression due to their inability to communicate like they used to.

What Are The Types of Aphasia?

Aphasia is classified into types based on the area of the left hemisphere that is injured or damaged. Some of the common types include.

• Wernicke’s or Fluent Aphasia
• Broca’s or Non-fluent Aphasia
• Global Aphasia
• Conduction Aphasia
• Mixed Aphasia
• Transcortical Aphasia
• Primary Progressive Aphasia

What Symptoms Do People With Aphasia Experience?

People living with aphasia suffer a wide range of symptoms depending on the type. If you experience any of these symptoms, especially after a brain injury or damage, you may have aphasia.

• Difficulty understanding words or sentences
• Labored speaking – exerting a lot of energy when speaking
• Problems with finding the right words
• Difficulty repeating words, phrases, or sentences
• Saying incomprehensible words or making up new words
• Substituting words while speaking
• Problems with writing or understanding written sentences
• Speaking words in the wrong order
• Difficulty saying long or complex sentences
• Saying short or incomplete words or sentences

These symptoms can be mild or severe depending on the extent of injury.

How is Aphasia Treated?

After stabilizing you and conducting a comprehensive history taking, examination, and assessment, your therapist will create a personalized treatment plan for you. This plan generally depends on your overall health, age, and the type and severity of aphasia. Here are some treatment modalities your doctor may recommend.

1. Speech and Language Therapy: It is the primary treatment for aphasia and is guided by a certified speech-language therapist. This therapy may consist of the following.

1. Melodic Intonation Therapy
2. Word Retrieval Therapy
3. Constraint-Induced Language Therapy

1. Medications such as bromocriptine, galantamine, memantine, and donepezil.
2. Brain Stimulation: Including transcranial direct-current stimulation and transcranial magnetic stimulation.
3. Augmentative and Alternative Communication, such as gestures, writing, and drawings.

Depending on your treatment goals and recommendations from your doctor and speech-language pathologist (SLP), your treatment may consist of one or more of these strategies. It is essential to note that these treatments are most effective when started early and complied with.

Does Reading Aloud help with Aphasia?

Yes, reading aloud can help with aphasia. It is an essential aspect of Oral Reading for Language in Aphasia. This is a common aphasia treatment where you and your speech therapist read full sentences aloud together. This process is aimed at improving your intonation and prosody. It can also help to improve pronunciation, fluency, and articulation.

Can Someone Recover from Aphasia?

Can aphasia be fixed? Yes. However, the recovery journey for each person differs. Recovery can take weeks, months, and in some cases, years. While some people fully recover from aphasia, some may not. Some people recover well enough to engage in meaningful conversations, while others are taught alternative methods of communication to make communication as easy as possible. Additionally, a few people recover spontaneously, particularly people who suffer a mini-stroke, while most individuals with aphasia may need weeks to years of speech-language therapy.

Whether or not a person fully recovers depends on the underlying cause and how severe the damage or injury is.

Life After: Living with Aphasia

Can someone with aphasia drive? Can I return to my job? Does it affect my intelligence?

These are only a fraction of the questions that individuals with aphasia or their families have to deal with, especially in the initial phases. Life after a brain injury or brain damage is tough – being unable to do something you could previously do effortlessly is frustrating. People with aphasia struggle with depression and, even worse, other physical symptoms like weakness or paralysis of one part of the body. While their intelligence is left intact, they may experience difficulties returning to different aspects of their life, such as jobs and driving (4).

As such, it is essential that they get the right type and level of support to thrive and adapt to their new reality while striving to improve. Here are a few ways you can offer support to a friend or family member struggling with aphasia.

• Engage them in your conversations
• Use simple words and sentences while speaking with them
• Allow them to complete their sentences themselves
• Encourage them to communicate in a method comfortable to them
• Give them adequate time to fully express themselves, and don’t try to correct their speech. Learn to ask them questions when you’re not sure what they mean.
• Encourage them to participate in group therapy and join support groups.

Conclusion

Aphasia isn’t just a speech disorder, it is a life-altering condition that affects how individuals communicate and connect with their family, loved ones, and the world. While it has no impact on intelligence, the communication barriers it creates can affect you emotionally and socially. Fortunately, with early diagnosis, individualized treatment, and adequate support, many people with aphasia can experience significant improvement and, in some cases, full recovery. Regardless of the treatment modality, progress and recovery are possible.

However, whether you’re newly diagnosed or have been dealing with aphasia for some time, remember to take one step at a time, join group therapy and support groups, and stay consistent with treatment.

Written by: Dr. Ori Otokpa, MBBS

Medically Reviewed by: Dr. Danielle Kelvas, MD

References

1. What is Aphasia? – The National Aphasia Association. (2024, July 30). Retrieved from https://aphasia.org/what-is-aphasia/
2. Kirshner, H. S., MD. (n.d.). Aphasia: practice essentials, background, pathophysiology. Retrieved from https://emedicine.medscape.com/article/1135944-overview#a6
3. Ivanova, M. V., Zhong, A., Turken, A., Baldo, J. V., & Dronkers, N. F. (2021). Functional contributions of the arcuate fasciculus to language processing. Frontiers in Human Neuroscience, 15. https://doi.org/10.3389/fnhum.2021.672665
4. Wallace, H. E., Gullo, H. L., Copland, D. A., Rotherham, A., & Wallace, S. J. (2024). Does aphasia impact on return to driving after stroke? A scoping review. Disability and Rehabilitation, 46(25), 5977–6000. https://doi.org/10.1080/09638288.2024.2317989