Aphasia and stroke: recovering communication
Imagine going to sleep tonight and waking up in the morning in a foreign country, unable to speak the language or understand what is being said to you. A stranger hands you a pen and gestures for you to write your responses to her questions, but you can no more write the words then speak them. "I know, I know," is all that you can say. In your mind you feel panic. You know what you want to say, but have no way to communicate.
The scenario above may be similar to the experience of a person with aphasia following an acute stroke. Aphasia is an acquired communication disorder that impairs a person's ability to process or produce language.
Aphasia impairs the ability to speak and understand others. Most people with aphasia experience difficulty with reading and writing, but their intelligence is usually intact. So, like the person in a foreign country, the message may be in the brain, but without access to the words communication will fail -- or be limited to facial expressions and gestures.
Aphasia can result from brain tumors or trauma and occurs in about 25-40 percent of stroke survivors. Aphasia post-stroke is associated with damage to the left side of the brain, where most of the language functions are housed. A less common form of is primary progressive aphasia, which is associated with neurodegeneration and a gradual loss of language abilities. The inability to translate thoughts into verbal expression or fully understand what is being said can result in frustration for patients and their loved ones.
In the past, it was thought -- and taught -- that recovery from aphasia would occur in the first 6 months following a stroke, and expectation for language recovery beyond a year was thought to be limited. With advances in neurological imaging techniques, theories are evolving about neuroplasticity (the brain's capacity to create new pathways over a lifetime) and -- in the case of a brain damage from stroke -- for undamaged areas to take over for damaged areas. From aphasia research, we are learning that the recovery varies significantly among patients. Many patients experience some spontaneous recovery well after what is traditionally defined as the chronic phase of stroke. For these patients with chronic aphasia, successful aphasia treatment -- along with improving communication ability -- does influence both brain function and brain structure.
Further research in this area, including singing to stimulate undamaged areas of the brain, will hopefully guide speech-language pathologists in the selection of the best individual treatment approaches.
For more information:
•Stroke Connection, a free publication from American Heart Association, www.strokeassociation.org.
•National Aphasia Association, www.aphasia.org/index.html.
To locate a licensed speech-language pathologist visit www.asha.org/default.htm.
Mary Spremulli, MA, CCC-SLP, is a licensed speech-language pathologist and private practice owner. When her mother suffered a stroke in February of 2012, she chronicled her experiences on her blog: http://voiceaerobicsdvd.blogspot.com/2012/02/aphasia-is-now-unwelcome-visitor-to-my.html.