Saturday, October 31, 2020

Understanding Aphasia in Stroke Survivors

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There are many different types of aphasia.  In general, the different aphasia types are classified into two major categories, based on whether or not the person with aphasia has fluent or non-fluent speech.  With fluent aphasias, the person’s ability to produce connected speech is relatively preserved.  However, this does not mean that their word choices and how they express themselves is normal.  Often times, the speech of these individuals can best be thought of as a “word salad”, because even though they can say a lot of words and sentences, it doesn’t generally make sense.  Additionally, their ability to understand both spoken and written language is impaired, and their attempts to write often are similar to their speaking abilities.  Individuals who have these types of difficulties might be referred to as having a “Wernicke’s aphasia”, or a “Transcortical Sensory” aphasia, if they have the ability to repeat words and sentences that are spoken to them.

Other types of fluent aphasias are “Conduction” aphasia and “Anomic” aphasia.  In Conduction aphasia, the person has a relatively preserved ability to understand language, both spoken and written, but they have significant difficulty with repetition and saying specific words.  They will often produce “phonemic paraphasias”.  These are word errors in which the speech sounds produced are similar to the desired word.  For example, a “spoon”, might be referred to as a “poon”, “soon” or even “pone”.  In Anomic aphasia, the primary limitation is the ability to retrieve specific words when needed during communications.  It might best be thought of as an “it’s on the tip of my tongue” disorder.  Individuals with Anomic aphasia are generally able to understand language, both written and verbal.  Their writing abilities are often similar to their speech difficulties, in that they have difficulty thinking of specific words.

The non-fluent aphasias are designated to those individuals who have a limited ability to produce speech, wherein their spoken messages are often very slow, halting and may contain only three to four words.  However, their ability to understand spoken and written language is a relative strength.  “Broca’s aphasia” is a type of non-fluent aphasia that fits this description.  Similar to Broca’s aphasia is “Transcortical Motor” aphasia, in which the person is able to repeat words and sentences, but they essentially have all the other characteristics of Broca’s aphasia.

The more severe types of non-fluent aphasias are “Mixed Non-Fluent” aphasia and “Global” aphasia.  In Mixed Non-Fluent aphasia, they have speaking abilities that are similar to Broca’s aphasia, but their understanding of language is not adequate enough to classify them as having Broca’s aphasia.  The most severe form of aphasia is Global aphasia.  With this type of aphasia, the individual has severe-profound difficulties with all forms of communication (i.e. talking, listening, reading and writing).  Communication is very difficult, not only for the person with aphasia, but also for their communication partners

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