Aphasia

Aphasia (sometimes called dysphasia) is a disorder which affects language. This may affect a person’s ability to communicate with others.  It does not cause speech problems such as slurring, but it can co-occur with a speech disorder, such as dysarthria and/or apraxia. It is caused by damage to the left side of the brain, often a stroke.

Aphasia can make it difficult for someone to speak, understand what people are saying, read or write.  It does not damage intelligence or hearing.

Aphasia can be very confusing and frustrating for the person and their family and friends.

What problems can a person with aphasia have?

• They may know what they want to say but cannot find the words.
• They may say the wrong word
• They might have problems with reading, writing and numbers.
• They may find it hard to understand what others are saying, even though hearing and thought processes are unaffected.
• They might have trouble shopping, paying bills or talking on the phone

Communication difficulties can also change from day to day and are likely to be worse when feeling tired, unwell or anxious.

If you’re talking to someone with aphasia:

• Remove distractions/background noise.
• Make sure the person can see your facial expression when you are speaking
• Be patient and allow the person plenty of time to express him/herself and to understand you.
• Use short, simple sentences and lots of pauses. For example, instead of “we're going to have some lunch in the cafe after going for a walk”, say “We’re going for a walk (pause). Then we’re going to have lunch”.
• Keep to one topic at a time
• Use gesture, drawing, writing to help get your message across.
• If either of you are becoming frustrated, stop the conversation and come back to it later on.
• Ask yes/no or closed questions. For example, “Do you want your glasses?”, “Would you like your bed higher or lower?”

If the person is having trouble saying a word:

• try giving them the first sound, e.g. “ch” for chair.
• ask if they can describe it.
• ask if they know the first letter or sound, e.g. “ch” for “chair”.
• ask if they can show you with a gesture or point to it.

It is very important not to pretend to understand: let the person know when you do not understand. For example, “I’m sorry, I don’t understand, let’s try again..”

Remember: speak to the person like an adult. Aphasia does not affect intelligence.

A speech and language therapist can identify the problems with your language and look at ways to help you communicate and if appropriate, give you exercises to try and improve your communication.

If you have aphasia, it may be hard to:       

Speech and Language Therapy Department

Strategies to help with word finding difficulties

When you have word finding difficulties, some things can help you to find the word you’re looking for:

• Think of related items within the same category e.g. if you can’t find the word table then think of related items in the same category like chair, furniture, stool etc.
• Describe to someone how you might use it or where it would be found, e.g. You would need this to write a letter on, to lean on, you would find it in a living room etc for table
• Think of the first sound or letter of the word e.g. “t” or “tay” for table
• Think of another word it rhymes with e.g. “fable” for table.
• Think of how many syllables it has, e.g. 2 syllables for table.

You can also do the following to help when you have word finding difficulties:

• Draw a picture of the word you’re trying to find. 
• Point to the item if it is around you. 
• Mime an action that might give some clues about the word. 
• Use facial expression to show the word (particularly useful with emotions). 
• Use an alphabet chart to help remind yourself of the starting letter of the word.

Remember:

• To stay calm when you can’t find a word – if it becomes too frustrating just leave it and come back to it later 
• Let people know what works for you – e.g. if you don’t like people guessing then tell them 
• Take your time and don’t be afraid of silence

What can I do about my speaking problems?

Practise, practise, practise…

The more you practise your communication, the more progress you’ll make. So take every opportunity you can – read things out loud, repeat the names of songs on the radio, list the days of the week in the shower, whatever you can think of. And ask your friends and family to help you. Communication is also about confidence, which will come with practice too.

…but know when to stop

Communication can become exhausting, especially to begin with. So it’s important that you don’t push yourself too hard. Listen to your body. If you’re getting tired, take a rest. Find things to do that don’t need you to talk, so that you can give yourself a break. Try listening to music, watching sport or gardening, or playing a game, for example.

Laugh as much as you can

It’s easy to feel stupid when you’re always getting words wrong. And the constant struggle to get across what you want to say can be both frustrating and exhausting. It’s a lot to cope with, but for many people laughing is the best way to do it. Not only is it a good way to release tension, but it can help the person you’re talking with to feel more relaxed and happy as well.

Be up front with people

People are more likely to give you the help and time you need if they know you’ve had a stroke and struggle with speaking because of it. So explain to new people. Using a communication card may help. It’s not always easy to do, but you’ll usually find people are much more understanding than you think they will be.

Let it out

Coming to terms with the effects of your stroke is difficult enough, but it can be even harder when you’re not able to talk about it very well. But this shouldn’t stop you from getting the emotional support you need. So if you’re finding things difficult, talk to your speech and language therapist or speak to a friend or family member. You may have to arrange it so that you have the time and space you need to talk things through, but it will be worth the effort if you do. Hobbies like art, music, photography or poetry can give you a way of expressing your feelings as well.

Embrace technology

Even if you’re not used to technology, smart phones and tablet computers are actually pretty easy to use and many people with communication problems find them helpful. You can use them to video chat with people, for example, which is often easier than speaking on the phone. Or you can use them to take pictures of things that you want to ask for, like your favourite foods or members of your family. Of course, they can be expensive to buy but many people find them worth the investment.