APHASIA

APHASIA      

          Aphasia is defined as a language impairment which affects the expressive, receptive, auditory and visual abilities of the patient. More specifically, it includes comprehension, speech, writing and reading difficulties. So, a patient with aphasia may face spelling problems, difficulties in putting his ideas and thoughts into spoken and written language or combine words together in order to create a grammatical sentence, understand what the others are saying or writing.         

 Aphasia can be the result of stroke (a third of all people who have stroke develop aphasia) or traumatic brain injury, tumour, infection or toxicity. It has been estimated that “in the United Kingdom, at least 20.000 people suffer from aphasia every year”.(Parr S.,Byng S.,Gilpin S.,Ireland C.,2003, p1) Moreover there seems to be “a higher frequency of aphasia in male than in female patients approximately 3:1”. (Enderby P., Emerson J.,1996, p11).         

 Aphasia can be classified in many different types, although there is disagreement about how aphasia should be classified or “whether classifications should exist at all”.(Shipley K.G., McAfee J.G.,1998, p 301) Despite these dissents the major aphasia types are: Wernicke’s aphasia, Broca’s aphasia, conduction aphasia, transcortical, sensory, transcortical motor, global, anomic and atypical aphasia. Apart from having different types, aphasia may also vary in severity. For this reason, it is considered as a complicated impairment.       

 As it has been referred previously aphasia can be the result of stroke, or Traumatic Brain Iinjury (TBI), or tumour. As far as it concerns the cerebral stroke or brain attack, aphasia may occur due to “bleeding into the brain from a ruptured blood vessel or by blockage caused by thickening in an artery which supplies blood to the brain or by a clot of blood which may have formed in the heart and then broken away from its source to travel towards the brain”.(Johnson M.,1987, p 2) So, the main two types of stroke are: “the ischemic, which is the most frequent since it appears with a rate of 80% and is caused when the flow of blood into the brain cells is interrupted by a blood clot and the hemorrhagic stroke which happens due to uncontrolled bleeding in the brain and thus the brain cells are killed”.(http://www.National Stroke Foundation.htm) Τhose  brain cells that die, cause the loss of the abilities that are controlled by a certain area of the brain. More specifically, the one half of the body (the opposite side to the site of the damaged brain) doesn’t function.(Powell T.,2003) This influences the motor, the visual, the sensory and the auditory abilities of the aphasic. So, stroke patients may face problems and difficulties with their speech, their muscles, their sight and their emotions. But the severity of the condition and the rehabilitation depends upon the specific area that has been affected by the stroke and the extent of the brain damage.          

 The right hemisphere stroke patients  who suffer from Wernicke’s aphasia, may have paralysis of the left side of their body, face problems with perception and reception, have memory loss and disturbances with their vision and behavior.          

 In addition to this if the stroke affects the left hemisphere of the brain (which controls the language) the patients suffer from Broca’s aphasia and have paralysis on the right side of their body. The fundamental characteristics of that type of aphasia are basically language, speech and communicational problems. Dyphasia, dysarthria and dyspraxia are the three main components that accompany a stroke. Thus, the linguistic ability of aphasia is characterized as nonfluent, they have word-finding difficulties, impairment in forming words, producing words that are wrong or substitute them with others, “a phenomenon that is called paraphasia”.(Johnson M.,1987, p 97) Besides, people with aphasia may lack comprehension, have phonation, articulation problems and speech output difficulties which make their linguistic ability slow, slurred and deliberate. Being more specific, “function words and grammatical affixes may be omitted and syntactic structure simplified or even be absent. Repetition is also disturbed in line with the disruption of spontaneous speech”.(Goodglass & Kaplan, in Johnson M.,1987, p141)  Moreover they may have disturbances with the personality, difficulties with their memory and their ability to express themselves through writing.       

 Traumatic Brain Injury results in aphasia by “an external physical force, causing total or partial functional disability or psychosocial impairment or both”.(Nichcy-GeneralinfoaboutTBI.htm) There are two types of head injury, the closed head injuries which occur when the head is being hit by a sharp object suddenly but doesn’t gets into the skull and the open head injuries where the violent object enters into the tissue of the brain.(http://www.NINDSTraumaticBrainInjuryInformationPage.htm).

   A TBI patient will present the same linguistic disturbances as the stroke patient: may lack comprehensive abilities, be speechless or repeat meaningless words again and again, or “pronounce non-sense words (jargon)” (Johnson M.,1987), have word finding difficulties, bad performance in reading and writing and problems with articulation (monotonous, slurred and slow speech).

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• (dissertation: The role of positive thinking in the linguistic recovery of dysphasia, MA in Language Disorders, University of Essex, Colchester 2003) 
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• ΠΑΤΙΟΥ ΙΩΑΝΝΑ
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• Εκπαιδευτικός Ειδικής Αγωγής – Λογοθεραπεύτρια