June is National Aphasia Awareness Month

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Each year, congress passes a resolution that designates June as National Aphasia Awareness Month to support efforts to increase the awareness of aphasia, a communication impairment caused by brain damage. According to the National Institute of Neurological Disorders and Stroke (NINDS), aphasia affects at least 1,000,000 people in the United States.

Aphasia is an acquired communication disorder that impairs a person’s ability to process language, the ability to speak and understand others, and, in most cases, the ability to read and write. Because people with aphasia have difficulty communicating, others mistakenly believe that the condition affects intelligence. It is the ability to access ideas and thoughts through language that is disrupted, not the ideas themselves.

The most common cause of aphasia is stroke. About 25-40% of stroke survivors have aphasia. Aphasia can also result from a head injury, brain tumor, or other neurological causes. It is most common among older people, but can occur in people of all ages.

There are many types of aphasia which correspond to the location of the brain injury and the parts of communication that are affected.

Global aphasia is the most severe form and patients can produce few recognizable words, understand little or no spoken language, and cannot read or write. Global aphasia may occur immediately after a stroke, however if brain damage is not too extensive, it may rapidly improve.

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Broca’s aphasia, also called non-fluent aphasia, is where speech output is severely reduced, mainly consisting of short utterances of less than four words. The person may understand speech relatively well and be able to read, but vocabulary access is limited for speaking and writing.

In mixed non-fluent aphasia, patients have limited and effortful speech, similar to Broca’s aphasia. However, they are also limited in their comprehension of language and cannot read or write beyond an elementary level.

Wernicke’s aphasia (fluent aphasia) patients have an impaired ability to grasp the meaning of spoken words but their own ability to produce connected speech is not much affected. However, sentences do not hang together and irrelevant words may intrude the language in severe cases. Reading and writing are also impaired.

In patients with anomic aphasia, there is a persistent inability to find words about the things they want to talk about, particularly nouns and verbs. This is evident in both writing and speaking. They understand speech from others well, but their own output becomes frustrating.

Aphasia can be temporary, a condition called transient aphasia. More than have of those who initially show symptoms of aphasia recover completely within the first few days. If symptoms last longer than two or three months after a stroke, a complete recovery is unlikely, but some patients may continue to improve over a period of years.

The National Aphasia Association gives these tips for communicating with a person with aphasia:

1. Make sure you have the person's attention before communicating.
2. During conversation, minimize or eliminate background noise (such as television, radio, other people) as much as possible.
3. Keep communication simple but adult. Simplify your own sentence structure and reduce your own rate of speech. You don't need to speak louder than normal but do emphasize key words. Don't talk down to the person with aphasia. Repeat a statement when necessary.
4. Encourage and use other modes of communication (writing, drawing, yes/no responses, choices, gestures, eye contact, facial expressions) in addition to speech.
5. Give them time to talk and let them have a reasonable amount of time to respond. Avoid speaking for the person with aphasia except when necessary and ask permission before doing so.
6. Praise all attempts to speak; make speaking a pleasant experience and provide stimulating conversation. Downplay errors and avoid frequent criticisms/corrections. Avoid insisting that each word be produced perfectly.
7. Whenever possible continue normal activities (such as dinner with family, company, going out). Do not shield people with aphasia from family or friends or ignore them in a group conversation. Rather, try to involve them in family decision-making as much as possible. Keep them informed of events but avoid burdening them with day to day details.

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