Speech and language therapy for aphasia (brain damage after a stroke or head injury)

Aphasia is a brain condition, usually caused by a stroke or severe head injury, which affects the parts of the brain responsible for speech and language. Many people who have suffered a brain injury lose all or part of their ability to communicate such as controlling speech movements, remembering words, expressing thoughts, and understanding what they are told. The loss of a human tool as essential as communication has a strong impact on the affected person and their family. Thankfully, speech and language therapy can attempt to recover what is lost in people who suffer from aphasia.

Logopedic intervention aims to improve altered functions and help in the acquisition of new compensatory communicative skills. The family of an aphasia patient plays a primordial role in speech and language therapy and can learn specific strategies to enhance the communication of the person affected. At the same time, medical advances are emerging that provide new procedures for the rehabilitation of speech.
 

What is aphasia?

Aphasia is a language disorder due to acquired brain injury, usually to the left hemisphere. The cause of aphasia may be a stroke, tumour, infection, or traumatic brain injury. People with aphasia may have difficulties, both in expression and in understanding of language, as well as in reading and writing. It is an alteration primarily of language. It is not surprising that a person with severe aphasia is able to recognise their friends and remember facts of their life, as well as to understand and remember what they see, even if they have difficulty understanding precisely what is said to them.

Different types of aphasia:

1. Global aphasia – the most severe form. Affected patients cannot express themselves further than ‘hello’ and ‘goodbye’, nor can they write or communicate through gestures but they do understand visual information like the clock or the calendar.
2. Broca’s aphasia – patients speak slowly with great effort and with difficulty in finding words. At the same time they have problems with the components of language; articulatory, grammatical and lexicography.
3. Wernicke’s aphasia – speech is fluent and abundant without difficulty but with multiple errors, which in the initial phase gives rise to unintelligible jargon. Attention and listening are severely affected and people cannot follow conversation.

What does aphasia rehabilitation involve?

Logopedic intervention is part of a comprehensive rehabilitation that includes medical, neuropsychological and social aspects. It begins with an assessment to establish the diagnosis and to determine which language components are affected and which are retained. Rehabilitation is then initiated, with two objectives: providing the means to communicate more effectively and achieving the maximum possible recovery of language skills.

At the same time, a relationship is established that will help the patient and their family to be encouraged to find new goals and to adapt to their new situation. Recovery requires a lot of effort and is usually partial, although it varies greatly from one case to another. The involvement of the family can significantly increase the results of rehabilitation. Guidelines are given to the family to provide an environmental stimulation of language and to collaborate in the daily work necessary to optimise the recovery.

Communication strategies for speech and language therapy in aphasia

• Make sure you have the patient’s attention before commencing
• Minimise background noise
• Maintain your own voice at a normal level
• Keep communication simple but do not talk down to the patient
• Give them time to speak without finishing their sentences or words
• Use drawings, gestures, writing and facial expressions
• Ask ‘yes’ and ‘no’ questions
• Engage in normal activities and try to involve patients in day to day activities
• Encourage their independence

A speech language therapist diagnoses the condition by testing the patient’s language capabilities and they can help arrange the correct treatment, whether that’s in group therapy sessions or personal. There are also a number of computer-based programs to support people with aphasia.