Aphasia means having language difficulties after a brain injury, usually after a stroke. You may have difficulty speaking and writing, or understand spoken and written language. When you cannot communicate as you are used to, life is affected in many ways. But there is much to do and several tools to use to improve.

The trouble is usually greatest for the first time after a stroke. In most people, the trouble diminishes after some time and for some, they disappear completely. Many, on the other hand, still face difficulties, but can learn to live with them.

Symptoms of aphasia

If you have aphasia, it is common for you to have difficulty with the following:

  • To talk, for example, because you cannot find the right words or exchange words and letters.
  • To interpret and understand what others are saying.
  • Understanding what you read.
  • To read aloud.
  • To spell and formulate sentences in writing. 

Everyone who has aphasia has a hard time finding the right words. You may not even come across the word you want to say. You can also say the wrong word or repeat the same word over and over. It may also be that you only find short words such as, and that, but, just, just and like. Then it becomes difficult for the surroundings to understand what you want to say. You may have difficulties both when speaking and when writing.

During the first few days after a stroke, it is very common for you to have difficulty understanding what the surroundings are saying. 

Hard to talk without having aphasia

If you have a hard time articulating and talking sleazily it is not aphasia. It is called dysarthria. Then you have no difficulty with the language but can read, write and understand what the surroundings say.

Apraxia means you have difficulty controlling the tongue, lips and other parts of the mouth. Then you cannot form words and letters that you want. You also have difficulty mimicking mines and making the wrong move when, for example, you are asked to stretch out your tongue or around your lips.

It is not uncommon to have aphasia, dysarthria, and apraxia at the same time.

To talk

When you talk, it may be fluid or non-fluid. It is common for you to have difficulty getting started and talking. You may need help from someone who says the first sounds of a word.

If you have a fluent speaker, you can speak without difficulty but may exchange letters or whole words so that the speech becomes difficult to understand for the surroundings. It can even be that you talk without interruption and use words that you find on your own. In the beginning, it is very common for you to repeat a word and use it when you really want to say something else. For example, it may be when you answer a question, when some always answer yes, even though they sometimes say no, and vice versa.

The difficulty of finding the right words often becomes particularly clear when you say the names of your relatives. You may also have difficulty with numbers, such as phone numbers or social security numbers.

Interpret and understand

If you have had symptoms of aphasia after a stroke, you often find it difficult to interpret what other people say. You may also find it difficult to understand what you are saying yourself and therefore cannot correct yourself when you have said something wrong. Thus, it is the brain that has difficulty interpreting what the ears hear. For most, the difficulties gradually decrease.

To read

It can be difficult to read or understand what you are reading because you do not recognize letters and words. You may also look bad or have difficulty interpreting what you see. This means that you do not understand the whole lines of text or words. The limitations can be different and vary from not being able to read at all to missing or reading errors on single words. 

Spell and formulate sentences

The ability to spell is affected by most people who have aphasia. It is not uncommon for you to not be able to write at all because you cannot enter the first letter of the word. Sometimes letters are exchanged for each other, sometimes whole words can be omitted. It is also not uncommon for you to get stuck in a word or syllable and rewrite it.

Many who have had aphasia after a stroke are also paralyzed on the right side of the body. For a right-handed person, it may take time to learn how to write with your left hand.

Express yourself with body language

Many may find it difficult to express themselves with gestures, faces, and body language. This is especially true in the beginning. The difficulty may be because you will not be able to plan and execute movements, so-called apraxia. People in the area may then initially have difficulty interpreting what you want to express.

When and where should I seek care?

  • Hard to find words and talk or if what you say suddenly becomes wrong.
  • Hard to understand what the surroundings are saying.
  • Problems with reading or writing.

Contact a health care center if difficulties with the language have come for a long time.

Treatment of aphasia

The treatment of aphasia you receive depends on the difficulties you have. In the beginning, it is common for you to get individual linguistic training from a speech therapist, who works to help people who have difficulties with communication, language, speech, and voice. 

Later it is common for you to get training in groups. Together with the speech therapist, you can practice using the speech, for example by naming nouns and verbs and putting words together into sentences. Similarly, you can practice formulating yourself in writing. You can train reading comprehension by pairing written words or sentences with pictures or objects.

If you find it very difficult to talk, you can instead practice communicating by, for example, pointing, drawing or using mines and gestures. Then you get new ways to get attention, ask for something, express an opinion or make a decision.

You may need to practice different ways of dealing with everyday situations. Many people who have had aphasia have learned to always carry a calendar with them to be able to point out important dates, names, notes and the like. It is also common to have a shopping list with you when shopping.

Other ways to communicate

Both you who have aphasia and close relatives may need to practice using other means of communication. Sometimes you are helped by having a so-called communication book with pictures, maps, text, symbols or whatever is best. The communication book is produced in collaboration between you, the logo pediatrician and related persons. It is important that the environment also takes responsibility for its use.

A computer can also be a tool if you can spell a little. Many people are used to being able to send e-mails and keep in touch with people you might not meet so often. When working with a computer, you can save the text and review it when you have finished writing. There are also programs that can facilitate such as spelling programs, speech synthesis, and screen reading. With these programs, you can have the text read on web pages or in e-mails.

A smartphone or tablet can facilitate in several ways. With the help of the camera, calendar, and map on your smartphone or tablet, you can tell you both what you have done and what to do and about places you have or should visit. In addition, there are special communication apps with content that can be customized to your needs.

With a camera or scanner, you can make a data file of, for example, a letter that you need help understanding. A recipient who receives the file via e-mail can then tell us what is in the letter.

Other things that can be easier are, for example, image telephony, speech magazines, and voice books.

Read more about how it is possible to get a tool, and how you can find out what tools are available to get where you live.

Long-term linguistic training is often needed

Often you will need to receive linguistic training for a long time and both you and your relatives may need support and guidance. Often you may also need to contact a curator.

In many places, there are day rehabilitation and home rehabilitation that can offer continued treatment of aphasia at the speech therapist once you have been discharged from the hospital. In some parts of the country, there are special daily activities with employees of speech therapists for people with aphasia.

There are also aphasia associations in most counties that organize activities tailored to people who have aphasia, where you have the opportunity to share experiences. In some of these, there is “Meeting place Afasi” with, among other things, linguistic training at a computer. There are also special computer programs that you can use and exercise at home.

In some parts of the country, there is Taltjänst, which is an interpreting business that you can get help with when you have a disability-related to voice, speech or language. Speech services can help, for example, at doctor’s visits or in social contexts, for example at an association meeting.

What is aphasia?

Aphasia is a disability that means you have language difficulties after a brain injury. For example, you may find it difficult to speak, write, find words and understand spoken and written language. Sometimes the word dysphasia is used instead, but it means the same thing.

It is most common for you to have aphasia after a stroke. Other causes may be that you have injured your head in an accident or that you have had a brain tumor.

Interaction between different parts of the brain

Aphasia is because of the parts of the brain that process language that has been damaged. In most, there are linguistic features in the left hemisphere. In some, they are in the right hemisphere, especially in the left hand. Also, damage to other parts of the brain can cause you to have problems with the language since the language function is an interaction between different parts of the brain.

The language difficulties vary from person to person

The linguistic difficulties differ from person to person and depend, among other things, on the part of the brain that has been damaged and the size of the injury. Often you have a combination of different difficulties. 

Languages ​​are many different things, such as the following:

  • To talk
  • Understanding what you and others are saying.
  • To write by putting words together into sentences.
  • To read by interpreting the words in a text.

All these ways of using the language can be affected when you have aphasia. Therefore, each individual’s abilities and difficulties in different language areas are often examined.

Some will be good again

If you are going to get rid of the linguistic difficulties depends largely on what has caused the brain damage, how extensive the damage is and wherein the brain is located. It also depends on how well you recover in the rest. If you get worse, it is very likely that it also affects aphasia.

Some people who have had aphasia after a stroke become completely healthy again, but for most people, the difficulties remain. The biggest improvements occur during the first three to six months, but there is a possibility that the language function will be improved for several years after the injury.

Investigations

If your difficulties with the language have come gradually over a long period of time, you will first be examined by a doctor at a health care center. Depending on what the survey shows, you can then get a referral to a speech therapist for further investigation.

When you come to an emergency room because of symptoms of aphasia that have come quickly, a doctor will investigate the cause. If it turns out that you have a brain injury such as a stroke, you may be hospitalized for more examinations and treatment of aphasia

If the linguistic difficulties remain, a speech therapist does a thorough investigation of the language and ability to communicate. 

A speech therapist performs various tests 

During the first call, the speech therapist needs to form an idea of, for example, how you find words, pronounce words, put sentences together and manage to tell something. You can do several different tests that show how you read, hear, talk and write. The speech therapist also examines how to use gestures, mines and body movements. Wakefulness, memory, attention and the impact on vision are also investigated. 

The tests you get to do include looking at pictures or objects and telling them what they represent. You can also answer questions, read and interpret a text and tell in speech and writing what you have read or heard. If you cannot write by hand, you may use a keyboard or a letter board. 

The speech therapist also examines what impact the linguistic difficulties have in everyday life and what needs you have. You or a relative may tell you, for example, what activities and contacts you have outside the home.

How is life affected by aphasia?

Getting aphasia can be a big change for many. In the beginning, both the person with aphasia and the immediate surroundings are often very frustrated, because you cannot talk as usual. You may not understand what others are saying and maybe annoyed when others do not understand.

Aphasia differs from individual to individual. One person can have a lot of difficulty with all the linguistic features, while another can have so little difficulty finding words that the surroundings barely notice it. For these people, life is affected differently. How one has used the language before the illness also has a major impact on how life is affected. If you have read books, solved crossword puzzles, written e-mails and talked to many people on a daily basis, life can change significantly. Often you will eventually find other ways of communicating.

Aphasia can affect social life

Aphasia is an invisible handicap and can be misinterpreted at times. Many people with aphasia find it helpful to show a small information card when meeting new people. The card may contain brief information that you have aphasia, what it means and what the person you are talking to should think about to facilitate the conversation. The card may also contain information about who should be contacted should something happen to you.

If you cannot communicate by talking and writing, participation in social interaction is severely limited and there is a risk that you will isolate yourself. You may find it more difficult to do everyday activities such as booking time, reading the morning newspaper, watching a foreign movie on TV, calling a friend, sending or reading e-mail and more.

Influence and participate in your care

StandardText. In order for you to be able to participate in your care and make decisions, it is important that you understand the information you receive from the healthcare staff. Ask questions if you don’t understand. You can also ask for information printed so that you can read it peacefully.

Being related

Aphasia also affects you who are related. As a close relative, you have an important role to support and often take on the role of managing contacts with the outside world.

You may be necessary help when visiting, for example, the health center or the bank, but anyone with aphasia must also be given the opportunity to be independent as far as possible. For advice and guidance, you as a relative can turn to a speech therapist.

In most parts of the country, there are aphasia associations that you can get support from even as close relatives. Contact information can be found on the Afasi Association’s website.

Need to plan more than before

Many people with aphasia and their relatives think that everyday life works better when planning the days. It is not uncommon to trade on a weekly basis instead of trading occasionally. Before a visit to the doctor, it is usually easier to go through together in advance what symptoms of aphasia and inconveniences you want to ask questions about, and maybe even record it so that nothing is forgotten.

How can you facilitate conversations?

It is good if you encourage those who have aphasia to use gestures, faces and body language, although many who have aphasia have difficulty communicating so in the beginning. The best part is that you yourself are extra clear in your facial expressions, pointing to what you are talking about and using clear, everyday and simple gestures. Anyone with aphasia can thus learn to use body language to communicate.

Keep this in mind when talking to someone who has aphasia:

  • Talk clearly.
  • Use simple, short sentences.
  • Feedback, that is, make sure you understand correctly.
  • Don’t pretend you understand when you don’t.

It can be good to write support words while you talk, for example about the topic of conversation, what you have decided, what day you should do something, who to attend on the birthday and the like. Then it will be easier for you to summarize what you talked about for the person who has aphasia.

It may feel difficult to start communicating in a new way. A speech therapist can, therefore, train and help relatives to do this in a natural way.

Ehtisham Nadeem

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