Thursday, March 7, 2013

Aphasia 101


As I was going through my e-mail this evening I came across an e-mail from the National Aphasia Association! I thought I would share that they have a conference coming up! Below are some of the details. If you are interested visit http://www.aphasia.org/RegionalConference.html.


NAA's Regional Speaking Out! Conference 2013 
Co-Hosted by
National Black Association for
Speech-Language & Hearing (NBASLH) 

April 20th, 2013 
L'Enfant Plaza Hotel
Washington, DC 

*Photograph by James Forsberg; stroke survivor; member of the Stroke Comeback Center

Conference DescriptionSuggested Audience
This conference offers the expertise of leaders in the field of aphasia rehabilitation who will be presenting the latest perspectives on aphasia management, research, treatment models, technological advances, and advocacy through presentations and hands-on demonstrations. The conference offers a unique integration of views from professionals and people living with aphasia and their loved ones. *People with aphasia & their families
Aphasia Community Group Leaders
Rehabilitation professionals and researchers; including speech-language pathologists, physicians, psychologists, social workers, and nurses
For more information, please contact the National Aphasia Association
(800) 922-4622
naa@aphasia.org





So what is aphasia? It is an acquired communication disorder due to brain damage. Usually the brain damage is caused from a stroke. The brain damage causes specific deficits within language - expressive language, receptive language, reading, and/or writing. 


Here is a nice image of our major landmarks!

For a good review over stroke and aphasia check out the above video!

There are many different types of aphasia...

The Non-Fluent Aphasias (include...)
1. Broca's Aphasia: We call this a non-fluent aphasia because the patient's verbal output is severely reduced. Some have short utterances (often less than 4 words). Verbal output is often labored and word finding deficits are apparent. Typically the patient is able to understand language and able to read, though caution there are sometimes receptive language delays that should not be ignored. A patient diagnosed with Broca's aphasia has damage to Broca's area. 

Key Characteristics: Limited and labored verbal output with relatively intact receptive language and reading skills.



2. Transcortical Motor Aphasia: These patient's have great difficulty with the initiation of verbal output though once started expression is fairly well articulated. These patient's also have difficulty organizing their response. They will respond briefly to questions, confrontation naming is relatively intact, they are able to repeat. These patient also have difficulty in initiation of writing though will typically write upon command and examples of what to write. 

Key Characteristics: absence of spontaneous speech and writing, able to repeat and good reading comprehension, confrontation naming is relatively intact. 

3. Global Aphasia: This is the most severe form of aphasia. Patient's with global aphasia have very few, if any, recognizable words and can understand little or no spoken language. These patient's reading and writing skills are also severely damaged. Sometimes within the acute care setting we will see a patient with global aphasia but then they will rapidly improve - sadly this is not always the case.  

Key Characteristics: Severely impaired expressive and receptive language skills as well as reading and writing.


The Fluent Aphasia (includes...)
1. Wernicke's Aphasia: The patient here has severe receptive language deficits though verbal output is fluent. That being said just because the fluency of the verbal output is intact that does not mean that the verbal output will be coherent. Many times these patient's will speak in jargon. They also have severe impairments in reading and writing.

This is how I imagine the very general difference between fluent and non-fluent aphasia... I think of speaking with a patient and I pretend to turn off the sound. Does the patient look they they are carrying on a conversation with you? If yes they are speaking fluently. Or does the patient look like they are grasping for words with lots of hesitations? If so they are non-fluent. A patient with Wernicke's aphasia is labeled this due to damage of Wernicke's area in the brain.

Key Characteristics: fluent though possibly non-choherent speech, receptive language deficits and severe impairments in reading and writing.

These are both great videos of Wernicke's Aphasia:




2. Conduction Aphasia: This type of aphasia is unique because the damage for this type of aphasia to occur happens to the connection between Broca's and Wernicke's area. When this damage occurs these two crucial components to language cannot communicate. Patient's with conduction aphasia have the inability to repeat with others say though their comprehension skills are relatively intact. These patient's have circumlocution (talk around what they really want to say), have word finding deficits, has increased paraphasias and has severe writing deficits.

Key Characteristics: inability to repeat, has circumlocution, word finding deficits, and relatively intact receptive language skills.

3. Transcortical Sensory Aphasia: This type of aphasia is when Wernicke's area becomes isolated from the rest of the brain though the brain remains "connected" with the other language areas such as Broca's area. The patient is able to repeat though does not initiate verbal output, comprehension is impaired, paraphasias and neologisms are common and reading and writing are severely impaired. Something unique about TSA is that these patients will often have echolalic speech. 

Key Characteristics: impaired comprehension, able to repeat though poor initiation of verbal communication, impaired reading and writing, echolalic, and paraphasias and neologisms are common.

Other Aphasia and Related Disorders...
1. Anomic Aphasia: Two words...WORD FINDING! These patient's have severe word finding difficulties. They have fluent and well formed sentences but in severe cases communication may feel lacking. Auditory comprehension should be relatively intact. The patient tends to purposefully circumlocute. These patient's may feel like they are more on the non-fluent side.

Key Characteristics: word finding, intact comprehension and circumlocution. 



2. Primary Progressive Aphasia: Now this aphasia is the exception to the rule of aphasia being "acquired." This type of aphasia occurs due to a degeneration of the brain in certain forms of dementia. Any of the above "symptoms" can occur within this type of aphasia, it all depends upon the area of the brain that is going through degeneration. 

3. Alexia and Agraphia: Some patients that have experienced a stroke have primary deficits in reading and writing.


The following are my references where you can find out more about aphasia!

*All of the videos were found on www.youtube.com 

If you have any questions or experiences you want to share about aphasia please post below! 


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