From the Guidelines
The term for a stroke patient who cannot find their words is aphasia, specifically expressive aphasia (also called Broca's aphasia). This condition occurs when there is damage to the language centers in the brain, typically in the left hemisphere, due to a stroke. Patients with expressive aphasia understand what others say but struggle to produce speech, often knowing what they want to say but being unable to form the words. They may speak in short, simplified phrases, omit small connecting words, and become frustrated by their inability to communicate effectively. This differs from receptive aphasia (Wernicke's aphasia), where patients speak fluently but with little meaning and have difficulty understanding others. Treatment typically involves speech therapy, which should begin as soon as possible after the stroke for best outcomes, as recommended by the US-Stroke-Foundation and AUS-Stroke-Foundation 1. Early aphasia therapy, starting within the first 4 weeks post stroke, should be provided to maximise language recovery. Recovery varies depending on the severity of brain damage, with some patients showing significant improvement while others may have persistent communication difficulties. Family members can help by speaking slowly, using simple sentences, and being patient during conversations. Intensive aphasia therapy (at least 45 minutes of direct language therapy for five days a week) may be used in the first few months after stroke, as suggested by the AUS-Stroke-Foundation 1. Additionally, speech and language therapy should be provided to improve functional communication, reading comprehension, general expressive language, and written language, as recommended by the AUS-Stroke-Foundation and US:-Rehab-and-Recovery 1. Computer-based therapy and communication partner training may also be beneficial in improving communication outcomes, as indicated by the American Heart Association/American Stroke Association 1. Overall, the goal of treatment is to improve communication and quality of life for individuals with aphasia, and speech and language therapy should be provided to achieve this goal, as recommended by the American Heart Association/American Stroke Association 1.
From the Research
Definition of Aphasia
- Aphasia is a loss or impairment of verbal communication that occurs as a consequence of brain dysfunction, typically caused by a left hemispheric lesion 2.
- It manifests as impairment of almost all verbal abilities, including abnormal verbal expression, difficulties in understanding spoken or written language, repetition, naming, reading, and writing.
Types of Aphasia
- There are different classifications of aphasia syndromes, but for practical use, classification according to fluency, comprehension, and abilities of naming seems to be most suitable 2.
- Nonfluent aphasias include Broca's, transcortical motor, global, and mixed transcortical aphasia, while fluent aphasias include anomic, conduction, Wernicke's, transcortical sensory, and subcortical aphasia.
Treatment and Recovery
- Many speech impairments, including aphasia, have a tendency for spontaneous recovery, with the most remarkable recovery occurring in the first three months after stroke onset 2.
- Treatment for anomia, a type of aphasia characterized by word-finding difficulty, has demonstrated short- and long-term efficacy, with phonological cueing being a successful behavioral facilitation tool 3, 4.
- Telerehabilitation has also been shown to be a feasible and effective treatment approach for poststroke anomia, yielding comparable results to conventional face-to-face treatment 5.
- Speech and language therapy (SLT) for aphasia following stroke has been found to be effective in improving functional communication, reading, writing, and expressive language, with high-intensity, high-dose, or long-duration therapy being potentially more beneficial 6.