FRIDAY, Aug. 26, 2005 (HealthDay News) -- If you're like most people, you've probably never heard of the disorder called aphasia, let alone know just how devastating it can be.
A communication disorder, it affects a person's ability to use and understand spoken or written words.
For instance, the word may be on the tip of your tongue, but you just can't utter it.
Or read it. Or perhaps write it. Or understand it when it's spoken to you.
You're trapped in a world you either can't comprehend or can't describe -- or, in the worst of cases, both.
About 1 million people in the United States suffer from aphasia. It's more common than Parkinson's disease, cerebral palsy or muscular dystrophy, according to the National Aphasia Association, a nonprofit group dedicated to educating the public about the disorder and providing support to its victims.
The condition results from damage to the side of the brain dominant for language, usually the left side, according to the National Institutes of Health. Aphasia usually occurs suddenly and often results from a stroke or head injury, but it can also develop slowly because of a brain tumor, an infection or dementia.
"If you have aphasia, going to the store is a nightmare," said Joan Peters, executive director of the National Aphasia Association. "If you have to ask for something, if you have to make change, clerks look at you like you've got some mental problem, but you are perfectly rational. They're the same inside. That's what's so frustrating. They know what they want to say, but they just can't get it out."
But even though a million Americans suffer from aphasia, few people have heard of it, Peters said.
"On a recent episode of ER, Cynthia Nixon played a young woman with aphasia following a stroke," Peters said. "She suffered all of the symptoms. But the word 'aphasia' was not used once. Someone watching the show would know what it is but wouldn't know there's a name for it."
Part of the problem understanding the disorder is that there are many different types of aphasia, depending on where the brain has been damaged or how the person acts.
"There's a huge variety of problems we might call aphasia," said Sandra Neuburger, a staff speech pathologist at the VA Hospital in Portland, Ore.
"Some people might have a hard time speaking words," she said. "Others might talk all the time and you can't get a word in edgewise, but when you think about what they're saying it doesn't make any sense. You have to figure out what they're doing, what their distinctive situation is, and then match it with what you know about the disease."
The National Aphasia Association divides aphasia into two broad categories: fluent and nonfluent aphasia.
People with fluent aphasia have problems understanding spoken and written language, while people with nonfluent aphasia have difficulty communicating orally and in writing.
Some specific types of the disorder, according to the National Aphasia Association, include:
- Global aphasia. This is the most severe form of aphasia, in which the patient can produce few recognizable words and understands little or no spoken language. People with global aphasia can neither read nor write. The condition often appears immediately after a stroke, and may improve rapidly if damage to the brain hasn't been severe. But if the brain damage is severe, the disability may last a lifetime.
- Broca's aphasia. In this form, speech output is severely reduced and limited mainly to short utterances. Vocabulary is also limited as someone struggles to form sounds. However, the person may understand speech relatively well and be able to read.
- Wernicke's aphasia. The ability to grasp the meaning of spoken words is impaired. And while the ability to string words together isn't really affected, sentences often don't make sense.
- Anomic aphasia. Sufferers struggle to find the words to describe the very things they want to talk about, particularly nouns and verbs.
Because it's a disorder caused by brain damage, there is no cure for aphasia.
Instead, doctors and therapists teach aphasia victims tactics and methods designed to return as much control of their lives to them as possible.
For example, Neuburger said, people who have trouble selecting the right word in conversation are often taught compensating strategies like describing the word they want to use.
"If you can't say 'chair,' you would say, 'You sit in it,'" Neuburger said. "Or you point to a chair. The issue isn't getting the word out. It is communication."
Drills using flash cards can help restore some vocabulary to people who've lost the ability to read, she said. Reading to the patient or having them write also can help.
For those who have trouble comprehending speech, Neuburger recommends talking slowly to them, using short sentences, and supplementing your words with gestures and pictures.
Above all, you should help a person with aphasia by not condescending to them, Peters said.
"Simply letting them finish their sentence can be the best thing you'll do for them," Peters said. "Even though you know what they're going to say, just let them finish."
More information
To learn more about aphasia, visit the National Aphasia Association.
