Aphasia Rehabilitation and Recovery

Aphasia is a neurological language disorder that impacts a person’s ability to communicate effectively. It does not affect a person’s intelligence; rather, it impairs the brain’s language processing centers, making it difficult to use or understand words.

Because it affects the brain’s communication network, aphasia can impact all four primary areas of language:

• Speaking: Difficulty finding the right words, substituting words, or struggling to form sentences.
• Listening: Trouble understanding spoken language or following fast-paced conversations.
• Reading: Difficulty processing written words, sentences, or books.
• Writing: Struggling to spell words, write grammatically correct sentences, or copy numbers.

Acquired aphasia occurs when the parts of the brain that control speech and language (usually the left side of the brain) are damaged. The most common cause is a stroke, but it can also occur due to traumatic brain injuries, tumors, and infections, along with other health conditions that affect the brain.

Primary progressive aphasia—a rare kind of aphasia—is a neurological condition that causes slow and gradual difficulty when the brain tissue used for speech and language shrinks over time.

More than 2 million people in the United States have aphasia. About 1 in 3 people who have a stroke develop aphasia.

Yes, there are different types of aphasia. The type of aphasia someone has depends on what kind of language difficulty they have, and where their brain was damaged. 

Aphasia is classified by how well someone can repeat and understand spoken language, and how fluent or smooth their speech is when they talk. A speech-language pathologist (SLP) can help determine what type of aphasia someone has.

• All types of aphasia make it hard to find words: It can be mild, like having trouble thinking of specific words in a conversation, or very severe, like not being able to say any words at all.
• Most people also have difficulty understanding what others say: It can be mild, like missing small details during a complex discussion, or very severe, like not understanding any words at all.

Fluency refers to how smoothly someone’s speech flows.

Someone with non-fluent aphasia has difficulty initiating speech and may speak in only short words or simple phrases. Their speech may be slow and halting, with unnatural melody and rhythm. They have a lot of trouble saying what they mean.

Someone with fluent aphasia has natural rhythm and melody and can speak in longer sentences; however, what they are saying may not make sense, and they may use “made-up” or incorrect words.

People with aphasia have trouble finding the right words, and communicating what they want to say. They might make mistakes when speaking, including:

• Saying a word that is close, but not correct (i.e., saying “orange” for “apple”)
• Saying a word that is not related at all (i.e., saying “fish” for “apple”)
• Mixing up sounds in a word (i.e., saying “apsel” for “apple”)
• Using words that seem made-up (i.e., saying “clospow” for “apple”)
• Describing a word when they can’t find the word (i.e., saying “That thing that grows on a tree” for “apple”)
• Getting stuck and repeating words they have already said
• Not being able to speak at all

Some people also have trouble understanding others. This can make it hard to:

• Participate in conversations
• Understand questions
• Follow directions
• Recognize pictures or objects

Sheltering Arms Institute offers inpatient and outpatient aphasia therapy services with licensed and certified speech-language pathologists, along with an Aphasia Support Group for community members with aphasia and their families, friends, and caregivers.

Aphasia therapy is personalized to focus on the specific areas of language that are challenging for each individual person. It might focus on improving skills related to speaking, understanding, reading, and writing, practicing other ways to communicate, and teaching family and caregivers the best ways to communicate with someone who has aphasia.

In both the inpatient and outpatient settings, people with aphasia participate in individual therapy sessions with a speech-language pathologist (SLP).

In the inpatient setting, people may also attend aphasia therapy groups to increase their communication confidence and practice talking in social settings. They may also work with a music therapist to improve their language skills through music, rhythm, and melody.

Speech-language pathologists (SLP) can help determine specific strategies to support communication, depending on each person’s individual strengths and areas of difficulty. The following strategies are generally helpful when talking to someone with aphasia:

• Speak in short, simple sentences.
• Try writing or using visuals like gestures, pictures, or objects to help communicate your message.
• Ask the person questions that they can answer with “yes” or “no.”
• Be patient and give them extra time to respond.
• Remove any distractions (i.e., TV or radio).
• Speak to them like adults. Remember, people with aphasia communicate differently, but aphasia does not affect a person’s intelligence.
• Use a normal volume. Aphasia does not impact hearing, so speaking louder will not help them to understand.

Aside from seeking therapy, visit our aphasia resources and support group pages for more information on resources to aid in the recovery journey.