Aphasia is an acquired language disorder, meaning that a person may develop this disorder after experiencing a traumatic event such as a stroke. A stroke happens when blood flow to the brain is disrupted resulting in the death of brain tissue. The damaged area is also called a lesion. Exactly where the lesion is and its size is different from one stroke survivor to the next. Some stroke survivors have no trouble speaking or listening, but they may have weakness on one side of their body or face. This is called hemiparesis and happens when a lesion affects areas of the brain that controls body movement. Interestingly, many motor (movement), speech, and language areas are close to each other in the brain.
So, after a stroke, some people may still be able to think and understand you just fine, but skilled, fine motor movements (like moving the lips to create speech sounds) are much more difficult. This could manifest as being unable to say words with a lot of consonants (e.g., b, p, t, v), or other difficult speech sounds that require intricate mouth movements. This problem is typically called apraxia of speech. Motor difficulties can also manifest as slurred speech due to trouble controlling the muscles in the mouth and throat, otherwise known as dysarthria.
Sometimes, people have lesions that affect the motor part of speech more than language. Broca’s aphasia is one example of this, where someone may be able to understand you well, but struggle to respond with more than a few words at a time. As lesions get farther away from motor areas, we see disorders like Wernicke’s aphasia where the person can move just fine, but struggle with more complex use of language like stringing together sentences or responding appropriately to questions. In our lab we tend to study people that primarily have lesions in the language areas of the brain, meaning that they probably experience some degree of trouble understanding or using language. We broadly refer to this group as people with aphasia (PWA).
In the LAB lab, we also study how people that have not had a stroke can arrive at meaningful words and sentences from individual speech sounds. Our lab is one of many in the world that is working to map language functions to different parts of the brain in people without traumatic brain injuries. We also work backwards by connecting the lesions that people with aphasia have to the type of language difficulties they experience. The hope is that studying the way all people use language will help us understand how different areas of the brain work together to make speech and language possible.
It will take many people many years to conclusively identify which areas of the brain are responsible for language use. Unfortunately, this leaves those living with aphasia without all of the answers and help they need. One day, a person with aphasia may be able to remember the names of things around their house, and the next they may genuinely struggle to recall those same words. Some days are riddled with more confusion than others, and it is very likely that recovery will feel like an eternity of taking forward and backward steps. Because of this, many people with aphasia have been led to believe that they will never speak again, or never understand speech or language again.
The truth is that aphasia recovery is nonlinear and dynamic, and for many stroke survivors the hours in speech, physical, and occupational therapy truly add up. The disorder is chronic, meaning that people with aphasia will likely always have to use strategies to aid them during conversations, reading books, or writing because aphasia can affect all modalities of language.
In this primer, there is very little mentioned about how aphasia actually affects the person with aphasia’s life. It is always important to remember that we are more than our brain activity. Luckily, our student writers care about the intersection of aphasia and everyday life, and they filled the 2024 issue of The Spoken Word with answers as to how people with aphasia are able to navigate multiple facets of life after surviving a stroke or other neurological conditions. So, as you read through the articles I urge you to consider the context of the participants in these studies.
For most of their lives, people with aphasia had complex relationships, fulfilling experiences, and nuanced opinions. In a matter of moments their ability to communicate ceased to exist, not them as a person. For people with aphasia or their family members that may read this magazine please know that there are hundreds of researchers and other professionals that spend their days thinking specifically about the difficulties you face. Many of my own days at work are infinitely better when I have the pleasure of giving a person with aphasia a listening ear, and I know so many people that share this sentiment. Below, we share a list of resources that may benefit anyone living with aphasia, those helping people with aphasia, or others curious about aphasia.
More resources about aphasia:
Public Health
• F.A.S.T (Face, Arm, Speech, Time). Recognize the signs of a stroke and intervene early: www.stroke.org/en/help-andsupport/resource-library/fastmaterials
Statistics and resources on stroke and aphasia
• American Speech Language and Hearing Association (ASHA): https://www.asha.org/ practice-portal/clinical-topics/ aphasia/
• The National Aphasia Association: https://aphasia.org/what-is-aphasia/
Fun!
• Aphasia Access: https://www.aphasiaaccess.org/
• Interact-ABI-lity, Online Communication Partner Training: https://abicommunicationlab.sydney.edu.au/courses/ interact-abi-lity/
• Aphasia choirs around the world: https://singaphasia.com/aphasiachoirs/
• Find aphasia groups near you: https://aphasia.org/ stories/support-all-states/
• Aphasia affinity groups (connect with people with the same identities):
Black Americans: https://aphasia.org/series/blackamerican-aphasiaconversation-group/
Spanish speaking aphasia group: https://www.biav.net/ resource-directory/grupo-deafasia-para-hispanoparlantesspanish-speaking-aphasiagroup/
The aphasia community: https://www.aphasia.com/
Aphasia Recovery Connection: https://aphasiarecoveryconnection.org/arc-board/
International Aphasia Movement (IAM): https://aphasianyc.org/iam-on-zoom