APHASIA occurs
when there is damage to the areas of the brain
responsible for processing language causing an
inability to find the right words for things or
the ability to put words together to form meaningful,
purposeful sentences. There also may be
an inability to understand what another person
is saying and an impaired ability to read and
write. Causes of aphasia include a stroke
that, for most people, affects the left side of
the brain as well as traumatic brain injuries,
including gunshot wounds or blows to the head,
and brain tumors.
APRAXIA of SPEECH (also called
verbal apraxia or dyspraxia) is a communication
disorder between word selection and the act of
speaking. While the intended words are correctly
selected in the initial process of turning thoughts
into words, when speaking begins, the sounds of
the letters within and between words are frequently
switched and/or substituted, making the intended
word unintelligible. For example, “television”
may sound like “veletinsion.”
To complicate things, the person with apraxia
often is aware of what has been said and repeated
attempts to correct the mistake cause stress and
frustration. Apraxia is caused by damage to the
areas of the brain that coordinate processing
of language with speaking.
DEMENTIA encompasses
multiple disorders that result in memory loss
and overall cognitive impairment that is progressive
in nature and often irreversible. Alzheimer’s
dementia is the most common but dementia also
may be caused by multiple stroke events and diseases
such as Parkinson’s and Huntington’s.
Deterioration in successful communication is associated
with cognitive deterioration. Often called
“the language of confusion,” dementia
leads to conversations that cannot be successfully
followed: sentences are not finished; questions
are not answered. These symptoms result from disorganized
thought and memory, and although irreversible,
other strategies may be employed for successful
interactions.
DYSARTHRIA refers
to “slurred speech,” as described
previously. The muscles of the mouth, tongue,
and jaw involved in speech production are weakened
from a stroke, brain injury, degenerative disease
of the central nervous system, or surgical alteration.
Severity ranges from slight disturbance of the
word to unintelligible.
RIGHT HEMISPHERE BRAIN DAMAGE
also leads to similar but more subtle cognitively-based
communication deficits. The brain’s
right hemisphere plays an important role in personality,
behavior, perceptual skills and memory. Alterations
in memory, attention, reasoning, and judgment
can lead to incomplete, inappropriate, or off-target
communication. Patients may be unaware of
these communication problems which make the resolution
more challenging. Causes include stroke but may
also be the result of a brain tumor, surgery,
infection or trauma.
Treatment
Through individual testing and consultation with
the patient's family, physicians, and other
rehabilitation professionals, the speech-language
pathologist provides a comprehensive evaluation
and treatment plan for each patient. The
goal of treatment is finalizing and developing
the best means of achieving functional communication.
