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.
