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What is Aphasia?
Aphasia is a communication impairment that affects all aspects of language, including speaking, understanding speech, reading, and writing. Imagine going to a foreign country where you do not speak the language, or you only remember a few words from your high school or college language course. You would have difficulty saying what you mean, understanding what others were saying to you, reading the language, and writing things down. This provides a little insight into what it might be like to have aphasia.
Aphasia is caused by a brain injury, typically due to stroke, traumatic brain injury, or some other illness. Depending on the exact location of the brain injury, aphasia can manifest itself in many different ways. Some people with aphasia have more difficulty understanding what is said to them and reading than they do speaking. Other people with aphasia have more difficulty saying what they want to say but understand much of what is said to them. Sometimes aphasia is more severe and affects understanding, speaking, reading and writing quite broadly.
What Causes Aphasia?
Aphasia is usually caused by a stroke or brain injury with damage to one or more parts of the brain that deal with language. According to the National Aphasia Association, about 25% to 40% of people who survive a stroke get aphasia.
Aphasia may also be caused by a brain tumor, brain infection, or dementia such as Alzheimer’s disease. In some cases, aphasia is a symptom of epilepsy or other neurological disorder.
What Are the Types of Aphasia?
There are types of aphasia. Each type can cause impairment that varies from mild to severe. Common types of aphasia include the following:
- Expressive aphasia (non-fluent): With expressive aphasia, the person knows what he or she wants to say, yet has difficulty communicating it to others. It doesn’t matter whether the person is trying to say or write what he or she is trying to communicate.
- Receptive aphasia (fluent): With receptive aphasia, the person can hear a voice or read the print, but may not understand the meaning of the message. Often times, someone with receptive aphasia takes language literally. Their own speech may be disturbed because they do not understand their own language.
- Anomic aphasia: With anomic aphasia, the person has word-finding difficulties. This is called anomia. Because of the difficulties, the person struggles to find the right words for speaking and writing.
- Global aphasia: This is the most severe type of aphasia. It is often seen right after someone has a stroke. With global aphasia, the person has difficulty speaking and understanding words. In addition, the person is unable to read or write.
- Primary progressive aphasia: Primary progressive aphasia is a rare disorder where people slowly lose their ability to talk, read, write, and comprehend what they hear in conversation over a period of time. With a stroke, aphasia may improve with proper therapy. There is no treatment to reverse primary progressive aphasia. People with primary progressive aphasia are able to communicate in ways other than speech. For instance, they might use gestures. And many benefit from a combination of speech therapy and medications.
- Aphasia may be mild or severe: With mild aphasia, the person may be able to converse, yet have trouble finding the right word or understanding complex conversations. Severe aphasia limits the person’s ability to communicate. The person may say little and may not participate in or understand any conversation.
I am been working on invention, innovation, expert, and consultant. Aphasia is a condition that robs you of the ability to communicate. It can affect your ability to speak. Aphasia typically occurs suddenly after a stroke or a head injury. He is stroke on September 2013. I could ever have a 2013-2016 is aphasia can understand language, but can’t speak. Although has this problem he has been working with various electronic projects, 3D animation, photography, video, art, jewelry, painting, digital prints, food, drink since then.
A-FROM in Action at the Aphasia Institute
Aura Kagan, Ph.D.
As a result of this activity, the reader will be able to (1) situate the work of aphasia centers within an outcome-driven framework for intervention that is grounded in the World Health Organization’s International Classification of Functioning, Disability and Health; (2) use key Living with Aphasia: Framework for Outcome Measurement (A-FROM) principles to broaden thinking about intervention and outcome; and (3) adapt illustrative A-FROM examples to his or her own setting.
A-FROM in Action at the Aphasia Institute
Aura Kagan, Ph.D.
Aphasia centers are in an excellent position to contribute to the broad definition of health by the World Health Organization: the ability to live life to its full potential. An expansion of this definition by the World Health Organization International Classification of Functioning, Disability and Health (ICF) forms the basis for a user-friendly and ICF-compatible framework for planning interventions that ensure maximum real-life outcome and impact for people with aphasia and their families. This article describes Living with Aphasia: Framework for Outcome Measurement and its practical application to aphasia centers in the areas of direct service, outcome measurement, and advocacy and awareness. Examples will be drawn from the Aphasia Institute in Toronto. A case will be made for all aphasia centers to use the ICF or an adaptation of it to further the work of this sector and strengthen its credibility.
Communication Aid for Capacity Evaluation (CACE)
The Aphasia Institute is pleased to offer you the Communication Aid for Capacity Evaluation – CACE
Alexandra Carling-Rowland, Ph.D., developed and tested CACE, a communicatively accessible capacity evaluation process to help health care professionals determine whether or not people living with communication barriers have the capacity to decide where they shall live. CACE is designed to be used with individuals who need help to understand information and to express themselves. CACE can be used with people living with aphasia, speech disorders or hearing loss and with those who speak English as an acquired language.
The Aphasia Institute has partnered with Alexandra to publish CACE. We strongly recommend you watch the CACE training video and read the manual before you first administer CACE.
Click here for the entire CACE package or click each individual item, as follows:
- CACE Manual
- CACE Evaluator’s Version – it is recommended that you print this version in colour
- CACE Communication Cards
- CACE Response Form and Rights Information
- CACE Addendums
- CACE Training Video (38 min.)
Aphasia Reference Collection
Our goal is to provide a free, user-friendly tool for researchers, clinicians, administrators and policy-makers looking for publications relevant to the real-life issues faced by individuals and families living with aphasia.
Measure of Skill in Supported Conversation/ Measure of Level of Participation in Conversation (for partner with aphasia)
The MSC and MPC are two complementary measures designed to capture elements of conversation between adults with aphasia and their speaking conversation partners. The MSC provides an index of the conversation partner’s skill in providing conversational support. The MPC provides an index of the level of participation in conversation by the person with aphasia. The article A Set of Observational Measures for Rating Support and Participation in Conversation Between Adults with Aphasia and Their Conversation Partners presents the background to the development of the MSC/MPC, and includes preliminary psychometric evaluation.
Kagan, A., Winckel, J., Black, S., Duchan, J. F., Simmons-Mackie, N., & Square, P. (2004). A set of observational measures for rating support and participation in conversation between adults with aphasia and their conversation partners. Topics in Stroke Rehabilitation, 11(1), 67-83.
Developed with funding from the Ontario Ministry of Health and Long-Term Care, via the Ontario Stroke Network, the Communicative Access Measures for Stroke (CAMS) is a set of simple and practical measures, which may be useful in developing heath equity plans, accreditation planning, service quality improvement initiatives and continuing education needs assessments related to stroke care in various healthcare settings. The measures include three questionnaires for evaluating status and satisfaction with communicative access in stroke care:
- CAMS1 Policies and Procedures
- CAMS2 Frontline Practice
- CAMS3 Patient Satisfaction
This tool will be in helpful in developing health equity plans, accreditation planning, service quality improvement, and continuing education needs for stroke survivors in various health care settings.
CAMS will be ready in Winter 2015.
Assessment for Living With Aphasia (ALA)
Developed with funding from the Ontario Ministry of Health and Long-Term Care, via the Ontario Stroke Network, this comprehensive assessment package provides tools to better assess the impact of aphasia and identify the factors that affect the quality of life and exacerbate or reduce disability.
Benefits of the Assessment
- Provides quantitative and qualitative data from the perspective of the person living with aphasia
- Uses pictographic approach which allows for participation across a full range of severity
- Based on Living with Aphasia: Framework for Outcome Measurement A-FROM
- In line with World Health Organization’s ICF
- Psychometrically sound: demonstrated reliability and validity (n=101)
- Captures real-life issues for planning and evaluating aphasia treatment and making funding decisions
On-line – Self-Directed Learning
When communicating with a person with aphasia, keep some of the following materials on hand to help enable conversation and comprehension:
- Blank paper to present one or two pictured items or words at a time.
- Markers or pencils – the bolder or larger the writing, the better to see so use a thick black marker. For those with aphasia, writing with a pencil is easier. Make sure to place the pencil and paper right in front of him/her.
- Cut out window, created from construction paper – use this to frame one picture at a time.
Paper and flashcards – whether letter-sized or small sheets, flashcard can be used to write keywords (e.g., TOOTHBRUSH) or to introduce or change a topic.
On-line – Self-Directed Learning
How to Use Communication Techniques
The fundamental thing to remember when working with someone with aphasia is to be natural. Use communication techniques when breakdowns occur, gradually layering when needed. Overusing communication techniques can also cause incomprehension if the person with aphasia feels you’re being patronizing. Watch the cues from the person with aphasia closely and follow the path that seems to be getting the most response. And remember – everyone experiences communication challenges from time to time, even the most skilled communication partners.
Those with severe aphasia will likely need more extensive support to absorb messages both in and out so use as many communication techniques that appear to be helping.