Understanding Aphasia: Causes, Symptoms, and Therapies

In late March, Bruce Willis's family announced that the Die Hard star was stepping away from his acting career after being diagnosed with aphasia.

The news shocked fans of the beloved movie star and thrust aphasia, a language disorder that is often misunderstood, into the spotlight.

What is aphasia?

Aphasia is an acquired language disorder that affects a person’s ability to produce and/or understand language.

It is most commonly a result of brain injury, such as stroke or head trauma.

Millions of Americans are living with aphasia and more than 200,000 Americans are diagnosed with the condition on a yearly basis.

As a result of stroke, about one-third of those individuals will have aphasia.

The type and severity of the aphasia are dependent on the location and severity of the stroke or trauma.

Primary progressive aphasia (PPA) is another, more rare type of aphasia.

Rather than being caused by brain injury or trauma, PPA is a neurodegenerative disease that results from decline of the frontotemporal lobe of the brain.

PPA comes on slowly and worsens over time, causing the decline of language abilities.

What does aphasia look like?

A person with aphasia may have difficulty finding words and understanding written or verbal language, but their intelligence is intact.

Their thoughts are still in their head, but their ability to communicate those thoughts is disrupted.

As a result, aphasia can cause great frustration for the person living with the condition: they know what they want to say, they just can't get the words out.

Is aphasia treatable?

There are several evidence-based therapy interventions that have been well researched for treatment of aphasia.

Severe cases of aphasia, resulting in complete loss of spoken expression, may benefit from alternative-augmentative communication strategies.

Speech-language therapy can help individuals with aphasia regain language or provide support for language breakdowns in conversation.

PPA, as mentioned above, is progressive, and will get worse with time.

However, there is some evidence that speech-language therapy can slow the progression of PPA and provide family support for communicating with loved ones with this condition.

How can you better communicate with a loved one who has aphasia?

Aphasia can result in significant communication breakdowns, increasing frustration for both for the person living with the condition and for their loved ones. Aphasia frequently results in social isolation.

It's important to practice patience with aphasia, but to avoid condescension. 

Strategies include:

  • Talk in a quiet place, avoiding background noise
  • Use simple language but do not “talk down” – aphasia does not affect intellect
  • Use shorter sentences
  • Repeat back key words to confirm what the person said or meant
  • Give the person extra time to speak
  • Avoid finishing the person’s sentences or correcting their speech
  • Ask more ‘yes’ and ‘no’ question and fewer open-ended questions

This blog post was written by Sofia Stratford, a graduate SLP clinician from Northeastern University, and Jaime Cascarano, MA, CCC-SLP.

Learn more about Speech Therapy at South Shore Health.