Celebrity Bruce Willis has recently shared with the world his diagnosis of Aphasia.  In the extensive news coverage surrounding this announcement, Bruce Willis announced his decision to take a step back from his acting career to manage his diagnosis with friends and family. Thanks to Willis’ courage to discuss his condition publicly, “Aphasia” is receiving national attention. In this article, we are going to provide a summary from The American Speech Hearing Language Association (ASHA) about Aphasia, including its signs, causes, testing, and treatment. We will also cover recommendations for those who have loved ones with Aphasia, and how they can communicate more effectively with those afflicted.  

About Aphasia

Aphasia is a language disorder that happens when you have brain damage. Your brain has two halves. Language skills are in the left half of the brain in most people. Damage on that side of your brain may lead to language problems. Damage on the right side of your brain may cause other problems, like poor attention or memory. Aphasia may make it hard for you to understand, speak, read, or write. It does not make you less smart or cause problems with the way you think. Brain damage can also cause other problems along with aphasia. You may have muscle weakness in your mouth, called dysarthria. You may have trouble getting the muscles of your mouth to move the right way to say words, called apraxia. You can also have swallowing problems, called dysphagia.

Signs of Aphasia

Aphasia can lead to a number of different problems. You may have trouble talking, understanding, reading, and writing.

Talking

You may find that you:

• Can’t think of the words you want to say.
• Say the wrong word. Sometimes, you may say something related, like “fish” instead of “chicken.” Or you might say a word that does not make much sense, like “radio” for “ball.”
• Switch sounds in words. For example, you might say “wish dasher” for “dishwasher.”
• Use made-up words.
• Have a hard time saying sentences. Single words may be easier.
• Put made-up words and real words together into sentences that do not make sense.

Understanding

You may:

• Not understand what others say. This may happen more when they speak fast, such as on the news. You might have more trouble with longer sentences, too.
• Find it hard to understand what others say when it is noisy or you are in a group.
• Have trouble understanding jokes.

Reading and Writing

You may have trouble with the following things:

• Reading forms, books, and computer screens.
• Spelling and putting words together to write sentences.
• Using numbers or doing math. For example, it may be hard to tell time, count money, or add and subtract.

Causes of Aphasia

Aphasia is most often caused by stroke. However, any type of brain damage can cause aphasia. This includes brain tumors, traumatic brain injury, and brain disorders that get worse over time.

Testing for Aphasia

You should see a doctor if you have trouble speaking or understanding what people say. A doctor will determine if there is a medical cause for your problem. A speech-language pathologist, or SLP, will test your speech and language skills. The SLP will ask you about the problems you have and what you want to work on. The SLP will test how well you:

• Understand words, questions, directions, and stories.
• Say words and sentences. The SLP will ask you to name objects, describe pictures, and answer questions.
• Read and write. The SLP will have you write letters, words, and sentences. You will also read short stories and answer questions about them.
• Find other ways to share your ideas when you have trouble talking. This may include pointing or using other gestures and drawing pictures.

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Treatments for Aphasia

There are many ways to work on your language. The type of treatment you get depends on what you want and need. You may work with an SLP on your own or in a small group. You may want your family to be a part of your treatment. They can help you use the skills you learn with the SLP at home. You may also join a support group or Stroke Club for social activities. Do you speak more than one language? You may talk better in one language and have more trouble in the other. Or, you may have trouble in both. You should work with an SLP who speaks both languages if you can. In severe cases, you may need to find other ways to answer questions or tell people what you want. These may include simple hand gestures, writing, pointing to letters or pictures, or using a computer. This is augmentative and alternative communication , or AAC. The SLP can help you get ready to go back to work or school if that is your goal. You may need to change how you do your work. Or you may need special equipment to help you communicate. Your SLP can work with your boss or teachers to make these changes. See ASHA information for professionals on the Practice Portal’s Aphasia page.

Tips for Communicating With a Person Who Has Aphasia

These tips may make it easier for you to understand and talk with others. Share these tips with your family and friends.

To help me talk with you:

1. Get my attention before you start speaking.
2. Keep eye contact with me. Watch my body language and the gestures I use.
3. Talk to me in a quiet place. Turn off the TV or radio.
4. Keep your voice at a normal level. You do not need to talk louder unless I ask you to.
5. Keep the words you use simple but adult. Don’t “talk down” to me.
6. Use shorter sentences. Repeat key words that you want me to understand.
7. Slow down your speech.
8. Give me time to speak. It may take me longer. Try not to finish my sentences for me.
9. Try using drawings, gestures, writing, and facial expressions. I may understand those better than words sometimes.
10. Ask me to draw, write, or point when I am having trouble talking.
11. Ask me “yes” and “no” questions. Those are easier than questions that I have to answer in words or sentences.
12. Let me make mistakes sometimes. I may not be able to say everything perfectly all the time.
13. Let me try to do things for myself. I may need to try a few times. Help me when I ask for it.

Other Resources

This list does not include every website on this topic. ASHA does not endorse the information on these sites.

• Aphasia Hope
• National Aphasia Association
• American Stroke Association