(ORDO NEWS) — The news that movie star Bruce Willis has retired from acting due to aphasia has brought attention to this little-understood communication disorder. Here’s what you should know.
What is aphasia?
“Aphasia means that a person has a language problem they were not born with,” explains Hugo Botha, a neurologist at the Mayo Clinic in Minnesota.
The most common cause is a stroke or head injury – and experts stress that while aphasia can affect the production and understanding of both spoken and written language, it usually does not affect intelligence.
About 2 million Americans suffer from the condition, according to the National Aphasia Association, making it more common than Parkinson’s, cerebral palsy, or muscular dystrophy.
A 2016 survey by the same group found that less than 9 percent of people know what it is.
Although it is usually triggered by a specific, one-time event, such as a stroke, “there are other possibilities, such as a neurodegenerative disease,” explains Brenda Rapp, a cognitive scientist at Johns Hopkins University.
In such cases, the damage is progressive, and therapy is aimed at preventing further loss of function.” Willis’s family did not provide a reason for his diagnosis in their statement.
What are the different forms?
The brain system that controls language is a “very complex machine” that includes choosing the right words, the appropriate mouth movement to say them, and understanding and deciphering their meaning, Rupp says.
Everyone has difficulty finding the right word from time to time, “but you can imagine that with aphasia it happens very often,” she added.
Physicians sometimes divide aphasia into broad clinical categories that correspond to where the brain injury occurred.
With expressive aphasia, people “usually understand quite well, but have difficulty speaking words,” says speech pathologist Brooke Hatfield of the American Speech Hearing Association (ASHA).
A person with this type of aphasia may use simple sentences like “I want to eat” to be understood.
In receptive aphasia, “words come easily, but they can be wrong words. And it’s hard for the person to understand what they’re hearing,” Hatfield adds.
The good news, says Hatfield, is that “everyone has a chance to get better” in the long run.
“There are people who had a stroke 30 years ago and are still working on their speech and communication and are still making progress.”
The brain is extremely plastic, and speech therapy can use other parts of the brain to “get around the obstacles” of damaged areas and make new connections, Rupp says.
Such therapy also teaches people to talk about a topic if they get stuck on a particular word.
Family members can also develop strategies to be better understood: “Things like shorter sentences and making sure you’re talking to a person in plain sight and not in another room and minimizing background noise,” Botha says.
Some people do well with assistive devices because their ability to write doesn’t suffer as much.” In the future, there are experimental therapies combining electrical brain stimulation with speech therapy that have shown promise in restoring function, Rapp says.
All the experts stressed the importance of patience. Aphasia can be frustrating and isolationist because “our relationships with other people depend a lot on being able to talk and connect with them,” Rupp says, which can lead to the person or their caregivers withdrawing into themselves.
“It’s like a sudden awakening in a country where you don’t speak the language,” Hatfield said, “rather it’s a change in basic cognitive abilities.
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