Laura Thorburn, M.S., CCC-SLP
This article is a guide to global aphasia. It will help you learn what aphasia is, the main symptoms of global aphasia, and how global aphasia is treated. You’ll also learn 10 helpful tips for communicating with a person who has aphasia.
What is aphasia?
First, it’s helpful to understand what aphasia is. Aphasia is a complex neurological condition that affects a person's ability to understand and express language. It often results from brain damage, typically occurring in the left hemisphere, which is responsible for language processing in most right-handed individuals. This damage can be caused by injuries such as stroke, a physical trauma to the brain, or a tumor.
There are several types of aphasia, each with distinct characteristics. Aphasia can be categorized through an evaluation with a speech-language pathologist.
Rather than being a specific condition, aphasia can affect a person’s language function in different ways. People with aphasia may have varying degrees of difficulty with speaking, listening, reading, and writing. The four primary areas of language where people with aphasia may have problems are:
1 Speech repetition
Repeating words, phrases, and sentences that someone else says
2 Naming
Being able to name objects
3 Auditory comprehension
Understanding words, phrases, or sentences that are spoken by another person
4 Fluency
The smoothness, rhythm, and rate with which a person speaks
Every brain is different. While we can make fairly reliable statements about the parts of the brain and the areas they control, there is variation. But one thing is certain, speech therapy will make a big difference in recovery for every type of aphasia, including global aphasia.
What is global aphasia?
Global aphasia is called “global” because it results from damage to both the receptive and the expressive language areas of the left side of the brain. Receptive language refers to how we understand words that we hear. Expressive language refers to how we express our thoughts and feelings.
In global aphasia, most areas of communication are affected. This includes speaking, understanding, reading, and writing. The assessment profile of a person with global aphasia usually closely resembles the following:
Speech repetition: Poor
Naming: Poor
Auditory comprehension: Poor
Fluency: Nonfluent
What does global aphasia sound like?
The hallmark symptom of global aphasia is nonfluent speech. The person may be limited to a single word or group of sounds and repeat them over and over. The melody and rhythm of speech may sound correct, but it may be hard to understand because the sounds or words are repeated.
Here’s an example of how a person with global aphasia might sound:
Speech therapist: “How are you?”
Person: “Je je je je jeee.”
What are other symptoms of global aphasia?
Because auditory comprehension is affected, the person is not able to self-monitor and hear their jargon-like sounds or words.
A person with global aphasia will also have difficulty reading and writing even simple and familiar words, including their name.
How is global aphasia treated?
Communication is incredibly complex. When receptive language and/or expressive language is impaired, speech therapy can help in two ways:
1 Impairment-based treatment
This treatment is aimed at improving language function to its prior level. Examples include Melodic Intonation Therapy (MIT) and Visual Action Therapy (VAT).
2 Communication-based treatment
The goal here is to provide the person with some sort of communication abilities in order to improve their quality of life or reduce their frustration. Examples include augmentative and alternative communication (AAC) devices and supplemental communication.
It’s important to note that a combination of these treatment types may be used. Because of the extensive variation in brain function and damage, global aphasia can have varying degrees of severity. One treatment program may be useful for one person, while another program may lead to better outcomes with another.
In addition, a person may begin with one type of treatment and, as they improve, change to another program. Your speech therapist will work with you to determine the specific type that will best support your communication needs.
10 tips for communicating with a person who has global aphasia
As we’ve explained, aphasia varies in its severity. However, a person’s sense of self can be greatly impacted when they have aphasia. Some people have severe aphasia, but they continue attempting to engage with others. Other people may have mild word-finding problems, but they are much less comfortable socializing than they were before.
It’s important to support a person with aphasia by maintaining a sense of respect. We need to recognize that language alone has been impacted, not the person’s intelligence level. Here are 10 simple ways to increase success when communicating with a person who has aphasia.
1. Check in and confirm they understand by asking them “yes” or “no” questions.
2. Encourage the person to communicate; try to avoid talking for them.
3. Use a normal volume when speaking unless the person asks you to speak more loudly or quietly.
4. Pause and allow the person time to speak. Do not finish their sentences.
5. Limit any background noise to promote a calm and quiet environment.
Encourage the person to communicate; try to avoid talking for them.
6. Ensure the person is paying attention to you when you’re talking to them.
7. Do not correct the way they pronounce words. Keep a pleasant facial expression while listening to the person speak.
8. Take advantage of alternate ways to communicate, such as pictures, written words, gestures, and facial expressions.
9. Use a simple form of communication. This doesn’t mean speaking about simple, child-like things, but using the least complex words and sentences when discussing information.
10. Encourage participation in group conversations. Shift the topic to the person with aphasia: “Dave, what do you think about that game?”
Support from family, friends, and a speech therapist can significantly improve a person's ability to navigate daily interactions and regain confidence in their communication abilities. At Expressable, our speech therapists are knowledgeable in all types of treatment programs. We will work with you to establish a plan of care that gets you back to communicating to your top potential.
