All About Aphasia by Tom Broussa
Aphasia is a language disorder typically resulting from a stroke, with language problems including reading, writing, and speaking deficits. It usually affects older individuals but younger people acquire aphasia too. Brain injuries resulting in aphasia can also arise from head trauma, brain tumors, or infections.
There are about 2.6 million people with aphasia in North America, and about 25% to 40% of people with a stroke acquire aphasia. It is more common than Parkinson’s disease, cerebral palsy, and muscular dystrophy, combined but most people have never heard of it before.
Aphasia can be severe (unable to speak at all) or very mild. Severity is affected by the location in the brain and the amount of time passing without blood and oxygen. It is called Time is Brain. It may affect a single aspect of language deficits, such as the ability to find the names of objects, or the ability to make a sentence, or being unable to read. The various language modalities from a stroke are all damaged differently; able to read but not write, able to hear but can’t express, able to do all those things with no memory of doing those things.
The main types of aphasia are: Global, Broca’s, Wernicke’s, and Primary Progressive Aphasia.
Conventional language therapy is designed to help start the process of repairing the language of patients. But the short bursts of intermittent therapy are not the silver bullet that some might think. Nothing about recovery is fast or immediate.
Repetitive, persistent language activities (diary/journaling, voice/video recording, pictures, walking/exercise and more) themselves are the fuel that rewire the connections among and between the neuronal networks that drive recovery and language improvement. The activities created the fuel that is needed to start ignite plasticity.
Experience-dependent neuroplasticity is the lifelong process of creating, organizing, and shaping the neural connections that occur as a result of a person’s life experiences. Differing life situations and circumstances influence how areas of the brain develop and continue to grow in certain directions.
A stroke destroys a random set of neurons and the associated dendrites and synapses. As a result, the effect of the damage is also random across many different neural networks. The remaining neurons can still produce more dendrites and synapses based on similar experiences used by previous habits and well-established experience-dependent neuroplasticity-inducing activities.
The brain is built to shape and repair the living environment by using the same tools, the same activities, and the same habits that had been used the first time the links were established. The activities induce plasticity and create the dendrites and synapses that are needed to rebuild the learning (synaptic) field.
The activities themselves must become habitual such that once they are deeply rooted, induce plasticity and keep the momentum going. That is the direct link between cognitive activities, plasticity and rewiring the brain.
Here are the principles for lifelong, self-directed therapy:
Motivation - Learn more about your personal history looking for the motivational habits that made you who they were, before your stroke. Motivation is the start of almost every recovery but it comes from within.
Various Stimulus - Start regular journaling/diary, voice/video recording, pictures, walking & exercise, and other activities. Review the evidence of your activities and the resultant feedback.
Timing - Start early (likely through your family before you are able) with the long-term therapeutic & habitual processes long before the end of conventional therapy. Habit and the underpinning cognitive structure requires the repetitive actions to flourish in order for recovery to take effect over time.
Materials – Ask for (or ask your family to ask for) educational materials about aphasia (i.e., The ABCs of Aphasia: A Stroke Primer) before being discharged at the hospital.
Recovery Plan – Ask for help for a long-term recovery plan before conventional therapy ends that begins the lifelong, self-directed therapy that is needed. There are also high- and low-tech activities, social groups, books clubs, and others that can help support the creation of your recovery plan after your formal therapy have ended.
The basis for recovery for people with aphasia is about the need for long-term, purposeful, self-directed activities that provide the fuel that induces neuroplasticity and the resultant learning.
There are a number of useful resources and websites for people with stroke and aphasia including the National Aphasia Association (NAA) (www.aphasia.org) and the American Stroke and Heart Association (www.heart.org.). There are also useful resources, websites, and books (e.g. The ABCs of Aphasia: A Stroke Primer) provided by people with aphasia themselves, Stroke Educator, Inc. (www.StrokeEducator.com) and Aphasia Nation. Inc. (www.AphasiaNation.org) are among them
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