Fact Sheet for Doctors

Aphasia is a disorder of language processing and communication.

• Patients with this disorder may have difficulty expressing themselves through spoken or written words, or they may have difficulty understanding speech or reading.
• Aphasia does not affect a person's intelligence. While patients with aphasia may have difficulty generating or interpreting language, their ability to understand nonverbal communication is still intact.
• People with aphasia can understand emotional intonation and facial expression very well. Thus, people with aphasia may not be able to share thoughts with others, while exquisitely aware of the gist of what is being said to (or about) them.

• Many clinicians have been taught that there is an "outer limit" for the time course of recovery, after which little change occurs. This is untrue for most people with aphasia - many changes and improvements in function can occur in the chronic period.
• It is not too late to refer a stroke survivor with aphasia a year or more after the stroke or brain injury! Some stroke survivors report that they experienced their best recovery three or more years after the brain injury occurred.
• Medical providers can refer people with aphasia to speech language pathologists, psychologists, and neuropsychologists to help plan chronic rehabilitation.
• A rehabilitation physician (physiatrist) or neurologist who is knowledgeable about aphasia may also be of assistance.

• For this reason, it is important for medical providers to explore use of alternative forms of language.
• Approaches may include writing or drawing instead of speaking, use of numbers to allow selection from lists of options, pointing, gesturing, observation of body language, and addition of emotional content to improve communication.
• Some patients have learned to use computer programs, alphabet boards, or cards to assist in communication with others.
• It is useful to check for understanding during a conversation: ask the patient to restate what you say.
• Finally, if a patient has a caregiver or friend particularly adept at interpreting their style of communication, ask that person to be present during the patient's medical visits. Be sure to confirm that your patient approves of the person's presence during his/her appointment.

• Many people with aphasia have difficulty sequencing events, understanding the relationships between actions and the objects being acted upon, using tools, using numbers, and talking on the telephone or understanding written material.
• Verify that your patient has understood all important information that is transmitted via the telephone. Since you are unable to see the patient's facial responses - such as a puzzled look - the person with aphasia has no opportunity to communicate nonverbally with you.

• The Aphasia Institute provides resources such as training materials and kits to help facilitate supported communication in the physician office, and other settings. Their web site is www.aphasia.ca.
• There are many organizations offering information for support and education of caregivers for individuals with aphasia. For additional information, contact the organizations listed below and/or view the resources provided at the websites listed below.

• National Aphasia Association - Frequently Asked Questions
• National Institute On Deafness And Other Communication Disorders - Aphasia Page
• National Institute of Neurological Disorders and Stroke - Aphasia Page
• The American Speech-Language-Hearing Association - Aphasia Page
• National Aphasia Association - Technology Resource Information
• Aphasia Hope Foundation
• The Aphasia Institute

• Understanding Primary Progressive Aphasia www.aphasia.org Accessed July 23, 2008.
• EMedicine Article www.emedicine.com Accessed July 23, 2008.
• Technology Resource Information www.aphasia.org Accessed July 23, 2008.
• Sarno MT & Levita E. (1979, Nov-Dec.10) Recovery in Treated Aphasia in the First Year Post-stroke. Stroke. (6):663-70.
• Sarno, T., Postman W., Cho Y., & Norman, R. (2005, Mar-Apr) Evolution of Phonemic Word Fluency Performance in Post-stroke Aphasia. Journal of Communication Disorders, 38(2):83-107.