What Are The Different Forms of Aphasia?
If your loved one has had a stroke or is suffering from a neurological disorder and you notice that they are having significant problems speaking, writing, and understanding other people, then they may be experiencing aphasia. In this blog, we hope to define what aphasia is and the different forms it takes.
Individuals experience aphasia when they have difficulty communicating or comprehending spoken or written language. Aphasia results from damage to the left hemisphere of the brain which primarily deals with language and speech. This damage is commonly caused by a stroke or head trauma, but it is also possible for aphasia to come progressively, i.e. as the result of a degenerative neurological disease.
Aphasia that comes acutely, as when a stroke occurs, can result in different outcomes depending on the extent of damage. Experiences of aphasia can vary from person to person but are usually divided into three main types:
- Expressive aphasia is when an individual experiences difficulty expressing themselves verbally or in writing but can more easily understand what is communicated to them. Speech is usually grammatically incorrect and phrases can be reduced in length.
- Receptive aphasia is when an individual cannot understand what is being communicated to them but can speak with agility. Usually individuals with this type of aphasia speak meaningless jargon or with made up words. Those with severe stages receptive aphasia usually have very poor comprehension of information communicated to them.
- Global aphasia is aphasia caused by more widespread brain damage and is the most severe type. It usually encompasses deficits from both types of aphasia above. 
Aphasia that results from a degenerative disease comes on progressively and usually comes from Alzheimer’s disease or frontotemporal lobar degeneration. This form of aphasia is called Primary Progressive Aphasia (PPA). At first, the experience may not be too debilitating since memory, reasoning, and vision are not dramatically affected. But as the degenerative disease becomes worse, the ability to speak, write, and comprehend what is being communicated also declines. The experiences of this form also have three main categories:
- Semantic PPA results when a person loses the ability to remember common nouns (for example, “salt” or “cat”) and may seem puzzled when these words are mentioned by someone else. Speech is usually fluent, but nouns are commonly missing from phrases.
- Agrammatic PPA results when word order and forming sentences becomes disorganized. The length and complexity of sentences is significantly reduced, as well. People who experience this type of aphasia may be able to understand words spoken to them but may not understand more complex sentences. Once this form progresses, it is common for speech to disappear altogether.
- Logopenic PPA results when an individual experiences great difficulty finding words. People who experience logopenic PPA are fluent in conversation but have to speak “around” the words they are trying to find in order to convey what they mean. 
The varieties of experiences surrounding aphasia are unique to every individual. Many of the strategies to communicate with your loved one affected by aphasia boil down to being mindful of their incapacity, whatever it may be. Here are some points to consider:
- Listen to what your care provider has to say. Every case of aphasia has its own needs and requirements and communicating with your loved one will vary depending on what form of aphasia they are experiencing
- Listen attentively to your loved one
- Don’t always correct them if they misspeak
- Try to simplify what you say. Use “either/or” questions or phrase questions so that their answer is a choice between “yes” or “no”
- Speak slowly
- Try to avoid distracting environments
- Visual communication can be helpful such as using arm gestures, head movements, and facial expressions 
Remember that an individual who experiences aphasia has a language and speech deficit but not necessarily an intellectual deficit. The experience of aphasia, like all degenerative diseases, transforms your loved one’s identity and can take away much of their autonomy. It is crucial to provide your loved one with as much control over their situation as possible and to let them communicate what they want to the extent of their capabilities. The journey is never easy for any party, but with mindful communication you can do your best to assure your loved one’s value and personhood.
If you want more information and advice, then please visit ElderCare at Home’s blog for more tips for caregivers or call us at 561-585-0400.
 Labreche, Tammy, et al. “Empowering Individuals with Aphasia and Visual Impairments through Effective Communication.” Journal of Visual Impairment and & Blindness 110, no. 3 (2016): 183-187.
 Hillis, Argye E. “Aphasia: Progress in the last quarter of a century.” Neurology 69, no. 200 (2007): 200-213.
 For more information, please see: http://brain.northwestern.edu/dementia/ppa/
 Labreche, Tammy, et al. 2016.
 Cf. Horn, Elizabeth A. Doughty, et al. “Identifying and Addressing Grief and Loss Issues in a Person with Aphasia: A Single-Case Study.” Journal of Counseling & Development 94, no. 2 (2016): 225-233.