I meant what I said and I said what I meant. (Dr. Seuss)
What if you had a stroke and all of a sudden you were not able to say what you meant, even though you knew what you meant?
Aphasia is an acquired language disorder. It results from damage to the brain. It means someone will have difficulty with talking, listening (understanding what others say), reading, writing or using numbers. Sometimes it is a mild difficulty, other times it is a severe difficulty that affects every aspect of a person’s ability to communicate and function in their everyday life.
I read in Diane Ackerman’s book Aphasia described as “having a head full of holes, in which the perfect repository of words have shamed themselves.” A lyrical way of saying that finding words for what you want to say is really hard. It’s one of life’s ironies that we never really pause to comprehend the magnitude of the complexity and utter brilliance of the human language and speech function until we are left without it. We effortlessly and, for the most part, unconsciously recall and construct sentences from lexicon that is like a massive home storage warehouse. Sometimes we store words away for years, others we bring out for regular use. It happens in milliseconds. To give you an idea of the language mapping system check out the Psycholinguistic language processing model (I won’t lie; it was the bane of my third year of university existence). Psycholinguistics is the study of language processing in terms of how word meaning, sentence meaning, discourse meaning are computed and represented in the mind. Incredible.
Imagine though, that you wake up tomorrow and have trouble comprehending the time on your alarm clock, or go to text your friend and can’t spell out what’s in your head, or can only produce single words when trying to order a chai latte at your regular coffee joint. This is called Aphasia. An invisible impairment that is all too real for some.
I’m not going to go too much into what Aphasia is in this blog, but if you’re interested, check out our previous blog: Language Difficulties Following a Stroke. What I do want to look at is the ongoing social consequences of Aphasia.
Friendship relationships are essential to social engagement, quality of life, and emotional well-being (Davidson, Howe, Worral, Hickson & Togher, 2008). A study by Davidson, Howe, Worral, Hickson & Togher, 2008 examined the impact of Aphasia on everyday social communication interactions (i.e. friendships). An Australian study, the research found that people with aphasia communicated with fewer friends and had smaller social networks. Particularly for older people with aphasia, friendship was a core area of communication and the ability to participate in leisure and educational activities was a key part of everyday communication. This should not be a surprise to anyone, considering the nature of our average everyday communicative interactions. They usually involve friends, family, education and work.
Another US study identified that clinicians working with people with aphasia need to be conscious of the social ramifications of a change in the ability to communicate (Vickers, 2010). Specifically the authors identify“shrinkage of social networks and reduced frequency of contact with partners after onset of aphasia”. This has wide reaching implications, considering research indicates that social networks are the foundations for communication and life participation. Being an active participant in social events and relationships is associated with adult health, wellbeing and longevity (Vickers, 2010). In other words, not being able to communicate with your usual social networks can have significant consequences for overall health.
The take home message here for speech pathologists, people with aphasia and family and friends is that we must consider and actively integrate the need for social communication into our assessment and rehabilitation plans. We also need to make sure family and friends are aware of good strategies and approaches for supporting someone who has aphasia. We also need to be tuned in to the perspectives and needs of the person with Aphasia.
- Vickers, C.P. (2010). Social networks after the onset of aphasia: The impact of aphasia group attendance . Aphasiology 24(6-8), 902-913.
- Social participation for older people with aphasia: the impact of communication disability on friendships. Top Stroke Rehabiliation.