Aphasia is a disorder that results from damage to the language areas of the brain.

A person with aphasia may experience difficulties with:

  • Speaking, 

  • Understanding, 

  • Reading and/or 

  • Writing

Dierdre Tay, Head of the Speech Therapy Department at Singapore General Hospital (SGH)​, a member of the SingHealth group, explains that aphasia is often caused by stroke but any disease or damage to the brain parts t​hat control language can give rise to aphasia. 

This includes traumatic brain injury, dementia and brain tumours. For most people, the language areas are located in the left side of the brain. Therefore, left brain damage can cause a person to suffer from aphasia.

Caring for a loved one with aphasia? Check out this article for useful tips and watch this video!


Aphasia: Signs and symptoms

​Some people with aphasia have receptive aphasia, which means they have problem understanding what is said. Some may have expressive aphasia, which is difficulty expressing oneself using words. Others may have both receptive and expressive aphasia.

Aphasia can also cause problems with written language. Aphasia may lead to difficulties with reading and writing in people who were literate before the brain damage.

The severity of the aphasia depends on the extent and area of damage to the brain. Persons with mild aphasia may be able to partake in day-to-day conversations fairly well but may have difficulties understanding complex instructions. They may also experience some trouble in expressing their thoughts fluently due to difficulty "finding the right words" to use.

In contrast, people with severe aphasia may not understand anything that is said to them. They may be unable to say anything, or if they attempt a few words, those words may be repeated again and again (a phenomenon called perseveration) in all responses. In other cases, a person with severe aphasia may appear to be speaking fluently, but most of the words and sentences do not make sense.

Aphasia: How is it diagnosed?

When a person shows signs of changes in communication ability after brain damage, doctors or other healthcare professionals caring for that person may refer him or her to a speech-language therapist (SLT).

The SLT assesses the person and determines the type and severity of aphasia through a detailed evaluation of the person's com​munication ability. The assessment may include an assessment of the person's speech, voice, understanding, ability to use words, reading and writing. SLTs around the world use different tests developed in a variety of languages and countries to best assess people with aphasia.

In Singapore, language assessment tools used by local SLTs were developed in mainly English-speaking countries such as the United States, the United Kingdom and Australia. At times, the materials used in these tests are unfamiliar to the Singaporean population, which may lead to inaccurate responses. The lack of suitable Mandarin aphasia tests further limits the in-depth analysis of aphasia in Mandarin-speaking Singaporeans.

The Singapore Aphasia Test (SGAT) was developed by a team of speech therapists from SGH. It is designed to provide speech therapists in Singapore with a better understanding of the extent of language and speech problems in the local population of people with aphasia. It has been developed in English and Mandarin.

Aphasia: How is it treated?

Aphasia treatment depends on the needs and goals of the person with aphasia.The SLT may emphasise working on specific language skills identified as problems after brain damage. For example, the patient may practice naming objects, following instructions or answering questions. The exercises vary depending on the person's needs and can become more complex and challenging as language skills improve.​

When speaking is not possible, the SLT may teach the person with aphasia other ways to express their ideas. For example, the person may be more able to use gestures and writing.

For people with mild aphasia, the SLT may focus on conversation skills. Sessions may include role-playing common communication situations such as making a telephone enquiry, ordering a meal in a restaurant, and giving a presentation. These role-play activities eventually equip the person with skills and confidence to communicate independently.

​​Ref: I23 (ed)

Other articles you may be interested in:

Caregiver Tips for Aphasia (Communication Difficulties) After Stroke

Stroke Recovery: What to Expect

Videos: Stroke Rehabilitation Exercises & Wellness Guide

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