What is aphasia?
A language disorder caused by damage to the brain’s language areas, most often from a stroke. It can affect speaking, understanding, reading and writing, and many people also notice changes in attention, memory and thinking.
People with aphasia often describe
- Knowing the word but not being able to find it
- Short, effortful phrases, or fluent sentences that don’t make sense
- Trouble following fast speech, long sentences or group conversations
- Difficulty reading, writing, or using numbers and phone screens
- Frustration, withdrawal and avoiding conversation
Common types of aphasia
Aphasia presents differently from person to person. An individual may show features of more than one type, and the pattern can change during recovery. The following are the main types we most often see:
- Broca’s (non-fluent)
- Slow, effortful short phrases; understanding is often better preserved.
- Wernicke’s (fluent)
- Speech flows but is hard to follow; understanding is more affected.
- Conduction
- Fluent speech and understanding are relatively preserved, but repeating is hard and word-choice errors are common.
- Anomic
- Fluent speech with trouble finding words, especially names and nouns.
- Global
- Severe difficulty speaking and understanding, often soon after a large stroke.
Other changes after a stroke
We also assess motor speech (how speech sounds are planned and produced) and the cognitive-communication components, such as attention, memory and problem-solving.
Right hemisphere stroke
A stroke on the right side of the brain usually leaves words and grammar intact, so the changes are easy to miss. Speaking may sound normal, but conversation feels different:
- Missing things on the left side: food on the plate, words on a page, people in the room
- Rambling, drifting off topic, or giving too much or too little detail
- Taking sarcasm, jokes or figures of speech literally
- A flat voice, or difficulty hearing emotion in other people’s voices
- Missing the main point or the implied meaning of a story
When to start, and how long recovery lasts
Starting early puts supports in place sooner. Many people begin in the hospital or inpatient rehab and continue with outpatient or home therapy after discharge; we can pick up from there.
Recovery is often fastest in the first weeks and months, but aphasia is often long-term and many people keep improving, in small steps, for months or years. It is never too late to ask whether therapy could help.
Progress depends on the size and location of the stroke, the number of strokes, overall health, the amount of therapy, and practice between sessions. We set realistic goals together and adjust them as things change.
How it works
- Comprehensive clinical evaluationWe talk with you both, review the stroke history and any hospital, rehab or neurology reports, and assess speaking, understanding, reading, writing, speech clarity and thinking. Goals are then set together, based on the results and what matters most to the person and family.
- Therapy sessionsLanguage and communication work built around your goals, with family included whenever possible.
- Take-home strategiesExercises the person and family can practice together at home, with a few key strategies covered briefly during sessions. Families who want more in-depth training can book separate caregiver education sessions.
- Ongoing updatesEach time a goal is met, we set a new one and check in with the family on progress. We coordinate with doctors and other therapists, and refer out when needed, for example to occupational therapy, counseling or other specialists.