Expressive Aphasia – What You Need To Understand
Generally, aphasia refers to a class of communication disorders that occur when the language center of the brain becomes damaged – usually due to a left-hemisphere stroke or traumatic brain injury.
When individuals language center of the brain becomes damaged, they may have difficulty accessing information in the brain that helps control various aspects of their communication.
There are four primary aspects of communication that can be affected by aphasia, these are:
- Spoken language expression
- Spoken language comprehension
- Written expression
- Reading comprehension
Expressive aphasia occurs when the primary difficulties involve spoken language expression and written expression. This is where the name comes from.
Expressive aphasia is also known as Broca’s aphasia, because the first scientist that identified this condition was Paul Broca.
Later, they named the particular area of the brain that controls speech production Broca’s Area. Aside from expressive aphasia, it is also possible for someone to overlap with other types of aphasia.
For example, receptive aphasia involves difficulty with comprehension. If individuals with expressive aphasia also overlaps with receptive aphasia, they may have difficulty with expression and some difficulty with comprehension, too. This is why diagnosis by an expert is important.
Some Potential Symptoms Of Expressive Aphasia
Expressive aphasia often occur in form of difficulty with language production. However, the symptoms can vary individually
Below are some symptoms that individuals with expressive aphasia may present:
- The use of lots of effort to make speech, or can’t speak at all
- Struggles to find the right words, and may put incorrect strings of words together (commonly known as “word salad”)
- Utters short sentences or single words repeatedly
- Finds difficulty with grammar and using conjunctions
- Reads just fine but may struggle with writing
Individuals with expressive aphasia may not struggle with knowing what to say; but they may struggle putting what they want to say into words. When expressive aphasia is severe, the individuals may not speak at all or only utter single words repetitively. Sometimes, the single words they do use are not the words they intended to say.
It is important to know that expressive aphasia is about the cognitive skill of expression, not the motor skill of moving your mouth.
Expressive aphasia is different from dysarthria, a condition that involves difficulty moving the muscles of the tongue and mouth, which often leads to slurred speech.
This condition is distinctly different from aphasia, and treatment differs for both. This is another important reason to work with an expert for a diagnosis.
But does aphasia affect individual’s intellectual abilities? Find out the answer in the next section.
Aphasia Does Not Mean Loss Of Intelligence?
If you sit down to have a conversation with an individual struggling with expressive aphasia, there is the need to be patient. As you can imagine, it can be quite frustrating for the person that wants to express himself but unable to do so, patience is key.
People with expressive aphasia can sometimes still comprehend verbal speech and written words. This means they can listen to you, but may struggle with responding.
Because of delay in, or lack of response, many people assume that someone with expressive aphasia has reduced intelligence, but that’s not correct! Aphasia does not affect someone’s intelligence. It only affects the ability to communicate.
Caregivers or family members caring for individuals with aphasia, should speak to them as they normally did before the aphasia. If an individual has mixed aphasia and also struggles with comprehension, it helps to use simpler words and a slower pace, too.
Most importantly, do not raise your voice if you think someone does not understand you. People with expressive aphasia can hear you. Your job is to be patient as their healing brain comes up with the right words to respond to you.
A great way to develop empathy for someone with expressive aphasia is to recall the feeling of having an idea on the tip of your tongue, but you can’t remember it. It can be frustrating if you “rack your brain” trying to remember it, but unable to. This might be what expressive aphasia is like.
The individuals might know what they want to say, but the healing brain is struggling to put it into words. So be patient.
The Best Treatment Approach For Expressive Aphasia
The best way to treat expressive aphasia is to start working with a Speech Language Pathologist. These experts know how to diagnose your type(s) of aphasia and create a treatment plan for your unique needs.
Almost every speech rehabilitation plan will include speech therapy exercises. They are a staple, because they help heal the brain and improve communication.
When the Broca’s area of the brain has been damaged by stroke, for example, the person cannot access the information once stored in that area of the brain. In order to regain the ability to produce speech, the brain must rewire itself and store that information elsewhere.
This rewiring process is known as neuroplasticity. It allows the brain to create and strengthen new pathways in order to become more efficient.
For example, neuroplasticity is the reason why drivers have increased grey matter in the areas of the brain responsible for road maps.
They have practiced regular navigating around, and the brain has adapted in response. The same concept applies to speech rehabilitation.
After damage to the Broca’s area of the brain, a person with expressive aphasia must work diligently with an SLP to practice speech therapy exercises. By practicing the task of speech production, the brain will respond by strengthening new pathways that control speech production.
The process is slow and requires consistency long-term in order to produce results. But when patients are diligent, they can often overcome expressive aphasia and regain their voices. In the next section, we will consider why expressive aphasia requires personalized treatment approach.
Why Expressive Aphasia Treatment Requires Unique Treatment Approach
It’s important to work with an SLP when beginning treatment for expressive aphasia. All brains are wired differently, which means there are differences in how expressive aphasia manifests between individuals.
For example, one person with expressive aphasia might struggle with verbal speech production while another struggles with writing. This is why working with an expert is necessary, especially in the beginning.
After you are diagnosed and begin exercises with your SLP, they may send you home with homework to keep practicing at home. This is essential for feeding the brain with stimulation it needs for recovery.
To improve motivation at home, SLP’s designed apps for Speech and Cognitive Therapy. It includes many speech exercises that you can practice on your own.
Best of all, your SLP can assign certain exercises for you to work on.
If your insurance no longer covers speech therapy and you’re looking for ways to improve on your own, apps might be helpful.
It includes an initial assessment test that helps identify areas to improve. However, it works best to get started with the help of an expert, and then take matters into your own hands after you’ve developed confidence in your customized rehabilitation plan.
Aphasia – The Recovery Timeline
Statistically, over one-third of stroke survivors have some type of aphasia after stroke. Of these individuals, 60% still have speech problems more than 6 months after their stroke. This does not mean that aphasia will stop improving after six months, though.
Don’t let this stop you from pursuing recovery. When you put in the work, the brain will respond.
It’s essential to keep recovery going strong at home, because the brain requires stimulation in order to heal. Even putting in just ten minutes a day will be beneficial. In a way, this helps tell the brain that speech production is important, and you want to get better at it.
The Summary
Expressive aphasia occurs when there is damage to the part of the brain that controls speech production (Broca’s area). Individuals often use a lot of effort to produce speech and struggle with speaking and writing.
This does not mean the person has lost their intelligence. It simply means their brain needs extra time to retrieve the right words. Fortunately, steady speech therapy exercises plan can help people improve expressive aphasia.
Recovery requires consistency and diligence, so be sure to stick with it on a daily basis. If necessary, invest in speech therapy apps that help motivate you to practice. The next chapter will consider another type of aphasia with milder effects than the expressive, try finding out if it relates what you know or you’re going through.
Book to link: Understanding your aphasia types – the 4 most effective keys to recovery without boarder after stroke.