Many of you reading this have probably been living in a family with aphasia for a while now, but your exposure to good resources, education, and other families may be limited. Every day, more families who have never heard of aphasia learn about it when their loved one is affected. I meet families all of the time who still don’t know a lot about aphasia and have no one to ask. Many families are confused or alarmed by behaviors that can be attributed to aphasia in general. Since each person with aphasia is unique in their specific levels of deficits and strengths, there will be some skills that are better or worse than others, but people with aphasia can have many things in common.
It’s a long list, so we’ll tackle a few at a time.
The first topic is anomia, which you may never have even heard, but you may have heard of other names for it—“word retrieval deficit”, or “word-finding” or even “naming”. Anomia means that the person has problems finding the word he/she wants to express. To a certain degree, people without aphasia and elderly people can have this problem. I seem to have it frequently and have to use description and gestures to get my point across—I can see the item or person in my head but the label doesn’t come.
Except in case of milder aphasia, expect anomia to be a big issue. Every type of aphasia has a problem with word-finding to varying degrees. Examples of anomia are when you are trying to name someone or something that’s right in front of you (“water”), saying who or what is in a picture (“my mom”), or just during conversation (“I’m going to ….”). Anomia applies to verbs as well as nouns, and applies to writing as well as speaking.
Anomia can be frustrating for everyone involved in the conversation because it creates communication breakdowns. There are communication breakdowns between people without aphasia all the time—you usually clear it up by asking questions (“What are you talking about?”) or clarifying (“You mean today?”). In a communication breakdown, the flow of information exchange is interrupted because both people feel that they are being very clear in their communication. With aphasia, one person cannot communicate effectively, so the other person is left with filling in the blank. This becomes a back-and-forth habit that can evolve into ’20 Questions’. For ease of getting on with the day, most caregivers start to provide the word (if they know where the conversation is going) for their loved one. This can start a cycle of dependence on the caregiver, which makes life superficially easier but doesn’t help anyone in the long run.
Anomia can be treated by an aphasia therapist. For example, during an intensive treatment program at The Aphasia Center, we would suggest and try out several different types of methods to find the ones that worked best for the family with aphasia. It may be using writing or gestures to cue retrieval, or we may teach the client to use a specific type of research-based method. Each person with aphasia will respond differently, so we try many different methods. The most important aspect of this treatment, in addition to finding the right combination of methods, is that the intensive schedule provides hours and hours of practice using these methods. Our ultimate goal is to increase the independence of the person with aphasia—in order to do this, that client needs to be able to do as much as possible on his/her own.
For example, many therapists or caregivers may use what’s known as a cloze cue to produce a certain answer (I don’t want salt, I want ________________). This is a fancy way of saying a fill-in-the-blank at the end, in which the end word you want is an automatic response.
This is all well and good, but then the person with aphasia is always going to need someone else to tell them what they want to say. To move beyond this, we need to develop different strategies and processes to help the client self-cue, or “do it themselves”. Read our aphasia case studies page to see the outcomes of some clients with anomic aphasia.