June is Aphasia Awareness Month, which is as good a time as any to share how much it shocks me that so few people know about Aphasia. Consider that 1 in 3 Canadians who survive a stroke have Aphasia. The disorder is not uncommon, and it’s certainly something that cannot be ignored, especially as rates are expected to increase with Canada’s silver tsunami (i.e. ageing population).
My first exposure to Aphasia was in the first year of my undergraduate degree, as a student in PSY100 – Introductory Psychology. Being a new university student, I had not yet learned that leaving mountains of readings to the night before a midterm was probably the worst thing I could do. I sleepily tried my best to get through chapter after chapter, praying that I was retaining the information. One chapter in particular taught me the different sections of the human brain and their general functions. Among the many specialized areas of the brain, there were two that would come back and play a big role in my future interests: Broca’s Area and Wernicke’s Area. Both areas play a role in language abilities, but damage to one over the other can lead to very different consequences.
So, what exactly is Aphasia? Aphasia is a language disorder where individuals who have suffered brain damage to either Broca’s Area or Wernicke’s Area are left with a significantly reduced ability to communicate. Broca’s Area is responsible for the motor production of speech, thus individuals who suffer damages to this area, and who are subsequently diagnosed with Broca’s Aphasia, might have difficulty producing speech; their speech comes out broken, but their comprehension remains mainly intact. Conversely, Wernicke’s Area is the region of the brain that correlates with language comprehension. In Wernicke’s Aphasia, individuals sustain damages to this area of the brain, and can often speak relatively well, but comprehension poses a barrier. As such, they might have challenges in understanding what is said by others. Global Aphasia describes situations where both brain areas are effected.
The effects of Aphasia range in severity. Some Aphasic individuals communicate almost entirely normally, perhaps struggling with word-finding or mixing words up. Others might sustain more severe cases, losing a chunk of communication abilities in both oral and written forms. Symptoms of Aphasia are relatively common following a stroke. You might have read Emilia Clarke’s (A.K.A. Game of Thrones’ Daenerys Targeryen) essay in The New Yorker, in which she shares her experiences of having two life-threatening brain aneurysms and was terrified when she was unable to say her own name. With time, she was able to overcome Aphasia. However, if symptoms persist for longer than a few months post-stroke, complete recovery becomes unlikely. As such, many patients with Aphasia have to learn to adjust to a whole new life. Imagine, you know what you want to say, but when you open your mouth, either nothing comes out or it’s as if your words are overlapped with someone else’s. You might say ‘Yes,’ when you really mean ‘No.’ I once asked someone with Aphasia how many siblings they have. With their fingers they indicated three, but what came out of their mouth was ‘four!’ Occasionally an answer to a question might sound like nonsense, with words said that are entirely irrelevant to what is being discussed.
When you really think about it, our abilities to read, write, and speak, are essential to almost every single task we complete both in our personal lives and professionally. These are among the first things we learn as children. A baby’s first word is a milestone, and while literary abilities are cultivated in youth, by adulthood they’re expected. A person with Aphasia does not just lose their ability to communicate. It is taken away from them. And quite often, a sense of autonomy also goes with it. It doesn’t matter where you come from, what language you speak, and where you currently are; losing your ability to communicate in any form poses challenges in this world.
Following my undergraduate degree, I took a gap year, and because of my interest in pursuing a career in Speech-Language Pathology, I was encouraged by many of my peers to visit the Aphasia Institute (AI) located in North York, Toronto. The center is dedicated to providing Aphasic individuals, called members, with new ways to communicate. Members are primarily individuals who have suffered strokes or traumatic brain injuries. Staff and volunteers work together with members and their families to practice communication strategies that best work for them. For instance, some members may struggle with speech production, but very clearly know what they want to discuss. They might use technology to type or draw, or even share relevant content to the conversation at hand.
While I had learned the textbook definition of Aphasia in school, it was really my experience with AI that taught me what Aphasia and living with Aphasia means, as well as the importance of accessibility. I began volunteering in the organization’s Conversation Groups, hour-long group sessions where two trained volunteers sit with a number of members and just talk. Sometimes it can be quiet, other times it takes a long time to confirm with a member that I understand what they wish to say, and a lot of the time, I leave the table with a big smile on my face, having had a good discussion. While what’s discussed in the group varies week-to-week depending on what members are in the mood to talk about, their purpose never changes; they are meant to provide members with a chance to communicate in new ways, with others who are in a similar situation as them and who really understand the challenges that accompany living with Aphasia. The AI works to remind people that members are still competent individuals. Offering other programs like Toastmasters (for public speaking), book club, and a movement and dance group, members are encouraged to participate in all aspects of life to help improve their physical and mental wellbeing, and not let the barriers posed by Aphasia define how they live their lives.
A foundational principle fixed into the minds of all Psychology students is that all humans are social animals. We thrive in social settings, seek belonging in groups, and when isolated, can be affected both physically and mentally. Critical to meaningful social interaction is an ability to communicate. At MCIS Language Solutions, we are very familiar with the ill-effects that language barriers might pose. There’s the inability to access critical information and sometimes polarized relations between communities, simply because they don’t speak the same language. Incredibly, that’s not the worst communication barrier possible. As an e-mail from the AI once put it: living with Aphasia is like living in a foreign country where you don’t speak the language. However, the country is actually your own.