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The following post summarizes the research article by Klein and Micic (2014).
Everyone’s experience with aphasia is different. Did you know there researchers have identified several different types of aphasias which can be told apart based on cause (etiology), symptoms, and brain lesions?
Depending on the cause, aphasia is acute or progressive. Acute aphasia develops suddenly and is associated with strokes or internal bleeding. Progressive aphasia develops slowly and may result from a brain tumour or neurodegenerative disease.
(Klein & Micic, 2014)
As for the presentation of aphasia, a primary distinction is between fluent and non-fluent aphasias. There are three subtypes of fluent aphasias, and three subtypes of non-fluent aphasias. These can be categorized again by the person’s ability to comprehend spoken language, and then again by their ability to repeat speech back.
(Klein & Micic, 2014)
Different areas of the brain are involved in various aspects of language processing. Neuroimaging such as MRI and CT scans provide information about which areas of the brain are damaged. This information supplies the aphasia diagnosis.
While the differences in cause, symptoms, and brain lesions provide a basic classification for eight aphasia types, this isn’t the end of the story. Two people with the same type of aphasia will have speech and language challenges unique to each of them. Clinicians perform thorough language assessments involving speech, reading, writing, comprehension and more to identify the degree of impairment in each aspect of language. (Klein & Micic, 2014)
Together, these classifications and assessments help speech-language pathologists to provide patients with appropriate therapy tailored to their unique experience.
Klein, G., & Micic, D. (2014). Aphasia. In A. Ettinger & D. Weisbrot (Eds.),
Neurologic Differential Diagnosis: A Case-Based Approach (pp. 34-40). Cambridge University Press. doi:10.1017/CBO9781139028899.007
The 2023 CHAT in the Park fundraiser was a great success!
“ What advice would you give to someone who has just been diagnosed with aphasia ?” At a Let’s CHAT session this spring, C.H.A.T. Society members explored this question .
Research article summary: Kjellén, E., Laakso, K., & Henriksson, I. (2017). Aphasia and literacy-the insider's perspective. International journal of language & communication disorders , 52 (5), 573–584. https://doi.org/10.1111/1460-6984.12302
This June, Debbie shares her experience with aphasia. It's Aphasia Awareness Month!
Learn more about getting involved in aphasia research studies.
November 5, 2007, started like every morning – woke up, got ready for work, packed a lunch, and said “see you later turkey” to my youngest daughter, Heather. I remember I wasn’t feeling right the day before – but I brushed it off. I stopped at McDonalds for my usual coffee and muffin and drove to my job in Human Resources at CapitalCare. I drove in the parking lot, parked my car… And then it happened. I was found by a colleague laying in the parking lot and transported to the University Hospital. The next five days were spent in the emergency room, in and out of consciousness, with my family by my side. The first 24 hours the swelling in my brain was so vast the neurosurgeon had a team on standby to potentially remove a portion of my skull to give more room for my brain to swell. My family was told at this point, you should be preparing for the worst. But, thankfully, the swelling in my brain slowly started to decrease and I went through a series of medical tests such as MRI’s, EEG’s and assessed by multiple doctors. I started to regain consciousness for longer periods of time approximately five days after my stroke however I had suffered severe effects. I had no ability to speak, my right side was completely paralyzed, therefore I couldn’t walk or write. I remember being confused and my mind feeling cloudy - I couldn’t understand what happened to me, why was I here? Why can’t I do the things I normally can do? I was transferred to a ward on the 4th floor of the University of Alberta and stayed there for six weeks. One evening I started moving my foot back and forth on my own, once my brain caught up with my body on what was happening, I immediately stood up and took my first steps in nearly a week. It was so exciting to finally be able to use the bathroom ALONE! One of the protocols after a stroke is getting assessed by a Speech Pathologist to ensure I can safely chew and swallow solid food without choking or aspirating. Until you are cleared, you are placed on a pureed food meal plan and my first meal was a pureed egg salad sandwich. To make pureed sandwich more appealing (if a pureed sandwich could ever be appealing) is to puree the bread, the eggs and then shape the pureed food back into the form of a sandwich. To this day, my family still talks about that sandwich – all I remember is that I couldn’t wait to have some French fries! The six weeks I spent at the University Hospital continued with multiple medical assessments, physiotherapy and speech therapy. My family came everyday after work to visit and I had lots of friends visit me as well, I am very thankful for all my visitors as it was very boring at times. I was transferred to the Glenrose Hospital and was there for another 6 weeks. I underwent intense physiotherapy, I was able to walk but still had paralysis in my right arm. I also worked with Speech Language Pathologists on my speech as I still had not regained any of my ability to speak. When I had free time, I would walk through the tunnel from Glenrose Hospital to the Royal Alexandra Hospital and go to the Tim Horton’s in the cafeteria for a coffee – I’m pretty sure that wasn’t technically allowed to do! I also enjoyed meeting new patients and working with students. To be discharged from the Glenrose, I had to prove I could safely live a normal life at home. This includes making my own meals or doing regular daily tasks. You live in a mini condo that is in the Glenrose and therapists will monitor you through cameras and give you a pass/fail on the assessment. I am proud to say I passed with flying colors! After a very long 12 weeks, I was finally able to come home and I couldn’t wait to see my two cats, Snoopy & Marbles. I suffered a left middle cerebral artery cerebrovascular accident (CVA) involving the left frontal temporal & parietal lobes. I have Broca Aphasia and still have paralysis in my right arm. It is frustrating not being able to express what I’m thinking and putting it into words or have a coffee and conversation with a friend. Regardless of having aphasia, I live a normal life. I enjoy shopping at West Edmonton Mall, go to concerts with my daughter Heather, and play games at the lake with our neighbors. I want my story to educate others on aphasia and persons living with aphasia. Our intelligence is still intact – I can understand what you are saying, I just cannot respond quickly. Be patient, slow down and give me time to process and be able to respond which may not be through words but through other methods such as a speaking device or writing. I am so grateful I didn’t miss out on the special moments in life such as my daughter, Nancy, graduating from Law School and going to Disneyland as a family trip. I saw my other daughter, Heather, get married and as a surprise I went to extra speech classes and spent an entire summer practicing, and I gave a toast at the wedding (watch below!). I’m a person living with aphasia but I’m not letting it define me or stop me, I’ve still got a lot of fight left in me.
Before my aneurysm and the ensuing stroke, I was a linguist working as an occupational therapist, and volunteering with people who stutter. Communication was important to me, not only as a science, but also as an essential skill in my life. Then, March 20, 2020, hit. Hard. Now I'm officially a new member of The Chat Society! How I got here can be addressed in another blog (or two!), but I don't want to miss giving a nod to May as Better Speech and Hearing month and June as National Aphasia Awareness month. As someone affected with stroke-induced aphasia and some hearing issues, I say "Hats off!" to speech language and audiology health professionals. Communication remains ever important; however, I've learned about the importance of approaching communication from different ways than what I used before. The suggestions for communicating when speaking to someone with hearing loss are not hard to remember...they are basically the same as when speaking to someone with aphasia! My audiologist (Natalie Roy) provided me with this list. Does anything look familiar? (For full explanations of points, see here.) Communication Suggestions When Speaking to Someone with Hearing Loss Get the listener's attention first before you speak. Speak clearly and decrease your speech to a slow-normal rate to allow the listener to "catch up." Do not shout. Do obstruct your face. [Editor's note: Face masks make life interesting, no?] Rephrase rather than offer a repetition. Avoid conversation if the television or radio is playing, the dishwasher is running, and so on. Alert the person with the hearing loss if the topic of conversation is changing. Talk to hard-of-hearing people, not about them. Remain patient, positive, and relaxed. Communication Suggestions for Those with Hearing Loss Minimize noise distractions. Strive for a clear view of the speaker's face. Do not say, "Huh?" or "What?" Limit interruptions. Provide feedback. Plan ahead. Set realistic goals. Write out important information. Do not bluff! **** Communication obstacles are obviously similar for people with hearing loss and speech conditions, aphasia being one such condition. It is, however, important to learn these points, exercise what you can, and share with others! Remember, even when we don't agree with someone else's point of view, they are entitled to it--and that makes it important! Our speech and our hearing are two gifts that we can appreciate; we must respect people who must, or choose to, speak or listen in ways different from our own. Check out the literature from the Audiology Clinic of Northern Alberta: suggestions, guidelines for speaking clearly, and ideas to use when dining out. (Courtesy of Natalie Roy, Audiology Clinic of Northern Alberta.)
To get involved with CHAT Society, visit the "Get Involved" page of our website. We look forward to meeting you!
My story about my brain injury starts on March 28th, 2018. I had just left my parent’s house in Clareview and I went to the Goodlife gym. My brain injury story includes my Dad, my Mom and two brother’s. My brain injury occurred in Edmonton, AB. My Mom and my Dad told me the rest of my brain injury story because I was in a coma for about 10 days at Royal Alexandra Hospital following my injury. While I was in the coma, my Mom said that she and my Dad cried a lot. My two brothers were also there with me. On March 28th, 2018 I was shot in the head by two men in a stolen SUV. Two minors were in the SUV as well. They were on a crime spree all day. Apparently an undercover police officer had been tracking the stolen SUV. The two men had been in a home invasion as well. I had been sitting in my car waiting to leave the gym, when the gun went off and I was shot in the head. The police were silently chasing the suspects in the vehicle. When I turned off of Manning Drive the one driver started shooting.The police officer in his car did not know what I was doing out of the vehicle. I started throwing up all over the place. The officer didn’t know that I got shot. The officer let the two minors go because they were just watching. But the other two adult men got arrested and handcuffed. The first memory when I woke up the nurse just said hi and asked me to say something. I only responded with one word f***. The nurse laughed and said no problem it seemed everyone said the same first word! My second memory that I had following my brain injury was a nurse asking me what date and the year it was. I got the date wrong and I didn’t know what year it was. I remember that I was in the ICU trying to figure out what had happened to me. I remember that I asked my Dad and he just told me that I got shot, but he didn’t say where. I stayed in the ICU for about little over 2 weeks and then I was transferred to the trauma unit for another 2 weeks. After the ICU/Trauma unit then I was transferred to the Glenrose Rehabilitation Hospital. I stayed there for 5 months. When I was transferring out, one of the ICE Doctors said to my parents that I wouldn’t be able to speak, eat or even walk again. The Doctor said I couldn’t take care of myself and live by myself. I had a feeding tube when I was in the ICU. Since I was in the ICU, I was only on a feeding tube with nutrients and fluids NOT any real food. My doctor at the Glenrose Rehabilitation Hospital recommended another feeding tube in my stomach because I wasn’t chewing my food enough. I needed to see a Speech Pathologist because she was in charge of telling the Nurse Practitioner when to put the feeding tube in my stomach. I was limited to the amount of food and the type of food I could eat. Basically all I could eat was very soft foods and I had swallowing tests done. I couldn't have any snacks. After about a month I went to see my Speech Pathologist again. My Speech Pathologist told me that I failed the test because I wasn’t chewing my food again! That day, I was sure I would get my feeding tube taken out of my stomach, but she said no. It was a hard day for me. Then I went back in about a month later and she did the test again. To my excitement, I found out that she actually passed me. I was super excited because this was the day I could finally eat real food. I had the feeding tube in my stomach for 2 months! The excitement was short lived. Why do you ask? Because the food wasn’t that great, actually it was quite unspectacular to say the least. All of the staff at the Glenrose Rehabilitation Hospital was wonderful. Most importantly, I thought that I couldn’t walk again, but after about 3 months I could walk, although very slowly. After that I spent about 5 months at the Glenrose, and then I was transferred to Halvar Jonson Centre for Brain Injury in Ponoka, AB. At the Halvar Jonson Centre, the staff ran all the tests again. They told me I could drive again but I needed to pass all the tests. At first I refused because I was actually scared to drive again! The Halvar Jonson Centre was beautiful because they had so much that I could do. When they first scheduled my day, I didn’t think they had included enough activities. So I scheduled much more, until my day was full. Halvar Jonson Centre had Woodworking, Ceramics, Leather-working, Swimming and they had all the classes that I was looking for and I also made this beautiful purse for my Mom which took 2 ½ months to make. My Mom loved the purse. But the most important class that I was taking was my speech class, which I took twice a day. At the Halvar Jonson Centre, the food was extraordinarily good. And I could even go back for a second helping of food! They also gave me a snack after dinner which was so awesome I can’t even explain it! Halfway through my time at Halvar Jonson Centre I summoned the courage up and I told the staff I wanted to drive again. But learning to drive again was a long process and the Glenrose Hospital was the only place that did the driving test. I had to go back from the place where it all began. Not knowing if I could drive or not but I will give it my best shot. I made many friends at the Halvar Jonson Rehab Centre. I kept most of them. They were special to me because they understood what I went through and all the progress that I made to get there. I was supposed to stay at the Halvar Jonson Centre only for 7 months but my parents came and they had a meeting with the entire staff. The staff said I could stay for an extra month. I was super nervous because I didn’t know what to do after I got out of the Halvar Jonson Centre. All of a sudden, it was my last day at Halvar Jonson Centre for Brain Injury. I asked the staff to buy me a cake and I had to come up with a speech about my time at Halvar Jonson Rehab Centre. Luckily I had lots of help from my Speech Therapist. I told myself that I wouldn’t cry during my speech. But you as you know, tears are uncontrollable! I cried during my entire speech and my Speech Therapist had to finish it for me! But she let me say the final words of my speech, which was so nice of her. The staff even gave me a plaque with everyone saying something nice about me. Now my time at Halvar Jonson Centre for Brain Injury had come to a close. After Halvar Jonson Centre. I was a patient at the Glenrose Rehabilitation Hospital where I took the simulated driving machine for a few months. I failed the driving tests twice! The staff at the Glenrose Rehabilitation Hospital were amazing! The staff set me up with a coordinator about which courses I had to take. They set up most things for me like driving, riding a bicycle, playing pickle-ball and playing badminton etc… Everything was more work on my part but I liked it because it got me to be more independent for myself. I had to go through many tests to see if I could even drive again. I passed the first test. Now the second test was the on road driving test. It took me four lessons to pass the test. On Halloween I actually passed the test. Finally after one and a half years of relying on my parents I could drive again! I took my parents and my little brother out for dinner. I am so proud of the accomplishment of driving once again. I have no words that can describe it! Four or Five months later, COVID-19 hit us like a brick wall. I remember asking my instructors if I should stay at home and not come to class. All my instructors agreed we should stay at home because none of us knew anything about the virus. That was the last time I saw my instructors face to face. So now I’m on Zoom with all my classes and I actually like it. I don’t have to drive anywhere and I can be in shorts or underwear! Just joking about being in my underwear! But I do miss the meals at Halvar Jonson Rehab Centre! That was some extraordinarily great food! That’s my journey about my brain injury.
