Language Problems in Adult
Communication problems can arise in the adult population due to different medical complications. The common medical conditions which result in communication problems in adults include stroke, head injury, cancer, and other degenerative diseases which affect the language function.
Communication involves the exchange of information between two or more individuals using a set of symbols and gestures. Communication can be defined as non-verbal communication and verbal communication. Facial expressions, gestures, and pointing are forms of non-verbal communication. Speech sounds, words and sentences are considered as verbal communication. Both non-verbal and verbal communication modes are important for us to understand others and express our ideas.
Aphasia
Aphasia is the term we use to describe the condition in which a person loses the ability to understand, speak, read and write. Sometimes we distinguish between the term aphasia and dysphasia. Aphasia means that the person has lost the ability to communicate totally while dysphasia means that the person has lost the ability partially. The presentations of the problem can be different among individuals and the following profiles of patients will give you some ideas on how a person with aphasia communicates with others.
Case studies
Uncle Tay, 70 years, suffered from a stroke which led to difficulty in speaking. Before the stroke, he was bilingual and spoke Mandarin and English. After the stroke, he could not understand and speak English anymore. He also seemed to have difficulty in “finding” the words in Mandarin occasionally. He will use other words to replace the correct words. For example, he sometimes use “Car” to mean the “MRT”.
Mrs. Wong, 60 years, came to our clinic with her family. Her family reported that Mrs. Wong suffered from a stroke 3 months ago. She has difficulty in following instructions and can only understand very simple commands such as “Take this” or “Let’s go”. She also became non-verbal (unable to produce speech) after the stroke. She needs to use gestures or pointing to communicate with others.
Peter Wong, 37 years, suffered from a head injury when he was working at a construction site. He has difficulty with his speech since the injury. Initially he was not able to produce any sounds. After one week, he began to produce simple words and later on he could use sentences to communicate with others. However, his family noticed that he sometimes produced grammatically inappropriate sentences. For example, he would say sentences like “I sit char” when he wants to sit in the armchair.
Natalia 58 years of age was a bubbly housewife and communication was one of her strengths until she underwent a surgery for the removal of a huge blood clot in her brain. Her personality appeared to have changed following the surgery and she had severe communication difficulties. She could hardly speak and got easily frustrated. She repeated irrelevant words when ever she wanted to say some thing. She had difficulties focusing on any task and had severe mood swings. Few days into therapy, she started attending to speech and verbal commands better. She now repeats words and is able to follow simple one step commands like ‘take the cup’, ‘give me the pen’. She continues to work on improving her speech and language skills with the help of her family and therapist.
Diagnosis and Language Therapy
The diagnosis of aphasia requires a Speech and Language Assessment by a Speech-Language Therapist. The therapist will perform a comprehensive evaluation of the person’s ability to understand, speak, read and write.
Speech-language therapy will involve intensive exercises in which the patient will be guided to follow directions, understand words, sentence meanings, repeat, think, problem solve, read and write. Computer aided therapy may also be used to supplement therapy.
Non-verbal Communication
For some patients, the speech-language therapist may teach strategies to enhance communication with non-verbal means such as gestures or pointing. It is sometimes useful for a patient with word-finding difficulty to use gestures to compensate his verbal communication. For example, if a patient couldn’t use the word “Car”, he can learn to compensate this by gesturing driving on the wheel.
Prognosis
The extent to which a person recovers from Aphasia depends on various factors including the nature and severity of the brain damage and the location and cause of the injury. These factors are always out of our control. However, if we provide active and intensive therapy for the patients, the outcomes from therapy can vary. In general, the outcomes from therapy are dependant on a number of factors such as the age of the patient, the general health, the motivation and willingness to participate in therapy. Family support is also an important element in the outcome of the therapy.
RASSW provides detailed assessments and comprehensive rehabilitation programs catered to the individual needs of adults suffering from various communication difficulties. Call us to find out more.
