When Communication Is Lost

Treatment for aphasia up until now has been limited mainly to speech therapy, helping people either re-learn speech or pick up tactics for getting around the roadblocks now present in their minds.

One very important way to cope with aphasia is to focus on non-verbal skills, Rao said.

"Non-verbal communication is often better in these people," he said. "It's what you'd do in Italy. You'd use gestures to communicate things such as you need something to drink. If someone gave you hell on the highway, you wouldn't know what they were saying, but you would know to back off."

Rao often begins his work with aphasia patients by creating clear "yes" and "no" signals, which he considers the most essential basic form of communication.

"If it's not the nodding up and down, it's the thumbs-up or thumbs-down," Rao said. "I start that right off the bat for folks with severe aphasia."

Ongoing research may end up providing a better way to improve the benefits of speech therapy, Small said.

The goal of the research is to find techniques that will make the brain more adaptive to speech therapy -- in Small's words, "to change the brain, and then have the speech pathologist help change the brain in the right way."

Techniques under investigation include magnetic or electrical stimulation of the brain, as well as several promising drugs, he said.

Most important, Small said, is making sure the aphasia patient doesn't end up being ignored because of the disability. He cited the example of a woman who was facing a surgical procedure, and her doctors ignored her as they discussed it. Small made a point of asking the woman directly if she wanted the surgery, and she communicated -- she gave a thumbs-up.

"People who have aphasia need to be included in life," he said. "You need to have patience speaking with them. But if you have patience, they have a lot to say."

More information

To learn more, visit The National Aphasia Association.

SOURCES: Paul Rao, Ph.D., speech language pathologist, and vice president of clinical services, quality improvement and corporate compliance, National Rehabilitation Hospital, Washington, D.C.; Steven Small, M.D., Ph.D., professor of neurology and psychology, University of Chicago, and medical director, Comprehensive Aphasia Center of Chicago; U.S. National Institutes of Health; The National Aphasia Association

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