doctor discussing aphasia diagnosis with patient

Diagnosing Aphasia

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Aphasia is a group of speech disorders in which an individual’s ability to speak or comprehend becomes interrupted or limited. The most common cause of aphasia is a stroke (nearly half of all stroke survivors develop some form of aphasia), although traumatic brain injury and other kinds of damage are also responsible for the different types of aphasia. 

One of the most important aspects of treating aphasia is to begin quickly -- and that means an accurate and timely diagnosis. Here’s a look at how your medical team will likely go about diagnosing aphasia. 

Neurological Exam

Since there is a generally an emergency incident to herald the development of an aphasia, the doctor managing the presenting issue will likely be among the first to notice something is amiss. However, in the case of degenerative diseases that cause aphasia, a loved one may notice speech patterns have begun changing and request an appointment with a doctor. Often, this doctor will be a neurologist. The first step is likely a physical neurological test. This involves a series of seemingly strange pokes and instructions that test reflexes, strength, and sensation. 

It’s also important to figure out what is causing the aphasia. This generally means a series of magnetic resonance imaging or computerized tomography tests to search for abnormalities in the brain. These tests can show areas of brain damage, which can give your doctor a head start in figuring out the type of aphasia you might have (for example, if you have damage to Wernicke’s area, you will likely have a form of fluent aphasia). 

Your doctor will likely take you through a series of queries that evidence the extent of the aphasia, as well as key factors that can suggest what kind of aphasia is present. This might include:

  • Holding a normal conversation
  • Naming objects
  • Evaluating how well you use and understand words
  • Repetition
  • Response
  • Following instructions
  • Answering questions
  • Reading
  • Writing

Speech-Language Pathologist

You may be sent to a speech-language pathologist, who specializes in helping those with speech or comprehension difficulties master these problems. Your speech language pathologist may give you a more comprehensive evaluation. According to the American Speech-Language-Hearing Association, this may include a battery of examinations encompassing “auditory comprehension, verbal expression, reading and writing, and functional communication.” Some of these may be similar to those posed by your doctor. 

This exam may include seeing how well you understand everything from a sentence to a conversation to a story told. Verbal expression often includes your ability to recite sequences (such as months of the year), name various objects, and answer questions or hold a conversation. Reading and writing may be tested by taking in and putting out nonverbal communication from letters to full paragraphs. Functional communication involves assessing how well you can find alternative means of explaining yourself when you have difficulty finding the right word or producing proper sentences. 

If you suspect you or a loved one are experiencing an aphasia, talk to your doctor as soon as possible so she can recommend you to a specialist and you can get to work on regaining your ability to communicate. 

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