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How to Overcome Expressive Aphasia After Concussion

learn the best practices to overcome expressive aphasia after concussion

If you are now having trouble finding the right words to say after experiencing a concussion, you may have a condition called expressive aphasia.

Expressive aphasia after concussion is more common than some people may think. Fortunately, there are effective ways to treat aphasia and regain your speech.

This article will break down the causes, treatments, and management techniques for expressive aphasia after concussion.

Understanding Expressive Aphasia After Concussion

Aphasia refers to a group of communication disorders that impair a person’s ability to produce and understand language. It occurs when the language center of the brain, usually the left hemisphere, sustains damage.

Expressive aphasia (also called Broca’s aphasia or non-fluent aphasia) is a subtype of aphasia that affects a person’s ability to produce language. With expressive aphasia, you know what you want to say, but you cannot.

Most of the time, expressive aphasia occurs after a stroke. However, it is possible for it to occur after a serious concussion, especially if the blow struck the left side of your head.

Some symptoms of expressive aphasia after a concussion can include:

  • Effortful speech
  • Difficulty finding the right words
  • Uttering short sentences or single words repeatedly
  • Difficulties with grammar and using conjunctions
  • Can read but struggles to write

Expressive aphasia is a separate condition from dysarthria, which causes difficulty moving the mouth and tongue. Therefore, the two will require different treatment approaches.

Treating Expressive Aphasia After Concussion

speech therapist talking to patient about treatment options for expressive aphasia after concussion

Expressive aphasia, especially after a mild TBI like a concussion, can sometimes resolve itself on its own.

If your aphasia lasts longer than a few days however, you should seek treatment right away. It’s possible your aphasia is a sign of worsening brain damage. Therefore, it is critical to get examined by a doctor as soon as possible.

Once your doctor has examined you and ruled out any serious brain damage, they will recommend you begin therapy.

The earlier you can begin treatment, the better chances you have of regaining your speech. To ensure maximum recovery, schedule an appointment with a speech-language pathologist (i.e. a speech therapist). A speech therapist can suggest the best therapy practices that fit your needs, and teach you exercises to do at home.

Some therapies for expressive aphasia after concussion that a speech therapist might suggest include the following:

1. Constraint-Induced Language Therapy

Constraint-Induced Language Therapy (CILT) was designed to help people with more severe aphasia regain speaking skills. The goal is to force the person to speak by eliminating any compensatory tactics they may have picked up.

The idea is, with enough practice, the brain will engage its neuroplasticity, and the patient will regain function.

Neuroplasticity refers to the brain’s ability to reorganize neurons and allow undamaged portions of the brain to take over functions from damaged ones. Therefore, by practicing CILT, the goal is that the brain will rewire itself and recover its language abilities.

The same principles apply to Constraint-Induced Language Therapy. With this speech therapy method, a patient would have to:

  • Avoid using compensatory tactics such gestures, drawings, or writing
  • Communicate only by speaking
  • Practice heavily for at least one hour per day.

With enough practice, you can activate neuroplasticity to encourage improvements in speech.

2. Melodic Intonation Therapy (Singing Therapy)

elderly couple singing and playing guitar on couch

One of the most promising and exciting treatments for expressive aphasia is singing therapy, formally called Melodic Intonation Therapy (MIT).

Speech-language pathologists developed it when they discovered that even when their patients with expressive aphasia could not speak a word, they could still sing a song fluently.

This could occur because singing engages the right side of the brain, whereas speaking utilizes the left side. Since most speaking disorders are caused by damage to the left side of the brain, the side that controls singing is left intact.

Singing therapy involves singing simple words or phrases to the tune of familiar melodies. With enough repetition, patients eventually turn their singing speech into normal speech.

What’s more, most patients permanently maintain the improvements that they gain from music therapy. This makes it an effective way to re-learn how to speak after brain injury.

If this sounds promising to you, try seeking out a speech therapist trained in music therapy. A combination of speech and singing therapy can really help boost your recovery.

Managing Expressive Aphasia after Concussion

While expressive aphasia is treatable, it’s not an instant fix. In the meantime, you are going to need to learn how to manage it and communicate effectively with others.

Here are some steps both you and your loved ones can take to make communication easier.

  • Ask yes or no questions. Family members and friends should try to use yes or no questions as often as possible. This puts less strain on the person with expressive aphasia and will make conversation flow smoother between you two.
  • Listen. Even when the person is struggling to find the right words, it’s important to listen patiently. Don’t try to put words in their mouth. The best way to beat aphasia is to practice speaking, which means you must let them speak as much as possible, even if it is slow and laborious. If you feel that they truly require help, ask first before assisting them.
  • Keep groups small. People with aphasia usually avoid one-on-one conversations, but many still feel comfortable interacting in small groups. A small group puts less pressure on the person with aphasia to do all the talking, and allows them to respond when they feel like it. Be sure to include your loved one in conversation and keep them involved, but don’t push them too hard.
  • Use pictures and drawings. The left side of the brain controls language, but the right is responsible for non-verbal and visual functions. Meaning the ability to draw and interpret images is usually still intact in people with aphasia. Therefore, if communication is especially difficult, try drawing what you mean. You might even consider creating a book full of words, photos and pictures that can assist you with conversations.

These techniques should help make communication a little easier as you work to overcome aphasia.

Overcoming Expressive Aphasia After Concussion

In many cases, expressive aphasia after concussion is temporary and normal speech returns after only a few days. For some people, however, it can last for years, and might even be permanent.

The best thing you can do to prevent permanent loss of speech is to start speech therapy right away. It helps encourage the brain to overcome expressive aphasia so that you can speak with confidence again.

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