Not all patients with a brain tumour will develop aphasia. Whether or not a brain tumour impacts a person's ability to create and/or understand language will depend on where in the brain it is located.
Aphasia can be caused by pressure from the tumour itself, the impact of treatment in the area of the tumour (such as surgery or radiation), or by swelling in the area. These factors will also influence whether the aphasia is temporary or longer term.
It is important to remember that aphasia does not affect a person's intelligence or ability to make decisions. Communication strategies can help a person with aphasia to get across what he/she would like to say.
A speech-language pathologist can work with patients to find helpful communication strategies and/or provide therapy to improve language (when possible).
A common complaint in cases of milder aphasia is word-finding difficulties (feeling like the word is at the tip of the tongue).
- Be patient. You may find the word comes out on its own while trying some of these strategies. Don't rush yourself and ask your communication partner to give you time
- Describe what you are trying to say. For example: If you were stuck on the word 'apple', instead of stopping, try describing. Here are some ideas:
- Meaning – "It's a type of fruit that is grown on a tree"
- Use – "You eat it"
- Sounds like/starts with – "It starts with an /a/ sound"
- Category – "A type of fruit"
- Colour/Shape /Material – "It's round and can be red or green"
- Association – "It reminds me off that tree in our backyard that we picked"
- Use gestures – use your hands and body to act out the word. This can help your partner understand and can also help you get to the word yourself by activating a different area in your brain
- Draw/Write – sometimes words or pictures come out more easily than speech. Keep a pen/paper with you
- Try again later – if you can't come up with the word and these strategies aren't helping, try taking a little break and trying again later
Communication is a two way street. Here are some strategies for communication partners of people experiencing aphasia that can help support them to understand and express themselves:
- Give reassurance, say "I know that you know" at appropriate times.
- Ask yes or no questions instead of open ended
- Ask one question at a time
- Ask fixed choice questions such as, "do you want water or coffee?" instead of "what do you want to drink?"
- Ask him/her to gesture, point to objects or pictures, or write key words, such as "Can you show me…"
- Give him/her sufficient time to respond. Ensure that you aren't looking tense or rushed
- Repeat the message to ensure that you have understood correctly ("let me make sure I understand")
- Don't pretend to understand what the other person has said if you do not
- Avoid interrupting or filling in words for a person (unless they have asked you to)
- Use short, simple sentences
- Speak slowly and clearly at a steady pace
- Do not speak more loudly – remember that this is not an issue with hearing
- If the person has not understood you, try saying your message in a different way
- Use gestures in addition to what you are saying
- Write down key words or topics, so that you can both see them together – e.g., PAIN, in large, bold print
- Use pictures to illustrate an idea, and focusing on one picture at a time
- Eliminate distractions whenever possible – one on one, turn off television or radio etc.
- Take a break if you are both tired. Provide reassurance that you will keep trying
- Be careful not to talk down to the person with a communication difficulty. Remember that the issue is not related to intelligence