Have you heard this term before?
If you haven't, you're not alone. Based on the National Aphasia Association (NAA)'s 2016 national survey on aphasia awareness, 84.5% of people have never heard the term "aphasia," a language disorder that impacts a person's ability to access, use and/or understand language. Aphasia results from damage, such as from a stroke or traumatic brain injury, to the areas of the brain that promote production or understanding of language through various modes (e.g., speaking, listening, writing, reading, signing, gesturing, etc.). While language is affected with aphasia, intelligence is not.
Aphasia is a diverse disorder, ranging from mild to severe, and can look different in each person who experiences it. For the majority of people who have aphasia, both understanding and producing language are affected to some degree. Different aphasia profiles might look like:
- being able to understand the majority of what is said to him/her but only able to produce 1-2 words at a time. This person can understand conversation and follow directions with greater ease than he/she is able to ask for a cup of coffee. This person might say one word like "cup" or "coffee."
- being able to understand about half of what is said to him/her but able to speak in complete sentences with some difficulty thinking of the right word. This person can ask for a cup of coffee with greater ease than he/she can understand conversation and follow directions. This person might say, "Can I have some tea... no, the other one... coffee?"
- being unable to understand what is said to him/her and unable to produce any meaningful words. This person has equal difficulty understanding conversation and following directions as he/she has with asking for a cup of coffee. This person might say an automatic phrase, like, "Oh, boy. Oh, boy."
June is National Aphasia Awareness Month. Craig grad Nicole Yehl, who lives with this disorder, is a vibrant young woman with a passion for poetry and a flair for fashion. Nicole shares with us her unique perspective about aphasia, including regaining her communication skills and thriving in this new chapter of her life.
In February 2017, Nicole had a stroke at the age of 31. The stroke impacted the right side of her body and her ability to produce and understand language. In the first few months after her stroke, Nicole was only able say one or two words at a time, such as "yeah" and "good." She found it difficult to think of the specific word she wanted to say. Now, Nicole is able to speak in sentences of eight or more words. You'll notice that she continues to have difficulty with word choice and grammar, but she is able to communicate her main idea. When reflecting on her language recovery, Nicole says, "One year ago, it is really hard to get my words. But right now, my progressing is helping. Just take it slow, day by day. Now my words are moving forward. It's easier now."
Nicole received speech language therapy at Craig as an inpatient. "My treatment was at Craig Hospital for the aphasia. The people is caring, compassionate and inspiring. I love my speech department and my doctors!" She then returned to Craig as an outpatient for three rounds of the Craig Hospital Aphasia Therapy (CHAT) Program, a specialized, intensive aphasia treatment program. In this program, Nicole received individual speech language therapy three hours a day, five days a week, for three weeks. She also participated in yoga therapy and group language therapy. In reference to the CHAT Program, Nicole says, "We were working for three weeks intensive. Kristen [her Craig speech language pathologist] and I were one-on-one and a group too. I worked on past tense. It was really hard, but it is progressing." Nicole highlights the importance of mass practice (i.e., repetition) in aphasia therapy. "It was repeat, repeat, repeat!"
Despite making incredible progress, Nicole still struggles when communicating in the community. It's especially difficult since most people aren't familiar with aphasia, and this limits the type of interactions she can have with people. "My loss of words is hard. In the community, it's really hard to talk. My husband and I were at a grocery store, and my conversation back-and-forth is just a little bit. It's a conversation, but not conversation. Same with Uber too. 'Hi, how are you?' 'Good, how are you?'" Nicole describes the strategies that help her best communicate in the community, "[I] take it slow, pause, wait and breathe." She also tells people, "I had a stroke, and I have difficulty speaking, so please be patient with me."
In addition to patience, Nicole finds it to be helpful when people speak slowly. When others use a slower speaking rate, it helps her understand what is being said and also gives her more time to formulate her thoughts. On one occasion, an airport security employee spoke to Nicole quickly and it was hard for her to understand. "We were at the airport in Phoenix, and I was a pat-down [at security]. I'm like, 'Oh, okay.' The woman and I were so fast because I'm like, 'Oh my gosh. That [your talking] is really quick! Can you slow down please? That was really fast.'"
Not only is Nicole a strong advocate for herself, but she is also an advocate for others with aphasia. "All different people had brain injury. We were all [different] but the same!" She finds power in solidarity and encourages others to join aphasia support groups like Brain Buddy, a group she meets with weekly. "I love my group. It's kind of older people. I'm the youngest one. I love discussing out loud and just observing too because it's individual."
Two years after her stroke and after intense therapy and rehabilitation, Nicole is ready to start thinking about what comes next for her in life. One passion she has returned to is expressing herself through poetry. Though difficult because of her aphasia, Nicole loves to write and has found a creative new voice. Below is a poem Nicole wrote before her stroke and another she wrote just earlier this year, after her stroke.
Through poetry, Nicole has regained a part of herself, and she hopes to help others with aphasia do the same. Before her stroke, Nicole frequently volunteered in the Denver area, so it is no surprise that she now wants to give back to the community. "I want to volunteer my time with Craig. In the future, [husband] Dane and I will get volunteering and help stroke survivors." Nicole has found hope in her healing, and she wants to inspire others learning to live with aphasia. "It is hard to take all of it back, but push harder and keep fighting!"
- Find a Stroke Support Group in Colorado
- More information about how to best communicate with a person with aphasia
"You have the choice to create the kind of live you want to live." - Nicole, January 1, 2006
1. Stay better connected with the news: world, local
2. Always be in the middle of reading a good book: read, read, read!
3. Photograph beauty that meets the eye
4. Write and share penmanship with others
5. Invest in expressive stationery and a name stamp or seal
6. Eat more locally grown foods that are in season
7. Travel when you yearn to do so
8. Become fluent in one other language
9. Create friendships with those from different cultures
10. Consciously breathe every day
"Dark or Sun" - Nicole, April 21, 2019
One bright, colorful drop
Color red, for the brain.
White, black, gray...
Sun comes up!
Two bright, colorful water
Color red, for the heart.
White, black, gray...