Sunday, November 29, 2009

myths about aphasia #5

The final installment about aphasia deals with intelligence. When a person gets aphasia, it's difficult to determine where they are cognitively. The general consensus is that the person's intelligence remains intact, but their abilities to communicate that intelligence have been affected. After all, how do we generally assess intelligence? Language!
We listen to what a person says, how he speaks, and give him directions using language (writing or speaking). All modalities of communication--writing, listening, reading, and speaking--are the ways in which we determine someone's intelligence.
Almost every person who comes into our center is assessed for both language and cognitive skills. Almost every single person performs above 85% on the cognitive tests, while scoring in the severe to mild range for language skills. Believe that the person with aphasia knows what they want to say, knows all of the information they knew before the brain injury, but the methods to get this information to others is more difficult.
I once spoke with a gentleman who was convinced that his wife, having had two strokes and little speech, had no idea what was going on around her. He used this belief to behave inappropriately, and wanted someone like myself to validate his belief. He said, "I can ask her what 2 plus 2 is and she don't know". This was his criteria for believing that she was more or less in a waking coma. Now, I firmly believe that this woman knew what the answer was, but did not have the means to communicate the answer. People with aphasia may need a pen and paper, to have the question written out for them, or to have multiple choices in writing to communicate. The information is in there, it's a matter of finding a way to help get that information out that may take a bit of work.