What is Aphasia? A Guide for Families

You had a stroke. Or maybe a brain injury. And now the words won’t come.

You know what you want to say. It’s right there. But somewhere between the thought and your mouth, something breaks down.

That’s aphasia.

What aphasia actually is

Aphasia is a language disorder caused by damage to the parts of your brain that process language. It usually happens after a stroke, but head injuries, brain tumours, and infections can cause it too.

It doesn’t affect your intelligence. You’re still you. You still think clearly, have opinions, feel everything you always did. The wiring between your thoughts and your words has been disrupted.

Around 30% of people who have a stroke experience aphasia. In New Zealand, with roughly 9,000 strokes per year, that’s close to 3,000 people every year suddenly finding that language no longer works the way it used to.

What it looks like

Aphasia shows up differently for everyone. The symptoms depend on which part of the brain was damaged and how much.

You might:

• Struggle to find the right word. It’s on the tip of your tongue, always just out of reach.
• Mix up words without realising. “Table” when you mean “chair.” “Wednesday” when you mean “Friday.”
• Speak in short, broken phrases. You know the full sentence, but only fragments come out.
• Have trouble understanding what others say, especially when people talk quickly or in groups.
• Find reading or writing suddenly difficult, even though you’ve been doing both your entire life.

Some people have mild word-finding difficulties that frustrate but don’t stop them. Others lose most of their language. There’s a wide spectrum, and where you fall depends on the location and extent of the brain injury.

The main types

Broca’s aphasia (non-fluent): You understand what people say, but speaking is effortful. Sentences come out short and halting. You might say “walk… park… dog” when you mean “I walked the dog in the park.” You know your speech isn’t right, which makes it more frustrating.

Wernicke’s aphasia (fluent): Speech flows easily, but the words don’t always make sense. You might use the wrong words or string together sentences that sound fluent but carry little meaning. You may not realise others can’t follow what you’re saying.

Global aphasia: The most severe form. Both speaking and understanding are significantly affected. This often occurs immediately after a major stroke and can improve considerably with time and therapy.

Anomic aphasia: The mildest form. Conversation flows reasonably well, but you consistently struggle to find specific words, especially nouns and verbs. It’s like having a permanent tip-of-the-tongue experience.

Is this you?

You had a stroke three months ago. Your body has recovered well, but conversations exhaust you. You avoid phone calls because you can’t find words fast enough. Your partner finishes your sentences, which helps and irritates you in equal measure. People assume you’re better because you look fine. You’re not.

Your parent had a stroke and now they seem like a different person. They get frustrated, sometimes angry, when they can’t communicate. Family gatherings have become stressful. You don’t know how to help without making them feel worse. You miss the conversations you used to have.

You’ve noticed words slipping away gradually. It wasn’t sudden like a stroke. Over months, word-finding has become harder. Names escape you. Reading takes longer. Your GP mentioned something about “primary progressive aphasia” and you’re trying to understand what that means for your future.

How speech therapy helps

Your brain has more flexibility than you might think. Neuroplasticity, the brain’s ability to form new connections, means that damaged language pathways can sometimes be rerouted.

Speech therapy for aphasia works on multiple levels:

Rebuilding language pathways. Targeted exercises help your brain strengthen alternative routes to access words and construct sentences. Repetition matters. The more you practise specific language tasks, the stronger those new connections become.

Developing communication strategies. When words fail, there are other ways to get your message across. Gesture, drawing, writing key words, using communication apps on your phone. Therapy helps you build a toolkit of strategies so you’re never completely stuck.

Building confidence. Aphasia can make you withdraw from social situations. Therapy addresses this directly, helping you practise real conversations in a safe space before taking those skills back into daily life.

Supporting families. Aphasia affects everyone around you too. Part of therapy involves helping your family understand what’s happening and learn communication techniques that make conversations easier for everyone.

Research published in The Lancet Neurology consistently shows that speech therapy improves language outcomes after stroke. A 2022 Cochrane review of 75 studies confirmed that speech and language therapy leads to significant improvements in functional communication, reading, writing, and expressive language compared to no therapy.

Intensity matters. Studies suggest that more frequent sessions, particularly in the first year, lead to better outcomes. That’s one reason telehealth can be valuable. It makes it easier to attend sessions regularly without the barrier of travel.

What to expect from therapy

Your first session is an assessment. Sacha will work through a series of tasks to understand exactly how aphasia is affecting your language: speaking, understanding, reading, and writing. This isn’t a test you pass or fail. It’s a map of where you are now and what to work on first.

From there, therapy is tailored to your specific pattern of aphasia and your personal goals. Maybe you want to return to work. Maybe you want to be able to order coffee without anxiety. Maybe you want to read to your grandchildren again. Those goals shape the therapy.

Sessions are typically 45-60 minutes, and most people benefit from regular weekly sessions. You’ll also get exercises to practise between sessions, because the work you do at home matters as much as what happens in the therapy room.

Most people start noticing changes within the first few weeks. Sometimes it’s small things first: a word that suddenly comes easily, a conversation that flows a little better, reading a sentence without getting lost. These small gains build.

Recovery is real, and it takes time

The first three to six months after stroke are typically when the most rapid recovery happens. But improvement doesn’t stop there. Research shows people with aphasia continue making gains years after their stroke, especially with ongoing therapy and practice.

Recovery isn’t linear. You’ll have good days and frustrating days. That’s normal. The trajectory over weeks and months is what matters, not any single conversation.

Some people recover most of their language. Others find new ways to communicate that work for them. Both are valid outcomes. The goal isn’t perfection. It’s finding your way back to the conversations and connections that matter to you.

Getting started

If you or someone you care about is living with aphasia, speech therapy can help. You don’t need a referral from your GP (though they’re welcome to refer you directly through our referral page).

Sona Speech offers aphasia therapy via telehealth across New Zealand, so geography isn’t a barrier. Most people are seen within a week of booking.

Book a speech assessment to get started.