Aphasia is an acquired condition. In other words, it occurs in children whose language skills had been developing normally. The language loss or impairment follows damage to the brain caused by, for example, tumour, head injury, stroke or infection. The aphasic child may have a partial or total inability to understand or use words. They may also have difficulty reading or writing. The language skills lost or impaired depend upon the area of the brain injured.
Broca’s Aphasia and Wernicke’s Aphasia
Although aphasia in childhood has been recognised since the latter part of the 19th century, for more than 100 years it was believed that children only presented with non-fluent Broca’s aphasia from which they made a speedy recovery. It is now known that the condition is more complex, and adult like aphasic syndromes, and recovery patterns, may been seen in children. In Broca’s aphasia, speech will be limited; the aphasic will have difficulty in forming speech sounds. It is unlikely they will speak at a normal pace and they may also have trouble writing. People with Broca’s aphasia are normally able to understand speech.
In Wernicke’s aphasia, speech production is unaffected. However, the person affected will typically make use of meaningless words and may struggle not only to understand speech but also to read and write. Broca’s and Wernicke’s aphasias are named after two 19th century neurologists who contributed much to the developing understanding of the condition of language loss and impairment following brain trauma.
Landau-Kleffner Syndrome
One fairly rare type of acquired childhood aphasia is Landau-Kleffner Syndrome (LKS). In these children their ability to speak and understand, after developing normally, is lost with no apparent cause. LKS children may also have seizures.
Aphasia in Childhood: Symptoms
Injuries that bring about disturbance in language function can also affect the child's ability to swallow. Aphasia affects each child differently. Symptoms can range from very mild to severe. For example, anomic aphasia, where the child has difficulty finding the right words, is less severe. Symptoms can also change from day to day or hour to hour. If the child feels poorly or upset, their language impairment may appear worse. Whether aphasia is a temporary or permanent condition depends on a number of factors, not least the amount of brain damage suffered.
Aphasia in Childhood: Treatment
Speech therapy is the main treatment for most aphasias. The aim of the speech therapist will be to help the aphasic child strengthen his or her remaining language abilities. Strategies to compensate for lost language skills will be developed. The aphasic child will be encouraged to repeat words, to exercise his or her facial muscles to facilitate speech, to learn signing as a means of communication. The child will be assisted to make use of pictures and computer programmes designed specifically to improve communication in the language impaired. Although there are no drugs that can cure aphasia, anticonvulsant medications are given to LKS children presenting with seizures. Surgery may be carried out in a number of cases but only to treat the cause of aphasia. For example, it may be necessary to operate to reduce swelling from head trauma.
Further Information
The American Speech-Language-Hearing Association and The UK charity Afasic provide information on language disorders in childhood.
