After a serious head injury or stroke, while families may think the patient has fully recovered, they often overlook the loss of communication ability — a common but unnoticed effect of brain injuries known as aphasia. This condition frequently goes misdiagnosed, say experts. In India, aphasia is still a major but little-known handicap. According to recent estimates, there are around two million people with aphasia in India, with a frequency of 3,000 per million and a community incidence of 43 per 100,000 every year. As June is observed as Aphasia Awareness Month, experts shed light on care and treatments.
Aphasia is a language disorder caused by damage to the brain, most commonly due to stroke, traumatic brain injury, tumours, or neurological diseases.
Dr Yeshwanth Paidimarri, consultant neurologist at Apollo Hospitals, Jubilee Hills, explains that it affects a person’s ability to communicate effectively, including speaking, understanding speech, reading, and writing. “Importantly, aphasia does not affect intelligence — those with aphasia still possess their cognitive abilities but may struggle to express or comprehend language,” he pointed out.
“Depending on the underlying cause and severity of brain damage, aphasia can be either temporary or permanent,” added Prof Dr Rupam Borgohain, senior consultant neurologist and programme director – PDMDRC, Yashoda Hospitals. He pointed out that while brain damage, stroke, and brain tumours are major causes of aphasia, other reasons can include severe head injuries (for eg, accidents), conditions that impact the brain, neurodegenerative conditions (eg, progressive primary aphasia — a gradual loss of language skills), and short disruptions in blood flow to the brain caused by transient ischemic attacks (TIAs), migraines, or seizures.
“And there are several types of it,” says Dr Rupam. Aphasia can appear in a variety of ways: Broca’s aphasia involves difficulty in speech production, although understanding is good. Wernicke’s aphasia involves fluent but meaningless speech with poor comprehension. Global aphasia results in severe disability in both understanding and producing speech. Conduction aphasia is when a person has good understanding but difficulty repeating words or sentences. Primary progressive aphasia is a gradual loss of language abilities caused by neurodegeneration.
Aphasia, a lesser-known yet highly impactful neurological disorder, is increasingly being recognised as a public health challenge both globally and in India. “In India, experts estimate that up to 30% of stroke survivors may develop aphasia. In the United States, over two million people live with aphasia, with 1,80,000 new cases reported annually. Advocacy and support structures are more established in many Western nations. In India, limited public awareness and access to speech-language pathologists mean that only a small fraction receive timely intervention,” said Dr Yeshwanth.
Despite its prevalence, awareness about aphasia remains alarmingly low. Experts say that this lack of knowledge often leads to misdiagnosis, inadequate treatment, and social stigma — especially in countries like India, where speech and language therapy resources are scarce, Dr Yeshwanth pointed out.
He also said that beyond communication, aphasia affects a person’s emotional well-being and social life. Many patients withdraw from conversations, which can lead to isolation, depression, and an inability to return to work. For caregivers, the burden is equally heavy.
According to Dr Yeshwanth, a proper diagnosis of aphasia involves brain scans (CT or MRI) to locate and assess damage in language-related areas of the brain, and neurological exams to test reflexes, muscle control, and cognitive functions. Further, speech and language assessments conducted by trained speech-language pathologists evaluate a patient’s ability to speak, comprehend, read, and write. He specified that therapy is the lifeline, and once diagnosed, speech and language therapy becomes the cornerstone of treatment.
Although there isn’t a cure for aphasia at this time, recovery and improvement are possible, especially with prompt intervention, underscored Dr Rupam. Speech and language therapy is the mainstay of treatment, and is customised to each patient’s needs and symptom severity. Both experts suggested that improving speaking, comprehension, reading, and writing abilities is the main goal.
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Speech and language therapy: Strategies include practising alternative communication methods like gestures or drawing, classifying words, repeating words, and matching words to pictures.
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Technology use: Therapy software, communication apps, and voice-activated devices can facilitate daily conversation.
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Family and caregiver involvement: Therapy often involves training family members and caregivers to support communication and reduce frustration.
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Supportive therapies: Psychological therapy can help manage social isolation, depression, and anxiety.
Progress may continue for years, though the majority of improvement typically occurs in the first few months following brain damage. Therapy for different forms of aphasia emphasises communication maintenance and adapting abilities, mentioned Dr Rupam.
“Neurologists stress the importance of early diagnosis and therapy — particularly within the first six months of onset. During this window, the brain has the best chance of recovery and adapting to new language pathways. In India, institutions like the Indian Speech and Hearing Association (ISHA) are working to improve access to such services, though coverage remains limited,” added Dr Yeshwanth.
Experts advise that aphasia requires a multidisciplinary approach — neurologists, speech therapists, psychologists, and family members all play a role. With early diagnosis and consistent therapy, many people with aphasia can make meaningful progress, regain independence, and reconnect with their communities.
