A phase of grief
Ruiter: “You have to see it as a phase of grief. Speaking for myself, the way I use language is part of my identity. By communicating with words, I can do the work that gives me satisfaction: doing research and teaching. Language is so intertwined with my personality. Many people with aphasia say they feel they lose a part of their personality.”
Some people with aphasia enter a ‘fight mode’ after the brain injury occurs. They strongly believe they will overcome aphasia and that they will be able to speak again in no time. "Unfortunately, in practice that often doesn’t work because aphasia is chronic in many cases,” Ruiter explains. “And then the grief returns. Just like when someone has died and you can’t immediately believe it. Some people with aphasia repeatedly get stuck when forming sentences. Since communication moves quickly, conversation partners may drop out. That makes them sad again. Only then is there often room to find a way to adapt to permanent aphasia. In cases of persistent problems producing sentences, that can mean speaking in ‘telegram style.’”
She explains: “It’s comparable to children who are learning to talk and speak in two- or three-word expressions: functional, but less elegant. Actually, we all speak in telegram style sometimes. Do you ever say: ‘Nice weekend?’ or ‘Pretty busy day today’? Those are also examples of telegram style: a shorter, simplified message.”
Telegram style
People with chronic sentence-production problems due to aphasia are often referred to a speech and language therapist. “They need to learn a different way of speaking. Research shows that changing behavior requires a lot of repetition. When you’re one year old, you start speaking. Producing sentences runs on autopilot throughout your life. If that automatic process is suddenly disrupted by aphasia, it doesn’t mean you can immediately stop it. To speak in telegram style, you have to build a new speaking routine, which can be very complicated. Especially with brain injury. Intensive and repetitive practice is required, but that type of therapy is relatively expensive.”
A digital form
SimpTell is a web-based aphasia therapy consisting of telegram-style exercises that people with aphasia can partly practice themselves at home, allowing them to practice at any time of day. The speech and language therapist can then spend therapy time more effectively on learning how to apply this speaking style in daily life.
