It affects more than 2 million people, yet almost 85 percent of Americans say they’ve never heard of it, according to the National Aphasia Association (NAA).

It’s aphasia, and the NAA defines it as an impairment of language, affecting the production or comprehension of speech and the ability to read or write.

While there are varying levels of aphasia, it’s always caused by injury to the brain from a stroke or by brain injuries from head trauma, brain tumors or infections.

Typically, I see two types of aphasia the most: receptive and expressive.

Receptive aphasia is when someone is not able to identify objects. I could ask you to pick up a pencil, write your name and put the pencil back down, but it might seem as if I was speaking a foreign language. Another example would be if I asked you to touch your mouth. You know that your mouth is on your face, but you can’t seem to remember where on your face.

Expressive aphasia is when you’re not able to name things or carry on a conversation, or you call things by the wrong name. In other words, I could be holding a coffee cup and call it a flower. I know it’s not a flower, but I can’t remember the word coffee cup. It’s like the word is on the tip of my tongue.

Other signs of aphasia might be difficulty following commands, like if someone asks you to sit down or stand up. You might stumble through words in conversation or get stuck on simple words. My expressive aphasia patients tell me it’s frustrating. They can’t help but feel trapped, because they know what word should be used, but they just can’t say it. It’s just not possible for them to express how they feel.

If you’ve had a stroke or some type of brain injury, it’s important to ask your primary care doctor for a referral to get evaluated for aphasia. The sooner you can get therapy, the better you can recover.

Approximately one-third of my speech therapy patients have aphasia. Most of them recover in two to nine months. If you wait two years before starting therapy, it’s not as likely you will be able to recover. I have patients in their late 30s able to fully recover.

Another reason to get evaluated is because you might not know you have cognitive deficits. For example, people might not realize they can’t balance their checkbook. I can evaluate you and determine if you have deficits.

How do you know if you’re just getting old or you have aphasia? This is a hard line, because your brain has a right and left side. A stroke on the left side of the brain means you’ll probably have aphasia. A stroke on the right side typically causes cognitive problems.

In therapy, we are basically trying to rewire your brain. There are parts that are damaged as a result of a stroke or head injury. We find out your level of aphasia and work on whatever needs you have and go from there. It’s different for every person.

Aphasia is fascinating from a therapist’s point of view. For example, it’s fascinating when a person can count from one to 10, but when you show them the number two, they can’t tell you what it is.

It’s important to understand why it’s so difficult for those with aphasia to communicate. They’re not cognitively impaired or “slow,” they just can’t make out what you are saying or get their point across. The therapy strategies we use really help. To me, it’s rewarding, because patients feel like you understand them.

Erin Ward, MSCCC-SLP, is a certified speech pathologist helping people with speech impediments, cognitive communicative disorders due to stroke and/or aging, voice disorders, pediatric speech, dysphagia, dyslexia and dementia. She is part of the care team at MUSC Health Outpatient Rehabilitation Center in Florence. For more information, call 843-661-4360.