The Complex Skill of Language
What is Language?
While many complex definitions exist, language is the way that people communicate. In a language, words are connected in meaningful patterns to form logical sentences (syntax). The smallest component of language is a morpheme, or the root of a word that may or may not make sense on its own. A large component of a language is the lexicon, or vocabulary that is used to comprise sentences.
The Neurobiology of Language
The brain is the organ responsible for behavior. Language can be considered a behavior, as it is the result of input (auditory/visual stimuli) from the environment causing thought processes leading to verbal output (speech/writing).
In the brain, Broca’s area located in the left hemisphere sits above the temporal lobe where the sylvian fissure touches the frontal cortex. Specifically, it is located within the inferior frontal gyrus. Damage to this area of the brain results in expressive aphasia, the condition in which a patient comprehends language but cannot produce speech. Patients with expressive aphasia often have difficulty articulating words they want to say, have trouble writing sentences, and will sometimes have difficulty comprehending full sentences.
Connecting to Broca’s area is Wernicke’s area, located within the posterior superior temporal gyrus. Wernicke’s area has been linked to language comprehension for both written and spoken word. When damage occurs to this area, people have difficulty understanding language. While the ability to speak is preserved, people with Wernicke’s aphasia will speak full sentences that lack meaning.
Two major pathways have been identified: the audio ventral stream and audio dorsal stream. In the audio-ventral stream, the auditory cortex within the left temporal lobe connects to the media temporal gyrus, temporal pole, and inferior frontal gyrus. This stream informs people of “what” is being communicated. It processes sound, distinguishes background noise from meaningful sounds, and is needed to comprehend sentences.
The audio-dorsal stream in contrast, is composed of connections from the auditory cortex, parietal lobe, and inferior frontal gyrus. This pathway is needed for understanding “where” sound is coming from. In addition, this pathway is involved with speech production, repetition, and verbal memory.
Research has also found involvement of the right hemisphere in language. Originally thought to be only controlled by the left hemisphere, the right hemisphere is active in comprehending emotion and attitudes conveyed within language. Right hemisphere damage can cause someone to not understand when someone tells a joke, or if someone non-verbally communicates offense at something said. In this sense, the right hemisphere is responsible for comprehension of idiomatic/non-literal spoken and written language.
Common Cognitive Disorders of Language
Aphasia is the inability to comprehend or produce language due to brain damage, usually in the left hemisphere. Aphasia can have comorbid motor components such as dysarthria, or when someone cannot produce the roots of the words they wish to say.
Primary progressive aphasia occurs with dementia and Alzheimer’s disease. Patients with PPA gradually lose the ability to produce, comprehend, and read language. In comorbidity, executive functioning and memory are also gradually lost with this condition.
Apraxia of speech is a motor-cognitive disorder in which people have difficulty planning and coordinating the movements needed to produce speech.
Auditory verbal agnosia is when someone loses the ability to understand language, repeat words, and write dictated word. People with this disorder behave as if they were being spoken to in a foreign language, as they do not recognize words being spoken.
Dyslexia is a learning and neurodevelopmental disability that impacts someone’s ability to read and decode written language. Oftentimes, people with dyslexia misspell, repeat words when writing, and reverse letters or numbers in written text. The cause of dyslexia is still being researched, but some work has shown differences in activation of the inferior frontal gyrus, inferior parietal lobe, and medial-ventral temporal lobe.
Three Major Kinds of Therapists Who Work with Language
Speech-language pathologists work with patients to help them better communicate. They even help people be able to swallow! The mouth and the brain are highly connected. Speech and feeding are not too far apart in the brain, and brain damage can affect one’s ability to talk and swallow solid or liquid nutrition. Speech-language pathologists help identify where people are having issues communicating (does the patient not understand language, or do they have difficulty producing language?).
Neuropsychologists perform assessments and make treatment plans to help rehabilitate patients who have cognitive complications. For example, if someone suffers a stroke, a neuropsychologist will examine their language and cognitive abilities with neuropsychological tests to understand how they currently are performing and will develop a plan to get that patient better.
Occupational therapists help when someone is having difficulty with learning, focus, attention, and organization. They can help people with activities of daily living that they may not have developed the skills to do yet. While there is a large focus on coordination and motor skills, OT’s can help with cognitive rehabilitation of language, such as teaching a child how to slow down when reading and focus on the text at hand.
Why Does Language Matter?
We use language everyday to communicate thoughts, feelings, and ideas. When the ability to produce or comprehend language is lost, people find themselves not able to work, go to school, participate in social situations, and can suffer from depression and isolation.
People with speech and communication disorders are often very intelligent. Because people with language disorders may not be able to articulate what they would like to say, people treat them like they are stupid. This is unfair as conditions such as aphasia are a loss of language, not intellect.
It is important to take time and examine the interaction with someone who you may think has a language disorder, so you can effectively communicate. Strategies such as slowing down, communicating that it is OK to pause, asking if something needs to be repeated (in a non-condescending way!), and most importantly, listening to the other person and their communication needs are ways to foster dialogue with someone who may have a language disorder.
What Are Ways to Improve Language?
Be a curious learner – See a word you do not know? Look it up! Try integrating that word into your vocabulary.
Read – There are plenty of articles, magazines, inspiring and attention-grabbing novels to read. Pick something of interest and spend a bit of time reading each day.
Get out there – Socializing is a way to practice conversation skills. Get together with friends or relatives who make you feel good and ask about how their day was.
Try a cognitive rehabilitation program – If you have had a brain injury, stroke, or have been diagnosed with another neurological or psychiatric condition, there are therapists who do cognitive rehabilitation. Consult your physician or look up psychologists or neuropsychologists who perform cognitive rehabilitation in your area.