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Responding to Aphasia - When Language Fails

by Mike Kennedy

Over 1 million people in the US suffer from aphasia, an acquired impairment of the ability to comprehend or use language. At the Ready recently interviewed Tracey Wallace, a Speech Pathologist specializing in Acquired Brain Injury with Shepherd Pathways, Shepherd Center’s outpatient rehabilitation program for people recovering from brain injury. Tracey has worked with the Fulton County Public Safety Center to educate First Responders on responding to those with Aphasia.

Q. What is Aphasia and why is it so important that responders learn more about it by working with people like you?

A. Aphasia is an acquired impairment of the ability to comprehend or use language. It can affect speaking, understanding, reading and writing but does not affect intelligence. Stroke is the most common cause, but aphasia can also be caused by head injury, brain tumor and other neurological conditions. Many military service personnel are returning from Iraq with aphasia.

The communication difficulties people with aphasia experience often get worse in times of stress or pressure, such as emergency situations. Raising awareness and training police, fire fighters and emergency medical technicians to be able to communicate with people who have aphasia has the potential to increase the timeliness, efficiency and effectiveness of their response in emergency situations. Additionally, training may reduce the likelihood that a person with aphasia will be mistaken for being drunk or under the influence of illegal substances which sometimes occurs.

Q. What is the single most important thing that all responders should know about rescuing and communicating on-scene with someone who has Aphasia?

A. One of the most useful communication tips may be to ask questions that can be answered with yes and no rather than open-ended questions requiring lengthy verbal explanation. Additionally, the National Aphasia Association has produced a decal that some people with aphasia may use to help first responders recognize the person has aphasia. Those using the decal place it on the left rear passenger side window of their vehicle or at the front & back entrance of their home.

Q. Can you please provide a brief explanation of your work with responders so that others around the country can gain an idea of what a day of training with Tracey Wallace, or others around the country with your credentials, might look like?

A. Training included increasing awareness and knowledge of aphasia, how to recognize someone may have aphasia and tips for communicating with people with aphasia. Additionally, 2 volunteers living with aphasia spoke about how aphasia affects their communication and one of them told a story of how he struggled to communicate with first responders when his father had a medical emergency.

Q. With which element of the responder community (fire, EMS, law enforcement, emergency management) do you do the bulk of your work? Why this element?

A. The audience at my training was primarily fire and law enforcement and most attending reported that prior to the training they did not feel knowledgeable about aphasia and had not previously received any training on how to recognize when someone has aphasia or how to communicate with a person with aphasia.

Q. Is your work, and programs like it, best suited for just this element or should the rest of the community also learn more about Aphasia? Why?

A. This training is critical for first responders. However, since there are over 1 million people in the U.S. living with aphasia, I believe other member of the community also have the potential to benefit from becoming aware of aphasia.

Q. How many departments/agencies have you worked with and how did they learn about what you do?

A. I have only worked with the public safety training facility in my county which provides for law enforcement across the state. I contacted the Academy Director, Susan Miller, to offer the training. She indicated she reviewed the information and determined it was a topic that needed to be covered with her first responders. I then had to complete the process to receive Guest Instructor Certification, which verified my qualifications, to be authorized to instruct Georgia Peace Officers.

Q. How might a responder agency go about beginning work with professionals such as yourself to develop better rescue plans?

A. Agencies interested in finding someone to provide training on aphasia should contact the National Aphasia Association ( Agencies can also reach out to local hospitals and medical rehabilitation centers to connect with people qualified to provide training or consultation to support development of optimal rescue plans for people living with disabilities.

Q. You are listed as a National Aphasia Network state representative for Georgia. What exactly does a state representative do?

A. As a state representative I have offered support to people living with aphasia in Georgia by helping them and their caregivers locate skilled rehabilitative services and/or identify support groups in their area. Additionally, I have provided in-service training to Georgia businesses in need, such as an adult day care center. However, the National Aphasia Association just changed the way they utilize State Representatives and instead are moving to a National Affiliate Registry (which requires re-application as well as a fee). I have not decided whether I will register with this change in their program. I believe this means they are no longer listing State Representatives.

Q. How long have you been working with first responders and what motivated you to begin doing so?

A. I have only provided one training which was given to first responders in 2010 at the Fulton County Public Safety Training Facility in Atlanta, Georgia. The training I provided was targeted at emergency responders and followed a train the trainer model which allowed attendees to take information from my training and go back to their individual departments and train their staff. Several attendees told me they planned to incorporate some of the information into upcoming classes for their staff.

I was inspired to offer and provide this training after learning of the efforts of the National Aphasia Association toward raising awareness of aphasia and providing training for first responders. I received outstanding support from the National Aphasia Association as well as my employer, Shepherd Center, to provide this training.

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