In the U.S. today, there are more than 2 million Americans living with aphasia,1 a language impairment most commonly acquired from stroke, which can also be acquired from other types of brain injury or insult. Aphasia affects all language modalities, spoken, written, and gestural, and can have a substantial negative impact on quality of life. The hallmark difficulty is word retrieval impairment. A common sentiment expressed by those with aphasia is, “I know what I want to say, I just can’t get it out”. Aphasia can also affect language comprehension and the appropriate use and understanding of grammar. Whereas this textbook definition of aphasia focuses on its linguistic impact, people living with aphasia focus on its psychosocial consequences including loss of identity,2,3 loss of confidence,4 and social isolation.5, 6 These impacts are felt not only by the survivor but also by the co-survivors in their family. While one person in the family has aphasia, everyone in the family lives with aphasia.
The economic consequences of aphasia are also substantial. Recent evidence indicates that people with aphasia have a 21% lower income and 7% lower wealth relative to stroke survivors who do not have aphasia.7 This reduced solvency exists in the context of substantial economic burden due to factors including healthcare costs and loss of prospective income. For individuals with aphasia, this cost is estimated at more than $30,000 annually, over $6,000 more than for similar individuals who do not have aphasia. Extrapolated to the United States as a whole, this amounts to an annual economic burden of more than $15 billion.7
Neurorehabilitation makes a positive difference in the lives of families living with aphasia
Once an individual has acquired aphasia, evidence demonstrates that neurorehabilitation that includes speech-language therapy has a positive impact on communication skills and quality of life.8, 9 The cornerstone of this therapy is evidence-based practice, defined by the American Speech-Language-Hearing Association as the integration of clinical expertise, client and family perspectives, and evidence, including that from the scientific literature. Federal funding, for example, from the National Institutes of Health (NIH), supports science that advances our understanding of the nature of aphasia and the development of efficacious treatments thereof. With this support, innovative treatments have been developed that target specific language skills, facilitate use of these skills in the communication settings most meaningful to those living with aphasia, and that incorporate families and community members into the treatment process to reduce barriers to participation for those with aphasia. In addition, research has shown the benefit of augmenting behavioral treatment with innovations including non-invasive brain stimulation.10
Neurorehabilitation that includes speech-language therapy also has economic benefits. A recent study showed that the value of treatment exceeds its cost relative to improvements in quality of communication.11 In addition, speech-language treatment provided across the continuum of care has been identified as an integral component across the five key phases of return to work for individuals with aphasia,12 which can offset the economic burden of aphasia to families and to the public. Relative to public support for science, recent estimates suggest that NIH-funded research doubles return on investment (United for Medical Research 2025 annual report). For 2025, a conservative extrapolation of the value of NIH-funded aphasia research may be estimated at a return of more than $100 million.13
Informing stakeholders is a critical component of neurorehabilitation research
A recent groundswell in rehabilitation research has been recognition of the importance of collaborative goal setting and treatment planning with clients and families. Public access to evidence about treatments is a critical component of supporting people in being informed participants in their own rehabilitation. Information on federally funded research is available through several public sites. Grants are posted through the NIH Reporter, data from treatment trials are available on clinicaltrials.gov, and research articles are free to download on PubMed. Researchers can now also add summaries of their scientific articles to a recently developed ‘aphasia-friendly’ library, and efforts to develop AI to create such summaries are also underway.14
There is so much exciting work being done with and for those living with aphasia. Researchers at Jefferson Moss Rehabilitation Research Institute, supported by crucial federal investments in treatment innovation, are spearheading a number of these advances in language and psychosocial rehabilitation.
References:
1. The National Aphasia Association. (2024). https://aphasia.org/
2. Musser B, Wilkinson J, Gilbert T, & Bokhour BG. Changes in identity after aphasic stroke: Implications for primary care. International Journal of Family Medicine. 2015;970345:8 pages.
3. Shadden B. Aphasia as identity theft: Theory and practice. Aphasiology, 2005;19(3-5):211-223.
4. Babbitt EM & Cherney LR. Communication confidence in persons with aphasia. Topics in Stroke Rehabilitation. 2010;18(4):352-360.
5. Davison B, Howe T, Worrall L, & Togher L. Social participation for older people with aphasia: The impact of communication disability on friendships. Topics in Stroke Rehabilitation. 2008;15(4): 325-340.
6. Vickers C. Social networks after the onset of aphasia: The impact of aphasia group attendance. Aphasiology, 2010;24(6-8):902-913.
7. Jacobs M, & Ellis C. Aphasianomics: estimating the economic burden of poststroke aphasia in the United States. Aphasiology. 2023;37(1):25–38.
8. Brady MC, Kelly H, Godwin J, Enderby P, & Campbell P. Speech and language therapy for aphasia following stroke. The Cochrane database of systematic reviews. 2016;2016(6):CD000425.
9. Brady MC, et al. Precision rehabilitation for aphasia by patient age, sex, aphasia severity, and time since stroke? A prespecified, systematic review-based, individual participant data, network, subgroup meta-analysis. International Journal of Stroke. 2022;17(10):1067–1077.
10. Berube S & Hillis A. Advances and innovations in aphasia treatment trials. Stroke. 2019;50(10): 2977–2984.
11. Jacobs M, & Ellis C. Estimating the cost and value of functional changes in communication ability following telepractice treatment for aphasia. PloS one. 2021;16(9):e0257462.
12. Gilmore N, Fraas M, & Hinckley J. Return to Work for People with Aphasia. Archives of physical medicine and rehabilitation. 2022;103(6):1249–1251.
13. National Institutes of Health. https://report.nih.gov/funding/categorical-spending#/
14. Kasdan AV, Levy DF, Pedisich I, Wilson SM, & Herrington D. A practical guide to translating scientific publications into aphasia-friendly summaries. Perspectives of the ASHA Special Interest Groups. 2025;10(3):719–727.
Other Articles In This Series
Article 1: Reclaiming Lives: Neurorehabilitation Research is Critical to Advancing Care