Did make source you? Prable not. Is bξttΞ? Or window as reeds?

Did that make sense to you? Probably not. Is this better? Or still clear as mud?

Many people can read the second line above with ease, understand it if it's spoken out loud or write it themselves. But for people with a condition called aphasia, reading or speaking the second line is still not a given.

Aphasia is the loss of a person's ability to understand or produce language. It can be brought on by a stroke, tumor or brain injury, and make it difficult to speak, read, write or decode what others are saying. The above is not an exact representation of what it's like to read as a person with aphasia, but it might offer a hint of how exasperating it is to have your attempts to connect to others or their thoughts constantly hindered.

This condition may affect 38 percent of stroke survivors, and by National Institutes of Health's estimates about one million people in the United States have it. "There are more people living with aphasia in the US than there are with Parkinson's, but it seems everyone has heard of Parkinson's and nobody has heard of aphasia," said Megan Sutton, a speech language pathologist and a founder of Tactus Therapy Solutions, a company that develops apps for speech therapy.

Aphasia might resolve quickly or linger for months or years. Many people live with aphasia indefinitely. Even if someone never recovers the ability to effortlessly read a newspaper or announce what's on their mind, though, there are techniques people with aphasia and those around them can pick up to make communication flow more easily.

Flavors of aphasia

How a person's language skills are affected by aphasia varies widely, but most have difficulty with reading or writing as well as spoken or signed language. Sometimes people also have trouble drawing or working with numbers.

People with nonfluent aphasia, the type Sutton encounters most, have difficulty finding the right word. These people have trouble assembling full sentences, and often speak haltingly or just hit key words.

This condition is also called Broca's aphasia, named for a part of the brain in our frontal lobe that is important for speech production. Its discoverer, Paul Broca, is said to have identified the brain damage that causes nonfluent aphasia after encountering a man who could only say the word "tan" in 1861.

Another form of aphasia is called fluent aphasia. People with this condition can speak in complete but garbled sentences. "For someone who has fluent aphasia the words may come out really easily, but they're not the right words or they have trouble understanding what other people say to them," Sutton said. They might say things like "I hope the world lasts for you," the signoff given by stroke survivor Byron Peterson in a video of himself chatting with Sutton.

Fluent aphasia is also called Wernicke's aphasia, after another brain region in the temporal lobe that is involved in understanding language.

"Those types of aphasia tend to be related to damage in those areas but it really is not exact," Sutton said. "As we learn more about the brain we realize that not everyone's brain is the same, and that damage in certain parts can look different for different people."

Among people with the most severe form of aphasia, called global aphasia, all language abilities are profoundly compromised. These people can barely read, write, speak, or understand speech, if at all. But aphasia can also be relatively mild. Those with anomic aphasia, or anomia, can speak fluently but often cannot summon the right noun or verb for what they want to say. It's like having the word you want on the tip of your tongue all the time.

Life with aphasia

For most people, areas in the brain's left hemisphere are dominant in controlling language. After damage in these areas leads to aphasia, doctors may use speech therapy to try recruit regions that did not previously process language.

"Sometimes it will be the right side of the brain that starts taking over language and sometimes it will be the neurons right around the damaged area," Sutton said.

To treat their aphasia, people can do exercises that help them practice whichever language skills have taken a hit. "If they are having trouble saying words we might show them a picture and ask them to describe it," Sutton said. "If they can say one thing in it then we expand on that and try to get them to put two words together and then three words together, until they come up with a sentence."

Many people who have trouble understanding speech can piece together its meaning from the words they do catch or guess from context. Depending on what type of aphasia they have, people can also learn workarounds like drawing or describing the word they want to say.

"It's a common myth that if somebody can't speak for some reason you can just teach them sign language," Sutton said. "Because it's the language part of their brain that's impaired…it would be harder than anyone else learning another language."

She and her colleagues do, however, teach people how to convey basic ideas through symbolic gestures.

Some scientists are also looking into combining speech therapy with brain stimulation techniques, such as magnetic stimulation (TMS) or direct current stimulation (TCDS), and some have reported positive results. Over time, aphasia typically becomes less debilitating, with the exception of primary progressive aphasia, a neurological syndrome that occurs as neurons in the temporal and frontal lobes degenerate.

"For all other aphasias, the ones that come on suddenly with a brain injury, they do tend to get better over time as the brain heals and as people go through therapy," Sutton said. "And not only does the aphasia improve over time, the person with it and the family learn to adapt."

Still, aphasia can create a barrier to enjoying hobbies or navigating independently, on top of isolating those who have it from people around them.

"People don't know how to respond and often they just don't," Sutton said. "They'll avoid the situation because they don't know how to help."

A foreign country

Everyone's experiences with aphasia are a little different, although the impediments they face in speaking or understanding tend to fall into a few categories.

When someone's listening skills are fuzzy, they might have trouble deciphering the first part of what someone said, or perceive words that are related to what they actually heard (like hearing "dog" instead of "cat"), or experience sounds that are nonsensical and don't line up with any word.

Some people with nonfluent aphasia can call up the word they want to say in their heads but are unable to say it out loud, while others recognize an object or concept but can't pinpoint its name. Others can say the right word but not write it.

With fluent aphasia, people sometimes aren't aware that their speech is distorted. "A lot of people with Wernicke's aphasia don't know that the words that are coming out aren't the words they mean," Sutton said. "The man in that video [Byron Peterson] has been living with it long enough that he understands that his words often aren't right, but he can't fix it."

The words that people with aphasia unintentionally select when speaking aren't completely random. These wrong words might be semantic paraphasias, which have related meanings to the word someone meant to say. Others are phonemic paraphasias, which sound similar to the desired word. Sometimes a person ends up saying a completely made-up word, or neologism.

"Someone might make a whole lot of phonemic paraphasias whereas someone else might have speech that is just full of neologisms," Sutton said. "So there do tend to be patterns in the type of errors people make."

It's difficult for those without aphasia to imagine what it's like to have their words and others' muddied this way. There are a few simulations, though, that will swap out whatever you type, or cut another's voice with gibberish.

"It would be quite a bit like being in a country where you've only studied the language for six weeks," Sutton said. "You know some of the words, but you're missing the intricacies of the verb tenses or the prepositions."

She and her colleagues have a few communication tips, though, for those speaking with someone with aphasia for the first time. Among them: be ready to repeat or rephrase what you just said, state your topic at the start of a conversation, and when they are speaking, be willing to admit when you just don't understand.