Expressive/Nonfluent/Broca’s Aphasia

  • Associated with damage to the frontoparietal area of the brain.
  • Defined as the inability to form and express words although the person knows what they want to say.
  • The person struggles to get words out, speaks in short sentences, and may omit words especially small words such as “is” or “the”.
  • Typically, the person can be understood by others.
  • Someone with expressive aphasia is aware of the language challenge which results in frustration at not being able to speak fluently.
  • This type of aphasia makes the person seem more impaired than they really are.
  • Language is affected, not intelligence.
  • Anxiety and social isolation may occur.

Receptive/Fluent/Wernicke’s Aphasia

  • Associated with damage to the temporal lobe of the brain.
  • The person speaks easily but may incorrectly use or make up words creating a jumble known as “word salad”.
  • Receptive aphasia creates difficulty understanding what others are saying and the written word.
  • Someone with receptive aphasia typically doesn’t realize that speech is not understood which may lead to frustration.

Global Aphasia

  • The person has both expressive and receptive aphasia.
  • The brain’s language centers are poorly functioning and significant communication issues are present.
  • Understanding even simple words and phrases is severely limited.
  • May repeat the same words or phrases over and over again.


  • Defined as the inability to find the correct word when speaking or writing.
  • Often speak around a word to convey meaning.
  • Listening and reading is unaffected.

Primary Progressive Aphasia

  • Defined as the gradual loss of the ability to speak, read, write and comprehend.
  • Occurs as communication and language areas of the brain shrink due to dementia.


  • Stroke
  • Head injury
  • Dementia
  • Brain tumor
  • Infection


  • Difficulty naming familiar objects, places, or events.
  • Difficulty finding the correct word when writing or speaking including mixing up the order of the words, substituting a word that doesn’t make sense, or making up words.
  • Using great effort to produce a short sentence.
  • Difficulty understanding what others are saying or following a conversation.
  • Trouble reading or spelling.


  • Physical exam with specific attention to the brain, heart and blood vessels.
  • Assessment of language center
    • Naming objects
    • Participating in conversation
    • Repeating words or sentences
    • Following instructions
    • Answering questions about common subjects
    • Reading and writing
  • CT of the head or MRI of the brain


Speech therapy

  • Goals
    • Restoring as much language as possible
    • Learning other ways to communicate such as gestures, pictures, props, or computer assisted technology.


  • Medications to improve blood flow or enhance memory may be prescribed.

Strategies for the caregiver

  • Have the attention of the person before starting a conversation, establishing good eye contact.
  • Reduce background noise.
  • Speak slowly in short, uncomplicated sentences using a normal volume.
  • Avoid correcting the person’s speech or finishing their sentences. Suggesting a word being searched for may be helpful.
  • Yes and no questions may be easier for the person to respond to rather than long, complicated responses.
  • Writing key words and meanings may help convey the message.
  • Encourage other communication techniques such as writing, gesturing, pointing, or drawing.
  • Include the person in conversation whenever possible, providing extra time for responses, and continuing to value input.
  • Caregiver(s) should participate in speech therapy sessions to learn helpful techniques for communication.


  • Research on noninvasive brain stimulation is being conducted using electric current to stimulate damaged brain cells.
  • Medications to enhance communication between brain cells is ongoing.