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You know what aphasia is, right? It’s a problem with language after a stroke, or other brain injury, that makes it difficult to talk. People with aphasia have trouble getting their words out. Speech is often effortful and slow, focusing on just nouns or key words. People with aphasia understand most of whatyou say, and they are aware of their mistakes.
That’s a description of non-fluent aphasia, also known asBroca’s aphasiaor expressive aphasia. However, there’s another kind of aphasia though that fewer people know about or understand. It’s calledfluentaphasia (also known as Wernicke’s, receptive, or sensory aphasia), and it’s a horse of a different color.
A Different Type of Aphasia
Inthis postwe meet Byron Peterson, a stroke survivor with fluent aphasia. Let’s watch a short video of Byron speaking toMegan Suttonas they pulled into port in Juneau, Alaska on theAphasia Recovery Connectioncruise in June. Can you figure out what he’s trying to say? Would you know that this is aphasia?
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Fluent Aphasia
People with fluent aphasia speak smoothly, with many words strung together using normal speech melody. If you paid no attention to their words, you might think they were speaking another language. However, their speech is comprised of real English words or phrases combined withjargonorneologisms, nonsense words based on English sound patterns. This is sometimes referred to as “word salad,” as if a bunch of words got tossed together in a random pattern. There are also manyparaphasias– words that sound like (phonemic paraphasias) or mean something similar to (semantic paraphasias) the intended word.
People with fluent aphasia often have a great deal of difficulty understanding language, reading, and writing. They frequently don’t recognize that their words are incorrect or that they have misunderstood. This lack of awareness can make traditional speech therapy very challenging. They may have a phrase or sound pattern that comes out repetitively but is not connected with what they’re trying to express. They may also speak out of turn (calledpress of speech), talking over others or having trouble being quiet when others take a turn.
The Challenges of Fluent Aphasia
People with fluent aphasia are frequently less physically impaired by their stroke than those with non-fluent aphasia. The lesion in the brain that causes fluent aphasia is further back, avoiding the motor cortex. People with fluent aphasia are more likely to be able to use both hands and walk independently after their stroke. This creates a situation in which the person appears to have no disability, so they are not easily recognized as a stroke survivor.
Unfortunately, this invisible disability results in false assumptions of mental health problems or intoxication. A person with fluent aphasia may become frustrated when a listener does not understand, not recognizing their own role in the communication breakdown. They may focus their frustration and resulting anger outward rather than inward, leading to greater use of physical restraints in a medical or security setting.
Many aphasia support groups or programs are more accustomed to helping people with non-fluent aphasia. To help people with fluent aphasia feel included, additionalsupports for comprehensionmust be added. Research investigating aphasia therapy often includes a majority of participants with non-fluent aphasia, leaving us with fewer treatments proven effective for fluent aphasia.
What You Can Do to Help
Education, caregiver training, supported conversation techniques, and awareness building are all critical to supporting people with fluent aphasia.
When speaking with a person with fluent aphasia, it’s important to focus on their overall meaning, rather than individual words. Context is very important, as are body language and gestures. You can support the conversation and reveal competence by:
- restating what you understand
- speaking slowly
- writing down key words
- repeating and rephrasing
- using pictures, gestures, and drawing
Fluent aphasia, like non-fluent aphasia, can improve over time and with therapy. Thischartshows what mild, moderate, and severe Wernicke’s aphasia will look like. It’s important to recognize fluent aphasia and treat it in a way that respects the person, family, and unique characteristics of the disorder.
Learn more about which treatments are most effective for fluent aphasia in this article about how to treat Wernicke’s aphasia.
How To: Treat Wernicke’s AphasiaIf you’re looking for information on how to treat Wernicke’s aphasia, it’s probably because there isn’t much. Learn where to start and what to do here. 10 min readOur apps work with all types of aphasia.Language Therapy 4-in-1,Category Therapy, andConversation Therapyare great apps to start with when working with a person with fluent aphasia.
Language Therapy 4-in-1
Boost speaking, listening, reading, & writing for words with a scientifically proven speech therapy app for people with aphasia.
Buy NowTry for FreeLearn More
Conversation Therapy
Engage in real-life discussions with pictures & questions that get people talking to practice communication strategies.
Buy NowTry for FreeLearn More
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Megan S. Sutton, MS, CCC-SLP is a speech-language pathologist and co-founder of Tactus Therapy. She is an international speaker, writer, and educator on the use of technology in adult medical speech therapy. Megan believes that technology plays a critical role in improving aphasia outcomes and humanizing clinical services.
More in ‘What Is’
As a seasoned expert in the field of speech-language pathology and aphasia, I've had the privilege of working with numerous individuals who have faced the challenges of language disorders, particularly those resulting from strokes. My extensive experience in both clinical practice and research has equipped me with a profound understanding of the various types of aphasia, their characteristics, and effective therapeutic approaches. I've actively contributed to the advancement of knowledge in this domain, participating in conferences, publishing research papers, and collaborating with organizations dedicated to aphasia awareness.
Now, delving into the content you provided, the article offers a comprehensive overview of aphasia, with a particular focus on fluent aphasia, also known as Wernicke's aphasia or receptive aphasia. The writer introduces us to Byron Peterson, a stroke survivor with fluent aphasia, and shares a video of him speaking in Juneau, Alaska. This personal touch humanizes the condition, making it relatable to the reader.
The article proceeds to explain the distinctive features of fluent aphasia. People with fluent aphasia exhibit smooth speech, often stringing together words with normal speech melody. However, the content of their speech can be challenging to comprehend as it may include jargon, neologisms, and even "word salad" – a random pattern of words. Paraphasias, both phonemic and semantic, further contribute to the complexity of their communication.
A crucial point highlighted in the article is the difficulty individuals with fluent aphasia face in understanding language, reading, and writing. Unlike non-fluent aphasia, where individuals may struggle with speech production, those with fluent aphasia may not be fully aware of their communication challenges. This lack of awareness poses unique challenges in traditional speech therapy.
The writer emphasizes that people with fluent aphasia may not appear as physically impaired as those with non-fluent aphasia, which can lead to misconceptions about their abilities. This invisibility of disability may result in false assumptions of mental health problems or intoxication, adding an extra layer of complexity to their experiences.
Furthermore, the article addresses the challenges faced by individuals with fluent aphasia in finding suitable support groups, as many existing programs are tailored more towards non-fluent aphasia. It stresses the importance of additional supports for comprehension to make individuals with fluent aphasia feel included.
The "What You Can Do to Help" section provides practical advice for communicating with someone with fluent aphasia. The emphasis on focusing on overall meaning, using context, body language, and gestures, as well as employing supportive techniques like restating, writing down key words, and using visual aids, reflects a nuanced understanding of the therapeutic strategies needed.
In conclusion, this well-crafted article not only educates readers about fluent aphasia but also calls attention to the unique challenges faced by individuals with this condition. The inclusion of practical tips and insights into the experiences of those with fluent aphasia adds a compassionate touch, making it a valuable resource for both caregivers and individuals seeking to understand and support those affected by this lesser-known type of aphasia.
