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There are many different types of aphasia. Language is stored in several areas of the brain, so the type of language difficulty someone has depends on the part of the brain that was affected.

In reality, everyone’s brain is different, and each aphasia is slightly different too. Sometimes people will have aphasia that does not fit neatly into one of these categories. This is especially true for people who are multilingual, or people who are left-handed. Nonetheless, learning about common types of aphasia can be helpful.

Blumenfeld’s “Neuroanatomy Through Clinical Cases” has a diagram that illustrates some of the most common types of aphasia.

Types of aphasia, found in Blumenfeld’s “Neuroanatomy Through Clinical Cases”

Global Aphasia

Global aphasia is very severe. People with global aphasia will have difficulty with all language domains: talking, understanding, reading, and writing. They will say very few words, or they may say no recognizable words at all. They will understand very few words, or no words at all. They are unable to read or write. People with global aphasia can often evolve toward a different subtype of aphasia with time and/or speech therapy, but prognosis depends on the extent of the damage that caused the aphasia.

Mixed Transcortical Aphasia

Mixed transcortical aphasia is similar to global aphasia, but with the ability to repeat. A person with this type of aphasia will likely have very little voluntary speech, poor comprehension, and difficulty reading and writing. However, they will quasi-automatically repeat back words that they hear. The main areas of language are typically not damaged, but the brain tissue nearby is, which leaves the language areas isolated from the rest of the brain.

Broca’s Aphasia

Broca’s aphasia is a very common type of aphasia. People with Broca’s aphasia know what they want to say, but have difficulty getting their words out. Speech is slow and effortful. They can often understand most of what is said – especially clear, direct sentences, but may struggle to understand more complex grammar and/or longer sentences. Concrete nouns and verbs are easier to say than small grammatical words.

Transcortical Motor Aphasia

People with transcortical motor aphasia have significant difficulty producing spontaneous speech, but they can repeat phrases and sentences. Comprehension is largely preserved, but writing is difficult and often mirrors their spoken language. People with transcortical motor aphasia have a very hard time initiating speech, and sometimes, difficulty initiating other motor movements too.

Wernicke’s Aphasia

Wernicke’s aphasia is characterized by difficulty with auditory comprehension. This aphasia occurs when the area of the brain responsible for processing spoken words and attaching meaning to them is damaged. People with Wernicke’s aphasia are typically unaware that they are having difficulty. They can talk at a normal rate and rhythm. However, they often string together words that don’t make sense and include seemingly random or made up words.

Transcortical Sensory Aphasia

People with transcortical sensory aphasia also have significant difficulty with auditory comprehension. They can talk at a normal rate and rhythm, but typically have lots of errors in their speech. They are able to repeat words and phrases, sometimes repeating a question or part of a question back to the listener. They may have visual field deficits, or difficulty recognizing visually presented objects. They may have difficulty copying a line drawing.

Conduction Aphasia

Conduction aphasia is a type of aphasia where people can typically understand most of what’s being said and speak at a normal rate and rhythm. They still have errors in their speech, but have a high level of awareness of these errors. A hallmark of conduction aphasia is to attempt to fix errors in their speech, often getting closer and closer to the target word with repeated attempts. They have difficulty repeating, but can typically paraphrase what they’ve heard.

Anomic Aphasia

Anomic aphasia is the most mild form of aphasia. A person with this type of aphasia is relatively functional with speaking, understanding, reading, and writing. However, they have difficulty with word finding. Their speech is fluent, but with frequent pauses for word finding. When they have difficulty thinking of words, they tend to use vague language, such as “those things” and “the stuff over there” or attempt to describe the object they are thinking of. This also occurs in writing.

There is one more type of aphasia that is different from those mentioned above.

Primary Progressive Aphasia (PPA)

Despite its name, Primary Progressive Aphasia (PPA) is a type of frontotemporal dementia. It is caused by a deterioration of the areas of the brain that are involved in speech and language. This condition progresses slowly. People with PPA can lose the ability to speak and write and, eventually, to understand written or spoken language. There are also various subtypes of PPA.

More people have aphasia than cerebral palsy, multiple sclerosis, Parkinson’s disease, or muscular dystrophy. But very few people have heard the term "aphasia" or can tell someone what it is...

Aphasia is a language disorder, typically due to stroke, brain tumor, or brain injury. It does NOT affect intelligence, but it does make it difficult to connect thoughts to words.

As a simplified way of thinking about it...

Imagine that someone drops you into a foreign country where you don't speak the language. You would still know what an apple is and how a car works (your intelligence is intact!), but you wouldn't have the word for "apple" or be able to explain to someone how a car works (your language is impacted).

Aphasia is especially tricky, because unlike a physical limitation, we can't see it. Which often makes it harder for people to understand. We asked several people with aphasia to share their experiences to help build awareness for this "invisible disability."

Aphasia is an umbrella term. There are many different subtypes, severity levels, strengths, and weaknesses. Aphasia affects all areas of language – talking, understanding, reading, and writing, but it doesn't affect everyone in the same exact way.

It can range from virtually no ability to speak (very severe aphasia) to occasional difficulty thinking of words (mild aphasia). Comprehension, reading, and writing can also be affected to varying degrees.

Aphasia results from damage to the parts of the brain that are responsible for language. The severity of aphasia often depends on the extent of the damage and how quickly the person received treatment. Sometimes people recover quickly, but most people have some long-lasting difficulty with communication.

It can be very frustrating and isolating, especially when people don't understand what aphasia is.

Over 2 million Americans are living with aphasia, but many people have never heard of it. Share this post and help us spread the word! #aphasia #aphasiaawareness

How to optimize your recovery after stroke, brain injury, tumor

For a long time, researchers believed that the brain couldn’t change. It was thought that after childhood, the brain pretty much stayed the same throughout life.

However, science has proven this isn’t true. (Go science!)

And while it’s true that brains are more malleable in childhood, they can continue to adapt throughout life. Brains can change. And brains do change.

Brain cells can grow new branches to connect to other cells. They can also strengthen (or weaken) those connections, resulting in new pathways in the brain.

This is true whether you're learning a new skill, or re-learning skills after you have a stroke, brain injury, tumor, or infection.

However, this change takes time. And it requires repeated and specialized training. But if you understand how the brain responds to treatment and makes changes, you can optimize your recovery and create positive changes in your brain!

Here are the 10 principles of neuroplasticity, per research published by Kleim & Jones.

1) Use It or Lose It: Every thought, action, movement, and skill has a specific set of connections in your brain. When you don’t practice something for an extended period of time, the pathways for that task start to weaken, and they get weaker over time.

2) Use It and Improve It: However, if you practice something a lot, these connections can grow and become stronger. With aphasia, this means that the more you talk, listen, read, and write, the better your accuracy and speed will be in these areas.

3) Salience: Emotions can affect the strength of memory consolidation. If therapy is made interesting or important to you (ex: incorporating hobbies or interests), you can more easily remember new skills or pieces of information.

4) Repetition: Repetition of a learned (or re-learned) behavior is required for long-term changes in the brain. You need thousands of repetitions to master a skill. The more time you spend practicing, the better you perform.

5) Intensity: If you do something that doesn’t challenge you, you won’t see much of a difference. Intensity can be the number of times you do an exercise or how difficult it is. Try to find an intensity that is one step above your current level.

6) Specificity: You have to train your brain in very specific ways. Learning something new or re-training an old skill (rather than simply going through the motions of something you already know) helps increase connections in the brain.

7) Age: Our brains are the most flexible and adaptive when we are young. But connections in our brains can grow and change at any age! Effects are generally better in individuals with greater physical and mental activity.

8) Time: If therapy targets changing, increasing, and strengthening the pathways in your brain (using these principles), it should work any time. However, there may be windows of time where progress happens at a faster rate.

9) Transference: Learning in one situation (like therapy) can generalize to other situations (like social settings or the work environment). Similarly, training one specific skill can sometimes activate the pathways of nearby, untrained items and improve those skills as well.

10) Interference: Neuroplasticity means the brain is always learning. But it doesn’t know the difference between good and bad! Maladaptive habits or practicing the wrong things might interfere with the positive changes you want to make.

Yes – brains are adaptable and capable of change after injury. But we have to understand how these changes occur to optimize brain rehabilitation. At Atlas Aphasia Center, we capitalize on the principles of neurobiological recovery to make the most of your aphasia therapy.

Are you a rehab professional? Download our infographic to help explain neuroplasticity. (Or maybe just because you want it 😀)

Neuroplasticity – Atlas Aphasia Center
Download P • 8.30MB

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We’re based in Seattle and specialize in speech therapy for aphasia (speaking, understanding, reading, and writing after a stroke or brain injury).

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