Aphasia after brain injury can occur when the areas of the brain that control language are impacted, which commonly occurs after a left hemisphere TBI. There are many types of aphasia; some affect the ability to produce language while others affect the ability to understand it.
Because there are various types of aphasia and many different symptoms survivors can experience, it’s important to work closely with a Speech-Language Pathologist (SLP) for a proper diagnosis and rehabilitation plan.
This article will guide you through the three most common types of aphasia after brain injury and how to manage them.
What Causes Aphasia After Brain Injury?
Aphasia after brain injury is caused by damage to the parts of the brain responsible for speech and language, which for most people are located in the left hemisphere. In some left-handed individuals, the language centers may actually reside in the right hemisphere.
Within the brain, there are two areas in particular that control most language-related functions: Broca’s area and Wernicke’s area. Wernicke’s area is primarily involved with comprehension of language, and Broca’s area with speech production. When these structures become damaged by a traumatic brain injury, the neural pathways that control language are not able to function normally.
Fortunately, through regular and consistent therapy, the skill of language and communication can be relearned and strengthened. Before your Speech-Language Pathologist sets up a therapy plan, though, it’s important to determine in detail what type of aphasia you have so that you will have a rehabilitation program tailored to your specific needs. A Speech-Language Pathologist is the perfect expert to help you with this diagnosis and recovery plan.
Types of Aphasia Plus Common Symptoms
Aphasia is an acquired communication disorder that affects a person’s ability to understand or express language, typically following a stroke or brain injury. But not all aphasia is the same—there are several distinct types, each with its own patterns of speech, comprehension, and recovery. Let’s break them down to better understand what makes each one unique.
Broca’s Aphasia (Non-Fluent or Expressive Aphasia)
Broca’s aphasia is one of the most well-known types. It typically affects the ability to speak fluently, but comprehension often remains strong.
People with Broca’s aphasia may speak in short, broken sentences and leave out small connecting words like “is” or “the.” For example, instead of saying “I am going to the store,” someone might say “Go store.”
Signs and Symptoms of Broca’s Aphasia
- Halting, effortful speech
- Good understanding of spoken and written language
- Frustration due to difficulty expressing thoughts
Learn more about Broca’s Aphasia (expressive aphasia).
Wernicke’s Aphasia (Fluent Aphasia)
Unlike Broca’s aphasia, Wernicke’s aphasia affects comprehension more than speech fluency. Individuals can speak in full sentences with normal grammar and rhythm, but the content often lacks meaning—sometimes using made-up or unrelated words.
This can make conversation confusing for both the speaker and the listener.
Signs and Symptoms of Wernicke’s Aphasia
- Fluent but nonsensical speech
- Difficulty understanding spoken or written language
- Unawareness of errors in their own speech
Learn more about Wernicke’s aphasia (fluent aphasia).
Global Aphasia
Global aphasia is the most severe form of aphasia, typically resulting from widespread brain damage in the language-dominant hemisphere. It affects both expressive and receptive language abilities, making communication very limited.
People with global aphasia may be able to understand only a few words and produce very limited speech.
Signs and Symptoms of Global Aphasia
- Severely limited ability to speak or understand language
- Often affects both reading and writing
- Frequently occurs immediately after a large stroke affecting the left middle cerebral artery
Learn more about Global Aphasia.
Anomic Aphasia
Anomic aphasia is considered the mildest form. It mainly affects word retrieval—especially nouns and verbs—while speech, grammar, and comprehension often remain intact.
Individuals know what they want to say but struggle to find the right words, leading to vague descriptions or pauses.
Signs and Symptoms of Anomic Aphasia
- Difficulty finding specific words (especially names or objects)
- Clear, grammatically correct speech
- Good understanding of language
Learn more about Anomic Aphasia.
Mixed Transcortical Aphasia
Mixed Transcortical Aphasia, also called “isolation aphasia,” is a rare type of aphasia that combines traits of both Broca’s and Wernicke’s aphasia.
People with mixed transcortical aphasia have limited speech and poor comprehension but can still repeat words or phrases that others say—sometimes without understanding them.
Signs and Symptoms of Mixed Transcortical Aphasia
- Non-fluent speech and poor understanding of language
- Ability to repeat words or phrases
- Often associated with severe brain injury or damage
Learn more about Mixed Transcortical Aphasia.
Transcortical Motor Aphasia
Transcortical motor aphasia is similar to Broca’s aphasia but with one key difference: the ability to repeat phrases remains intact.
Speech is still effortful and limited, but comprehension is relatively preserved, and repetition skills can help in therapy.
Signs and Symptoms of Transcortical Motor Aphasia
- Reduced spontaneous speech
- Preserved ability to repeat words or sentences
- Good comprehension
Learn more about Transcortical Motor Aphasia.
Transcortical Sensory Aphasia
Transcortical sensory aphasia mirrors Wernicke’s aphasia in many ways. Speech may sound fluent and grammatically correct but lack meaning. However, repetition remains strong.
People may echo words they hear even if they don’t understand them.
Signs and Symptoms of Transcortical Sensory Aphasia
- Fluent but confused speech
- Poor comprehension
- Strong repetition ability
Learn more about Transcortical Sensory Aphasia
Conduction Aphasia
Conduction aphasia primarily affects repetition. People with this type can understand language and speak fluently, but they struggle to repeat words or phrases accurately, especially longer ones. This can make conversations feel disjointed or interrupted.
Signs and Symptoms of Conduction Aphasia
- Difficulty repeating spoken language
- Fluent speech with occasional word or sound substitutions
- Good comprehension
- Awareness of their language errors, but struggle with self-correction
Learn more about Conduction Aphasia.
Primary Progressive Aphasia (PPA)
Unlike other types of aphasia caused by sudden brain injury, primary progressive aphasia is a gradual decline in language ability due to neurodegenerative disease.
It typically starts with word-finding issues and progresses over time, eventually affecting reading, writing, and comprehension.
Signs and Symptoms of Primary Progressive Aphasia
- Slow, steady loss of language skills
- No initial issues with memory or thinking
- Subtypes include non-fluent, semantic, and logopenic PPA
Learn more about Primary Progressive Aphasia.
Aphasia Therapy: How to Treat Aphasia After Brain Injury
As you work with your SLP to overcome aphasia after brain injury, you will notice that practice is the essence of recovery. This is because practice helps activate neuroplasticity, which is one of the most efficient and important ways to help the brain heal and treat aphasia.
Neuroplasticity is the brain’s ability to rewire itself. When functions such as speech and language are affected by brain injury, neuroplasticity helps create new pathways and strengthen existing ones. This helps survivors restore their language skills.
One of the best ways to activate neuroplasticity is through therapy and repetition, or “massed practice.” The more frequently and consistently a skill, like language, is practiced, the more neuroplasticity is stimulated.
Here are several therapies available that can help activate neuroplasticity and improve aphasia after brain injury:
Here are several therapies available that can help activate neuroplasticity and improve aphasia after brain injury:
1. Cognitive Rehabilitation
Cognitive rehabilitation therapy is particularly helpful for survivors with aphasia. It involves a wide range of interventions to help stimulate the brain and improve cognitive functions. During cognitive rehabilitation, your therapist will prescribe a unique combination of exercises tailored to language and cognitive skills. The important component to cognitive rehabilitation is consistently stimulating your mind with the types of activities your therapist suggests. Although, motivation at home to keep up with these activities can wane, your brain still requires the stimulus prescribe to grow. This is why finding apps like Constant Therapy help you to effectively continue rehab activities throughout your day.
2. At-Home Speech, Cognitive and Language Therapy Apps
A popular method to effectively continue cognitive rehabilitation at home includes the use of the CT Speech and Cognitive Therapy App. It provides access to over 100,000 scientific-based speech and cognitive exercises designed by Speech-Language Pathologists for survivors to utilize anywhere, anytime. This makes it easier for survivors to stay engaged in therapy outside their appointments, which is essential to stimulate neuroplasticity. And the more you use the app, the better it understands what exercise and challenge levels you need.
Want to learn more about the CT Speech and Cognitive Therapy App? Get Started Here.
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3. Constraint Induced Aphasia Therapy
Another treatment for aphasia after brain injury is Constraint Induced Aphasia Therapy (CIAT). This is an intensive therapy model based solely on the use of verbal oral language. Any other channels of communications [or alternative communication methods] like writing, gesturing, or pointing are not allowed.
While it may be challenging or frustrating not to rely on gesturing to get your thoughts across, studies have shown that CIAT is effective in improving language performance including naming, comprehension, repetition, and written language. The study also found that expanding therapy sessions to about 2-3 hours a day can help survivors make significant improvement.
4. Melodic Intonation Therapy (Singing Therapy)
When aphasia is severe and survivors cannot talk at all or have very limited speech, such as with nonfluent aphasia, SLP’s may recommend Melodic Intonation Therapy (MIT), or Singing Therapy. This type of therapy works by allowing the individual to sing their words (a right hemisphere skill) instead of speaking their words (a left hemisphere skill).
During melodic intonation therapy, the therapist taps along with the song to help engage more areas of the brain (specifically the frontal-temporal regions of the right hemisphere). This allows individuals who otherwise cannot speak the ability to sing their words.
Overcoming Aphasia After Brain Injury
When the brain sustains an injury to the areas that control speech and language, those skills may become impaired — but there is hope for recovery. The brain is capable of rewiring itself through neuroplasticity, which can be activated through therapies like cognitive rehabilitation and singing therapy, among others.
To determine what type of aphasia you are looking to overcome, it’s imperative to work with a Speech-Language Pathologist. They can provide a proper diagnosis and create a rehabilitation plan most suitable for you.
