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Fluent Aphasia: Understanding the Symptoms & Management Techniques

woman with fluent aphasia smiling and looking normal, which many fluent aphasia patients do

Aphasia is a communication disorder that can occur after a stroke or brain injury. There are many different types of aphasia, and this article will focus on one type: fluent aphasia.

Fluent aphasia (also known as receptive aphasia or Wernicke’s aphasia) is a unique communication disorder that can cause a person to say phrases that sound fluent but lack meaning.

In this article, we’ll discuss the symptoms and characteristics of fluent aphasia, along with ways to manage the condition.

Use the links below to jump straight to any section:

What is Fluent Aphasia?

Fluent aphasia – also known as Wernicke’s aphasia or receptive aphasia – is caused by damage to Wernicke’s area of the brain.

Wernicke’s area was discovered by a neurologist named Carl Wernicke who was investigating the effects of brain damage on different aphasia patients.

Some patients, he noticed, were able to speak but could not comprehend language. They also used nonsense words and phrases, without seeming to realize it.

When examining the brains of these patients, Wernicke discovered that they all had lesions in the left hemisphere of their brains. Specifically, the lesions was found near the back of the left temporal lobe. This region is now known as Wernicke’s area and is thought to control a person’s understanding of spoken and written words.

Therefore, when this part of the brain sustains damage, due to stroke or brain injury for example, it can impair a person’s ability to understand language.

Symptoms of Receptive Aphasia

Unlike more common types of aphasia, such as expressive aphasia, fluent aphasia does not affect a person’s ability to produce words. Rather, they have lost their ability to grasp the meaning of words.

However, because they no longer understand others, the words they do speak may sound strange. Sometimes their sentences may even appear nonsensical and they will use made-up words (neologisms).

Watch this video to listen to a stroke patient with fluent aphasia demonstrate the ability to easily say phrases that lack meaning:

Some other symptoms of Wernicke’s aphasia include:

  • Producing sentences that do not make sense.
  • Speaking in a way that sounds normal but lacks meaning, as if they are speaking another language.
  • Difficulty understanding others
  • Inability to repeat words or phrases
  • Difficulties with reading and writing

In addition, most patients with receptive aphasia do not realize they have any problems with speech. As a result, they might express confusion or frustration when others do not understand them.

Diagnosing Fluent Aphasia

Damage to Wernicke’s area is not associated with other cognitive or physical disabilities. Because it’s location is towards the back of brain, the motor cortex and frontal lobe are usually still intact.

For example, patients with Wernicke’s aphasia do not struggle with left neglect, and they can still walk and perform many activities of daily living on their own.

As a result, the person can appear unaffected and is not easily recognized as a stroke survivor. Therefore, when they speak, others often assume they have a mental health problem. They are also often mislabeled as intoxicated.

That’s why it is important for family members to familiarize themselves with this type of aphasia and to seek a professional diagnosis from a speech therapist. If you recognize the symptoms of fluent aphasia early, you can seek treatment sooner. This will give the person a higher likelihood of recovery.

Progression of Wernicke’s Aphasia

Fluent aphasia often fades after a certain amount of time. However, it can be hard to evaluate the person’s progress if you do not understand the hierarchy of recovery.

This describes the typical progression of Wernicke’s aphasia from its most severe form to mild impairment. The following stages illustrate what recovery often looks like:

  • Stage 1: Very confused, with minimal understanding of written or spoken words. Speech is often garbled and nonsensical.
  • Stage 2: Confusion decreases, but speech is still garbled. They may begin to get frustrated from lack of understanding at this point.
  • Stage 3: They can now understand words in highly-contextual settings. For example, if you point to a salt shaker and ask if they want some, they might understand you.
  • Stage 4: Their speech now has normal rhythm and intonation, but the words they use are still nonsense. Their understanding has also improved a little.
  • Stage 5: Patient now realizes that what they think they say is not always what they actually say. They also will start to use more real words at this point.
  • Stage 6: Patient can now echo spoken words and read single words.
  • Stage 7: Speech begins to make sense and the person uses real words appropriately. They might still struggle to find specific words, however.

Everyone progresses at their own rate and may not follow these stages precisely. Still, these stages can help you understand what to expect as you recover from fluent aphasia.

Managing Fluent Aphasia

doctor helping patient manage aphasia

Receptive aphasia requires a different therapy approach than other types of aphasia. Unlike expressive aphasia, which is a motor-speech disorder, fluent aphasia is a result of a broken phonological system. This means the person cannot tell that the sounds they are using are incorrect.

Therefore, treatment will focus less on physical speech exercises and more on learning to process words again. For example, some treatments for Wernicke’s aphasia focus on improving the person’s attention skills, which may help the patient recognize and correct their speech errors. You should work closely with a speech therapist to create a recovery program that fits you or your loved one’s needs.

How Speech Therapy Can Treat Fluent Aphasia

Speech therapy exercises work by activating neuroplasticity. Neuroplasticity refers to the brain’s ability to form neural pathways in response to repetition. These pathways can allow undamaged portions of the brain to take control of functions that were previously controlled by damaged ones.

Therefore, even if a stroke severely damages the brain regions that normally control language comprehension, it is still possible for other areas to compensate. To activate neuroplasticity, patients must engage in repetitious exercise.

Speech therapy apps, such as the CT App, can help you accomplish enough repetitions to make progress. This top-rated app was designed by speech-language pathologists and features over 100,000 exercises that you can tailor to your individual needs.

In the meantime, the following are a few tactics speech therapists also can use to make communication a bit easier:

  • Use gestures
  • Draw pictures
  • Talk about things that are situationally relevant, such as if they want a drink
  • Slow your speech to give them time to process
  • Be close enough that they can hear you

When using these tactics, be careful not to use a tone or phrasing that you would use with a child. While the person may not understand your words right now, they can usually still detect condescension in your voice and facial expressions. Therefore, continue to speak to them as an adult.

Understanding Fluent Aphasia

Damage to Wernicke’s area can cause a person to lose their ability to understand language. They also will struggle to produce meaningful words and phrases.

This is often frustrating for the person, as they usually do not understand why others are confused by their words. Fortunately, this type of aphasia usually fades as their brain heals.

If symptoms of fluent aphasia do not improve on their own, a speech therapist can help you find tactics to increase the person’s language comprehension skills. 

Featured Image: ©iStock/Ridofranz

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