Fluent vs. Non-Fluent Aphasia: Why Communication Breaks Down (And What To Do About It) | #216

So we're gonna start with fluent aphasia.

Specifically in my mind, I'm thinking about Wernicke's aphasia.

I remember early in my career, I had this lovely woman, and I could look at her and I say, "Do you eat sticks?" And she's like, "Oh, yes.

Yes, I do." And then I say, "Do you like rocks in soup?" "Oh, delicious.

That is so good.

I la, la, la, la..." Whatever it is she went on to say.

So in a way, she got the intonation, like she knew I was asking a question, so she was responding with an answer.

On the first example, I did not have any confidence that she actually knew what I was asking her, and on the second example, when she responded "delicious" to the question of, "Do you like rocks in soup?" She must have gotten part of the question, right? 'Cause then she responded "delicious," which seems appropriate, but then the rest of the response didn't make any sense.

So if you're speaking to someone who has fluent aphasia and you're getting this kind of a response, you're like, "What do I do with that?" So Wernicke's aphasia, just to remind you, is known as a fluent aphasia.

It comes from damage to this area.

This is the posterior region of the left hemisphere, so it's behind the left hemisphere.

Think of it right around the ear area, this temporal lobe.

This part of the brain is crucial for understanding and processing language.

One of the hallmark features of Wernicke's aphasia is difficulty listening and understanding what they hear.

When someone with Wernicke's is standing in front of you, their presentation is going to be quite distinct.

Their speech rate and rhythm often sound very normal, much like speaking in a foreign language.

It seems like they have the grammar correct, they have full facial expression and body language.

It all seems like you should really be understanding what they're saying.

But their speech can have words in it that don't make any sense, like they're made-up words, or they might choose words that are irrelevant to the situation, whatever it is you asked or what the context is of that moment.

So let's start with a speech sample.

Literally, this is sound for sound, syllable by syllable.

Here we go.

"What is this?" This is me holding up a picture, and here's the response.

"I gosh, he has got his rain.

Rain cat spot for a par.