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What to do if I have both Expressive and Receptive Aphasia?

Zach Smith | Aphasia

Aphasia is a language disorder resulting from injury or damage to your brain, typically the left hemisphere, causing difficulties understanding or communicating through spoken or written language. It can affect different aspects of language processing and function depending on the part of the left hemisphere affected. Interestingly, aphasia is categorized into several types based on the part of the brain affected, with the most common types being receptive (or fluent) aphasia and expressive (non-fluent) aphasia.

Although several people live with only one of these, some suffer from both receptive and expressive aphasia. Let’s discuss receptive and expressive aphasia, the differences, and what to do if you have both types.

Key Takeaways

  • Expressive aphasia and receptive aphasia are some of the most common types of aphasia.
  • Receptive aphasia is a result of damage to Wernicke’s area in the brain and generally affects comprehension, while expressive aphasia occurs following Broca’s area damage and affects speech production.
  • Individuals with receptive and expressive aphasia have moderate to severe communication difficulties due to their difficulty or inability to speak, understand, read, or write.
  • With proper treatment, people with expressive and receptive aphasia can have significant recovery, especially in comprehension. However, recovery depends on multiple factors such as age and the extent of brain damage.

Expressive Aphasia and Receptive Aphasia: What’s the Difference

Expressive Aphasia

Expressive aphasia, also known as non-fluent aphasia or Broca’s aphasia (1), occurs after damage or injury to Broca’s area in the dominant hemisphere, usually the left hemisphere of the brain. It limits your ability to express your thoughts or ideas through writing or speech.

In non-fluent aphasia, you understand what others say to a great extent, but find it difficult to communicate. While your comprehension is generally preserved, your reading and speaking can be significantly affected depending on the extent of brain damage.

Symptoms

If you suffer from expressive aphasia, you may experience some of the following symptoms:

  • Trouble repeating words or sentences
  • Speaking in short or incomplete sentences
  • Difficulty or inability to use linking words, prepositions, and conjunctions like “the,” “an,” and “is.”
  • Trouble finding the right words while speaking
  • Difficulty writing
  • Laborious speech and poor grammar

Although your comprehension is generally preserved in expressive aphasia, you may experience difficulty understanding long and complex sentences. You may also experience frustration and depression due to your communication difficulties.

Causes

Any injury to the language processing area, specifically the frontal aspect of your left brain, will result in expressive aphasia. Here are some possible causes of expressive aphasia.

  • Stroke
  • Space-occupying lesions, i.e, brain tumors
  • Traumatic brain injury due to road traffic accidents or falls
  • Brain infection
  • Neurodegenerative disease, e.g, dementia, Alzheimer’s

Receptive Aphasia

Receptive aphasia, also known as fluent or Wernicke’s aphasia (2), is another common type of aphasia that occurs following damage to the posterosuperior area of your temporal lobe, the area responsible for processing words. Affected persons often experience difficulties understanding words, sentences, or symbols.

As the name implies, people with receptive or fluent aphasia generally have no difficulty speaking. However, communication is impaired because of their inability to grasp spoken and written words and sentences, even when they are simple or short.

Symptoms

Some of the symptoms of receptive aphasia include

  • Trouble understanding words and sentences
  • Reading difficulties or inability to understand written words or sentences
  • Difficulties repeating what others say
  • Using too many words or complex words while speaking
  • Speaking fluent sentences that don’t make any sense

People with receptive aphasia may also experience other symptoms such as acalculia (inability to calculate), visual field impairment, and agraphia (problems with writing). Whether they experience these symptoms often depends on the extent of brain damage.

Causes

Injuries that cause brain cell damage or death in the Wernicke’s area will cause receptive aphasia. These injuries can result from.

  • Traumatic brain injuries
  • Strokes
  • Neurodegenerative conditions such as dementia
  • Brain tumors
  • Central nervous system (CNS) infections.

Can I Have Both Receptive And Expressive Aphasia?

Yes, it is possible to have both receptive and expressive aphasia. It is common for these two types of aphasia to overlap following brain injury or damage. Damage to Broca’s and Wernicke’s areas in the brain often results in global aphasia. This type of aphasia is characterized by severe language and speech impairment that affects comprehension and speech production (3).

People with global aphasia are only able to understand and say a few words and phrases like “yes,” “no,”  and “excuse me.” However, they may be able to communicate better through gestures, facial expressions, or changes in their tone of voice.

Additionally, they may experience extreme difficulties with reading or writing, or be completely unable to do either. This type of aphasia is the most severe and occurs as a result of extensive damage to the left hemisphere of your brain following a stroke, brain injury, brain infection, or a tumor.

What Next: Seeking and Getting Help

If you experience receptive and expressive aphasia symptoms, chances are that you have suffered a major brain injury and need to seek professional help immediately.

How You Will Be Diagnosed

Global aphasia usually occurs following extensive brain damage. If your doctor or health professional suspects that you have global aphasia, they will conduct comprehensive assessments and evaluations to confirm their diagnosis and curate a personalized treatment plan for you. These assessments may include:

  • Health History: Your doctor will ask you or your loved ones for information about your symptoms and previous health history.
  • Neurological exams
  • Physical exams
  • Imaging Tests such as MRIs, CT scans,
  • Speech and Language tests: Your Speech Language Pathologist will ask you questions and carry out detailed tests to confirm if you have aphasia, the type you have, and also rule out other types of communication problems.

Treatment Options

After extensive evaluation and assessment, your doctor and speech language pathologist will work hand-in-hand to create an individualized treatment plan based on the extent of brain damage and the severity of your communication problems. Your treatment plan may improve your language skills, teach you an alternative means of communication, or do both. Treatment may include.

  • Speech Therapy: This is the main treatment option for global aphasia. Here, your speech therapists employ specific techniques to help improve your communication, restore speech and language skills, and teach you alternative means of communication.
  • Visual Action Therapy: This non-verbal therapy (4) aims to teach people with global aphasia how to communicate their needs using symbolic gestures. It typically involves a 3-level structured training process that begins with matching objects to pictures and ends with using gestures or pantomiming to communicate simple messages. Visual action therapy (VAT) is often the preferred treatment option for individuals with severe global aphasia who may not benefit from advanced verbal techniques.
  • Music Therapy or Medical Intonation therapy: The music therapy uses musical intonation, rhythm, and hand-tapping to improve verbal expression. It capitalizes on the preserved singing functions of the right hemisphere.
  • Electrical Brain Stimulation: Although relatively new, electrical brain stimulation has proved beneficial in the treatment of global aphasia. It uses two major techniques, transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS), to improve language recovery. Your speech therapists may combine this treatment modality with speech therapy to improve your chances of recovery.
  • Medications: Medications such as donepezil, galantamine, and bromocriptine may help to improve speech production.

Before your healthcare professionals address your communication problem, they’ll stabilize you and commence treatment of the underlying cause to prevent additional damage and help you recover as much function. Your speech language pathologists may also encourage use of apps and devices to aid language recovery and speech production.

Can I Recover From Expressive And Receptive Aphasia?

Recovery differs per person. It depends on factors such as the extent of brain damage, the severity of aphasia, compliance with treatment, and personal motivation. However, recovery from global aphasia takes time, patience, and determination. While full recovery may not be possible, some individuals can make significant improvements through months to years of treatment. Research shows that most individuals with aphasia make reasonable recovery during the first 2 to 3 months of treatment, and this peaks at 6 months. After this, they record slower improvement over the years of treatment.

Conclusion

Global aphasia is one of the most common and severe forms of aphasia. Its impact on speaking, understanding, reading, and writing creates a ripple effect across every area of your life, including jobs and relationships. As such, it is essential to seek proper treatment, stay consistent with treatment, and remain motivated to regain control of your life.

If you have a loved one or friend who has expressive and receptive aphasia, you can help them by offering maximum support.

How can you do this?

  • Use simple words and sentences when speaking to them
  • Observe their gestures, body language, and intonation while speaking.
  • Use gestures to support spoken language
  • Give them time to respond while conversing. Don’t rush them or try to quiz them.
  • Help to find support groups and communities.
  • Participate in therapy with them – either physically or through apps like the Constant Therapy App

The Constant therapy app provides adaptable, personalized treatment plans that help you reach your communication goals as quickly as possible! Try it out for free here!

Written by: Dr. Ori Otokpa, MBBS

Medically Reviewed by: Dr. Danielle Kelvas, MD

References

  1. Pracar, A. L., Biondo, N., Dronkers, N. F., & Ivanova, M. V. (2025). The neuroanatomy of Broca’s aphasia. Frontiers in Language Sciences, 4. https://doi.org/10.3389/flang.2025.1496209
  2. Acharya, A. B., & Wroten, M. (2023, August 8). Wernicke Aphasia. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK441951/
  3. Adjei‐Nicol, S., Sacchett, C., & Beeke, S. (2025). Evaluating the effect of a non‐linguistic cognitive intervention on functional communication in global aphasia: A case series study. International Journal of Language & Communication Disorders, 60(1). https://doi.org/10.1111/1460-6984.13155
  4. Helm-Estabrooks, N., Fitzpatrick, P. M., & Barresi, B. (1982). Visual Action Therapy for global aphasia. Journal of Speech and Hearing Disorders, 47(4), 385–389. https://doi.org/10.1044/jshd.4704.385
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