Expressive Dysphasia

Dysphasia is an impairment of language due to brain damage and is divided into receptive and expressive dysphasia.

In expressive dysphasia, understanding is preserved and the patient tries to convey meaningful responses to the questions asked. Reading and writing may be impaired, but understanding is intact.


Testing Understanding Video

When testing a patient's speech, you should always test first to see whether they can understand you. Here, the patient is being asked his name and address as well as being asked to follow a simple three stage command.

    Which type of dysphasia does this already rule out?
Testing Expression Video The patient tries to convey meaningful responses to the questions asked, for example when asked what the remote is he points to the TV but just cannot find the word. Also when asked to describe the picture, his speech is hesitant and stuttering. These are all characteristics of EXPRESSIVE DYSPHASIA where the patient understands the question but the response is non-fluent. The lack of fluency is seen as the patient recognises that their speech is incorrect. Contrast this with receptive dysphasia, in which a patient's speech might be fluent and confident, but does not make sense – because he or she does not recognise the errors that they are making.
Predominant expressive dysphasia video In this clip, the patient can follow a three stage command but speech is slightly hesitant and carefully constructed even though she does make mistakes. This is a good example of expressive dysphasia – she recognises the errors. She also uses made up words to convey meaning – ‘short' instead of stroke and ‘wash' instead of watch. These words are called neologisms. She has some nominal dysphasia – able to identify the pen and comb, but not name the nib of the pen. She uses neologisms to describe the magazine cover, but there is clear poverty of expressive speech.