This is the 2007 version. Click here for the 2017 chapter 02 table of contents.

Aphasic Speech

Two types of speech are often spared in people with Broca's aphasia: cursing and song lyrics. Aphasic patients can often sing the words to a song if assisted by somebody who sings along with them. If the assistant stops singing, the aphasic person may continue to sing a few more bars before trailing off into silence. Probably the reason cursing and singing are spared is that neither type of speech requires a conscious act of retrieval or the assembly of a meaningful sentence. Curse words are typically spontaneous; they just "pop out." Song lyrics are encoded into memory as sounds, as much as language (as shown by singers who memorize lyrics in a language they do not understand).

What types of speech often remain possible for a patient with severe Broca's aphasia?

Broca's aphasia eliminates the ability to communicate meanings in language, but it does not eliminate the ability to pronounce words. Broca's aphasia in a deaf person who uses sign language impairs the ability to communicate with signs. Because it affects an individual's ability to express meaning linguistically, Broca's aphasia is often called expressive aphasia.

Broca's and Wernicke's Areas

Can Broca's aphasics understand language?

Broca's aphasics typically understand language, although they cannot express it. Sometimes a sentence or two can be spoken, to the surprise of relatives and doctors.

I knew of a man who suffered Broca's aphasia after an auto accident. He had serious brain damage and was confined to a hospital bed until he died about 10 years later, but he could still understand language and he appreciated visitors. One visitor commented about the man's son, saying the son had "nice dark hair." The man suddenly said, "He's blond." His wife said those were the only words he spoke after the accident, and he never again spoke until he died. My interpretation of this is that the response to the visitor's comment was immediate and automatic, like an interjection or curse word, so it bypassed the retrieval impairment of the Broca's aphasia. In other words, a Broca's aphasic has trouble formulating meaning, but sometimes a meaningful phrase can be "blurted out" without a conscious planning process.

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