Why do I see wrong words


Brief overview

  • What is aphasia? Language disorder due to damage to the language centers in the brain. Aphasic people have problems speaking and often reading and writing as well. However, the patients are not mentally impaired.
  • Forms of aphasia: Wernicke aphasia (sensory aphasia), Broca aphasia (motor aphasia), amnestic aphasia, global aphasia (most severe form)
  • Causes: Brain damage as a result of stroke, traumatic brain injury, brain tumor, inflammatory diseases of the brain, poisoning.
  • Diagnosis: By the speech therapist using special tests (mostly Aachen aphasia test, AAT)
  • Therapy: Individually adapted speech therapy with a speech therapist as early as possible
  • Tips for relatives: Respectful, patient treatment of those affected in order to avoid additional frustrations.

Aphasia: description and types

The term "aphasia" comes from the Greek and means "speechlessness". Aphasia occurs when the language centers in the dominant, usually left hemisphere, are damaged. Those affected have problems speaking and understanding, often reading and writing as well.

Are aphasia Speech disorders - no speech disorders. This means that it is not the process of word formation that is disturbed, as is the case with stuttering, for example, but rather the underlying skills of coding and decoding speech.

No mental handicap

Aphasia is not a mental handicap. Aphasia sufferers are difficult to make themselves understood and others are also difficult to understand. Some patients confuse words or speak in telegram style. Others can only express themselves in stereotypes or meaningless chains of syllables. In spite of all this, their mental abilities are mostly not impaired - aphasic persons can still access their knowledge and their life experience. The ability to analyze situations, recognize connections and understand non-linguistic signals is also retained.

Types of aphasia

How aphasia is specifically expressed depends on which areas of the brain are damaged. Accordingly, there are four types of aphasia:

Wernicke aphasia: confusing gibberish

In Wernicke aphasia (sensory aphasia), the so-called Wernicke area (Wernicke language center) is damaged. It is located in the upper temporal lobe of the brain and is responsible for understanding language. Patients with this form of aphasia can therefore only partially understand spoken language and communicate with one another only with difficulty. When speaking, they mix up words and sounds and form long, nested sentences.

Those affected often do not even notice their language disorder. The words gush out of them, but remain confused and incomprehensible. In some people affected, the aphasia is so pronounced that they only utter "gibberish". Often these patients are mistakenly suspected of having a thought disorder.

Broca's aphasia: speaking the telegram style

This form of aphasia affects the speech center (Broca's area), which is located in the frontal lobe of the brain. The language disorder primarily affects the ability to articulate language. That is why doctors also refer to Broca's aphasia as motor aphasia.

The patients can understand their interlocutor well, but can only formulate what they have spoken with difficulty. Those affected speak haltingly in incomplete, telegram-style sentences. They often confuse sounds, for example saying "Meskel" instead of "Messer". The patients usually do not speak spontaneously at all. They can read and write, although their writing skills are just as limited as verbal ones.

Broca's aphasia should not be confused with what is known as dysarthria. This is a speech disorder in which those affected have difficulty speaking understandably due to motor disorders.

Amnestic Aphasia: Finding Words

In this type of aphasia, the lower temporal lobe at the transition to the parietal lobe of the brain is damaged. Those affected mainly suffer from word-finding disorders. You can understand your counterpart well and articulate yourself naturally. But words are lacking for them. This is why patients speak hesitantly, often using placeholders such as "the thing", "that there" or "it" or describing a term based on its properties, for example "the thing from which one drinks water" instead of "the glass". So the flow of language stalls again and again. The word finding disorders also occur when writing.

Global aphasia

Global aphasia is the most severe form of speech impairment. It affects language comprehension and speaking ability. Parts of the frontal, temporal and parietal lobes in the brain are usually damaged. This makes verbal communication almost impossible. The speech understanding of those affected is so severely impaired that at best they can understand very simple instructions. The main symptom are so-called Speech automatisms. These are repeated, awkward, wooden utterances. Some patients with global aphasia only use fragments of words or meaningless repetitive syllables like "dadada". Others use automated phrases like "oh dear" or "my god".

Aphasia: causes

Aphasia occurs when the language centers in the brain have been injured or damaged. The main causes are:

  • Stroke (responsible for about 80 percent of all aphasia cases)
  • traumatic brain injury
  • Brain tumor
  • inflammatory diseases of the brain
  • Poisoning

Diseases with this symptom

Find out here about the diseases that can cause the symptom:

Aphasia: diagnosis

Speech disorders are always an alarm signal. In addition, if they occur suddenly, you should call an emergency doctor immediately.

The diagnosis sets Speech therapist with the help of special tests (such as the Aachen Aphasia Test, AAT). These include questions about symptoms, work, family, and leisure activities. In addition, the patient's speech is analyzed in order to identify any abnormalities:

  • Twisted words and sounds
  • Word finding disorders
  • Repetitions of words

In addition, the following aspects are assessed:

  • the patient's ability to repeat syllables, words and sentences
  • Attention and ability to concentrate
  • Language comprehension
  • the ability to name things
  • the ability to read and write

Aphasia: therapy

Aphasic people should as early as possible Have speech therapy treated. But even years after the onset of the disease, success can still be achieved with an appropriate therapy.

Aphasia therapy has the following goals:

  • To reactivate the diseased areas of the brain (reorganization).
  • To stimulate other brain areas to take over the tasks of the disturbed areas (compensation).
  • Encourage the patient to speak.
  • To reduce the fear of not being understood and of making mistakes.
  • To free the patient from his isolation.

A comprehensive aphasia therapy usually includes Speech, concentration and comprehension exercises, but also Role play, in which everyday situations are trained. The latter often take place as part of group sessions. Patients who suffer from a very severe form of aphasia learn about Gestures to communicate with others.

The therapy includes three stages:

  • Activation phase: First of all, it is important to encourage the patient to speak as early as possible. This phase should begin as soon as possible after the brain damage, even if it is not yet clear which form of aphasia is present.
  • Practice phase: The practice phase should include several one-hour sessions per week. Initially, the practice is usually in individual therapy, later often in group sessions. The practice phase lasts at least a year, often longer. Since every brain damage has a different effect, there is no standard therapeutic procedure. Rather, the training plan is individually tailored to the patient's abilities, complaints and personality.
  • Consolidation phase: In the last phase of aphasia therapy, the patient learns to use his skills optimally and to develop them further.
Chronic aphasia: speech therapy helps
Speech disorders are often the result of a stroke. But speech therapy can also help with chronic disorders, show new studies. By Larissa Melville

Aphasia: tips for loved ones

Losing the ability to speak upset and frustrates those affected. Many react desperately or aggressively, and some even develop depression. Aphasia patients also have to work very hard to express themselves and understand others. As a result, they are often quickly exhausted and need a lot of rest.

It is particularly difficult for those affected when those around them regard them as mentally handicapped and patronize them. That is why it is important to be aphasic to be treated with respectso that they do not completely lose their self-confidence and their zest for life.

The following Tips can make it easier for you to deal with aphasia:

  • Be patient: People with aphasia need time to grasp the content of the conversation. Speak slowly, use simple sentences, and take breaks.
  • Do not take the word out of the aphasic's mouth: People with aphasia often stop speaking and look for words for a long time. Wait to see whether the aphasic does not find the term he is looking for, because every linguistic sense of achievement is important to him. He often succeeds in expressing himself if you give him enough time. If the aphasic is approached by a third party, avoid the temptation to answer on their behalf.
  • Make communication easier: speak slowly and clearly and underline what has been said with facial expressions and gestures. Make sure you understand: If you are not entirely sure whether you have correctly understood a person with aphasia, ask simple yes / no questions: "You are talking about Ms. Schulze?". If the person concerned seems confused, actively ask whether they have understood everything.
  • Do not correct too much: people who suffer from aphasia are often afraid of linguistic errors and therefore do not dare to speak. Constant correcting increases this fear.
  • Eliminate sources of interference: People with aphasia find it difficult to focus on more than one thing at a time. If several people are involved in the conversation, they should not all speak at once. Distracting sources of noise such as radio or television should also be turned off during a call.
  • Make contact with others easier: Many people are unsure how to deal with an aphasic. Encourage them to speak to the victim and share your knowledge and experience as to that aphasia further.

Additional information


  • Aphasia: Speech disorder after stroke or traumatic brain injury by J├╝rgen Vesak and Thomas Brauer, Schulz-Kirchner Verlag (2013)
  • Understanding the Silence: On Aphasia by Luise Lutz and Wolfgang Schlote, Springer (2010)


  • Guideline "Rehabilitation of aphasic disorders after stroke" of the German Society for Neurology

Self help:

Author & source information