Wernicke’s Aphasia Progression Handout

It can be difficult to gauge progress with Wernicke’s aphasia because you aren’t aware of the hierarchy of recovery. Everyone is different and their progression may not follow this timeline precisely. Wernicke’s aphasia is a posterior aphasia that affects the phonological (word sounds) system. You will not have apraxia (motor speech disorder) with this type of aphasia. Speech and writing will be similarly affected, as will understanding and reading. By the moderate/mild stage, the diagnosis may change to Conduction aphasia, then Anomic aphasia. 

Wernicke’s aphasia requires a different therapy approach than non-fluent aphasia.

Severe Intermediate Moderate/Mild
Very confused, little understanding of written/ spoken information.May have no speech or garbled/nonsensical speech. May have some physical weakness in arm or leg. Speech has normal intonation and rhythm but remains largely nonsense. Understanding and awareness may be improving in daily life activities. Has difficulty understanding therapy tasks and switching activities. Understanding continues to improve. Patient receives good input, may begin to repeat or “echo” spoken sounds during conversation or read aloud single words. He may also begin to purposefully repeat words and use written cues more reliably.
Less confusion. Any physical issues may have lessened (remaining hand weakness). May get frustrated due to poor understanding. As understanding improves, patient may begin to understand that what he is saying is not what he thinks he’s saying. May be larger pockets of intelligible and relevant words (you can understand them and they make sense given the moment). As speech relevance and intelligibility improves,  patient receives more good input (written and spoken information) during daily life situations that help continually improve speech and writing. More speech makes sense and uses real words appropriately.
Understanding is still difficult except for highly-contextual situations (“Do you want salt on that?” while eating).
Speech is fluent (more than 5 words at a time) but largely gibberish (neologisms). Makes sound errors in words (consused = confused).
The aphasia may progress into conduction or anomic aphasia. All people with aphasia have anomia (problems finding specific words). Example: “Yesterday we ended up at the ___”. Anomia is the mildest form of aphasia.

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