Laura Thorburn, M.S., CCC-SLP
This article is a guide to transcortical motor aphasia. It covers the main symptoms of transcortical motor aphasia, along with how transcortical motor aphasia is treated. You’ll also learn 10 helpful tips for communicating with a person who has aphasia.
What is aphasia?
First, it’s helpful to understand what aphasia is. Aphasia is a complex neurological condition that affects a person's ability to understand and express language. It often results from brain damage, typically occurring in the left hemisphere. This is the part of the brain responsible for language processing in most right-handed people. This damage can be caused by injuries such as stroke, a physical trauma the brain, or a tumor.
There are several types of aphasia, each with distinct characteristics. Aphasia can be categorized through an evaluation with a speech-language pathologist.
Rather than being a specific condition, aphasia can affect a person’s language function in different ways. People with aphasia may have varying degrees of difficulty with speaking, listening, reading, and writing. The four primary areas of language where people with aphasia may have problems are:
1 Speech repetition
Repeating words, phrases, and sentences that someone else says
2 Naming
Being able to name objects
3 Auditory comprehension
Understanding words, phrases, or sentences that are spoken by another person
4 Fluency
The smoothness, rhythm, and rate with which a person speaks
Every brain is different. While we can make fairly reliable statements about the parts of the brain and the areas they control, there is variation. But one thing is certain, speech therapy will make a big difference in recovery for every type of aphasia, including transcortical motor aphasia.
What is transcortical motor aphasia?
Transcortical motor aphasia is also known as “commissural” or “white matter” dysphasia. The damage occurs in the front portion of the frontal lobe on the left side of the brain. With transcortical motor aphasia, the language centers of the brain are preserved. However, the part of the brain responsible for initiating verbal speech is affected.
The assessment profile of a person with transcortical motor aphasia usually resembles the following:
Speech repetition: Good
Naming: Mild to severe challenges
Auditory comprehension: Mild challenges
Fluency: Nonfluent
What does transcortical motor aphasia sound like?
The hallmark symptom of transcortical motor aphasia is that of severe nonfluent speech, along with problems with comprehension. However, the person is typically able to repeat words said verbally.
When asked a question, a person with transcortical motor aphasia may repeat portions of what they heard. Here’s an example:
Speech therapist: “How are you feeling today?”
Person with aphasia: “How are you feeling today?”
Because of problems with speech fluency, or the ability to speak smoothly, a person with transcortical motor aphasia does not tend to speak spontaneously on their own. Instead, they respond to and repeat verbal responses from others.
How is transcortical motor aphasia treated?
Communication is incredibly complex. When language is impaired, speech therapy can help in two ways:
1 Impairment-based treatment
This treatment is aimed at improving language function to its prior level. Treatment approaches for transcortical motor aphasia may include graded naming tasks or automatic speech activities.
2 Communication-based treatment
The goal here is to provide the person with some sort of communication abilities in order to improve their quality of life or reduce their frustration. Treatment programs might include Supported Conversation for Adults with Aphasia or Life Participation Approach to Aphasia (LPPA).
It’s important to note that a combination of these treatment types may be used. Transcortical motor aphasia can have varying degrees of severity. One treatment program may be useful for one person, while another program may lead to better outcomes with another.
In addition, a person may begin with one type of treatment and, as they improve, change to another program. Your speech therapist will work with you to determine the specific type that will best support your communication needs.
10 tips for communicating with a person who has transcortical motor aphasia
A person’s sense of self can be greatly impacted when they have aphasia. Even a person who has only mild word-finding problems may be much less comfortable socializing than they were before.
It’s important to support a person with aphasia by maintaining a sense of respect. We need to recognize that language alone has been impacted, not the person’s intelligence level. Here are 10 simple ways to increase success when communicating with a person who has aphasia.
1. Check in and confirm they understand by asking them “yes” or “no” questions.
2. Encourage the person to communicate. Try to avoid talking for them.
3. Use a normal volume when speaking unless the person asks you to speak more loudly or quietly.
4. Pause and allow the person time to speak. Do not finish their sentences.
5. Limit any background noise to promote a calm and quiet environment.
Remember that language alone has been impacted, not the person’s intelligence level.
6. Ensure the person is paying attention to you when you’re talking to them.
7. Do not correct their speech. Keep a pleasant facial expression while listening to the person speak.
8. Take advantage of alternate ways to communicate, such as pictures, written words, gestures, and facial expressions.
9. Use a simple form of communication. This doesn’t mean speaking about simple, child-like things, but using the least complex words and sentences when discussing information.
10. Encourage the person with aphasia to join in group conversations. Shift the topic to them: “Dave, what do you think about that game?”
Support from family, friends, and a speech therapist can significantly improve a person's ability to navigate daily interactions and regain confidence in their communication abilities. At Expressable, our speech therapists are knowledgeable in all types of treatment programs. We will work with you to establish a plan of care that gets you back to communicating to your top potential.
