Speech and Language Disorders in Adults (Aphasia, Dysarthria, Apraxia)
Aphasia
Know the classic syndromes: Broca's (nonfluent, effortful, relatively preserved comprehension), Wernicke's (fluent, poor comprehension, poor repetition), conduction (fluent, good comprehension, impaired repetition), global (all severely affected), and anomic (word-finding). Understand that aphasia is acquired language impairment after brain injury, most often left-hemisphere stroke. Distinguish aphasia from confusion and from motor speech disorders.
Motor speech disorders
Dysarthria is a neuromuscular execution disorder-flaccid, spastic, ataxic, hypokinetic, hyperkinetic, or mixed-each with characteristic voice, articulation, and prosody features. Apraxia of speech is a planning/programming disorder with distorted, inconsistent errors, groping, and slow rate, often with relatively preserved automatic speech. Right-hemisphere damage affects pragmatics and prosody; dementia affects cognition and language broadly.
Traps in questions
A common trap is labeling Wernicke's patients as "uncooperative"-their comprehension is impaired. Another is confusing apraxia of speech (planning) with dysarthria (execution). Do not attribute aphasia recovery solely to "motivation"; lesion site and time since onset matter. Also distinguish dysarthria from aphasia: a dysarthric patient may have intact language but unclear speech.
Rule of thumb
Test four axes: fluency, comprehension, repetition, and naming. Placement on those axes identifies the syndrome.
Worked example: Fluent speech, poor comprehension, impaired repetition → Wernicke's aphasia, typically posterior superior temporal lesion.