Guide to Mixed Transcortical Aphasia: Causes, Symptoms, and Treatment

This article is a guide to mixed transcortical aphasia. It will help you learn what aphasia is, the main symptoms of mixed transcortical aphasia, and how mixed transcortical aphasia is treated. You’ll also learn 10 helpful tips for communicating with a person who has aphasia.

What is aphasia?

First, it helps to understand what aphasia is. Aphasia 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, which is responsible for language processing in most right-handed people. This damage can be caused by injuries such as stroke, a physical trauma to 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 mixed transcortical aphasia.

What is mixed transcortical aphasia?

Mixed transcortical aphasia is also known as isolation aphasia. That’s because this type of aphasia isolates the language centers of the brain from other areas of the brain. Mixed transcortical aphasia results from damage that is near those language areas. 

The assessment profile of a person with mixed transcortical aphasia usually resembles the following: 

  • Speech repetition: Moderate challenges

  • Naming: Poor

  • Auditory comprehension: Poor

  • Fluency: Nonfluent 

What does mixed transcortical aphasia sound like?

The hallmark symptoms of mixed transcortical aphasia include severe nonfluent speech and problems with comprehension. However, the person can still repeat information they hear someone else say.

A person with mixed transcortical aphasia does not tend to speak spontaneously, but they respond to and repeat verbal statements from others. In other words, if someone asks them a question, they may respond by repeating parts of the question, rather than answering it.

Here is an example:

Speech therapist: “My name is Laura. I will be serving you today.” 

Person: “My name is Laura. I serve today.”

How is mixed transcortical 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 mixed transcortical 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. Examples might include graded drawing tasks or conversational partner training.

It’s important to note that a combination of these treatment types may be used. Because of the extensive variation in brain function and damage, mixed transcortical 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 mixed transcortical 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. 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.

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 participation in group conversations. Shift the topic to the person with aphasia: “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.

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