Written by OneRehab · Last reviewed: October 28, 2026
Expressive aphasia makes it hard to get words out. Receptive aphasia makes it hard to understand words coming in. Both usually follow a stroke, and both are treated by a speech-language pathologist, but they look very different day to day and call for different therapy.
If someone you love has just been told they have aphasia, here’s how to tell the two apart and what helps.
Side by side
| Expressive (Broca’s) aphasia | Receptive (Wernicke’s) aphasia | |
|---|---|---|
| Speech | Short, slow, effortful; words often missing | Flows easily, but may not make sense |
| Understanding | Usually fairly good | Often hard to follow what others say |
| Aware of errors? | Usually, and often frustrated | Often not |
| Brain area involved | Frontal lobe, usually on the left | Temporal lobe, usually on the left |
| What it can sound like | “Coffee… want… kitchen.” | Full sentences with the wrong or made-up words |
Many people don’t fit neatly into one type. Some have a mix, and the picture often changes in the weeks after a stroke. A third type, global aphasia, affects both speaking and understanding severely.
What expressive aphasia is like
The person knows exactly what they want to say. The words just won’t come, or come out in pieces. Short phrases with the key words, like “walk… later,” are common. Because they understand most of what’s said to them, they’re usually aware of the struggle, which can be exhausting and frustrating.
Therapy focuses on getting words out: naming practice, cues that help a word surface, building from single words to phrases, and backup ways to communicate, such as writing, gestures or an app.
What receptive aphasia is like
Speech sounds normal at first: the rhythm is right and the sentences are long. But words may be swapped or invented, and the meaning gets lost. Following instructions or a conversation is hard. Often the person doesn’t notice the errors, which can confuse family members.
Therapy focuses on understanding: matching words to pictures and objects, following directions step by step, and learning to notice and fix errors.
How to talk with someone who has aphasia
These help with either type:
- Get their attention and cut background noise (TV, radio) before you talk.
- Use short, simple sentences, and one question at a time.
- Give them extra time to answer. Don’t finish their sentences unless they ask.
- Ask yes-or-no questions when they’re tired.
- Use gestures, pictures or writing alongside speech.
- Treat them as the adult they are. Aphasia affects language, not intelligence.
Can aphasia improve?
Yes. Many people improve the most in the first few months after a stroke, and with therapy, progress can continue for years. Starting speech therapy early helps, but it’s rarely too late to make gains. A speech-language pathologist’s evaluation is the best way to know which type of aphasia is involved and where to start.
At OneRehab, speech-language pathologists work alongside our physical and occupational therapists, so stroke survivors can work on speech, walking and daily tasks in one place. Learn more about aphasia treatment at OneRehab, or call our Richardson clinic at (972) 845-7875 to set up an evaluation.
