is telegraphic, meaning that articles,
conjunctions, prepositions, auxiliary verbs and pronouns
(function words) and morphological inflections (e.g.
plurals, past tense), are omitted. In addition, nouns,
verbs, adjectives and adverbs (content words) may be
retained. Output can be restricted to noun-verb
combinations. There is often a concomitant apraxia of speech
Sentence length is
short. Average utterance length (MLU) is typically about 2.
In extreme cases, the patient may only be able to produce
single word utterances.
morphology are affected; only the most basic and
over-learned grammatical forms are produced (often limited
to nouns and verbs).
Speech is labored
Agility is impaired. Potential problems include:
consonant clusters (e.g. t/st, p/spl).
paraphasias may occur. They will usually be
Repetition is typically impaired, falling at
about the middle of the Boston Diagnostic Aphasia
Examination (BDAE) scale. (Repetition and spontaneous speech
are impaired to about the same degree in Broca's
In Broca's aphasia auditory comprehension appears superior to expressive language, and usually falls within the 50th-90th percentile range on the Boston (McCaffrey, 2005). The patient's ability to understand grammer will be affected. So, while it can be said that auditory comprehension is good in comparison with expression, it is not normal. The knowledge of linguistic rules will be the same, but expression may be apraxic as well as aphasic.
In our clinic a Broca's aphasic patient when asked what his favourite food was he said: "Uh...uh...uh....choc...like...chocolate."
Note: I have
frequently used the Token Test (DeRenzi & Vignolo,
1966), which assesses subtle receptive language dysfunction,
to evaluate the auditory comprehension of Broca's aphasics
and to differentiate between Broca's aphasia and apraxia of speech AOS. when the patient does well you know that s/he doesn't have aphasia. When s/he does poorly it is more difficult to make a diagnosis. The test which is also normed for children, has five parts involving the manipulation
of objects of different colors, shapes, and sizes, and
becomes progressively more difficult. It tests receptive
language by requiring the patient to follow instructions
like "Put the red square on the yellow circle." However you
must be aware that words like "before" which are grammatical
morphemes may be missed due to conceptual or semantic
problems. Also, limb apraxia or colour blindness may not allow the patient to
carry out the instructions, even though s/he understands
Hemiplegia/Hemiparesis of the right
side is common (remember, the language center is in the left
hemisphere for more than 90% of the population) The face and
arm are most likely to be affected due to the organization
of the motor strip.
accompanies this type of aphasia as it is likely caused by
lesions to area 44/45. This poorly articulated speech shows up
most frequently in longer words and phrases.
Broca's aphasics typically have low frustration tolerance. They are aware of
their errors and may respond to them with a catastrophic
reaction which might include weeping.
may receive a rating of 1 or 2 on the BDAE, especially soon
after their strokes, due to the scarcity of their speech output. As they recover, they may be rated as 3, 4 or 5 (Goodglass and Kaplan, 1983).
Typically there is
better recovery of language function in Broca's than in any
of the other aphasia syndromes.