difficulties naming certain words, linked by their grammatical type (e.g., difficulty naming verbs and not nouns) or by their semantic category (e.g., difficulty naming words relating to photography but nothing else) or a more general naming difficulty. people tend to produce grammatic, yet empty, speech. auditory comprehension tends to be preserved. anomic aphasia is the aphasial presentation of tumors in the language zone; it is the aphasial presentation of alzheimer's disease. anomic aphasia is the mildest form of aphasia, indicating a likely possibility for better recovery. individuals with transcortical sensory aphasia, in principle the most general and potentially among the most complex forms of aphasia, may have similar deficits as in receptive aphasia, but their repetition ability may remain intact. global aphasia is considered a severe impairment in many language aspects since it impacts expressive and receptive language, reading, and writing. despite these many deficits, there is evidence that has shown individuals benefited from speech language therapy. even though individuals with global aphasia will not become competent speakers, listeners, writers, or readers, goals can be created to improve the individual's quality of life. individuals with global aphasia usually respond well to treatment that includes personally relevant information, which is also important to consider for therapy. individuals with conduction aphasia have deficits in the connections between the speech-comprehension and speech-production areas. this might be caused by damage to the arcuate fasciculus, the structure that transmits information between wernicke's area and broca's area. similar symptoms, however, can be present after damage to the insula or to the auditory cortex. auditory comprehension is near normal, and oral expression is fluent with occasional paraphasic errors. paraphasic errors include phonemic/literal or semantic/verbal. repetition ability is poor. conduction and transcortical aphasias are caused by damage to the white matter tracts. these aphasias spare the cortex of the language centers but instead create a disconnection between them. conduction aphasia is caused by damage to the arcuate fasciculus. the arcuate fasciculus is a white matter tract that connects broca's and wernicke's areas. people with conduction aphasia typically have good language comprehension, but poor speech repetition and mild difficulty with word retrieval and speech production. people with conduction aphasia are typically aware of their errors. two forms of conduction aphasia have been described: reproduction conduction aphasia (repetition of a single relatively unfamiliar multisyllabic word) and repetition conduction aphasia (repetition of unconnected short familiar words. transcortical aphasias include transcortical motor aphasia, transcortical sensory aphasia, and mixed transcortical aphasia. people with transcortical motor aphasia typically have intact comprehension and awareness of their errors, but poor word finding and speech production. people with transcortical sensory and mixed transcortical aphasia have poor comprehension and unawareness of their errors. despite poor comprehension and more severe deficits in some transcortical aphasias, small studies have indicated that full recovery is possible for all types of transcortical aphasia. classical-localizationist approaches cortex localizationist approaches aim to classify the aphasias according to their major presenting characteristics and the regions of the brain that most probably gave rise to them. inspired by the early work of nineteenth-century neurologists paul broca and carl wernicke, these approaches identify two major subtypes of aphasia and several more minor subtypes: expressive aphasia (also known as "motor aphasia" or "broca's aphasia"), which is characterized by halted, fragmented, effortful speech, but well-preserved comprehension relative to expression. damage is typically in the anterior portion of the left hemisphere, most notably broca's area. individuals with broca's aphasia often have right-sided weakness or paralysis of the arm and leg, because the left frontal lobe is also important for body movement, particularly on the right side. receptive aphasia (also known as "sensory aphasia" or "wernicke's aphasia"), which is characterized by fluent speech, but marked difficulties understanding words and sentences. although fluent, the speech may lack in key substantive words (nouns, verbs, adjectives), and may contain incorrect words or even nonsense words. this subtype has been associated with damage to the posterior left temporal cortex, most notably wernicke's area. these individuals usually have no body weakness, because their brain injury is not near the parts of the brain that control movement. conduction aphasia, where speech remains fluent, and comprehension is preserved, but the person may have disproportionate difficulty repeating words or sentences. damage typically involves the arcuate fasciculus and the left parietal region. transcortical motor aphasia and transcortical sensory aphasia, which are similar to broca's and wernicke's aphasia respectively, but the ability to repeat words and sentences is disproportionately preserved. recent classification schemes adopting this approach, such as the boston-neoclassical model, also group these classical aphasia subtypes into two larger classes: the nonfluent aphasias (which encompasses broca's aphasia and transcortical motor aphasia) and the fluent aphasias (which encompasses wernicke's aphasia, conduction aphasia and transcortical sensory aphasia). these schemes also identify several further aphasia subtypes, including: anomic aphasia, which is characterized by a selective difficulty finding the names for things; and global aphasia, where both expression and comprehension of speech are severely compromised. many localizationist approaches also recognize the existence of additional, more "pure" forms of language disorder that may affect only a single language skill. for example, in pure alexia, a person may be able to write but not read, and in pure word deafness, they may be able to produce speech and to read, but not understand speech when it is spoken to them. cognitive neuropsychological approaches although localizationist approaches provide a useful way of classifying the different patterns of language difficulty into broad groups, one problem is that a sizeable number of individuals do not fit neatly into one category or another. another problem is that the categories, particularly the major ones such as broca's and wernicke's aphasia, still remain quite broad. consequently, even amongst those who meet the criteria for classification into a subtype, there can be enormous variability in the types of difficulties they experience. instead of categorizing every individual into a specific subtype, cognitive neuropsychological approaches aim to identify the key language skills or "modules" that are not functioning properly in each individual. a person could potentially have difficulty with just one module, or with a number of modules. this type of approach requires a framework or theory as to what skills/modules are needed to perform different kinds of language tasks. for example, the model of max coltheart identifies a module that recognizes phonemes as they are spoken, which is essential for any task involving recognition of words. similarly, there is a module that stores phonemes that the person is planning to produce in speech, and this module is critical for any task involving the production of long words or long strings of speech. once a theoretical framework has been established, the functioning of each module can then be assessed using a specific test or set of tests. in the clinical setting, use of this model usually involves conducting a battery of assessments, each of which tests one or a number of these modules. once a diagnosis is reached as to the skills/modules where the most significant impairment lies, therapy can proceed to treat these skills. progressive aphasias primary progressive aphasia (ppa) is a neurodegenerative focal dementia that can be associated with progressive illnesses or dementia, such as frontotemporal dementia / pick complex motor neuron disease, progressive supranuclear palsy, and alzheimer's disease, which is the gradual process of progressively losing the ability to think. gradual loss of language function occurs in the context of relatively well-preserved memory, visual processing, and personality until the advanced stages. symptoms usually begin with word-finding problems (naming) and progress to impaired grammar (syntax) and comprehension (sentence processing and semantics). the loss of language before the loss of memory differentiates ppa from typical dementias. people with ppa may have difficulties comprehending what others are saying. they can also have difficulty trying to find the right words to make a sentence. there are three classifications of primary progressive aphasia : progressive nonfluent aphasia (pnfa), semantic dementia (sd), and logopenic progressive aphasia (lpa). progressive jargon aphasia is a fluent or receptive aphasia in which the person's speech is incomprehensible, but appears to make sense to them. speech is fluent and effortless with intact syntax and grammar, but the person has problems with the selection of nouns. either they will replace the desired word with another that sounds or looks like the original one or has some other connection or they will replace it with sounds. as such, people with jargon aphasia often use neologisms, and may perseverate if they try to replace the words they cannot find with sounds. substitutions commonly involve picking another (actual) word starting with the same sound (e.g., clocktower – colander), picking another semantically related to the first (e.g., letter – scroll), or picking one phonetically similar to the intended one (e.g., lane – late). deaf aphasia there have been many instances showing that there is a form of aphasia among deaf individuals. sign languages are, after all, forms of language that have been shown to use the same areas of the brain as verbal forms of language. mirror neurons become activated when an animal is acting in a particular way or watching another individual act in the same manner. these mirror neurons are important in giving an individual the ability to mimic movements of hands. broca's area of speech production has been shown to contain several of these mirror neurons resulting in significant similarities of brain activity between sign language and vocal speech communication. facial communication is a significant portion of how animals interact with each other. humans use facial movements to create, what other humans perceive, to be faces of emotions. while combining these facial movements with speech, a more full form of language is created which enables the species to interact with a much more complex and detailed form of communication. sign language also uses these facial movements and emotions along with the primary hand movement way of communicating. these facial movement forms of communication come from the same areas of the brain. when dealing with damages to certain areas of the brain, vocal forms of communication are in jeopardy of severe forms of aphasia. since these same areas of the brain are being used for sign language, these same, at least very similar, forms of aphasia can show in the deaf community. individuals can show a form of wernicke's aphasia with sign language and they show deficits in their abilities in being able to produce any form of expressions. broca's aphasia shows up in some people, as well. these individuals find tremendous difficulty in being able to actually sign the linguistic concepts they are trying to express. severity the severity of the type of aphasia varies depending on the size of the stroke. however, there is much variance between how often one type of severity occurs in certain types of aphasia. for instance, any type of aphasia can range from mild to profound. regardless of the severity of aphasia, people can make improvements due to spontaneous recovery and treatment in the acute stages of recovery. additionally, while most studies propose that the greatest outcomes occur in people with severe aphasia when treatment is provided in the acute stages of recovery, robey (1998) also found that those with severe aphasia are capable of making strong language gains in the chronic stage of recovery as well. this finding implies that persons with aphasia have the potential to have functional outcomes regardless of how severe their aphasia may be. while there is no distinct pattern of the outcomes of aphasia based on severity alone, global aphasia typically makes functional language gains, but may be gradual since global aphasia affects many language areas. cognitive deficits in aphasia while aphasia has traditionally been described in terms of language deficits, there is increasing evidence that many people with aphasia commonly experience co-occurring non-linguistic cognitive deficits in areas such as attention, memory, executive functions and learning. by some accounts, cognitive deficits, such as attention and working memory constitute the underlying cause of language impairment in people with aphasia. others suggest that cognitive deficits often co-occur but are comparable to cognitive deficits in stroke patients without aphasia and reflect general brain dysfunction following injury. the degree to which deficits in attention and other cognitive domains underlie language deficits in aphasia is still unclear. in particular, people with aphasia often demonstrate short-term and