Some authorities use the terms mixed aphasia and global aphasia interchangeably. However, in general, mixed aphasia refers to less severe global aphasia. Other classifications exist, an indication that aphasia is never purely receptive or purely expressive. No classification is completely satisfactory. Recovery from aphasia, if it occurs, is most pronounced during the first 3 months after brain injury.
Rehabilitation focuses on establishing the most effective means of communication.
For mildly impaired patients, a context-centered approach that emphasizes ideas and thoughts rather than words is effective. Patients and caregivers may be able to convey messages by pointing to images in a photography or picture book or by using a communication board or another augmentative device. Bilingual or multilingual aphasic patients are likely to regain their native language first and may not regain their secondary language skills. The physician and speech pathologist can help family members and friends understand that aphasia is a speech disorder, not a mental illness. Dysarthria is the second most common speech disorder among elderly patients.