Sentence structure is something that is difficult for many people with aphasia. Treatment of Underlying Forms (TUF) is a treatment strategy to improve sentence structure. It is mostly used with people who have nonfluent aphasia, like Broca’s aphasia. People with nonfluent aphasia usually have difficulties with agrammatism. This includes word order, sentence structure, and using “small” words like prepositions, conjunctions, and articles.

TUF takes a different approach than many other aphasia therapies. Many aphasia treatments start at a simple level and become more difficult as the person progresses. However, TUF starts with more complex sentences. The goal is that success with complex sentences will automatically lead to success with simpler sentences.

An example of this is passive sentences. Passive sentences are typically more difficult for people with aphasia to understand and use. An example of a passive (as opposed to active) sentence is:

  • Passive: Karen was given flowers by Gus.
  • Active: Gus gave Karen flowers.

In TUF, training would focus on passive voice. The treatment directly targets the more complex sentence. The treatment’s goal is that improvements will also be seen in the use/understanding of the simpler sentence.

TUF is designed for people who have impaired grammar and sentence structure. People who are most successful will have basic comprehension abilities. This therapy might be too advanced for someone who has severe comprehension impairments.

TUF has been shown to be effective in helping people with aphasia to produce more complex sentences. It also has led to longer sentences and an improvement in the correct use of verbs.

Caregiver talking on phone with elderly love one looking on.

Lingraphica Can Help

During a free 30-minute free consultation, we’ll help you and your loved ones find exactly what you need to meet your specific communication goals.

We’ll help you to better understand your condition, offer simple strategies for communicating more effectively, and discuss communication and therapy devices and apps that can really help. Call us at 866-570-8775 or click the button below to schedule a consultation.

Schedule a Free Consultation

Free Aphasia Communication, Therapy, and Video Apps

TalkPath Therapy

Exercises designed for practicing and rebuilding speech and language skills.

TalkPath News

An online news source designed to engage and test language comprehension.


Icon and video-based apps that help you communicate in everyday situations.

Lingraphica Can Help

We help adults with speech and language impairments to reconnect with family and friends, improve communication, and live their best lives. Call us at 866-570-8775 or visit the link below to get started.