Agrammatism is difficulty with using basic grammar and syntax, or word order and sentence structure. It is a common feature in the speech of people with aphasia, especially Broca’s (non-fluent) aphasia.

People with aphasia are often able to use “content” words like nouns and verbs. However, they find it difficult to use “little” words, or function words. Examples are:

  • articles: “the,” “a”
  • prepositions: “in,” “on”
  • helping/auxiliary verbs: “is,” “are”

It can also be hard for people with aphasia to use grammatical structures and word “inflections.” Inflections are how we change a word to change its meaning or tense. Examples include:

  • adding “-ed” or “ing” to a verb to change its tense
  • adding “s” to a noun to make it plural
  • using correct pronouns

Agrammatism also makes it hard to put words in the right order. This can be especially difficult in questions, when word order is reversed in English.

Because of this, people with aphasia often speak in mostly nouns and verbs. This is called “telegraphic speech” – so called because it resembles the writing that was used in telegrams. For instance, someone with aphasia might say “Daughter go store, buy ice cream.” It is easy to understand the main message although it is not a complete sentence.

How Agrammatism Varies and Communication Considerations

As with other characteristics of aphasia, severity varies from person to person. Some people with aphasia will only be able to string together a few nouns. Other people can form complete basic sentences but might struggle with more complicated sentence structure.

Agrammatism can also affect language comprehension or understanding spoken language. Someone with aphasia might be able to understand a sentence with simple construction, such as “Roger gave Sally a cookie.” However, someone with agrammatism might not be able to understand the sentence “Sally was given a cookie by Roger.”

Agrammatism can often improve with time and therapy. It is also very helpful for caregivers and communication partners to be aware of these difficulties. Caregivers and communication partners can help by asking simple questions to clarify meaning when they do not understand their loved one’s message.

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