Some people with aphasia may have trouble thinking of the word that they want to write, even though they know the meaning or message that they want to communicate. In this case, the person will not be able to write the word or say it, because they cannot think of the word itself. We have all experienced this kind of problem, often called “tip of the tongue”. You know the name of a person, place, or object, you can picture it clearly, you can describe it, but you just can’t think of the name of it. When this happens to you, you can neither say the word nor write it.
In other cases, the person with aphasia may know the word that they would like to write, and they might be able to say it, but they can’t write it. In this case, the sounds that need to be put together to say the word are accessible, but the spelling of the word is not. This may seem odd to those of us without aphasia. Our abilities to pronounce words and write them are so closely intertwined that it is hard for us to imagine being able to do one but not the other. But that is what can happen in aphasia.
Sometimes certain kinds of information about the word is available. Sometimes a related word might end up being written, for example, writing “apple” when you want to write “banana”. Other times the person with aphasia might be able to write the first letter, or draw slots for how many letters are in the word, or write the first and last letters, but make mistakes on the remaining letters. In this case, preserved information about what the written word looks like is there, but it’s not complete.
Some people with aphasia might write extra letters or words, or even write down non-words.
Finally, some people who have a nonfluent type of aphasia might be able to write some words but omit “little” words or have more trouble with verbs. They will have more trouble writing sentences.