When Words Get Stuck: Treating Perseveration in Aphasia
- Anne Shaknis Quirk
- Sep 3
- 2 min read
Recently, I worked with a client who was experiencing language difficulties after a neurological injury. One of the biggest challenges they faced was perseveration-- getting “stuck” on words or phrases (numbers in his case!) we had previously discussed, even when the context had shifted.
For people with aphasia (PWA), perseveration can feel devastating. Imagine trying to say a new word, but the same old one keeps slipping out instead. This not only blocks communication but can also be frustrating and discouraging for the person speaking.
Interestingly, while perseveration is a common challenge in aphasia, it is rarely given much attention. In fact, one of the only structured treatment approaches developed specifically for perseveration is the Treatment of Aphasic Perseveration (TAP) program, created by Helm-Estabrooks and colleagues.
What is TAP?
The goal of TAP is straightforward: Reduce repeated, stuck-on responses so that the correct target words can come through.
How does it work? TAP brings perseveration to the client’s awareness and uses structured strategies to help them suppress unhelpful repetitions while practicing correct word retrieval. Therapy often includes:
Practicing naming objects, actions, or concepts.
Using a hierarchy of cues (gestures, drawings, first letters, sentence completions, or phonemic prompts).
Building in pauses and pacing to allow the brain time to reset.
Sensitizing techniques to help the person recognize and inhibit a repeated word.
Why It Helps
Research shows that when therapy is tailored to the underlying language deficit—not just the perseveration itself—clients can experience real improvements. In fact, studies of TAP have shown significant reductions in perseveration in as few as five sessions, alongside improved naming accuracy.
What This Looks Like in Therapy
With my recent client, we worked on:
Awareness: Talking about what perseveration is and how it affects communication.
Cues and strategies: Introducing specific prompts when words got stuck, so the client could “shift gears.”
Pacing: Building in pauses between attempts so the brain had time to find a new pathway.
The result? Over the session, my client began to break out of those stuck patterns more easily and found greater success in retrieving the numbers he wanted.
Moving Forward
Perseveration is not a hopeless barrier. With the right therapeutic approach—especially programs like TAP that address the underlying language difficulty—people with aphasia can regain flexibility and confidence in their communication.
At True Self Speech Therapy, we believe every person deserves the chance to be heard clearly. Whether it’s aphasia, voice changes, or cognitive-communication difficulties, our therapy plans are tailored to each client’s unique needs.
✨ If you or a loved one are struggling with aphasia or language recovery, reach out to learn how therapy can help.