In acute Wernicke's aphasia, the initial therapeutic focus should be on

• A. Encouraging self-monitoring of the adequacy of verbal output
• B. Increasing the rate of speech
• C. Improving the client's ability to elaborate verbally
• D. Increasing the complexity of sentence structures

Answer: (A)

In acute Wernicke's aphasia, the most effective first step is to help the person monitor the adequacy of what they are saying. These patients speak fluently but often say items that don’t convey the intended meaning, with semantic errors and poor comprehension. Encouraging self-monitoring trains them to hear mismatches between what they mean and what they produce, recognize when output isn’t accurate, and begin to make adjustments. This focus builds a foundation for clearer, more meaningful communication and sets up later work on more precise word choice and elaboration.

Pushing for faster speech or more complex sentences can worsen intelligibility at this stage, and aiming to elaborate verbally or increase sentence length assumes a level of accuracy and comprehension that isn’t reliably present early on.