While many difficulties can be explained with problems in accessing lexical semantics, she concludes that grammatical errors are widespread in fluent aphasia and fluent aphasics do not always have access to or cannot apply certain grammatical operations such as checking, even though the underlying grammatical representations per se are intact.
In reviewing this book, I would like to discuss two critical issues which arise from the initial premise that fluent aphasia is a clearly definable entity to be separated from nonfluent aphasia.
Avent and Wertz (1996) reported no significant differences between adults with fluent aphasia and adults with non-fluent aphasia with regard to pragmatic performance, but did observe that adults with fluent aphasia performed slightly better than adults with non-fluent aphasia.
If, on the whole, individuals with non-fluent aphasia are considered to be better functional communicators and individuals with fluent aphasia are better or at least equal pragmatically, then an examination of the relationship between pragmatics and functional communication in relationship to language impairment is warranted.
Fluent aphasias cause a problem with comprehension but don't deprive the sufferer of the ability to speak, while the non-fluent aphasias cause slow, stilted speech in spite of various levels of understanding.