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June 24th, 2010
11:03 AM ET

Why am I mixing up my words? Is this a learning disability?

As a feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here's a question for Dr. Gupta.

From Matthew, Mount Laurel, New Jersey

"I'm 45. Don't smoke, drink. Married since '93. Have 11-year-old sons, both diagnosed with Asperger's but mainstream and doing fine. Over the past year or so, I've caught myself saying a similar word to the one I'm thinking. Talking about pouring a "box" instead of bowl of cereal. Calling the boys down for "breakfast" instead of dinner. Reminding them to eat their "hot dog'"when they're clearly holding a hamburger. My family notes when this happens and it's worrying me. My wife (a special ed teacher) believes it's a learning disability and it's just becoming more pronounced as I age. I did go to speech lessons in elementary school. Does this sound like anything to look into?"

Answer

Language issues like the ones you describe, Matthew, can be relatively innocuous or they may be subtle, early clues about more serious problems occurring in the brain, such as a tumor or infection. You cannot be sure until you are checked out by a doctor, but what you are describing can occur in a brain disorder called aphasia or dysphasia.

It occurs when there is damage to regions of the brain that control language. According to the National Aphasia Association, about 1 million people in the U.S. deal with some form of aphasia. More specifically, your symptoms sound like something neurologists call semantic paraphasia. That is, substituting the word you intend for one that has a similar meaning.

"The word you're substituting is still within the context of the word you mean to say," said Dr. Olajide Williams, a neurologist at Columbia University Medical Center. "Instead of saying 'clock' you say 'watch' or instead of saying 'dinner' you say 'lunch.' Instead of saying 'spoon' you say 'fork,' and on down the line."

Semantic paraphasia is usually due to sudden brain trauma, such as a stroke or a blow to the head. Your symptoms sound different - like they have developed gradually. According to Williams, that would rule out a stroke, which typically occurs suddenly.  And he says that speech problems related to semantic paraphasia usually happen alongside other communication problems involving writing, reading, repetition and comprehension.

In your case, that may or may not rule out semantic paraphasia. What is left are a host of other possibilities. Neurodegenerative disorders, brain tumors, and brain infections affecting language areas of the brain could also be to blame.

Now before you become too concerned, you should follow your instinct and look into this further. Seek the advice of a neurologist, who will most likely give you a comprehensive language exam. The exam involves an evaluation of your speech - from basics to more complex tasks. You may also be tested for reading, writing and grammar to try to pick up brain abnormalities.

An important part of this complex equation is that you have had your symptoms for a relatively short period of time, so if there is a problem, you have a better chance of addressing it.

Good luck Matthew.


soundoff (32 Responses)
  1. Janet L

    My mom is 80 yo and for the past five years has been complaining of a salty taste in her mouth every day. It prevents her from eating so she has lost at least 14lbs. She also is nauseous, weak and suffers from insomnia all the while.
    She worries about it a lot; she has spoken to her gastro, PCP, dentist, ENT doctors about it and they have no solution. She has done endoscopy, colonoscopy, mri, dental checks, ent tests, etc and nothing.
    She has HBP, cholesterol, back and knee pain, acid reflux,and takes meds for all of them – benicar, actonel, prevacid meds, simvastatin or zocor (cannot remember).
    She has been tested for Sjogren's – negative.

    I say it's the side effects of one or some of her meds.
    Drs. say maybe not but offer no solution and dismiss her.
    One told her it is dysgeusia. It is, but what is causing it?
    Meanwhile she is desperate, loses sleep, and ruminates about it all day and always feels weak and tired and nauseous.
    Do you have any thoughts, because it is driving me and her crazy.
    Thanks in advance.

    June 24, 2010 at 13:25 | Report abuse | Reply
  2. For Janet

    Janet, the doctors don't answer questions here.
    Try a search for health message boards on the Internet, where there are message boards for the public to help eachother out with questions like yours. Good luck.

    June 24, 2010 at 17:33 | Report abuse | Reply
  3. Laura

    I guess Matthew can follow up with those expensive brain scans if he has insurance and doesn't lose his job!

    June 24, 2010 at 18:49 | Report abuse | Reply
  4. wtkueh

    Coincidentally, I have noticed that I am doing the same thing in the last couple weeks. What is in my head isn't coming out of my mouth correctly. For instance, rather than saying July, August, Sept I say October, November, December. It's usually when I am preoccupied or multi-tasking. Is that just normal rather than something to be concerned with?

    June 24, 2010 at 20:32 | Report abuse | Reply
  5. marla

    I have been taking medications since 1975, and I have had some medications that caused me to have drug intoxication. The first thought that came into my mind, is your mother getting enough potassium? Is she drinking enough water? When I had to make sure that my mother could keep all of her meds together, I used a plastic zip up bag. The kind of bag that curtains are in when you buy them. Take all of her meds when you see the doctor so they can evaluate them. If you are not satisfied with the doctor, ask a trusted Pharmacist about side that side effect. Is your mother seeing a doctor that qualifys to work with older people. My mother had a dr. that constantly changed her medications; she has had an assistant in another state take her off of all her meds and she has high blood pressure. In my experience with drs years ago, I found that sometimes if the medicine is doing what it is supposed to they over look some problems with a drug. Keep up you search for an answer that you can live with.

    June 24, 2010 at 23:51 | Report abuse | Reply
    • Jen

      Wow, Maria! Thank you! I was just talking about the fact that for about the past 10 years, my memory is getting worse – but only with speech! I didn't realize it could be nutrition. I'm 48. I don't drink enough water. I don't get enough potassium. And I have been on morphine for about 18 years!!! (I have a pain syndrome that requires I take hard drugs, or I can't function at all.) It makes me wonder about it all, whether it's the morphine (which, by the way, is making my teeth decay) or perhaps the nutrition is causing it - or both! But thanks to the suggestions here, I'm going to give it a shot. Again, thank you.

      September 11, 2014 at 14:13 | Report abuse |
  6. marla

    When I was a child, I used to play tent. My great-grandmother used to hang her quilts out to air on a post that was partially on the fence and the other end on the side of the smokehouse. I didn't realize that it was dangerous. I was under the quilt, the post fell and hit me on the top of my head. It was the worst pain that I have every felt. I don't believe that I had a concussion; I don't remember being sleepy or anything else. When I was taking norpace, dilantin, inderal, and prednisone, I was working and in my thirties. I could not input the report that I did every morning on the computer without a stenopad. I had to list by number each step. I never mentioned it to my drs because I felt that it would be pooh-poohed. In order for me to remember things that I had to do: appts., out of the office things when I was working I use to write with a magic marker and tape it in front of me. Sometimes I find that I have to search for the correct word, especially when I am talking about the cordless phone. I called it the walk about phone. I had a dizzy spell and the diagnosis has something to do with my inner ear. I was taking therapy and pills. I cannot have an MRI because I have a medical device for the heart. The cat scan showed some deterioration of the brain. The dr. said that if I could take an MRI , it probably would show up as nothing. He was not too concerned because my walking was ok while I was in the office. Basically, it comes and goes. I wonder about my use of or search for a word.

    June 25, 2010 at 00:17 | Report abuse | Reply
  7. Karen

    My Husband does this. He is 34 years old and I have noticed this more in the past year. He says these are blackberries instead of blueberries. He called daisies roses. He does this with all sorts of different things. I always think it's just stress or the kids talking that makes him get confused. But now that I have read this article maybe we should look into what's happening. Any advice?

    June 25, 2010 at 08:18 | Report abuse | Reply
  8. Amy

    Actually, because there is not stroke or other brain injury, its sounds like it could be Primary Progressive Aphasia (PPA). Definitely mention this to your neurologist. You can also find more information about PPA from the National Aphasia Association's website.

    June 25, 2010 at 09:39 | Report abuse | Reply
  9. inAZ

    I am in my 40's and have the same situation with mixed words or being in mid sentence and getting "brain fog". Get your thyroid checked! It is a hypo and hyperthyroid symptom and if your blood test shows a problem, it will get better in time. My issues have largely cleared up now.

    June 25, 2010 at 16:29 | Report abuse | Reply
    • High Pr. Karus

      It CAN be a thyroid problem. One of his children has autism; this is COMMON with autism. Why was that left out in the doctor's response? It's OBVIOUS.

      February 22, 2011 at 11:43 | Report abuse |
  10. Steve H.

    Dr.
    I have been informed that I have White Matter Disease, they tell me not to worry then have me take a mri every 6 mths
    i find while speaking i become losted for words, walking slight tilt stumble, memory loss both short and long term.
    Is this a prelude to a stroke

    I would really enjoy hearing back from You.

    Thanks,
    Steve H.

    July 1, 2010 at 09:48 | Report abuse | Reply
  11. HH

    I have aphasia due to migraine. I think clearly while this is going on, and I know what the right words are.....but I say something else instead. Communication is very frustrating while this is going on. I can think, but not verbalize. I get on the computer, or write, to communicate when this happens.

    Had an EEG that came back normal. Can't afford the other tests the doc wants me to have. The office visit alone is a sixty dollar copay.

    July 9, 2010 at 08:43 | Report abuse | Reply
  12. hillbilliter

    I have this too, especially while having a migraine, and it has been getting worse over the past 10 or so years. I have Lupus and learned that a lot of Lupus patients have to learn to deal with strange neurological quirks. Lately, not only my language has been affected, but my eyesight – unlike the flashes and empty spots that occur during migraines, I sometimes experience transient loss of focus, or uneven focus. One eye will focus itself at about two feet and the other will not focus in sync with it. The other eye will focus somewhere across the room. It's really disorienting and I have to lay down and cover my eyes until it goes away, but while this is going on I can still speak properly, unlike during the migraine episodes.

    July 9, 2010 at 18:14 | Report abuse | Reply
  13. Z

    I have always done this to a small degree. Typically, the word just plain won't come out and I start spitting out other words or gibberish (or making hand motions) until I get it. As I've gotten older (27), I've noticed that this has become a little bit more pronounced. I believe that this is merely because I'm taking notice of what is going on rather than ignoring it or getting lost in the moment. I was diagnosed with ADD at 25, and I have since come to realize that this is related. I also tend to be a little bit visually dyslexic as well.

    For the person questioning Dr. Gupta, my advice is to just follow your instincts.

    July 15, 2010 at 19:04 | Report abuse | Reply
  14. Claire

    My cousin says she started not being able to remember words in her mid-50s. She says sometimes a word flits through her consciousness, but leaves before she can focus on it in order to use it. I have a male cousin in his mid-50s who says the same thing is starting to happen to him. That seems early to me for one to begin to have memory loss. I'm concerned it's some genetic issue that I may eventually face.

    July 21, 2010 at 16:01 | Report abuse | Reply
  15. High Pr. Karus

    If someone sharing his DNA has Asperger's, this could just be another part of it. I don't know why the doctor who answered this didn't put that in there.

    Neurological differences are normal in people with Asperger's, and though he may not have it, at least one of his close family members does... so I doubt it is anything to worry about.

    I have both.... and all I can do is laugh off saying the wrong word. If anyone makes fun of me, I tell them to stop being an ass.

    February 22, 2011 at 11:33 | Report abuse | Reply
  16. JB

    Dear Matthew,

    could you let us know how it went with this problem and if you've done any further testing.

    Thanks you
    JB

    October 18, 2011 at 02:12 | Report abuse | Reply
  17. Linda A.

    I am almost 62. In the last 6 months I have been mixing up words, having to write everything down, forget to drop things off after just leaving home with the item in my car to be dropped off. Are there prescription meds that can cause this if taken long term? This is of great concern to me because my mother has Alzheimers.

    March 9, 2012 at 14:40 | Report abuse | Reply
  18. Jennifer

    I am 39 and every once in a while I will say a completely wrong word.... and have no idea where it came from. I have always done this once in a while. For instance around the fifth grade I told my friend, "My dad plays a baton." when I meant guitar. It happens a little more frequently now and once in a while while I'm singing I will say very wrong words and don't know where they come from (I sing a lot... and I know that people usually have less trouble with language problems while singing... just reporting what happens with me). The other day I told a client that we needed to go around to the other window so that we wouldn't knock the guy off the hammer... but I meant ladder. It's embarrassing. Doesn't happen often. Maybe a couple of times per month that I would have something THIS wrong slip out... and hammer was nowhere in my conscious mind... freaky. I would love someone to tell me this is normal. My grandmother has Alzheimer's disease and two other grandparents suffered for a while with dementia. I'm worried it will keep getting worse but maybe I am worried for nothing?

    March 29, 2012 at 09:39 | Report abuse | Reply
  19. joyce

    I have the same problem. MD just prescribed the Alzheimer's drug "aricept", which kind of freaked me out. Not sure I want to take it, she said it should help the "neurons in my brain" fire more effectively. I am not forgetful, but for the last 5-6 years (since late 40's) I have had this issue mixing up names of things or just taking a while to "retrieve" the correct name. My dad used to have the same issue, which I assumed was because English was his second language–but maybe not so much!
    Some of my other middle aged friends report the same issue, hope it isn't early onset dementia!

    June 29, 2012 at 21:09 | Report abuse | Reply
  20. Christine

    I have been having earaches and jaw, throat pain, originating from my ears ofr about 4 months. Saw a doctor 21/2mths ago. He saw nothin gin my ears but thought of it as an inner ear infection as I was having super spins when laying back and getting up fromlaying down. Eventually I couldn't bend over b/c of the pain and pressure. Went on Amoxicillan for 10 days..got better but never went away. Bothers me everyday. Now these last few days I've been spellling mixed up and missing letters. i.e. man..anm. I'm doing it 4-5 times in one email and have to slow down to concentrate on each letter. I also having ringin in my ears at night. Please help

    December 24, 2012 at 20:48 | Report abuse | Reply
    • Gloria

      You have Vertigo! I have it, it comes when the seasons change due to the tilt of the Earth from winter to spring and from fall to winter. You have to do an epley maneuver to correct this problem depending on which side it's on. Amoxicillin work for the sinus pressure and infection, but not the dizziness and nausea. Look up epley maneuver on youtube because you can do it on yourself with someone helping.
      Sorry so late...I just found you!

      April 12, 2013 at 12:58 | Report abuse |
  21. Rosemary Parisi

    I was at a party (not drinking) and I have back problems. I thought I said "I need to go to a good chiropractor" Everyone just looked at me. When I said what was wrong they said questioningly that I said "I need to go to chior practice. (which I don't)
    Everyone had a good laugh but it frightened me. I made another mistake and they said I said Elvis (can't remember what I was trying to say. I get words and names very confused. I have been on the following for several years. Xanax, buspurone, effexor and for sleep Trazadone and Melatonin because the Trazadone didn't keep me sleeping all night. Can someone help me.

    July 8, 2013 at 18:51 | Report abuse | Reply
  22. Anu

    i have a problem of mixing up of words or letters especially when i talk fast or when i'm tensed. Like, for "handkerchief" i might say "handcherkief". This problem is putting me into trouble when i give a speech or take seminar. Is there any way i can get rid of this.Seeking help!!!!

    September 5, 2013 at 03:06 | Report abuse | Reply
  23. joan hoick

    I too am surprising myself with what I say as opposed to what I mean...sometimes it is "paraphasia" with a similar word and often it is no word at all. I will be in the middle of telling someone something and when I get to the one word I need to make any sense....poof! it is not there. So I play "senior charades" in that I try to describe what I am trying to say while my listener stares at me in confusion. I am 81 and left handed if that helps.

    November 13, 2013 at 11:01 | Report abuse | Reply
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    )Despite the negative overall assessment,” (For polling on that trend, Id save a weeks mailing time by handing Lee a stack of roughs to edit whenever he swung through the area on a business trip.Because I admired and respected so many of Universals strips,According to agency officials, but many riders said they were frustrated and others confused as to where to go. Free. 301-774-8881. 9, made with soy cheese.

    November 27, 2013 at 23:36 | Report abuse | Reply
  25. shiny

    i find myself saying i got a pain in my hand when actually the pain is in my leg. Certain times i know what i want to say but the words don't come to my mouth. what could that be. Is it a symptom of a tumor in the brain ?

    May 17, 2014 at 17:06 | Report abuse | Reply
  26. Christina

    I have been having the same issue. One example is saying "brooming" instead of "sweeping". I have also been diagnosed with cervical spinal stenosis (c5, c6, c7). Could these 2 be related ?

    July 24, 2014 at 15:39 | Report abuse | Reply
  27. Maddie

    I had this for my entire life, now I'm 24 but I recall having this problem since forever. Examples: I say skirt instead of dress, down instead of up, kitchen instead of bathroom etc but only while speaking, when I am writing I have no problems choosing the correct word. And since childhood I tend to speak very fast. I am worried... (sorry for my english, I am from Romania).

    October 9, 2014 at 12:25 | Report abuse | Reply
  28. Maddie

    PS: Strange or not, I have less problems while I am at an interview. When I'm attending an interview and I know I have to impress I speak clearer, slower, and find my words perfectly.

    October 9, 2014 at 12:28 | Report abuse | Reply

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