Let me introduce myself, if you haven’t read my work before now..

I am a retired speech/language pathologist. For more than two decades, I spent every workday diagnosing and treating language disorders. I have helped people with a wide variety of communication deficits. I was very good at my job.

That’s why, in spite of the fact that I’ve been out of the field for several years, I am completely confident when I write that Donald Trump is exhibiting a serious language disorder.

Let me explain.

A deficit in expressing and/or understanding language is called aphasia.The term is most often used in diagnosing people who were not born with the disorder, but who acquire it later in life. Aphasia can be caused by a head injury, a stroke or as a part of a more significant cognitive decline in older adults.

The American Speech/Language and Hearing Association describes aphasia as a deficit in a patient’s ability to communicate effectively in everyday life. It can be variable in its severity, but it always involves a diminished ability to communicate.

One aspect of aphasia impacts a person’s expressive language. This is the kind of language disorder that is more obvious to those who interact with the affected patient. The person struggles to say what they mean. They may have difficulties in expressing ideas logically and specifically They might be seen to be searching for the right word as they speak. Many aphasic people develop an overreliance on empty words and phrases. I have known patients who included a favorite phrase or two into nearly every sentence spoken, as the rote language makes it easier to get out a full thought.

Some aphasic people make up words when they can’t find the one they need. The new word might or might not sound similar to the one that is missing.

People with expressive aphasia sometimes substitute one word or phrase for a similar one (ie, saying “chicken” when they mean “duck” or saying, “off the book” instead of “off the hook.”) Their conversations may seem rambling, with rapid jumps from one topic to another without any explanation. A story can go off on any number of tangents, leaving the listener confused.

Many people with what we call “fluent aphasia” can string together a long series of words that seem to make sense until you realize that there isn’t much content there. There are lots of pronouns and adjectives, but not enough nouns to make the meaning clear.

Aphasia can impact receptive language, or comprehension, as well. Aphasic people may struggle to follow complex conversations. They often misunderstand directions or fail to grasp the meaning of a question they’ve been asked. They find it confusing when more than one person is speaking at a time, or when the topic shifts in mid-conversation.

Some people with aphasia have problems with reading and writing. They may struggle to read anything other than the simplest of texts. Their writing can contain mistakes in syntax, word order or spelling that weren’t seen in the past.

Does this sound familiar to you? It certainly should.

The President of the United States is showing every one of these symptoms.

I’ll give you some examples.

Expressive Aphasia.

The following exchange was part of Mr. Trump’s remarks to the press on August 21.

“Mr. President, are you demanding that the fed chairman lower interest rates?”

“No, I don’t demand it but if he used his head he’d lower ’em. In Germany, they have a zero interest rate and we do compete. Much stronger than Germany but we do compete with Germany. In Germany, they have a zero interest rate. And when they borrow money, when you look at what happens, look at what’s going on over there. They borrow money, they actually get paid to borrow money. And we have to compete with that. So, ah, if you look at what’s happening around the world, Jay Powell and the Federal Reserve have totally missed the call, I was right and just about everybody admits that. I was right. He did quantitative tightening, he shouldn’t have done that. He raised interest rates too fast, too furious. And we have a normalized rate, I, we call it that. And now we have to go the other direction. We’ll see if he does that. If he does it, you’ll see a rocket ship, you’ll see….. And if he doesn’t, we have a very strong economy.”

“But we could have. We could be, we could be in a place that this nation was seldom at if we had interest rates cut by the federal reserve. The Federal Reserve has let us down. They missed the call. They raised it too fast and they raised it too high and they did quantitative tightening and they shouldn’t have done the tightening and they shouldn’t have raised them to the extent that they did. We could have had some raising but nothing like what they did.”

“Mr. President, what happened to your strong appetite for background checks?”

“Oh, I have an appetite for background checks, we’re gonnna be doing background checks. We’re working with Democrats, we’re working with Republicans. We already have very strong background checks but we’re gonna be filling in some of the loopholes, as we call them at the border, and speaking about at the border, it would be really nice if the Democrats would indeed fix the loopholes because it would be really nice. But despite that, I want to thank Mexico. They have 26,000 soldiers at our border and they’re really stopping people from coming in.”

“But what does that have to do with background checks and guns?”

“So what happens is….with background checks….we’re dealing with Republicans, we’re dealing with Democrats, we’re dealing with the NRA, we’re dealing with gun owners, we’re dealing with everybody. And I think we’re gonna have something hopefully that’s meaningful.”

Note the repetition of phrases in this small sample. “We’re dealing with” and “we’re working with” were used over and over, with no description or clarification. Does he mean that he is meeting with those groups, or that he is making deals with them or something else? My impression is the President relies heavily on memorized phrases, which are easy to pull out and use.

Watch any of Trump’s unscripted remarks and try to count how many times he says, “We’ll see what happens.”

Note the word “raising” in the phrase “We could have had some raising.” The meaning is clear, but the word choice is troubling to this language specialist. We would expect the President of the US to say, “We could have had an increase.”

I’m sure you also noticed the rapid and inexplicable jump from the topic of background checks to that of the Mexican army at the border. It’s as if the word “loopholes” triggered a thought of the border crisis for some reason and that thought let made Trump jump completely off the track of the question.

Look at the discussion of Germany. Trump says,

“In Germany, they have a zero interest rate and we do compete. Much stronger than Germany but we do compete with Germany.”

What’s much stronger than Germany? We can make a guess that he’s referring to our economy, but the language of the sentence is clearly abnormal. In English, we don’t use a comparative like “much stronger” without including the referent.

Then there is the repeated phrase “missed the call”. We have a few idioms that are close to this one (“missed the boat” or “missed the mark” come to mind.) But we don’t say “missed the call” unless we mean a phone call. Or we’re referring to a sports referee.

Receptive Aphasia

Do you recall when the President recently met with religious refugees in the Oval Office? The following exchange happened between Trump and a young Yazidi woman.

“All this happened to me. They killed my Mum, my six brothers, they left behind them… “

“Where are they now?”

“They killed them.”

She told him that her family had been killed. He asked “Where are they now?”

He did not have the slightest understanding of what she’d said.

We saw the same lack of comprehension this week when Trump was asked about having second thoughts on his trade war with China.

“Mr. President, do you have any second thoughts about escalating the trade war with China?”

“Yeah. Sure. Why not? Might as well, might as well.”

Once again, he completely failed to understand the question. A question which was then repeated by a different journalist, to which he replied,

“I have second thoughts about everything.”

Did he even understand the meaning of “second thoughts”? I am not at all sure.

Reading and Writing

Donald Trump is well known for his aversion to the written word.

When Rex Tillerson, the former Secretary of State, spoke about his time at the White House, he said that Trump didn’t like to read. Tillerson was told that the President would not be reading the usual briefing notebook each morning, but instead would only accept bullet points or charts.

Mr. Trump himself has stated that he doesn’t like to read. In an interview with Axios shortly after his inauguration, Trump said that he doesn’t like to read, preferring bullet points to full essays.

“I like bullets or I like as little as possible. I don’t need, you know, 200-page reports on something that can be handled on a page. That I can tell you.”

Although he is the author of several books, we know that each had a ghostwriter. Trump claims to have attended the best of schools, but has never let his school records be made public.

So.

I say all of this because it brings up the diagnostic question of whether or not the man has always struggled with reading and writing, or whether this is a new phenomenon.

Whether or not that disorder is progressive is difficult to say but when I analyze his conversations from years ago, I believe that it is. His past interviews were far more coherent and much more linguistically sophisticated than what we hear now.

Whether or not the language disorder is developing as part of some type of dementia is up to a neurologist to diagnose.

I am not qualified to say whether or not Donald Trump has a personality disorder or a mental illness. But I am qualified to say that when I listen to him speak, I am increasingly convinced that he has significant aphasia.

What I know is this. Something is most assuredly amiss in the brain of the President of the United States. And he is the one with the nuclear codes.