A patient sits through an entire interview producing no spoken words whatsoever, not even a single sound, despite appearing to understand and attend closely to everything said to him, though he does eventually communicate a brief message by writing on paper. Before revealing the answer: is this expressive aphasia?
No, this is more consistent with mutism than with expressive aphasia. Expressive aphasia typically retains at least some limited speech output, however reduced; here, there is a complete absence of any spoken output at all, with communication occurring only through writing, which is the defining pattern of mutism rather than expressive aphasia.
References
- Casey, P. & Kelly, B. (2019). Fish's Clinical Psychopathology, 4th ed. Ch. 4, 'Disorders of Thought and Speech'.