A patient's spoken output is severely reduced. Before revealing the answer, decide what distinguishes expressive aphasia from mutism.

Ask whether any spoken output at all is present, however limited. Expressive aphasia differs from mutism in that some speech output, however limited, is typically still present, including expletives or fixed utterances under emotional stress; even in severe cases, a few words, expletives, or fixed 'recurring utterances' can usually still be produced. Mutism, by contrast, is a complete loss of speech, with no spoken output produced at all, though the person may communicate through gesture or writing instead. The presence of at least some limited spoken output, however reduced, versus a complete absence of speech, is the key distinguishing feature between the two.