The nature of internal speech representation in a stroke patient with oral apraxia and a severe articulatory deficit was studied. Despite her total inability to speak, this patient, like normals, processed visually presented verbal material by transforming it into an acoustic-articulatory code, as shown by the nature of her errors in cancelling out or recalling printed letters. The results of visual rhyming tests demonstrated her ability to form and compare internal acoustic images of words. The findings are discussed with respect to the role kinesthetic feedback from the speech musculature has in the regulation of internal language.