The occurrence of paraphasias in the spontaneous speech of children with an acquired aphasia

Two children with an acquired aphasia were observed during the recovery process. In the spontaneous speech, paraphasias belonging to different categories, such as neologisms, verbal paraphasias, and literal paraphasias, were found. Especially with regard to neologisms the time of investigation was very important. In addition, one child with a phonemic jargon aphasia and one child with a fluent aphasia and empty speech were observed. These observations implicate a modification of the current clinical picture of childhood aphasia. Some aspects are discussed in relation to adult aphasia.     

Neologistic jargon aphasia: A case report

This study examined aspects of speech produced by an aphasic subject with neologistic jargon. Grammatical category, syllabic structure, and phonemic characteristics of neologisms, paraphasias, and correct productions were analyzed and compared. Results tended to confirm an anomic component in this type of aphasia and to support a role for the postactivation of phonemic units from prior utterances in the phonemic composition of some neologistic productions. In opposition to prior claims, however, the results also showed a striking similarity between neologisms and paraphasias, suggesting that similar mechanisms may be involved in both types of aphasic error.     

A computational account of deep dysphasia: evidence from a single case study.

We present a case study of a patient, NC, who demonstrates the defining characteristics of deep dysphasia including semantic errors in repetition and an inability to repeat nonwords. In addition, NC's single word repetition and lexical decision performances are influenced by the imageability of the word input. NC also demonstrates a severely restricted phonological short-term memory (one digit, one word). Although his phonological discrimination is good in a minimal pairs judgment task, it becomes impaired when a delay is imposed or rehearsal is prevented between presentation of each member of a pair. NC's output is fluent but contains many formal paraphasias and neologisms. NC's total language profile is evaluated within the framework of Dell's (1986) interactive spreading activation model of language production. Adapting this output model to input processes, we account for all of NC's deep dysphasic symptoms as well as his pattern of production in a way that is more parsimonious than other attempts to model this disorder. In particular, we suggest that the semantic and formal paraphasias in naming and repetition result from a pathological increase in the rate of decay of primed nodes in the semantic-lexical-phonological network. This rapid decay increases the probability that phonologically and/or semantically related lexical nodes primed by top-down and bottom-up feedback during the operation of lexical activation and retrieval will be activated and selected instead of the lexical target. The advantages of using this model to account for aphasic symptoms and the implications for other lexical theories are discussed.     

The selective impairment of phonological processing: A case study

A case study is reported of an aphasic patient with fluent speech and markedly superior comprehension of written vs. spoken words. Results of extensive testing supported the hypothesis that the patient suffers from a phonological processing deficit that affects performance in all tasks that require the generation of a phonological code. This selective deficit is interpreted as the underlying cause of diverse symptoms such as asyntactic comprehension of written sentences, the commission of spelling errors in writing, and the production of literal paraphasias and neologisms in spontaneous speech. Alternative possibilities for the classification of this patient are discussed.     

Schizophasia and jargonaphasia : A comparative description with comments on Chaika's and Fromkin's respective looks at “schizophrenic” language

Different varieties of deviant spoken language segments (phonemic, morphemic, verbal, and syntagmic paraphasias and télescopages, neologisms) and different forms of deviant spoken language behaviors (thematic production, dyssyntaxia, glossolalia, and glossomania) are defined and exemplified. Their production is shown to be rule-governed at phonetic and phonological levels; it is shown to be rule-governed or rule-deviant at morphological and/or syntactic levels. Their qualitative and quantitative attributes in normal discourse in the jargonaphasias and in schizophasia are compared. It is underlined that the latter is a behavior episodically observed in only a small proportion of subjects considered to be schizophrenics. Awareness of, and deliberateness in, deviant language production are discussed. A distinction is made between deviations testifying to diminished ability, which betray the speaker's intention, and deviations testifying to singular but rigorous use of ability, which are adapted to the speaker's intentions. The former are contended to be common in the jargonaphasias and occasional in standard discourse and schizophasia, the latter to be characteristic of schizophasia and of various forms of “literary” language, but incompatible with aphasia. In lapidary terms, this implies that ordinary speakers think and talk standard, that (most) jargonaphasic speakers think standard but talk deviant, that schizophasic speakers think quaint and talk accordingly. It is further suggested that the differential diagnosis of jargonaphasia and schizophasia, when made on the sole basis of tape recorded samples of discursive language, resorts mainly to quantitative appraisal of different types of deviant segments on one hand, and, on the other, to the listener's interpretations of the speaker's mode of ideation. Within the realm of pathological language production, nearly exclusive and important production of phonemic transformations is said to be characteristic of conduction aphasia; combined production of numerous phonemic and verbal transformations, and of neologisms, is said to be characteristic of Wernicke's aphasia proper; nearly exclusive and important production of verbal transformations is said to be possible in so-called transcortical sensory aphasia; and predominant production of morphemic transformations and of glossomaniac utterances is said to be characteristic of schizophasia. Linguistic definitions of the “disturbances” behind schizophasic utterances are reviewed. Indications are given concerning the evolution of language behavior in jargonaphasia and schizophasia.     

Hesitation and the production of verbal paraphasias and neologisms in jargon aphasia.

Techniques of hesitation analysis taken from studies of normal speakers were applied to the speech of a jargon aphasic. Neologisms were found to follow pauses indicating a word-finding difficulty. Other language functions—phonology, morphology, and syntax—appeared unimpaired, and further analyses of the linguistic and temporal characteristics indicated a single functional disorder in which there is a failure in the mechanisms which associate word-sounds with word-meanings. The patient strategically adapts to this functional impairment by substituting a neologism when lexical search fails. The source of a large class of neologisms, it is hypothesized, is a device which quasirandomly combines English phonemes in a phonotactically regular way. The implications for recovery patterns in jargon aphasia are discussed; and the implications of this case for models of normal language production are explored.     

A case of thalamic aphasia with postmortem verification

This study discusses a case of aphasia after dominant thalamic lesion, a hemorrhagic infarction. Unlike other such cases, both repeated standardized assessment and postmortem verification were available. The patient was assessed at 3 weeks and again at 9 weeks postonset. The aphasia demonstrated the syndrome common to dominant thalamic hemorrhage: fluent but paraphasic output sometimes deteriorating to jargon, comprehension less impaired than this type of output usually indicates, and the least impairment in repetition. As sometimes reported in previous cases, semantic paraphasias were more common than phonemic paraphasias. The lesion was located in the dorsal aspect of the lateral nucleus, but it extended into the pulvinar, including the anterior superior lateral aspect which has been implicated in language by previous studies. Thus, data from this case are consistent with an involvement of the dominant pulvinar in language and suggest that this role involves the semantic aspects of language.     

Phonological transformations in conduction aphasia

Different explanations and subtypes of conduction aphasia are analyzed. Characteristics of literal paraphasias in parietal-insular conduction aphasia are discussed, emphasizing that paraphasias in conduction aphasia are articulatory-based (articulatory literal paraphasias) and due mainly to phoneme substitutions and phoneme deletions; they result basically in switches in phoneme manner and place of articulation. Similarities between errors in ideomotor apraxia and conduction aphasia language deficits are presented. It is proposed that language deviations (in oral as in written language) in conduction aphasia can be understood as a segmentary apraxia of speech.     

Dissociation between linguistic and nonlinguistic gestural systems: a case for compositionality.

This paper addresses the issue of the separability of disorders of sign language from disorders of gesture and pantomime. The study of a left-lesioned deaf signer presents one of the most striking examples to date of the cleavage between linguistic signs and manual pantomime. The left-hemisphere lesion produced a marked sign language aphasia disrupting both the production and the comprehension of sign language. However, in sharp contrast to the breakdown of sign language, the ability to communicate in nonlinguistic gesture was remarkably spared. This case has important implications for our understanding of the neural mediation of language and gesture. We argue that the differences observed in the fractionation of linguistic versus nonlinguistic gesture reflect differing degrees of compositionality of systems underlying language and gesture. The compositionality hypothesis receives support for the existence of phonemic paraphasias in sign language production, illustrating structural dissolution which is absent in the production of pantomimic gesture. Understanding the neural encoding of compositional motoric systems may lead to a principled anatomical account of the neural separability of language and gesture. This case provides a powerful indication of the left hemisphere's specialization for language-specific functions.     

Deep dysphasia: An analog of deep dyslexia in the auditory modality

A right-handed patient, with two left hemisphere lesions, a small one in the prefrontal lobe and a larger one in the temporal, presents an unusual syndrome: a massive deficit for oral language (expression and comprehension) contrasting with a fairly good preservation of written language (expression and comprehension). The processing of isolated words and sentences has been extensively tested with repetition and dictation tasks. The patient performs rather well with nouns, verbs, and adjectives, poorly with adverbs and function words, and completely fails with nonsense words. A remarkable feature of his repetition is the frequency of semantic paraphasias. Thus, this patient exhibits a behavior rather similar to deep dyslexia, hence the possible label "deep dysphasia." The paper presents a "preunderstanding" hypothesis to account for such behaviors.     

Language and speech recovery in a case of viral encephalitis

The speech and language recovery course of a 47-year-old man with viral encephalitis is described. Over a 3-month period, the patient was evaluated six times using the same selected battery of tests. Results show that viral encephalitis can deleteriously affect communicative performance and that improvement in medical status is accompanied by rapid and dramatic gains on most standard speech and language measures. For this case changes appeared related to improved auditory attention and retention, increased efficiency in word retrieval, and improved mental status.     

A study of language functioning in Alzheimer patients

Language functioning in Alzheimer's disease is reviewed and the performance of 25 Alzheimer patients on a standard battery is reported. All these hospitalized patients were aphasic to some degree. As a group, they differed from normals on all language variables, and from stroke patients in terms of higher fluency and lower comprehension. Spontaneous speech showed high incidence of circumlocutions and semantic jargon, but no phonemic paraphasias or target approximations. Syllabic perseverations, shouting, inappropriate laughter, and mutism were late-appearing features. Transcortical Sensory, and Wernicke's aphasias were frequent, but Broca's and Transcortical Motor aphasias notably absent. Extent of language impairment correlated with current length of hospitalization but not age. Reading, writing, and performance scores except praxis, were lower than oral language scores. Findings were discussed in relation to previous results, methodology, and language organization in the brain.     

The QWERTY Effect: How typing shapes the meanings of words.

The QWERTY keyboard mediates communication for millions of language users. Here, we investigated whether differences in the way words are typed correspond to differences in their meanings. Some words are spelled with more letters on the right side of the keyboard and others with more letters on the left. In three experiments, we tested whether asymmetries in the way people interact with keys on the right and left of the keyboard influence their evaluations of the emotional valence of the words. We found the predicted relationship between emotional valence and QWERTY key position across three languages (English, Spanish, and Dutch). Words with more right-side letters were rated as more positive in valence, on average, than words with more left-side letters: the QWERTY effect. This effect was strongest in new words coined after QWERTY was invented and was also found in pseudowords. Although these data are correlational, the discovery of a similar pattern across languages, which was strongest in neologisms, suggests that the QWERTY keyboard is shaping the meanings of words as people filter language through their fingers. Widespread typing introduces a new mechanism by which semantic changes in language can arise.     

Formal paraphasias: A single case study

A case study is reported of an aphasic patient, RB, who showed frequent form-related whole-word substitutions in oral naming, writing to dictation, and reading aloud. In both written language tasks, the abstractness of the targets influenced the number of formal errors. In oral naming, a high proportion of formal paraphasias was related to the intended words in both form and meaning. A comparison between targets and formal paraphasias indicated a high agreement both in word class, number of syllables, stress pattern, and in basic (stressed) vowels. The agreement in consonants (including word-initial consonants), however, was low. It is argued that RB's formal substitutions are not caused solely by errors of lexical selection but that semantic, lexical, and segmental factors contribute to the error outcome.     

Paragrammatic speech without a comprehension deficit? A case report

In this article we present a case report of a patient, who had a peculiar pattern of language use following a stroke. The two most prominent features were language switches during spontaneous speech in the first months postonset, when the patient mixed English, German, and French words and utterances into his mother tongue (Dutch); clearly disturbed speech output, showing signs of word-finding problems and paragrammatism but hardly any paraphasias, while at the same time no evidence of a language disturbance could be obtained with standard clinical aphasia tests.     

Acute conduction aphasia: an analysis of 20 cases

In this study, the linguistic performance of 20 patients with acute conduction aphasia (CA) is described. CA presented as a relatively homogeneous aphasic syndrome characterized by a severe impairment of repetition and fluent expressive language functions with frequent phonemic paraphasias, repetitive self-corrections, word-finding difficulties, and paraphrasing. Language comprehension as assessed by tests of auditory and reading comprehension was only mildly impaired, whereas most patients performed poorly on the Token Test. Verbal-auditory short-term memory was reduced in all patients except one and seems to play a role in associated cognitive deficits, such as impaired syntactic comprehension or reduced mental arithmetics. A follow-up examination of 12 patients showed that CA often resulted in a chronic language deficit. Lesion locations were the posterior temporal and inferior parietal lobe.     

Two syndromes of aphasia occurring with ischemic lesions involving the left basal ganglia

Seven aphasic patients with circumscribed left basal ganglia infarctions were investigated within the first 15 days after their strokes. Five showed transcortical motor aphasia initially. Two patients suffered from anterior chorioideal artery infarction. As this vessel does not contribute to cortical supply, cortical malfunction probably cannot account for the language deficits. Patients with infarctions in the supply area of anterior lenticulostriate arteries became fluent with frequent phonemic and semantic paraphasias resembling Wernicke's aphasia. Three of four patients showed transiently more pronounced deficits in auditory than in written-language comprehension.     

Linguistic analysis of a bilingual stutterer

The ultimate test of the adequacy of linguistic models of fluency breakdown is the degree to which they may account for patterns of dysfluency in the speech of a stutterer who is fluent in more than one language. We present the case of an adult bilingual stutterer (Spanish-English), whose spontaneous language in both Spanish and English was structurally analyzed to assess the relationships of phonological and syntactic structure to the frequency and location of fluency breakdown. Our findings suggest that syntax is probably a greater determinant of stuttered moments than is phonology. Additionally, similarities and differences between English and Spanish sentence structure were associated with similarities and differences in the loci of dysfluencies across the two languages. The need for crosslinguistic research utilizing monolingual and bilingual speakers of languages other than English is emphasized.