The semantic organization and classification of fourteen words by aphasic patients

The purpose of this study was to assess both conceptual knowledge and classification skills in nonfluent and fluent aphasia by focusing on the aphasics' appreciation of class and function relations. The results illustrated that fluent and nonfluent aphasics appreciated both class and function relations. However, further study revealed that even though the fluent aphasic may know the function of an item, he is impaired in his ability to use this information. The nonfluent aphasics also illustrated this tendency not to use their knowledge about function, but to a lesser extent and without the consistency found in the performance of fluent aphasics.     

Semantic classification in aphasia: A study of basic, superordinate, and function relations

Nonfluent and fluent aphasics were given classification tasks that required the aphasics to identify three kinds of relations: same basic level category, same superordinate level category, and same function. The subjects received the items in word and picture form. In addition the aphasics were required to name the items they were asked to classify. The results showed that the ability to classify is more disrupted in fluent aphasia than in nonfluent aphasia. Within fluent aphasia, the degree to which classification is disrupted is dependent upon the type of relation being tested. While the overall performance of the fluent aphasics was depressed in comparison to nonfluent aphasics, it was significantly more depressed on function relations. The ability to name an item had a significant effect on the ability to classify only for basic level items.     

An Acoustic Analysis of Rate of Speech Effects on Vowel Production in Aphasia

The present investigation examined the production of tense and lax vowel duration differences at two speaking rates in the speech of 10 nonfluent aphasics, 8 fluent aphasics, and 10 normal control subjects. Subjects produced four repetitions of each of the vowels [i e æ o u I ε υ Λ] at each speaking rate. Acoustic analyses revealed that subjects in all three groups were able to manipulate overall rate of speech. In addition, normal controls and fluent aphasic subjects produced vowels under the fast rate condition which were significantly shorter than those under the slow rate condition. Despite a change in overall speaking rate, the nonfluent aphasics did not exhibit a significant difference in vowel duration at the two rates of speech, suggesting a deficit in the implementation of this temporal parameter. Both normal controls and fluent aphasic patients produced nonoverlapping distributions of tense and lax vowels at both speaking rates. In contrast, the nonfluent aphasics demonstrated a great deal of overlap in the distribution of tense and lax vowel durations at the fast rate. Results are discussed in relation to the nature of the speech production deficits in nonfluent and fluent aphasic patients.     

Reversal operations after brain damage

The ability to perform reversals—that is, the appreciation of the relationship between original and transformed states of knowledge—is critical to human thought processes. In order to assess whether a number of “special-purpose processors” are responsible for reversal operations, depending on the particular context in which the reversal is couched, or whether a single “core processing mechanism” subserves a critical aspect of reversal operations regardless of the specific context, patients with localized brain damage were asked to solve eight reversal problems. Visual and auditory reversals mediated by linguistic and non-linguistic symbol systems were presented. The findings demonstrate that patients with insult to the anterior portion of the right hemisphere encounter more difficulty performing reversals than patients with right posterior insult, Broca's aphasics, and fluent aphasics. This is regardless of the symbol system mediating the reversal, regardless of the modality of presentation, and regardless of the amount of available processing time. Subjects with insult to the posterior region of the left hemisphere or the right hemisphere also exhibit some difficulty solving reversal problems, although their difficulties appear modality specific. These data lend support to the claim that a core processing mechanism may play a critical role in the performance of reversal operations.     

Comparison of the performances of a fluent and a nonfluent aphasic on a pantomimic referential task

The pantomimic performances of a typical Broca's (nonfluent) and Wernicke's (fluent) aphasic were compared with each other and with four normal control subjects on a simple task of nonverbal referential communication. Both aphasic subjects demonstrated only about 50% accuracy in their pantomimic communication. Also, measures were obtained of the motoric fluency of the pantomimes of all subjects and comparisons were made between the fluent and nonfluent aphasics. These measures demonstrated distinct differences in the fluency patterns of the pantomimes of the two aphasic subjects similar to the differences in speech fluency which distinguish and characterize these two types of aphasia; that is, the fluent aphasic pantomimed fluently and like the control subjects and the nonfluent aphasic pantomimed nonfluently. The quantitative and qualitative similarities in the fluency patterns of the speech and the pantomimic behaviors of the aphasic subjects are discussed in terms of their implications for a definition of aphasia.     

Speed of Lexical Activation in Nonfluent Broca''s Aphasia and Fluent Wernicke''s Aphasia

Rapid, automatic access to lexical/semantic knowledge is critical in supporting the tight temporal constraints of on-line sentence comprehension. Based on findings of “abnormal” lexical priming in nonfluent aphasics, the question of disrupted automatic lexical activation has been the focus of many recent efforts to understand their impaired sentence comprehension capabilities. The picture that emerges from this literature is, however, unclear. Nonfluent Broca's aphasic patients showinconsistent,notabsent,lexical priming, and there is little consensus about the conditions under which they do and do not prime. The most parsimonious explanation for the variable findings from priming studies to date is that the primary disturbance in Broca's lexical activation has something to do withspeedof activation. Broca's aphasic patients prime when sufficient time is allowed for activation to spread among associates. To examine this “slowed activation” hypothesis, the time course of lexical activation was examined using a list priming paradigm. Temporal delays between successive words ranged from 300 to 2100 msec. One nonfluent Broca's aphasic patient and one fluent Wernicke's patient were tested. Both patients displayed abnormal priming patterns, though of different sorts. In contrast to elderly subjects, who prime at relatively short interstimulus intervals (ISIs) beginning at 500 msec, the Broca's aphasic subject showed reliable automatic priming but only at a long ISI of 1500 msec. That is, this subject retained the ability to access lexical information automatically if allowed sufficient time to do so, a finding that may help explain disrupted comprehension of normally rapid conversational speech. The Wernicke's aphasic subject, in contrast, showed normally rapid initial activation but continued to show priming over an abnormally long range of delays, from 300 msec through 1100 msec. This protracted priming suggests failure to dampen activation and might explain the semantic confusion exhibited by fluent Wernicke's patients.     

Part of speech and phonological form implied in written-word comprehension: Evidence from homograph disambiguation by normal and aphasic subjects

A sentence construction experiment examining the effect of part of speech and phonological form in written-word comprehension is reported. Normal and aphasic subjects had to write sentences incorporating a given word pair, one word was a homograph (e.g., “bank”) whose meaning was context-biased by the other (e.g., “money”/“river”). The effect of three psycholinguistic factors on subjects' performance was questioned: (i) The relative frequency of one meaning of the homograph as compared to the other meaning; (ii) The lexical/syntactic ambiguity (“ball”/“can”); (iii) The same/different phonological forms of the two meanings (“fair”/“bass”). The results are discussed in the framework of a model in which multiple special-purpose procedures are involved in normal processing, some of them being differentially impaired by brain disease in Broca's and Wernicke's aphasics.     

The conceptual structure of aphasic and schizophrenic patients in a nonverbal sorting task

Hierarchical and overlapping cluster methods were applied to the sortings of aphasic, nonaphasic brain-damaged, schizophrenic, and normal subjects presented with 30 pictures of animals. The hierarchical structure solutions were most diffuse for the groups of the schizophrenics and the fluent aphasics. The structure for the nonfluent aphasics showed more clarity, but was also deviant from the structures of the normals and the brain-damaged without aphasia. Fluent aphasics but not nonfluent aphasics tended to sort pictures which they could not name into smaller groups. For the nonfluent aphasics, there was a significant correlation between the commonality of the sortings and the severity of aphasic disturbances as measured by the Token Test. The relationship between conceptual disorganization and language impairment seems to be functionally different for fluent and nonfluent aphasics.This research was supported by a research grant from the Deutsche Forschungsgemeinschaft.     

Selective word-learning deficits in aphasia

The purpose of this study was to determine whether patients with focal brain damage can learn anything about a new word, and if so, whether selected aspects of the new word are acquired depending on the nature of the patient's language processing deficit. In the context of drawing pictures with a number of felt pens identical in all respects except color, agrammatic Broca's aphasics and fluent aphasics were exposed to the new word "bice," an adjective referring to the dark green portion of the color spectrum. Our findings revealed that brain-damaged patients can engage in lexical acquisition, but Broca's aphasics and fluent aphasics apparently learn about different aspects of the new word. Specifically, on successive exposures to "bice," both Broca's aphasics and fluent aphasics exhibit progressively more accurate hypotheses for identifying a bice-colored object. During subsequent assessments, agrammatic aphasics reveal on a metalinguistic judgment task their significant difficulty appreciating the grammatical form class of "bice"; on an object classification task, fluent aphasics are significantly impaired in their classification of bice-colored objects as "bice." Taken together, these unique word-learning profiles reinforce earlier observation on the selective nature of language processing deficits after focal left-hemisphere insult, and support the claim that separate language processing devices may be selectively compromised in different groups of aphasics. The relationship between syntactic and lexical semantic processing is discussed.     

Fluent versus nonfluent primary progressive aphasia: a comparison of clinical and functional neuroimaging features

To better characterize fluent and nonfluent variants of primary progressive aphasia (PPA). Although investigators have recognized both fluent and nonfluent patients with PPA, the clinical and neuroimaging features of these variants have not been fully defined. We present clinical and neuropsychological data on 47 PPA patients comparing the fluent (n=21) and nonfluent (n=26) subjects. We further compared language features with PET/SPECT data available on 39 of these patients. Compared to the nonfluent PPA patients, those with fluent PPA had greater impairment of confrontational naming and loss of single word comprehension. They also exhibited semantic paraphasic errors and loss of single word comprehension. Patients with nonfluent PPA were more likely to be female, were more often dysarthric, and exhibited phonological speech errors in the absence of semantic errors. No significant differences were seen with regard to left hemisphere abnormalities, suggesting that both variants result from mechanisms that overlap frontal, temporal, and parietal regions. Of the language measures, only semantic paraphasias were strongly localized, in this case to the left temporal lobe. Fluent and nonfluent forms of PPA are clinically distinguishable by letter fluency, single word comprehension, object naming, and types of paraphasic errors. Nevertheless, there is a large amount of overlap between dysfunctional anatomic regions associated with these syndromes.     

Agrammatism in a case-inflected language: Comprehension of agent-object relations

Yugoslav agrammatic aphasics and normal control subjects were tested for comprehension of agent-object relations in a series of simple Serbo-Croatian sentences consisting of two nouns (N) and a transitive action verb (V). The availability of nominative and accusative case inflections and a semantic contrast was systematically varied across sentences. Sentences were also varied with respect to the two sequences NVN and VNN. An analysis of subjects' agent-object assignments yielded the following results: While Broca's aphasics did show some sensitivity to case inflections, their ability to process such cues was greatly impaired relative to normal subjects, for whom morphological cues were almost completely deterministic. To a lesser degree, Broca's aphasics were impaired in their ability to employ a strategy of “choose the first noun as agent” when case inflections and semantic contrasts were not available. While Broca's aphasics showed no impairment in their ability to exploit semantic contrasts for agent-object assignment, there was no absolute compensatory increase in the degree to which they relied on semantic cues. Differences in word sequence had no effect on agent-object assignment in Broca's aphasics. Finally, Broca's aphasics frequently responded unsystematically when cues to agent-object relations occurred in isolation or in competition with one another, but when there was a convergence of cues their performance approached that of normal subjects. This result was interpreted in terms of an accessing hypothesis.     

Tonal Coarticulation in Thai after Unilateral Brain Damage

The magnitude and temporal extent of anticipatory and perseverative tonal coarticulation was investigated in Thai-speaking normal and brain-damaged adults. A total of 47 speakers (10 young normal, 10 old normal, 13 nonaphasic right-brain-damaged patients, 14 left-brain-damaged aphasic patients, 9 fluent, 5 nonfluent) produced all 25 possible sequences of two tones from the five lexical tones of Thai embedded in a carrier sentence.F₀contours were analyzed in terms of height and slope at 10% intervals throughout the duration of the two syllables. Acoustic analysis revealed that anticipatory and perseverative tonal coarticulation of tones was markedly reduced in left fluent aphasics, totally absent in left nonfluent aphasics, but reasonably intact in right hemisphere patients. Findings are interpreted to highlight the nature of speech disturbances in nonfluent and fluent aphasia, hemispheric specialization for tone, and tonal coarticulation in Thai.     

Aphasia in Turkish: speech production in Broca's and Wernicke's patients

Turkish speech production was studied in 7 Broca's and 10 Wernicke's aphasics. Turkish is an agglutinative language, with few free-standing closed-class morphemes. The speech of Broca's patients was not telegraphic; although nonfluent, noun and verb suffixes were used appropriately. The speech of Wernicke's aphasics was fluent, using a wide range of often inappropriate forms. Both groups used appropriate nominal morphology. Broca's patients used a limited set of verb forms in contextually appropriate fashion. Wernicke's patients used a wide range of verb forms, all morphosyntactically correct, but often semantically anomalous. Both groups retained canonical subject-object-verb word order and controlled various types of pragmatically appropriate word order variation. It is proposed that aphasic speech patterns reflect retrieval problems rather than impairment of a portion of the language system.     

Nonverbal categorization in fluent and nonfluent anomic aphasics

This study aimed to demonstrate that the naming difficulties of a particular group of aphasics, namely, fluent aphasics, are related to an underlying inability to organize feature set information. In order to test this hypothesis, the performance of fluent aphasics, nonfluent aphasics, and a nonaphasic brain-injured control group, was examined on a nonverbal categorization task, which was carefully structured in terms of instance typicality. Scores of visuoperceptual and naming tests were correlated with categorization task errors. As predicted, fluent aphasics showed a significant deficit in performance on the categorization task in comparison with other subjects. Differences in the nature of the errors the fluent aphasics made suggested that their problems were related to difficulties in abstracting the prototype for each category and in sorting category members with reference to these prototypes. For fluent aphasics, but not other subjects, a significant correlation was found between categorization task performance and naming ability.     

Compensation for Jaw Fixation by Aphasic Patients

The ability to compensate for fixation of the jaw by a bite block was investigated in 6 nonfluent aphasics, 6 fluent aphasics, and 10 normal control subjects. Acoustic analyses of the vowels [i u a æ] and fricatives [s s] revealed substantial but incomplete compensation for the perturbation in all three subject groups. Perceptual identification scores and quality ratings by naive and phonetically trained listeners indicated poorer identification of the high vowels [i u] under compensatory conditions relative to normal production. Of particular interest was the fact that all three groups of subjects exhibited similar patterns of results. The findings suggest that any deficit in speech motor programming demonstrated by the nonfluent aphasic patients did not affect compensatory abilities. Results are discussed with respect to normal speech adaptation skills and the nature of articulatory breakdown in nonfluent aphasia.     

Residual reading capability in a patient with alexia without agraphia

A case of pure alexia due to an ischemic lesion of the occipital temporal region is described. Written words could be matched but not read. Immediate memory span for graphemes was defective. The reading defect probably depends on the inability to modify the written word “globally”; the phonological process was intact, but the memory disturbance impeded reading. The dissociation is explained by the preservation of word forms, which are linked to the semantic stage. Nonwritten stimuli trigger a “meaning” which evokes the word form and so the written word is recognized even though it cannot be read.     

The word order problem in agrammatism : I. Comprehension

The results of a picture-pointing comprehension test show that agrammatic aphasics have difficulty understanding sentences in which the underlying semantic roles are marked by the order of noun phrases around a verbal element. Agrammatic patients performed poorly on reversible constructions involving spatial prepositions (e.g., “The square is above the circle”) and verbs (e.g., “The dancer applauds the clown”). These results have significance for the interpretation of the underlying disturbance in agrammatism—whether the deficit is syntactic or purely phonological.     

Unbiased and unnoticed verbal conditioning: the double agent robot procedure

Subjects who were told they were “experimenters” attempted to reinforce fluent speech in a supposed subject with whom they spoke via intercom. The supposed subject was to say nouns, one at a time, on request by the “experimenter”, who reinforced fluent pronunciation with points. Actually, the “experimenter” was talking to a multi-track tape recording, one track of which contained fluently spoken nouns, the other track containing disfluently spoken nouns. If the “experimenter's” request for the next noun was in a specified form a word from the fluent track was played to him as reinforcement; requests in any other form produced the word from the disfluent track. Repeated conditioning of specific forms of requests was accomplished with two subject-“experimenters,” who were unable to describe changes in their own behavior, or the contingencies applied. This technique improved upon an earlier method that had yielded similar results, but was less thoroughly controlled against possible human bias.     

Anatomoclinical correlations of the aphasias as defined through computerized tomography: Exceptions

We have studied the frequency of exceptions to classical aphasia localizations in right-handed, literate, adult, native speakers of Italian with focal vascular left-hemisphere lesions, correlating clinical and computerized tomography data. Two hundred sixty-seven subjects were given computerized tomography (CT) examinations; lesions were mapped onto lateral diagrams and the sites of the lesions were defined. Patients were then classified as nonfluent aphasics, fluent aphasics, and nonaphasics. Patients with negative CT scans (n = 10) or only "deep" lesions (n = 50) were not studied for anatomoclinical correlations. Of the remaining 207 patients, 36 presented unexpected findings. There were seven cases of fluent aphasia and "anterior" CT lesions and six cases with nonfluent aphasia and "posterior" CT lesions among them. The significance of these findings is discussed.     

Developing a self-report method for investigating adolescent road user behaviour

The aim of the present study was to develop a self-report questionnaire to provide a classification of aberrant road user behaviour in adolescent children. An Adolescent Road user Behaviour Questionnaire (ARBQ) was developed, comprising 43 items requiring respondents to rate the frequency with which they engaged in specific examples of road-using behaviour. The questionnaire was completed by 2433 children aged 11–16. Factor analysis showed that responses to the 43 items were best fitted by a three-factor solution. Factor 1 comprised items relating to “unsafe road crossing behaviour”, factor 2 comprised items related to “dangerous playing in the road”, and factor 3 comprised items which as a group were termed “planned protective behaviour”. A revised 21-item ARBQ was produced by selecting the items that loaded most strongly on the three factors. The 21-item instrument had good internal reliability. The effects of demographic variables on ARBQ scale scores were investigated. This study provided a tool that could be used in the future by researchers investigating adolescent road user safety. Possible avenues for future research include applying the ARBQ to the study of adolescents’ road accident involvement, and the study of the psychological variables that predict the ARBQ scales.