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.     

A case of acquired aphasia and convulsive disorder: some linguistic aspects of recovery and breakdown

Among the cases of acquired aphasia and convulsive disorder several children are reported to have experienced more than one aphasic period. We present such a case in more detail, with emphasis on some characteristics of spontaneous speech. The occurrence of paraphasias, and in particular of neologisms, appeared to be associated with language recovery and breakdown. At the beginning of the period of recovery, a rapid and total disappearance of neologisms was observed, while only literal paraphasias remained. A period of language breakdown was preceded by the return of neologisms. The process was not influenced by drug therapy.     

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.     

Syllable structure and sonority in language inventory and aphasic neologisms

Phonological theories have raised the notion of a universally preferred syllable type which is defined in terms of its sonority structure (e.g., ). Empirical evidence for this notion has been provided by distributional analyses of natural languages and of language acquisition data, and by aphasic speech error analyses. The present study investigates frequency distributions of syllable types in German, which allows for a rather complex syllable structure, and in neologistic utterances of a German speaking jargon aphasic. The findings suggest that the sonority structure of the patient's neologisms is generally in accordance with the notion of theoretically preferred syllables. Moreover, comparative analyses suggest that the predominance of the preferred syllable type is especially pronounced in the aphasic data. On the basis of these findings, the influence of sonority in impaired phonological lexical processing is discussed.     

Contrasting effects of phonological priming in aphasic word production

Two fluent aphasics, IG and GL, performed a phonological priming task in which they repeated an auditory prime then named a target picture. The two patients both had selective deficits in word production: they were at or near ceiling on lexical comprehension tasks, but were significantly impaired in picture naming. IG's naming errors included both semantic and phonemic paraphasias, as well as failures to respond, whereas GL's errors were mainly phonemic and formal paraphasias. The two patients responded very differently to phonological priming: IG's naming was facilitated (both accuracy and speed) only by begin-related primes (e.g. ferry-feather), whereas GL benefited significantly only from end-related primes (e.g. brother-feather), showing no more than a facilitatory trend with begin-related primes. We interpret these results within a two-stage model of word production, in which begin-related and end-related primes are said to operate at different stages. We then discuss implications for models of normal and aphasic word production in general and particularly with respect to sequential aspects of the phonological encoding process.     

A linguistic analysis of fluent aphasia

Fluent aphasia is a general term for those posterior aphasic syndromes which involve little or no motor difficulties and which exhibit rather normal rates of speech output. This paper is a comparative neurolinguistic study of three types of fluent aphasia. Differences as well as similarities regarding language behavior both within and across groups are analyzed. Much attention is given to anomia and to how it is confronted by each group. Various possible paraphasic processes which may be involved in the genesis of neologisms are discussed. Localization information is provided for the patients in the study, and special attention is drawn to prerequisite neuroanatomical involvement for neologistic jargon.     

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.     

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.     

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.     

On the universality of language dissolution: The case of a Turkish aphasic

The case of a Turkish aphasic suffering from motor aphasia is described. The transitional phonemic systems which could be observed in this patient in the course of speech rehabilitation are compared to the so-called “phonemic disintegration,” whereas the errors of his graphic performance are compared to the so-called “agrammatism” of Indo-European languages. It is found that there exists a strong parallelism between this agglutinative language and the inflecting Indo-European languages insofar as aphasic language dissolution is concerned.     

Some aspects of phonological impairment in aphasia

The relationships between expressive and receptive phonemic disorders and between disturbances of phoneme processing and general disorders of auditory comprehension were studied in 69 aphasic patients, by means of a phoneme discrimination test and of a standard aphasia battery. A significant but incomplete correlation between disorders of phonemic output and of phoneme analysis was found. The view is put forth that in some patients only phoneme encoding or decoding is disturbed, whereas in others a central level of phoneme processing is impaired. A significant but partial correlation was also found between disorders of phonological analysis and general disorders of auditory comprehension. This supports the view that, besides sequential phonological analysis, other processes operate in auditory comprehension.     

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.     

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.     

An acoustic study of vowel production in aphasia

A group of five anterior and seven posterior aphasic patients were recorded for their vowel productions of the nine nondipthong vowels of American English and compared to a group of seven normal speakers. All phonemic substitutions were eliminated from the data base. A Linear Predictive Coding (LPC) computer program was used to extract the first and the second formant frequencies at the midpoint of the vowel for each of the remaining repetitions of the nine vowels. The vowel duration and the fundamental frequency of phonation were also measured. Although there were no significant differences in the formant frequency means across groups, there were significantly larger standard deviations for the aphasic groups compared to normals. Anterior aphasics were not significantly different from posterior aphasics with respect to this greater formant variability. There was a main effect for vowel duration means, but no individual group was significantly different from the other. Standard deviations of duration were significantly greater for the anterior aphasics compared to normal speakers, but not significantly different from posterior aphasics. Posterior aphasics did not have significantly greater standard deviations of duration than did normal subjects. Greater acoustic variability was considered to evidence a phonetic production deficit on the part of both groups of aphasic speakers, in the context of fairly well-preserved phonemic organization for vowels.     

Speech sound errors in patients with conduction and Broca's aphasia

Speech sound errors exhibited by three conduction and three Broca's aphasic patients on naming and word-repetition tasks were subjected to phonemic and subphonemic analyses. In the conduction aphasic patients, errors occurred equally often on consonants and vowels in both the naming and word-repetition tasks, while in the Broca's aphasic patients errors occurred selectively on consonants. Transposition errors occurred almost as often as substitution errors in the conduction aphasic patients, while substitution errors constituted the majority of errors in the Broca's aphasic patients. The Broca's aphasic patients, as compared to the conduction aphasic patients, exhibited a markedly higher number of substitution errors occurring between phonemes separated by a single subphonemic feature on the naming task. On the basis of these findings, it was hypothesized that the differences in the error patterns of the two types of aphasia reflected differences in the underlying mechanisms of the impairment in each type.     

Production deficits in aphasia: A voice-onset time analysis

An experimental study was conducted to examine phonetic and phonemic deficits in the speech production of aphasics. Subjects included four Broca's aphasics, four Conduction aphasics, five Wernicke's aphasics, one nonaphasic dysarthric patient, and four normal controls. The subjects read a list of words containing word-initial stop consonants which were subsequently measured acoustically for voice-onset time. The results showed that Broca's aphasics exhibit a more severe production disorder than Conduction aphasics who in turn exhibit a more severe disorder than Wernicke's aphasics, in accord with clinical observations. In addition, although Broca's aphasics produced both phonetic and phonemic errors, the results showed that they have a pervasive phonetic disorder which affects their correct target productions as well as the total number of phonetic errors produced. This deficit however seems to be a speech deficit rather than a low-level motor control problem. In contrast, the Wernicke's aphasics show a deficit characterized by isolated phonemic mistargeting errors. Finally, the pattern of productions for the Conduction aphasics indicates that some patients show a predominantly phonetic disorder similar to the Broca's aphasics and others show predominantly a phonemic disorder similar to the Wernicke's aphasics.     

Reconstructive retrieval deficits in Broca's aphasia

Anterior aphasic patients' ability to utilize the phonemic and/or semantic features of verbal material for retention purposes was investigated. In the first experiment, patients were asked to either detect word repetitions, phoneme repetitions, or rhymes in a list of items. The aphasics performed well on word and phoneme repetition detection but below both normals and amnesic Korsakoffs on rhyme detection. In the second experiment the patients were instructed to analyze either the physical, phonemic, or semantic features of words they were later asked to recognize. Aphasics were differentially affected (as were normals) by these instructions: semantic feature analysis resulted in the best performance, followed by phonemic feature analysis. It was concluded that anterior aphasics can analyze, recirculate, and even store the phonemic features of words, but find difficulty in reconstructing the originally presented item from these features.     

The effects of semantic and phonemic prestimulation cues on picture naming in aphasia.

In this study of auditory prestimulation cues, picture naming performances under phonemic and semantic conditions were compared to picture naming performance under a neutral condition. Twenty aphasic subjects named 324 pictures (108 pictures x 3 conditions) each. Responses were scored using a coding system adapted by the investigator from classification systems used by Williams and Canter (1982) and Kohn and Goodglass (1985). Results indicated that naming accuracy was facilitated by phonemic and semantic cues. An examination of the distribution of errors under the three conditions revealed systematic effects of phonemic and semantic cues on the frequency of occurrence of specific error types. Increases in semantic paraphasia proportion scores and decreases in unrelated word error proportion scores were associated with the semantic condition, while increases in phonemic paraphasia proportion scores were associated with the phonemic condition. The finding that naming performance of aphasic adults varies as a function of the type of information provided by the cue is discussed in relation to cascade visual confrontation naming models.     

Semantic errors reconsidered in the procedural light of stack concepts

The purpose of this paper is to demonstrate the relevance of the stack concept in neuropsycholinguistics, a stack being a file with serially ordered elements. Number names (one, two, three, …) and the names of the days in the week may be viewed in this way. In a stack structure, any element is identified by two pieces of information: the particular stack to which it belongs and its position within that stack. Two experiments are reported that demonstrate a double dissociation. A deep dyslexic patient with agrammatism was found to sort stack elements on the basis of identity of position-within-stacks, while a fluent aphasic with semantic verbal paraphasias used another criterion, grouping together the items of the same stack. First revealed when handling number names, the two psycholinguistic procedures are also shown to be differentially operative with other linguistic material. Introducing the stack concept thus permits a procedural reinterpretation of some “semantic confusions,” particularly but not exclusively those dealing with quantities.