The repetition defect in conduction aphasia: Mnestic or linguistic?

Repetition difficulty is the cardinal feature of conduction aphasia. Traditionally this disorder has been considered secondary to a deficit in linguistic processing but recently a number of investigators have interpreted such cases as consequent upon a short-term memory difficulty in the auditory—verbal domain. We present here the case of a 24-year-old patient with conduction aphasia, whose symptom picture closely resembles those patients whose difficulties have been attributed to mnestic factors. Our patient's performance improved dramatically when stimuli were presented more slowly or when they were familiar, when the task involved matching rather than language production, and when multiple choices were provided for missed items. More crucially the patient's errors in repetition were primarily paraphasic and sequential; and repetition of single nonsense words was severely impaired. Taken together these results suggest that the patient's disorder, and perhaps that of other cases as well, would be better viewed as a linguistic deficit, specifically in the processing, synthesis, and ordering of phonemes. A tentative model for repetition disorder is proposed.     

The naming of objects and symbols by children and aphasic patients

Three studies of naming in children and in aphasic patients were conducted in order to determine the kinds of errors made in the naming of objects, parts of objects, and various kinds of symbols, and to evaluate the contribution of operativity to the ease of naming such elements. Operativity refers to the extent to which elements can be transformed and involved in a variety of sensory and motor schemes. It was found that operativity of depicted elements makes a significant contribution to ease of naming for both groups of subjects. However, children and aphasic patients made different types of naming errors. In the case of naming of symbols, the categories easiest for aphasics to name proved the most difficult for children to name. It is suggested that the partial loss of an acquired ability can produce a different clinical picture than the partial acquisition of that ability in the normal child. The concept of operativity may be a less useful concept in the relatively figurative domain of symbols.The research cited in this report was supported in part by Harvard Project Zero (through Grant No. GB-31064 from the National Science Foundation), the Livingston Fund, and the Milton Fund of Harvard University.     

Professional Politics and the Concepts of Family Therapy, Family Consultation, and Systems Consultation

At a time when an increasing number of professionals are calling themselves "family therapists," many teachers and theorists in this field are troubled that the term "family therapy" no longer adequately characterizes the concepts or activities of the field. Recently, clinical, political, and economic circumstances have emerged that suggest the need for alternatives to the role of "family therapist." By adding the roles of family consultant and systems consultant, we can open up new options for ourselves and our clients. During initial contacts with families, agencies, and other professionals, we can heighten our therapeutic potential by proceeding with consultative stocktaking, not starting with therapy. Family consultation also can assist in redirecting therapy when a new problem or an impasse develops, in focusing on competency rather than on pathology, and in engaging constructively with families that have a physically or mentally ill member.