Velar movements during speech in two Wernicke aphasic patients

The articulatory gestures of the velum in two Wernicke aphasic patients were examined to compare their performances with those of an apraxic patient by means of the fiberoptic technique. In contrast to the marked variability in the apraxic performance in terms of velum height and segmental duration, the two fluent aphasic subjects showed a relatively high degree of consistency in velar movements throughout several repetitions of nonsense syllables and meaningful words. In addition, both patients exhibited a normal pattern of anticipatory coarticulation. Analyses of the velar movement patterns during the speech-sound error processes of both patients suggested that these errors were not due to an impairment at the level of articulatory programming but to an error in the selection of a target phoneme.     

Nature of spelling errors in transcortical sensory aphasia: A case study

The nature and extent of spelling errors in a patient with transcortical sensory aphasia were investigated. The two experimental conditions required the patient to spell monosyllabic and polysyllabic words both verbally and in written form. Analysis of the spelling errors revealed partially preserved knowledge of the visual image of a word as a whole, as well as preserved knowledge of temporal order. Our patient's error patterns in both conditions were more similar than dissimilar. These findings in conjunction with results reported in the literature indicate that patients exhibiting different aphasia syndromes use separate spelling strategies.     

Group play therapy for Japanese children who stutter

Twenty-one sessions of group play therapy were conducted with children who stutter in order to improve their stuttering and to promote their development in social adaptation. Follow-up surveys were made 6 mo and 5 yr after therapy.As therapy progressed, a definite process of change was observed in each child, from periods of anxiety, appearance of aggressive behavior, frequent occurence of aggressive behavior, to a decrease in aggressive behavior. After the appearance of aggressive behavior, a fluctuation in stuttering occured as cooperative play with other children was established. This was followed by a decrease in stuttering. The appearance of aggressive behavior during therapy is thought to be of major significance for the disappearance of stuttering and for interpersonal relationships.A follow-up survey showed that both stuttering and social adjustment had improved, indicating the effectiveness of therapy.     

Learning from negative outcomes in stuttering therapy: II. An epiphany of failures

Proceeding on the premise that learning advances on the feet of failure, a litany of therapeutic failures with stutterers across 3 decades is recounted. The basis for these failures included the assumptions that stuttering is a neurotic symptom; that “lucky fluency” can be maintained permanently; that a fluent drone is preferable to stuttering; that controlled fluency, once established, can be maintained permanently; that a proper task for clinicians is to motivate clients to achieve and preserve fluency; that the clinician has the responsibility for marching clients through their therapeutic paces; and that stuttering is punishing to the stutterer, so it is not preserved by reinforcement. Unfortunately, more has probably been learned about what does not work than what does.     

The use of self-efficacy scaling in training student clinicians: Implications for working with stutterers

A scaling technique developed by Bandura for determining an individual's personal performance expectations (self efficacy) was applied to student clinicians working with stutterers. The self-efficacy scores of clinicians conducting treatment increased significantly while the scores of clinicians without treatment experience showed no significant change. As the student clinicians gained clinical experience there appeared to be a corresponding reduction in fear and avoidance of the treatment situation. Clinician fear concerning stuttering treatment appeared to have little relation to performance in treatment as rated by supervisors. The results indicate that self-efficacy scaling may be used to indicate clinician avoidance of working with stuttering clients.     

The effect of an intensive behavioral program on the distribution of EEG alpha power in stutterers during the processing of verbal and visuospatial information

Prior to an intensive behavioral treatment program, stutterers showed greater than normal activation of the posterior frontal region of the right hemisphere during the performance of speech tasks. After treatment they showed increases in proportional alpha for most regions of the two cerebral hemispheres, but most markedly for the posterior frontal region of the right hemisphere for both verbal and nonverbal tasks. This increase resulted in a reversal of the previous R/L interhemispheric alpha relationships with the left posterior frontal region showing greater activation during speech after treatment. The relationship of this finding to previous findings is briefly discussed and an hypothesis of decreased inhibitory control of the right hemisphere at the posterior frontal region by the left hemisphere during speech in stutterers is proposed and briefly expounded.     

Case study of a Thai conduction aphasic

A case study of a 55-year-old nonfamilial left-handed monolingual Thai patient with clinical and pathoanatomic evidence of major infarction in the left temporoparietal region is presented. He was studied at 9 years poststroke with a Thai adaptation of the Boston Diagnostic Aphasia Exam and supplementary tests. His language characteristics included fluent spontaneous speech, near-normal auditory language comprehension, and poor repetition, leading to a diagnosis of conduction aphasia. In regard to this aphasic syndrome, issues concerning classification, neuroanatomic correlates, and underlying neuropsychological mechanisms are addressed. The nature of his grammatical disturbance is examined critically in light of the notion of “information load.”     

Factor-derived categories of chronic aphasia

A large sample of patients with aphasia (N = 118), unselected for etiology, were administered the Porch Index of Communicative Ability more than 6 months after the onset of aphasia. Factor analysis of PICA subtest scores identified five factors which accounted for 83.9% of the total variance. The factors were labeled speaking, writing, comprehension, gesturing, and copying. Cluster analyses of the factor scores yielded five patient categories which differed in the pattern of impairment on the language factors as well as in overall severity of aphasia. A subgroup of the parent sample consisting of 52 patients with localized left-hemisphere CVA had cluster analyses repeated after having first been studied as part of the larger sample. The factor-derived categories for the subgroup were similar to those of the entire group. Discriminant functions of the PICA raw scores of the 52-patient subsample correctly classified all of the patients. When discriminant functions were based upon the factor scores of the 118-patient parent sample, 80.7% of the 52 patients were correctly classified into the five categories.