Critical reading of words and phrases in aphasia

To assess ability to read critically at the word and phrase level, four tests were administered to aphasic patients blocked on site of lesion and severity of auditory comprehension defect. Overall, site of lesion did not affect the quantitative scores or the patterns of errors in the four tests; this result suggests that there is a fixed order of difficulty in reading comprehension irrespective of the locus of the aphasic deficit. In contrast, profiles of performance differed significantly, depending on severity of comprehension difficulty. Patients with significant comprehension defect proved relatively superior at recognizing misspelled words; relatively poor at matching written nouns with their depicted referents; less likely to display improved comprehension when an additional substantive was included in a written phrase; relatively better at recognizing which words were the same parts of speech than at recognizing which words share salient semantic features; and relatively better at matching words which belonged together than at choosing the word which does not belong to a set. Taken together, the results suggest that strategies of reading may change in the presence of a severe aphasia, with such impaired patients relying less on semantic considerations and consequently more on orthographic information and on the distributional and sequential properties of words in sentences.