Aphasia

Question 1

Intro: what is aphasia?

Answer 1

Description: Aphasia is the impaired processing of language. Where deficits can occur: Aphasia affects input and output; comprehension and expression; written and spoken language.These deficits can be at: single word level, phrase level or sentence level. How people differ: People with aphasia differ; type of language problems differs; severity of problems differs; degree of adaptation differs; amount of recovery differ.

Question 2

Intro: what is simple word comprehension?

Answer 2

One example of classification of is deficits in single word comprehension. This is based on whether input versus output is affected as well as how they are able to process single words as opposed to deficits in sentence processing (as a result of grammar). People with a classification of single word processing tend to have their most severe deficits in understanding words - either in visual or auditory modalities.

Question 3

Cognitive neuropsychology

Answer 3

The way in which single word processing is assessed has been derived from a series of theoretical positions. Cognitive neuropsychology, an examples of this, provides a principled way of conceptualizing a language disorder. They can be used as a platform for understanding modelling and testing specific deficits, e.g. in single word comprehension. One of the first cognitive neuropsychological approaches was the development of the logogen models (morton and patterson, 1980) which was later revised by Patterson & Shewell (1987). This model was a box and arrow diagram, which displayed the components associated with the processing of language (in the boxes) and the how each of the features interrelate ( shown through the arrows). This model assumes that the modules operate independently, they are localized in different areas of the brain, normal people have the same cognitive systems and has negative implications on language processing (rather than resulting in new information-processings systems). Colheart et al, 2001 supported these assumptions, stating that: ‘if any bos or arrow was deleted from it, the result would be a system that would fail in at least one language processing task’. Each of these are necessary for fluent and complete comprehension of language.

Question 4

Assesment intro

Answer 4

The stages involved in the assessment of single word auditory comprehension in the Patterson and Shewell model (1987) involve the assessment at the acoustic analysis stage, the auditory input stage, the semantic stage and the breakdown between these modules. The assessment of orthographic processing of single words involves the assessment at orthographic analysis, orthographic input lexicon and, similar to the auditor assessment of words, the assessment of the semantic system and the connections between the modules. In this essay I will focus on the processes involved in the acoustic analysis.

Question 5

What is acoustic analysis?

Answer 5

Acoustic analysis is the first stage of processing, necessary for the comprehension of spoken words. It includes the identification of speech sounds and rejects other sound as not part of speech.The processing at this stage, discriminates phonemes, but has no information about words and meanings. It allows further access to the lexicon where words are held. As this is the first stage it plays a part in processing all auditory procedures.

Question 6

How is acoustic analysis tested?

Answer 6

Testing – Assessment procedures which determine the functioning of this module, include tasks such as word and non-word minimal pairs. These involve deciding whether two strings of sounds are the same or different.They only require sound discrimination and do not require knowledge of word forms, or of word meanings. (PALPA subtest 1,2,3,4 used for assessment of this stage).

Question 7

What will people struggle with when they have deficits in the acoustic analysis of speech?

Answer 7

struggle to distinguish between minimal pairs of two words

not understand words

not make lexical decisions

They will also be unable to repeat words, as they cannot translate from input to output by any route.

Question 8

What can people do when they have deficits in the acoustic analysis stage?

Answer 8

Normal recognition of nonverbal sounds, able to discern between different voices and different languages and normal hearing. Hearing and visual tests should be administered so that sensory impairments can be ruled out as a cause for their deficits.

Question 9

How can testers vary the difficulty of tests of the acoustic analysis stage?

Answer 9

Variables - These task can be made easier by using pairs which are maximally different – sounds which differ in terms of place manner and voice of articulation e.g. peb vs zeb. The task can be made harder by using sounds which differ by one feature only e.g. peb vs beb. An important note is that, 50% of the tests will be down to change, so people who score around or below this mark can be described as having deficits in the acoustic analysis of speech. The official diagnostic label for somebody with deficits in acoustic analysis of speech is word-sound deafness.Also very important to do other test, including tests to see if their sensory modalities are working adequately and that their deficits are not a result of impairments in these.

Question 10

what is the diagnosis given to somebody with impairments in the acoustic analysis stage?

Answer 10

word-sound deafness

Question 11

Wha is the assessment of auditory input lexicon?

Answer 11

The second stage of assessment, involves the analysis of the auditory input stage. The term lexicon is usually to describe a word store. A phonological input lexicon is a store of word forms that have been heard and remembered. An orthographic input lexicon contains words that have been read. They are stores of form but not meaning.

Question 12

Testing auditory lexicon.

Answer 12

Test: The test involved in the analysis of the auditory input module is lexical decision test. This involves deciding if an input is a real or a non-word. For people with deficits in the auditory input stage, the access to semantics should be impaired as is the performance on spoken words and semantic judgments. It is also importnt to note that some words are more difficult than others, so tests can be manipulated (in terms of difficulty) to test severity/ existence of deficits in the suditory input stage. The PALPA 5 considers the imageability and frequency of words as the measures of difficulty. The official diagnostic label for somebody with deficits in auditory input stage is word-form deafness.

Question 13

What people with deficits in the auditory lexicon are good at?

Answer 13

good peformance on minimal pairs

good repetition without understanding via the sub-lexical processes
normal non verbal sound recognition

Question 14

what are people with impairments at the auditory lexicon stage bad at?

Answer 14

For people with deficits in the auditory input stage, the access to semantics should be impaired as is the performance on spoken words and semantic judgments.

Question 15

what people with deficits in the auditory lexicon struggle with?

Answer 15

the acess to semantics is impaired

perfomance on spoken words

performance on semantic judgments

Question 16

how can tests to the semantic lexcicon be varied?

Answer 16

the imaginability of the words can be altered in terms of the imaginability and frequency of the words. PALPA 5 considers some of these difficulties

Question 17

what is the official diagonosis of somebody with deficits in the auditory input stage?

Answer 17

word-form deafness

Question 18

assesment at semantic stage

Answer 18

The last input module to be assessed in single word comprehension, for both auditory and orthographic comprehension, is the semantic store of words. It is the stored information of words, primarily in terms of its meaning. Most models claim that there is a single semantic store. Therefore, if representations within this system are damaged, the result will impair all processing routes which involve semantics: i.e. comprehension and production of spoken and written words.

Question 19

How is semantic stage tested?

Answer 19

Test –tasks include: word to picture matching, synonym judgment, odd-one-out, semantic categorisation, semantic verification(‘it’s a..’). Published tests include the Pyriminds and Palm trees test.

Question 20

what are people at the semantic stage bad at?

Answer 20

Performance in the semantic representations of words should elicit semantic problems from both visual and auditory modalities and for those people with specific deficits in these areas subcategories, rather that all semantic, are to be impaired.

Question 21

controversies at the semantic stage.

Answer 21

Controversies – However, some people have argued that if knowledge is diffusely represented in the brain, there cannot be one central store of the meanings of words. In support of this argument, people have described the patients with aphasia who, despite being unable to understand words, can make semantic judgements about pictures (e.g., Pyramids & Palm Trees Test), and when given an object, know what to do with it (e.g., patient JCU, reported by Howard & Orchard-Lisle, 1984). Another area of controversy is whether specific categories within the semantic system can be impaired (such as just the loss of meaning of fruit). Warrington (1975) (advocate of multiple semantic systems) claims you can. Others seek to reduce such effects to differences in the familiarity of categories, premorbid competence (e.g. tools).

Question 22

How can the level of difficulty in the semnatic stage be varied?

Answer 22

Variables: In order to make the change the level of difficult, imageability; concreteness ; animacy can be manipulated .

Question 23

what are people with deficits at the semantic stage good at?

Answer 23

Patients with impairments in semantics should be able to perform well on minimal pairs and lexical decision tasks.

Question 24

what is the official diagnosis of somebody with deficits in the semantic stage?

Answer 24

The official diagnostic labels for somebody with deficits in semantic representations of words is a central semantic impairment. Those that have specific semantic categories are diagnosed with a specific semantic impairment.

Question 25

break down between the mosules

Answer 25

In order to distinguish between the access versus the central disorder it is important to look for dissociations between modalities – i.e. a difference in performance between spoken and written stimuli. If comprehension by one modality is good, there cannot be a loss of semantic knowledge. For people with difficulty in accessing the processes corresponding between input phonology and meaning are classified as having word-meaning deafness.

Question 26

conclusion

Answer 26

After the assessment of single word comprehension has taken place, the patient can receive a diagnosis of their specific impairments within the Sheewell and Patterson model. They are eligible to receive one or multiple diagnostic labels, depending on the nature of their impairment. However, an important note is that patients are different and thier diagnosis may not explain their difficulties entirely. Conversational analysis has shown that deficits appear more severe in test situations than in real, context filled situations.

Question 27

plan

Answer 27

into what is aphasia,what is simple word comprehension cognitive neuropsychology assesment info acoustic analysis - what is it, how is it tested auditory input lexicon, testing semantic stage- controversies