Disorders of Language Flashcards
Define Aphasia
Impairment of language follwoing brain damage
How is Aphasia tested clinically?
Conversational Speech
- Fluent vs. Nonfluent
Comprehension of Spoken Language
- Comprehension of Spoken Language
Repetition
- Ability to repeat precisley wors presented by examiner
Word finding Difficulties (Anomia)
- Asked to name actual objects or pictures of objects
Describe characteristics of Broca’s syndrome
- Good comprehension
- Non-fluent Speech
- Poor repetition
Describe the characteristics of Wernicke’s syndrome
- Poor comprehension
- Fluent Speech
- Poor Repitition
Describe transcortical motor aphasia
- Good comprehension
- Non-fluent Speech
- Good repetition
Describe transcortical sensory aphasia
- Poor comprehension
- Fluent Speech
- Good Repitition
What does the auditory analysis system do?
Identify phonemes in sound wave (small units of sounds)
- Distincitive sounds that language uses
Describe the function of the Auditory input lexicon
Stores sound patterns of known words
- Word recognition units
Describe the function of the semantic system
Stored meanings of known words
Describe the function of the speech output lexicon
Stored spoken form of known words
- output string of phonemes
Describe the phoneme level
Leads to speech production
What is the nemonic associated with the speech comprehension and production pathway?
What is the progressive flow of the pathway and the systems associated with each step?
HAASSPS
1) Heard word
2) Auditory analysis
3) Auditory Input Lexicon
4) Semantic system
5) Speech Output Lexicon
6) Phoneme Level
7) Speech
What are the three pathways through which you can repeat a word
1) Auditory Input Lexicon -> Speech Output Lexicon (No processing through semantic system)
2) Auditory Analysis System -> Phoneme Level
3) Go through the longer route which includes the semantic system
What is the deficit associated with the Auditory Analysis System?
Pure word deafness
What is the deficit associated with the pathway from the auditory analysis system and the phoneme level?
Auditory phonological agnosia
What is the deficit associated with auditory input lexicon?
Word meaning deafness
What is the deficit associated with the semantic system?
Semantic anomia
What is the deficit associated with the speech output lexicon?
Output lexical anomia
Define Pure word deafness
Can hear just fine but deaf purely for words
- Impaired speech comprehension (conscious of this impairment)
- Normal hearing on audiometric testing
- Intact: speech production, reading, writing
- Poor repetiton (sythym is similar but actual words are not)
What cuases word deafness?
- Vowels identified better than consonants
- Better at slower presentations (particularly digits)
Where does the left ear project?
Where does the right ear project?
What about under dichotic presentation?
The left and right ear project to both the left and right hemisphere
- However contralateral side is dominant
Dichotic presentation: The dominant side wins
What phenomenon is shown under dichotic listening conditions
Words show a right ear advantage, but stead-state vowels do not
What is concluded from the phenomena observed with dichotic presentation of auditory stimuli?
There are two different modes of auditory perception
1) General Auditory Mode
2) Speech-Related Phonetic Mode
Describe the general auditory mode
- Capable of processing stead-state vowels
- Present in both hemisphere
Describe the speech-related phonetic mode
- Necessary for perception of rapidly changing acoustic signals that specify consonants
- Present in left hemisphere
Describe Pure deafness in terms of temporal distinctions
How one determined how fine tuned a patients rapid acoustic processing system is?
Pure deaf patients are unable to make fine temporal discriminations between rapidly changing accoustic signals that are necessary for identifying and discriminating spoken consonants
Pure deaf patients are impaired in distinguishing clicks
- They are not impaired in language processing. But in their ability to distinguish between all rapidly changing information
What cues can pure deaf patients use to extract meaning from noisy signals?
Can use lip movement cues and linguistic context to aid comprehension
“If I go blind, I won’t hear anything”
Decribe Word Meaning Deafness
Deaf to the meaning of the word
- Intact speech production, reading, & writing
- Impaired speech comprehension
- Otherwise normal hearing
- Can write down words heard with accuracy
- Only when reading written words, can patients understand
Where is the site of branwell’s patient’s deficit?
Why can she still extract meaning from words when reading?
Between the auditory input lexicon and the semantic system
She can extract semantic meanign form words because the visual input lexicon feeds information into the semantic system that processes the meaning of words
What does patient’s HN’s ability to spell irregular words properly indicate?
That he is able to acess the visual input lexicon
What is the deficit for patients who have Auditory phonological agnosia?
Can hear and repeat back words, but can not repeat non-words
They have an impaired phonological route: The only way to repeat speech is through lexicon
- Respond to non-word with most similar-sounding real word
Describe Patient JL’s behaviour
- Normal spontaneous speech
- Good reading aloud and spontaneous writing
- Complained of some difficuly understanding spoken language
- Repitition and writing to dictation
- Perfect on auditory lexical decision task
What is the most common way to asses anomia?
Confrontation naming
- Testing their ability to name pictures of objects
What will patients with semantic anomia do?
- Will make semantic errors in naming
- Will be poor at detecting those errors as incorrect
Patient JCU was a 43 y/o bar tender with a large LH lesion who suffered from semantic anomia
What was her speech behaviour like?
Could anything help her speech?
- Spontaneous speech was extremley limited
- Could name very few object pictures unaiaded, but retrieved many more if given the initial phoneme of the word as a cue
Was sucesptable to being influenced to make semantic errors if she was given the first phoneme of an associated object (Ex. tiger - l. she would say lion)
- At times she would accept associated objects as the truth, but not random word
What causes semantic anomia?
The semantic system is underspecified, which leads to the activation of many semantic representations being activated simultaneously.
Multiple semantic representations are sent to the speech output lexicon, and no semantic representation is prioritized. Target and associate objects are both vaguely activated.
How do patients with output lexicon impairment behave?
- Will not show semantic naming errors
- Will make phonological approximation errors to words they cannot fully express
- Probability of being able to produce word correctly is strongly affected by its frequency of use
Describe the behaviour of patient EST?
What would happen if you were to show him a picture of a snowman?
What would happen if you showed him a picture of a baseball bat, and the cue “Ra”?
- Knew exactly what he wanted to say but could not remeber many of the words he needed to express his thoughts.
Snowman
- He would come up with words associated with a snowman, but could not say “snowman”
Baseball bat
- Would recognize that the word does not start with the given false cue. He would propose a correct phoneme, but could not say the full word
Describe how frequency of use influences the behaviour of semantic anomia patients
The more frequent word use = the more easily to spontaneously say the word
What output lexical anomia?
Speech output lexicon is intact but inaccessible
- Reduced levels of activation
- Higher frequency words have higher baseline activation
