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Aphasia > Week 4 > Flashcards

Week 4 Flashcards

1
Q

Word Processing

A
  1. Nearly All PWA have comprehension deficit at some level
  2. Show written word and have PWA select correct picture
  3. Often a matching activity
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2
Q

Functional Levels of word Processing

A
  1. Sensation: I hear something
  2. Perception:
    a. Discriminate between 2 sounds (same or different?)
    b .Identification task (point to the /b/ sound)
    c. Discrimination-identification (point to ‘fan’)
  3. Recognition: recognizing a word, not necessarily understanding it. (Lexical decision task: is this a word?)
  4. Comprehension of word
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3
Q

Semantic Memory

A

concept that matches what we’ve heard and lexical representation as well

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4
Q

Concept

A

unit of semantic memory, e.g., ‘cat picture’

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5
Q

Lexeme

A

‘cat’, ‘chat’.. depending on language; written representation with letters

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6
Q

Semantic Networks

A
  1. How concepts are organized
  2. Related concepts are close together -> neighbors
  3. Less related concepts are more distant
  4. Are culturally dependent
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7
Q

Semantic Priming Effect

A
  1. Lexical decision task with semantic priming effect.
    a. Prime: nurse (related); flower (unrelated)
    b. target is doctor
  2. Lexical decision is faster when preceded by a semantically related prime vs unrelated prime = semantic priming effect
  3. PWA demonstrate semantic priming effect
  4. Ambiguous primes with multiple meanings activate both meanings.
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8
Q

Attributes of sentence comprehension

A

1.Complexity – passive more difficult than active
-Negative makes it more difficult
-Embedded clause is harder
-Think about complexity as a continuum

  1. Reversibility
    -It will be more difficult if reversible
  2. Canonicity
    -Easiest to understand structure

(Assess comprehension across different tasks)

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8
Q

Sentence comprehension deficits

A

o Need to understand thematic roles
-What’s the role of this or that noun
o How do we assess clients sentence comprehension?
-Match a sentence to a picture
-Follow instructions to manipulate objects
-Answer questions

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9
Q

Explaining comprehension deficits: Why do people with PWA have difficulties with sentence structure?

A

o Lexical processor
o Syntactic processor
o Interpretive processer
-Are these operating at the same time or in order?
-Are all damaged? Or just some?

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10
Q

Lexical system and sentences

A

o Lexical decision task with priming sentence for ambiguous word
o E.g., plant
o Pw/oA people define ambiguously
o PWA prime for only one meaning in context

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11
Q

Syntactic parsing mechanism

A

brain assigns structure to the words that we hear

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12
Q

Syntactic system & sentences: Processing theories

A
  • may be identified with general cognitive systems such as working
    memory
  • syntactic information associated with inflection isn’t activated fast enough
  • syntactic processor isn’t impaired in an all-or-none fashion, is impaired
    partially
  • People with aphasia don’t activate meanings of morphemes quickly enough
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13
Q

Do PWA have a cognitive limitations?

A

attention that exacerbate a language-specific
difficulty
* maybe

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14
Q

Is STM implicated?

A

not in comprehension deficits

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15
Q

Symptoms of Confrontational Naming Task

A
  1. Slow to respond
  2. Vague words
  3. Circumlocutions
  4. Paraphasias
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16
Q

Visual Agnosia

A

-Word errors not due to aphasia
-deficit in recognizing an object despite a normal visual system
-might recognizing the object through touch or hearing it (sound it makes)

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17
Q

Cognitive Neuropsychological
Model

A
  1. Operates serially (in a set order)
  2. For PWA, does the impairment lie in the semantic system or lexical system?
  3. Chart: 1st step problem = visual agnosia
    -Semantic is the concept of meaning
    -Phonological is the word itself

Chart: Picture of object -> Picture recognition -> Conceptual Semantic System -> Phonological Output Lexicon -> Articulatory Processes -> Spoken Name

18
Q

Semantic Deficit

A

naming specific category could be a semantic deficit

19
Q

Lexical Deficit

A

-they can do naming task
-can access first letter but not word

20
Q

Psycholinguistic Model

A
  1. Not differentiating between storage and process
  2. Simultaneously, rather than Serial fashion
  3. Picture word interference task
    -Measure time to name picture
    -Competing word
    -Interference from semantically related word slowed them down
    -Lexical access speed things up
21
Q

Action Naming (Verbs)

A
  • Are there grammatical category-specific deficits?
  • Which is more difficult, verbs or nouns?
  • posterior damageà nouns
  • anterior damage à verbs
  • Does that mean nouns and verbs are stored like this?
22
Q

Word Retrieval and Fluent Aphasia

A
  • anomic or other fluent aphasia -> emphasize word-finding over sentence structure
  • narratives vs. picture naming
  • word finding in narratives better than picture naming
  • we should assess word retrieval with
    • naming
    • narration
    • and probably, conversation
23
Q

What does circumlocution reveal about semantic vs lexical information?

A
  • one study:
    • show pictures of famous people
    • in cases of anomia, people w/anomic aphasia
    • gave semantic information 91% of the time
    • identified first letter only 7% of time
24
Conduction Aphasia and Word Retrieval
Lexical access problem?
25
Wernicke's Aphasia and Word Retrieval
* more errors overall * less likely to have ”tip of tongue” syndrome * Neologistic jargon or semantic jargon? * semantic access vs. lexical access?
26
Grammatical Symptoms
1. Grammatical Morpheme Omissions 2. Grammatical Morpheme Substitutions 3. Structural simplification -Actives > passive structure -Fewer subordinate clauses -Simple sequences, e.g., "a large house, a white house" rather than "a large, white house" 4. Don't make high level structural errors (e.g., illegal word order)
27
Agrammatism and Broca's
1. People with Broca's seem to retain grammatical knowledge (*Can tell when a sentence is not right) 2. People with agrammatism activate a canonical form to convey message. (e.g., simplification strategy) (Lost access to more complex grammar)
28
Have PWA lost Grammar knowldege?
No, PWA have not lost knowledge of grammar -> impairments should be identified with processing * if aphasia is an impairment of processing, that affects how we approach therapy * try to figure out where/what level the impairment is
29
Sublexical or Nonlexical Reading Route
Does not depend on activation of words in the lexicon -See word in print-> letter-to-sound conversion -> phonological buffer e.g., flig, skurt, lemmun, kattul
30
Where to assess reading impairments?
Assess at word, sentence, and paragraph level when possible
31
Alexia
o Disruptions at different points along the pathway o Orthographic lexicon: storage of familiar strings of letters o Phonological buffer = short term WM o You can skip semantic system to phonological buffer (sublexical route) o Not reliable with certain words like ‘yacht’
32
Pure Alexia
* aka, alexia without agraphia * retain ability to spell and write * impairment between visual and language system * will do letter by letter strategy * short words easier o Specific to reading o No writing issues o Can still access othrographic input lexicon, just need to do it letter by letter o Longer words likely to be slower and wrong
33
Surface Alexia
Impairments in the lexical semantic reading route Difficulties with: * irregular spellings, e.g., * homophones, e.g., * homographs, e.g., * low frequency words more difficult o Impairments between lexical and semantic systems o damage could be in a few different areas
34
Phonological Alexia
-Sublexical Route o non words will be harder o lexicalization: ‘dusp’ read as ‘dust’ -Sound to letter and letter to sound conversion blocked
35
Deep Alexia
o Same as phonological alexia with damage to semantic system
36
Agraphia
* ASSESS * spontaneous writing * written naming * writing to dictation * copying
37
Phonological Agraphia
* difficulty spelling nonwords * spelling errors typically not phonologically plausible * e.g., flewen for ‘flower’ o take a nonword like dusp make it dust (sound to letter conversion blocked) -Impairment: Sublexical Route -High frequency > low frequency High imageability > low imageability Content words > grammatical ❌ non-words
38
Deep Agraphia
-Impairment: Semantics + phonological -High frequency > low frequency High imageability > low imageability Content words > grammatical ❌ non-words ❌ semantic errors
39
Surface (lexical) agraphia
* lost or degraded orthographic representations Difficulties with: * irregular spellings, e.g., * homophones, e.g., * low frequency words more difficult -Impairment: Orthographic output Regular words > irregular words High frequency words > low frequency
40
Graphemic Buffer Agraphia
-Impairment: Graphemic buffer -Short words > longer words o longer words are going to be harder just because they are longer * a short-term memory issue * lexical-semantic and sublexical routes are intact * long words more difficult than short words * types of errors: * omissions, e.g., sweater ->sweatr * substitutions, e.g., peanut -> peanul * transpositions, e.g., painter -> painetr * additions, e.g., flower -> flowaer
41
Allographic conversion agraphia
-well-formed but incorrect letters or disturbed letter formation -Preserved oral spelling selective impairment: * upper vs. lower case * print vs. cursive Person will have preserved copy, but impaired transcoding (e.g., ask to transcode from upper to lower case)
42
Allographic conversion agraphia: treatment
use self-dictation!
43
Alexia/agraphia: summary
* identify where person has impairment * which type of words are hard to read or write? * Note: there is no fixed relationship between aphasia type and alexia/agraphia deficits

Aphasia (6 decks)

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