6) Acquired language disorders

List the acquired language disorders

• dementia

• aphasia (fluent & nonfluent)

• cognitive communication disorder)

Right hemisphere language disorder

Clear speech but deficits in attention, left-side neglect, memory, organisation, orientation, problem solving, reasoning, and pragmatics (social communication)

How does RHD affect verbal communication despite preserved linguistic structures

~50% of people with RHD have verbal communication difficulties that are not linguistic in nature, but instead due to deficits in attention, memory, executive function, and visuospatial skills

What are some subtle but important difficulties people with RHD show in conversation

Difficulty with….

• understanding inferences

• integrating information into a theme

• ignoring irrelevant info

• providing concise, focused answers

What is dementia and what are its two main classifications

A medical diagnosis for a range of cognitive-communication disorders

• Progressive: Alzheimer’s, Pick’s, Parkinson’s

• Non-progressive: multi-infarct dementia from multiple strokes

What are the early signs of Alzheimer’s Disease in the brain

Shrinkage of brain folds, gaps forming, and early loss of cells in areas responsible for memory & executive functions, especially in the frontal and temporal lobes

Aphasia

A multimodal language disorder (affecting speaking, listening, reading, writing) that occurs when all other intellectual, sensory, and motor functions are intact

Common causes of aphasia

• Stroke in the left cerebral hemisphere

• viral encephalitis

• brain tumours

• other neurological events

Broca’s Aphasia symptoms

• Word-finding difficulties (single-level, sentence-level, conversational)

• Speaking in short, telegraphic sentences

• Awareness of speaking difficulties → frustration

Aphasia: single-word difficulties

most consistent symptom of aphasia

Word-finding difficulties (WFD), which manifest as:

• Circumlocution: talking around the word

• Paraphasias: approximation of the target word (brain locates a similar word e.g freezer rather than oven)

• Neologisms: no (or minimal) obvious relationship with target word (jargon/made up words)

  • preservation: fixation on jargon words

Aphasia: sentence-level & onservational difficulties

Individuals may have difficulty with discourse, integrating information, using appropriate turn-taking, and navigating both spoken & non-verbal elements of communication

Fluent aphasia

e.g. Wernicke’s aphasia

• fluent output

• poor comprehension

• preservaton of function words (articles, pronouns, conjunctions)

• substitution errors

• poor error awareness

Nonfluent aphasia

e.g. Broca’s aphasia

• non-fluent verbal output

• good comprehension

• predominance of content words (verbs, nouns)

  • telegraphic speech

• errors of omission

• good awareness of errors

What psychosocial impacts are associated with acquired communication disorders

They can affect relationships, self-identity, emotional wellbeing, and quality of life, leading to feelings of isolation, depression, and reduced independence

Issues in aphasia

Cognitive communication disorder

The communication disorder following a TBI (traumatic brain injury)

Common consequences include deficits in:

• ettention

• concentration

• initiation

• judgement & perception

• learning & memory

• speed of info processing and communication

• other cognitive skills such as planning & organisation