APROSCA

Anomia

Overall impression of word-finding difficulties, which may be instantiated in many different ways, e.g.,
word-finding pauses, abandoned utterances, circumlocution, comments on inability to find words.
Some of these behaviors are also captured by other specific features. Nonaphasic speakers sometimes
have difficulty finding words, so occasional difficulties may be scored not present

Abandoned utterances

Utterances are left incomplete. The speaker may move on to another idea, stop talking, attempt to use
another modality (e.g., gesture), or give a vague conclusion to the utterance (e.g., shrug shoulders and
say “you know”).

Empty speech

Speech that conveys little or no meaning. Pronouns and nonspecific words such as thing, stuff, and do
are substituted for content words

Semantic paraphasias

Substitution of content words for related or unrelated content words, e.g., cat for dog

Phonemic paraphasias

Substitution, insertion, deletion, or transposition of clearly articulated phonemes, e.g., papple for apple

Neologisms

Word forms that are not real English words. The intended target may or may not be apparent.

Jargon

Mostly fluent and prosodically correct but largely meaningless speech containing paraphasias, neologisms,
and unintelligible strings

Perseverations

Repetition of previously used words or utterances in contexts where they are no longer appropriate

Stereotypies and automatisms

Commonly used words, phrases, or neologisms produced with relative ease and fluency, e.g., tan,
I know it, dammit

Short and simplified utterances

Utterances are reduced in length or complexity. A mild rating (1) should reflect utterances that are sometimes
shorter than expected based on the context (e.g., simple sentence structures, lack of subordinate clauses).
A severe rating (4) should be reserved for single-word utterances. Nonsentence responses (e.g., Did you
come with your wife? Yes, or Who did you come with? My wife.) should not be considered

Omission of bound morphemes

Inflectional or derivational morphemes are not used where they should be, e.g., I am go to the store

Omission of function words

Function words are not used where they should be, e.g., I going to the store

Paragrammatism

Inappropriate juxtaposition of words and phrases and/or misuse of function words and morphemes (e.g.,
It’s so much wonderful, Makes it hard to speech)

Pauses between utterances

Unfilled or filled (um, uh) pauses within utterances. Both prevalence and length of pauses should be taken
into account in assessing severity. Because pauses are a feature of unimpaired connected speech, a
score of not present (0) should be assigned if the number of pauses is within the typical range

Halting and effortful

Speaking is labored and consequently uneven. Intonation, rhythm, or stress patterns may be reduced,
absent, or inappropriately placed. Prosody or melodic line may be disrupted

Reduced speech rate

The number of words per minute within utterances is reduced. Speaking slowly and pauses within utterances
count toward reduced rate. Pauses between utterances, potentially reflecting utterance formulation, do
not count

False starts

Partial words are abandoned after one or two phonemes, e.g., It’s a ca- cat

Retracing

Sequences of one or more complete words are made redundant by subsequent repetitions, revisions,
amendments or elaborations, e.g., The kite is (.) the boy is flying the kite

Conduite d’approche

Successive approximations at target forms. The target may or may not be achieved. The patient is aware
of their errors. These instances also contribute to scores for Retracing and Phonemic paraphasias or
Neologisms

Target unclear

It is not clear what phonemes the speaker is attempting to produce. This is often due to dysarthria, apraxia
of speech, muttering, mumbling, or in some cases severe jargon

Meaning unclear

It is not clear what the speaker is talking about, or the topic may be clear but what is being said about it is not

Off-topic

It is not clear how what is being said relates to the context.

Expressive aphasia

Language production is disrupted.

Apraxia of speech

Speech contains distortions, substitutions, or omissions that tend to increase with length or complexity of
the word or phrase. Groping behaviors or impaired intonation may be present. See Duffy (2013) for more
information.

Dysarthria

Speech is difficult to understand and characterized as slurred, choppy, or mumbled. Errors are consistent
and are the result of impaired strength, tone, range of motion, or sequencing. Speech breathing, phonation,
resonance, articulation, and prosody may be impaired. See Duffy (2013) for more information

Overall communication
impairment

Overall impression of the extent to which the speaker is impaired in conveying their message.