Adult Lang Midterm-Key Components 2

Aphasia Syndromes and Characteristics

·       How are the types of aphasia classified?

o   Fluent (aka receptive or posterior) & Nonfluent (aka expressive and anterior)

o   Expressive & Receptive

o   Anterior & Posterior Dichotomies

·       What are limitations of classification systems based on relating function to neuroanatomic structure?

o   Fluent Aphasia

§  The name Fluent focuses on intact abilities while the name receptive is based on the primary area of deficit.

·       AKA receptive aphasia because people have more difficulty understanding language

·       AKA posterior aphasia because most fluent aphasias tend to be caused by temporal lobe lesions

o   Nonfluent Aphasia

§  The name nonfluent focuses on aphasia syndromes which are not very helpful or informative. The name doesn’t take severity of the type into account.

·       Explain what is meant by the dichotomous classifications of fluent/nonfluent aphasia, and why is it problematic to classify aphasia dichotomously as “fluent” versus “nonfluent”?

o   It is problematic because it doesn’t take the severity of the aphasia into account. Fluent vs nonfluent focuses on the intact abilities vs area of lesion so it doesn’t give much info.

·       What does it mean when one refers to aphasia as a “dissociation syndrome”?

o   Some abilities remain relatively intact while others are relatively impaired.

·       Give an example of a phonemic (literal) paraphasia.

o   Substitution of one or more sounds in target word.

§  Example: “spop” instead of “stop”

·       Give an example of a semantic (global) paraphasia.

o   Substitution of real word for the target word

§  Example: saying “ear” when you meant to say “nose”

·       What is primary progressive aphasia (PPA)? Be prepared to compare and contrast PPA with dementia and classic Aphasia.

o   PPA is a type of dementia

§  Dementia is a general term for brain conditions that affect memory and thinking

·       PPA: Difficulty speaking, writing, and understanding language. People with PPA may eventually lose the ability to speak and write.

·       Dementia: Memory loss, confusion, and personality changes

·       How might dyslexia and dysgraphia be conceptualized as symptoms versus syndromes?

o   essentially, they are manifestations of the underlying language processing deficits associated with the aphasia diagnosis

·       For each of the subtypes of aphasia listed below (consider making a chart or table to make this information flow a little better):

1.    Identify the typical associated site(s) of lesion according to classic models of structure and function. Be sure to refer to names of structures, names of any associated gyri and sulci, and numbers for associated Brodmann areas.

2.    Identify the origin of the blood supply for associated structures/brain regions.

3.    List the hallmark features and symptoms.

A. Broca’s aphasia

B. Wernicke’s aphasia

C. Conduction aphasia

D. Anomic aphasia

E. Global aphasia

F. Transcortical sensory aphasia

G. Transcortical motor aphasia

H. Primary progressive aphasia

I. Crossed aphasia

J. Subcortical aphasia

Terms to define

·       Agrammatism

o   Deficit in formulating and processing syntax

·       Catastrophic reaction

o   Extreme frustration that may be experienced when struggling to communicate

·       Circumlocutions

o   Word or words other than the intended word; used to express meaning of the intended word

·       Closed-class words

o   Function words belonging to a relatively small part of the lexicon in a given language compared to open-class words; new words in this category are rarely added to a language

·       Conduit d’approche

o   Language output characterized by repeated attempts to articulate a verbal stimulus

·       Content words

o   Nouns, verbs, adjectives, and adverbs

·       Continuous perseveration

o   a speech disorder that involves repeating words, phrases, or sounds in an uncontrollable and inappropriate way

§  Example: Repeating the letters "A-R-E" continuously or Getting stuck on a topic during a conversation

·       Disfluent

o   Characteristic of a spoken language with fewer units of verbal production conveyed per unit of time compared to a standard “normal” fluent speech

·       Dissociation syndrome

o   Symptom constellation in which some abilities remain relatively intact while others are relatively impaired

·       Dysnomia

o   Problem with word finding, often used with interchangeably with anomia, although prefix dys- insinuates a milder form

·       Emotional lability

o   Tendency to cry, swear and otherwise openly emote, in a way that is uncharacteristic of how a person typically responded to a stroke or brain injury.

·       Fluent aphasias

o   Any type of aphasia in which spoken language production in terms of morphemes or words per unit of time is normal or excessive; often used interchangeably with term receptive aphasia

·       Function words

o   Words relevant to specific time and setting

·       Grammaticality judgments

o   Task in which individuals are asked to make decisions about whether sentence constructions are correct or incorrect

·       Jargon aphasia

o   Type of aphasia characterized by tendency to produce nonwords; sometimes used for Wernicke’s aphasia

·       Logorrhea

o   Spoken language that is overly abundant in light of a given communicative conext.

·       Neologism

o   a newly created word that has no recognizable meaning or is used inappropriately in place of an existing word

·       Neologistic paraphasia

o   A type of paraphasia where a person substitutes a word with a neologism. This means the person replaces a correct word with a made-up word that sounds similar but is not real or understandable (e.g., "splark" for "car").

·       Nonfluent aphasias

o   refer to a group of aphasias characterized by slow, effortful, and halting speech.

·       Open-class words

o   content words that carry meaning, including nouns, verbs, adjectives, and adverbs. These words are part of the language’s core vocabulary and tend to evolve over time (e.g., "dog," "run," "happy")

·       Paraphasias

o   speech errors that occur in aphasia, in which a person substitutes, omits, or distorts sounds or words. Paraphasias can be classified into three main types: phonemic, semantic, and neologistic.

·       Phonemic paraphasias (also called literal paraphasias)

o   a type of speech error in which the individual substitutes, adds, or omits sounds within a word, often leading to a word that is similar in sound but incorrect (e.g., saying “tephelone” instead of “telephone”). This is often seen in Broca’s aphasia.

·       Press of speech

o   refers to a pattern of speech in which an individual speaks quickly, without pauses, and sometimes without regard for appropriate conversation flow. It is often seen in Wernicke’s aphasia or mania

·       Recurrent perseveration

o   Recurrent perseveration occurs when a person involuntarily repeats the same word or phrase after it is no longer appropriate in the conversation. This can be a result of a damaged frontal lobe

·       Reversible passives

o   Reversible passives are sentences where the subject and object can be switched without changing the meaning of the sentence (e.g., "The dog was bitten by the cat" can be reversed to "The cat was bitten by the dog"). Individuals with certain types of aphasia may have difficulty understanding or producing these constructions.

·       Semantic paraphasias (also called verbal or global paraphasias)

o   Semantic paraphasias occur when an individual substitutes one word for another word that is related in meaning (e.g., saying “dog” when they meant “cat” or “cup” for “glass”). This type of error is common in Wernicke’s aphasia.

·       Stereotypy

o   Stereotypy is the repetition of the same word, phrase, or expression in a fixed, rigid manner. This can be a part of certain aphasic syndromes and can be seen in global aphasia or Broca’s aphasia, where the patient might repeatedly use the same phrase without meaningful communication.

·       Stuck-in-set perseveration

o   refers to a situation where a person gets "stuck" in a particular response pattern and is unable to switch to a new one, even if the context changes. For example, they might keep naming objects that are related to the current set (like naming all fruits, even when the task asks for different categories).

·       Telegraphic

o   refers to speech that is characterized by the omission of function words (such as "is," "the," "of") and grammar, leaving only the essential content words. It is commonly seen in Broca’s aphasia, where individuals speak in a manner like a telegram (e.g., "Want food now" instead of "I want food now").

·       Verbal perseveration

o   the repetitive use of a word or phrase that is inappropriate or no longer relevant to the conversation. It can result from neurological damage, especially in conditions like frontal lobe dysfunction, where an individual may continue saying a word or phrase long after it is contextually appropriate.

Imagine two people engaging in conversation with you, one with Broca’s aphasia and the other with Wernicke’s aphasia. Which one is most likely to:

•       Speak “fluently”? - W

•       Have concomitant hemiplegia? - B

•       Have relatively good comprehension in conversation? - B

•       Perseverate on a word or a task? – W & B

•       Be depressed? - B

•       Have phonemic paraphasias? - B

•       Have press of speech or logorrhea? - W

•       Use fewer function (closed-class) words than content (open-class) words? - B

•       Use more nouns than verbs? - B

•       Demonstrate emotional lability? - W

•       Use agrammatic speech? - B

•       Use telegraphic speech?

•       Have poor self-monitoring of his or her linguistic errors?

•       Be especially upset or depressed about his or her loss of language abilities?

•       Struggle overtly with articulating words?

•       Have concomitant apraxia of speech?

•       Have concomitant dysarthria?

•       Have word-finding problems?

•       Show catastrophic reactions during interaction?

•       Use jargon in conversation?

•       Perseverate on a word?

•       Perseverate on a task?