Acquired Aphasia (eBook)

Martha Taylor Sarno (Herausgeber)

eBook Download: PDF

1998 | 3. Auflage
670 Seiten
Elsevier Science (Verlag)
978-0-08-052590-7 (ISBN)

Infos

With chapters containing up to 50 percent new coverage, this book provides a thorough update of the latest research and development in the area of acquired aphasia. Coverage includes the symptoms of aphasia, assessment, neuropsychology, the specific linguistic deficits associated with aphasia, related disorders, recovery, and rehabilitation. This comprehensive compilation, written by some of the most knowledgeable workers in the field, provides an authoritative text and reference for graduate students, clinicians, and researchers.

Key Features
* Chapters include up to 50 percent new coverage
* Provides update of latest research in the field
* Includes writings by the most knowledgeable workers in the field
* Comprehensive, exhaustive reference tool

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With chapters containing up to 50 percent new coverage, this book provides a thorough update of the latest research and development in the area of acquired aphasia. Coverage includes the symptoms of aphasia, assessment, neuropsychology, the specific linguistic deficits associated with aphasia, related disorders, recovery, and rehabilitation. This comprehensive compilation, written by some of the most knowledgeable workers in the field, provides an authoritative text and reference for graduate students, clinicians, and researchers. - Chapters include up to 50 percent new coverage- Provides update of latest research in the field- Includes writings by the most knowledgeable workers in the field- Comprehensive, exhaustive reference tool

Inhalt

Front Cover 1
Acquired Aphasia 4
Copyright Page 5
Contents 6
Contributors 12
Preface to the third edition 14
Preface to the second edition 16
Preface to the first edition 18
Chapter 1. Aphasia: Historical Perspectives 20
Early Contributions 20
Aphasia: 1800–1860 24
Aphasia: 1861–1900 26
Early Twentieth-Century Developments 30
The Modern Period 32
Contremporary Developments 33
References 39
Chapter 2. Signs of Aphasia 44
Aphasia 44
Signs of Aphasia 48
Classifications of Aphasia 51
Major Aphasia Types 53
References 59
Chapter 3. Neuroanatomical Correlates of the Aphasias 62
Fluent Aphasias 66
Nonfluent Aphasias 72
Atypical Aphasias 81
Conclusion 81
References 87
Chapter 4. Assessment of Aphasia 90
Purposes of Assessment and Testing 91
Psycholinguistic Evaluation of Aphasic Language 94
Contruction Principles of Aphasia Tests 96
Current Methods for the Assessment of Aphasia 102
Assessment of Aphasia in Children 147
Assessment of Aphasia in Clinical Practice 149
Conclusion 155
References 158
Chapter 5. Phonological Aspects of Aphasia 176
Introduction 176
The Sound Structure of Language: A Theoretical Framework 177
Speech Production 180
Speech Perception 191
Summary 198
References 199
Chapter 6. Lexical Deficits 206
A Lexical Deficit? 206
A Functional Architecture of the Lexical System 209
Aspects of the Internal Structure of the Functional Components 214
Conclusion 238
References 241
Chapter 7. Sentence Processing in Aphasia 248
Variability (and Malleability ) of Patients' Symptoms 251
Integrating Lexical, Semantic, and Syntactic Information in Sentence Processing 253
Sentence Production: Conceptions of Normal Production 255
Using the Model to Understand Aphasic Symptoms 257
Sentence Comprehension: A Framework for normal Comprehension 262
Sentence Comprehension Impairments in Aphasia 264
Resource Limitations, Capacity Constraints, and Short-Term Memory 271
Linking Syntactic Structure and Sentence Interpretation: Thematic Role Assignment 274
Discussion: Treatment of Sentence Processing Deficits 276
References 281
Chapter 8. Explanations of the Concept of Apraxia of Speech 288
Histrocial Background 289
Current Stands 295
General Characteristics of Limb-Kinetic Apraxia of Speech 303
Experimental Studies 305
Conclusions 317
References 319
Chapter 9. Aphasia-Related Disorders 328
Alexia and Agraphia 329
Acalculia 336
Finger Agnosia 339
Right-Left Disorientation 340
The Gerstmann Syndrome 341
Constructional Disorders 342
Apraxia: Disorders of Gestrual Behavior 345
Nonlinguistic Cognitive Abilities in Aphasic Patients 349
References 352
Chapter 10. Intellignece and Aphasia 360
Early Controversies 360
Intelligence 362
Intelligence and Brain Disese 366
Language and Intellectual Development 371
Acquired Aphasia and Congnition 375
Language Comprehension Impairment 381
Summary 386
References 387
Chapter 11. Artistry and Aphasia 394
Music 394
Literature 412
Drawing 402
Conclusion 421
References 422
Chapter 12. Aging, Language, and Language Disorders 432
Language in Normal Againg 433
Theoretical Explanantions for Language Changes in Normal Aging Aging and Aphasia 436
Aging and Aphasia 444
Language in Dementia of the Alzheimer's Type 446
Conclusion 458
References 459
Chapter 13. Acquired Aphasia in Children 470
Introduction 470
The Clinical Picture: Language Characteristics 473
Factors Related to Recovery of Language Abilities 485
Conclusion 458
References 495
Chapter 14. Aphasia after Traumatic Brain Injury 500
Introduction 500
Epidemiology and Mechanisms of Injury 501
Assessment of Initial Injury 504
Cognitive–Communicative Deficits beyond Aphasia 519
Discourse in Adults with TBI 523
Prognosis for Recovery 526
Aphasia in Children after Closed-Head Injury 531
Effects of Severity of Injury 536
Concomitant Neuropsychological Deficits 539
Special Aspects of Speech–Language Management 542
Summary 543
References 543
Chapter 15. Acquired Aphasia in Bilingual Speakers 550
Patterns of Recovery 550
The Role of Implict Memory 554
The Activation Threshold 557
The Role of the Right Hemisphere 559
Assessment of Bilingual Aphasia 560
Bilingual Aphasia Rehabilitation 561
Conclusion 563
References 564
Chapter 16. Ethnocultural Dynamics and Acquired Aphasia 570
Language as a Sociocultural Phenomenon in Aging 571
Culture and Ethnic Perceptions of Illness and Disability 572
Religion and Spirituality in Coping with Disability 573
The Role of Supportive Relationships in Aphasia Outcomes 578
Implications for Aphasia Rehabilitation and Research 580
Conclusions 583
References 583
Chapter 17. The Psychological and Social Sequelae of Aphasia 588
Historical Review 588
Language and the limbic System 595
Current Concepts of the Psychological Sequelae of Aphasia 599
Psychosocial Consequences of Aphasia 603
Management and Rehabilitation 605
References 610
Chapter 18. Recovery and Rehabilitation in Aphasia 614
Introduction 614
Early Accounts of Recovery and Treatment 614
Research Issues in Rcovery the Rehabilitation 619
Defining Recovery 620
Spontaneous Recovery 621
Predicting Recovery 621
Time since Onset and Recovery 623
Approaches to the Treatment of Aphasia 623
Studies of the Efficacy of Aphasia Treatment 632
A Philosophy of Aphasia Rehabilitation 634
The Aphasia Therapist 635
Concluding Comments 637
References 638
Subjet Index 652

Textauszug

2

Signs of Aphasia

Antonio R. Damasio

This chapter discusses the clinical presentation of the aphasias, the major types, and the principal signs. A discussion of the neuroanatomy and neurophysiology of language (and, by extension, a discussion of the physiopathology of the aphasias) is outside the scope of this text. However, the comments on the clinical evidence presented here reflect a particular theoretical perspective on neuroanatomy, neurophysiology, and physiopathology, which has been documented elsewhere in detail (A. Damasio, 1989a, 1989b, 1989c; A. R. Damasio & Damasio, 1994; H. Damasio & Damasio, 1989).

It is important to note that when I refer to the LOCALIZATION VALUE or CORRELATE of a given sign, I do not mean to say that the correlated brain locus normally operates to produce whatever function a sign reports as missing. In the perspective outlined in the earlier articles, language, along with other complex cognitive processes, depends on the concerted operation of multicomponent, large-scale neural systems. The anatomical components are often widely dispersed and each acts as a partial contributor to a complicated process rather than as a single purveyor. In this view, Wernicke's area, a part of which is a component of a language system, does not accomplish anything as complicated as auditory comprehension, although its impairment leads to auditory comprehension defects (A. Damasio, 1992).

Aphasia

Aphasia is a disturbance of the complex process of comprehending and formulating verbal messages that results from newly acquired disease of the central nervous system (CNS).

The disease processes that cause aphasia are acquired (e.g., cerebral infarction, tumor, contusion) rather than congenital (e.g., genetic or environment-induced perinatal cerebral defect). The former befalls individuals previously capable of using language appropriately. The latter may produce developmental language defects in individuals whose ability to use language will never attain a normal level.

Although it is clear that all mental activity and communication stems from the activity of the CNS, reference to the CNS is important because aphasia is not the result of a peculiar utilization of language related to psychogenic or social deviations.

Throughout the chapter I refer to VERBAL COMMUNICATION and LANGUAGE almost interchangeably. Under the terms verbal and language I include both auditory-based words and the visuomotor-based signs of sign languages. On the other hand, language and speech are not interchangeable. The latter should be reserved for the act of “speaking a verbal message” independently of the process of formulating the message itself. In this definition, I use VERBAL MESSAGES to call attention to the fact that aphasia relates exclusively to a disturbance in the use of words and signs, as opposed, for example, to the use of gestures, facial expressions, or body expressions, which are also important components of social communication but are not language in the sense used here.

Aphasia can affect comprehension of the language the patient either hears spoken or sees written, or both. It can also affect the comprehension of visuomotor signs from a sign language. Aphasia can affect the formulation of oral language production, writing, or both. In users of a sign language it affects the ability to sign in a linguistically correct manner.

Aphasia often disturbs both reception and expression of language, in both visual (written) and auditory (spoken) modes. Yet, each of the several fundamental types of aphasia compromises one of these modes preponderantly. Indeed, in some instances (e.g., in PURE ALEXIA or in PURE WORD DEAFNESS), only one of these abilities suffers while all others remain unaffected. There is more about this particular question later in the chapter.

The emphasis on COMPREHENDING and FORMULATING is especially pertinent. Aphasics have trouble comprehending verbal messages, that is, deciphering their meaning as opposed to hearing or seeing those messages. Neither deafness (peripheral or central) nor blindness is the problem. A deaf or blind person cannot comprehend language in the modality of the perceptual impairment, but will comprehend the same verbal message normally when processed by an intact sensory channel, for example, tactile Braille reading in the blind. Aphasics also have trouble formulating verbal messages, for example, selecting the lexical and syntactical items necessary to convey meaning and deploying them in a relational framework such that meaning is indeed imparted on the receiver of the message. Yet an impediment of phonation that prevents speech production has nothing to do with formulation of verbal messages (people can still write what they cannot say), nor does the loss of one's hands interfere with language formulation (people may still say it if they have formulated it, and they may even write with a pen held between the teeth or the toes).

To characterize the nature of the disturbance, stating what aphasia is not becomes just as important as stating what it is. To begin with, aphasia is not a disturbance of articulation. Many patients suffer from speech disturbances due to acquired disease of the basal ganglia, of the brain stem or cerebellum, or even of the cerebral cortex, and yet few of those patients will have aphasia. Although their speech sounds are poorly formed or are inappropriately repeated, word selection and sentence structure are grammatically correct, appropriate to the intentions of their author, and understandable to the attentive listener. That is to say, such patients have a speech disturbance but it does not follow that they have a verbal language disturbance: Their language formulation is normal, their communication is linguistically correct, and thus they do not have aphasia.

Patients with mutism, who can be entirely silent, are not necessarily aphasic, although on occasion their absence of speech does conceal an aphasia. Often these patients fail to indicate any desire to communicate by gesture, mimicry, or writing. Consequently, little is known about what they do or do not comprehend, or about what they may or may not want to say (or think, for that matter). However, when most mutism patients awake from these peculiar states of apparent indifference, they resume language communication and show no evidence of aphasia. When probed about their abnormal behavior, these patients clearly relate a strange experience of avolition and diminished richness of thought content, but not of any problem with the actual composition of verbal communication. Most such patients have disease in areas of the brain that are different from those that produce the aphasias, for example, in the supplementary motor area or in the cingulate gyrus as opposed to the region surrounding the Sylvian fissure. A few have acute psychotic states and no macroscopically detectable brain disease, although they may suffer from profound changes in neurotransmitter systems innervating certain regions of the brain.

Also not aphasic are patients with aphonia that may result from diseases of the larynx and pharynx. They are mute, in the narrow sense of the word, and are suffering from an impediment in their phonatory apparatus that prevents them from speaking. They should be able to comprehend language (and indicate so by nodding or pointing responses), and they should be able to turn their thoughts into language by writing, in addition to being able to mouth words. The exception, other than for malingering, is a conversion reaction, the currently infrequent psychiatric diagnosis of HYSTERICAL APHONIA.

Finally, it should be noted that the language disorder experienced in altered states of awareness is not an aphasia. Any patient with a confusion-al state will produce disturbed language and fail to comprehend verbal communication. But such patients have a concomitant disorder of their thought processes that parallels the language disturbance. Unlike the patient with aphasia who struggles to turn properly organized meanings into language and fails (or tries, without success, to turn the message heard into internal meaning), patients with confusional states communicate their disordered thought processes verbally, with remarkable success. Confusional states are most commonly produced by metabolic disturbances or by substance intoxication, but they can also be the result of cerebral tumors (directly or indirectly affecting brain structures that sustain vigilance) or of trauma.

A picture of a patient with aphasia should begin to emerge:

1. An aphasic produces some speech, or even abundant speech, which does not conform to the grammatical rules of the language being used. The errors include omission of words, such as conjunctions or prepositions (functor words), erroneous choice of words (substitution of the intended word for another that may or may not be related in sound or meaning), and disturbances of the relationship among words in a sentence (e.g., as expressed in word order). The rule that aphasic patients always produce some speech may not be true during the first hours or days of onset of disease. But even during a phase of speechlessness, most aphasic patients attempt to communicate by gesture or facial expression.

2. An aphasic often has difficulty in comprehending a purely verbal command (i.e., a verbal message given through auditory or visual means, without accompanying gestures, facial expressions, or meaningful emotional...

Produkt-Details

• Erscheint lt. Verlag: 9.9.1998
• Sprache: englisch
• Themenwelt: Geisteswissenschaften ► Psychologie
• Themenwelt: Geisteswissenschaften ► Sprach- / Literaturwissenschaft ► Sprachwissenschaft
• Themenwelt: Medizin / Pharmazie ► Gesundheitsfachberufe ► Logopädie
• ISBN-10: 0-08-052590-3 / 0080525903
• ISBN-13: 978-0-08-052590-7 / 9780080525907