Lecture 4.1 Flashcards
What helped to validate the Boston classification system?
correlations between groups of behaviours and sites of lesions
determined by autopsy or neuroadiology studies
What are some risks associated with using a classification system?
cast person into preconceived set of behaviours
ignoring critical assessment in areas the classification system does not cover
within-group variance often is larger than between-group variance for dimensions on which treatment may be being based
What did Hughlings Jackson contribute to aphasia classification?
classified aphasia based on function of language
propositional (intellectual, rational, volitional) vs. non-propositional (inferior, automatic, overlearned) utterances
persons with aphasia have language problems because they can’t propositionalize - express relationships between words
What aphasia classification system do we use universally now?
Goodglass & Kaplan
based on objective measurements
anteriors/non-fluents
- Broca’s (expressive)
- global (motor)
- transcortical motor (expressive)
posteriors/fluents
- Wernicke’s (receptive)
- transcortical sensory (receptive)
- conduction (sensory)
- anomic (sensory)
What theorists are localists in terms of aphasia classification?
Broca and Wernicke
What did Roman Jackobson contribute to aphasia classification?
linguistic approach
system based on linguistic functions of utterances
- contiguity (combination/encoding)
- can understand/produce key lexical items
- problems combining words, transforming sentences grammatically, rhythm and sequencing, etc.
- syntagmatic errors - sequencing of linguistic units, word relationships across class - similarity (selection or decoding)
- little difficulty with conversation and rhythm
- problems with word finding, labelling, categorizing
- paradigmatic errors - can’t generate items within same morphological class
What did Pick contribute to aphasia classification?
psycholinguistic perspective
agrammatism as core symptom of aphasia
expressive - motor
impressive - sensory
What did Goldstein contribute to aphasia classification?
motor aphasias:
- cortical motor
- transcortical motor sensory
- subcortical motor
sensory aphasias
- central
- transcortical
- amnesic
- global
What did Wepman and Jones contribute to aphasia classification?
based on test responses
- semantic
- word finding problems - pragmatic
- problems obtaining meaning from stimulus - syntactic
- omission or misuse of grammar - jargon
- neologisms, sound combinations
- unintelligible utterances - global
- severe impairment in production and expression
- single words, some gestures
What did Schuell contribute to aphasia classification?
unitary view
varies only along a dimension of severity in a single disorder, no qualitative differences
multi-modality disorder - crosses all language modalities
What did Luria contribute to aphasia classification?
6 subtypes
efferent motor sensory afferent motor acoustic amnestic semantic amnestic dynamic
What did Benson and Geschwind contribute to aphasia classification?
10!
aphemia - subcortical motor aphasia Broca's pure word deafness Wernicke's conduction anomic global transcortical motor transcortical sensory isolation
What categorization parameters are used in Goodglass and Kaplan’s classification system?
spontaneous language repetition auditory comprehension reading comprehension and matching reading aloud writing
What parameters are used to determine fluent vs. non-fluent spontaneous language?
articulatory agility
grammatical form
melodic line
average phrase length (words/breath group)
anomia - paraphasic errors
What would non-fluent in terms of articulatory agility look like?
increased effort to speak
mispronunciations at phoneme and syllable level
re-starts and re-formulations, repetitions
What would non-fluent in terms of grammatical form look like?
agrammatic
absent, incorrect grammatical structures
non-meaningful filler words or phrases
What would non-fluent in terms of melodic line look like?
altered prosodic features (duration, rate, loudness, pitch contours, stress patterns)
pauses/hesitations
disrupted rhythm
What are some features of a non-fluent/anterior aphasia?
short phrases (2-3 words)
high % use content words > functor words
low speaking rate (words/min)
restricted vocabulary
comprehension may vary
retains overlearned forms (stereotypes and serial items)
speaking impairments mirror writing impairments
Where are lesions in anterior aphasias?
anterior to central sulcus
superior to Sylvian fissure
What are some features of posterior/fluent aphasia?
normal phrase lengths
use all word classes but sometimes have semantically empty expressive language (filled with jargon and paraphasias)
significant word finding difficulties
impaired auditory comprehension
impaired reading aloud, reading comprehension, and writing
normal melody and rhythm
can be unaware of errors
Where are lesions in posterior aphasias?
posterior to central sulcus
What are some characteristics of spoken language in a person with Broca’s aphasia?
verbal output is laboured and sparse
short phrases, telegraphic speech
restricted vocabulary and grammar
poor articulation
dysprosodic
What are some features of agrammatism?
presents across language domains/modes
reduced in fluency (slower output)
omission of functor words, verbs uninflected if used
effortful, telegraphic like
impaired sentence comprehension
What are the characteristics of repetition in Broca’s aphasia?
abnormal
omits functor words
difficulty repeating same syntactical wording
know they’re not repeating the same words and same order
