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Aphasia is defined as a neurological disorder caused by damage to the portions of the brain that are responsible for language production and processing. Damage is more frequently on the left hemisphere and caused by a stroke, but this is not always true.
There are many different types of aphasia and ways to diagnosis characteristics of aphasia. It is key to remember that people do not typically fit into nice and neat profiles of aphasia and it is necessary to look at all the signs and symptoms, which is why we use a psycholinguistic model. To identify aphasia we need to look at the 4 language modalities: naming, fluency, repetition, and auditory comprehension...
Damage to 3rd frontal convolution
Damage to posterior half of first temporal gyrus
Damage outside broca's area, anterior superior frontal lobe
Damage to inferior parietal or connection between parietal and temporal lobes
Damage to connection between frontal and temporal lobes, the arcuate fasciculus
Damage looks like a small/mild lesion, maybe in multiple locations
Damage to large portion of the perisylvian assocation cortex
Job: Parse out the signal
Routes: 1st step in "hearing" a word, connects to both lexical and bypass route.
Lesion Symptoms: Pure-Word Deafness
Testing to Identify: BDEA-None directly, need to test other boxes in routes. PAL-Phoneme Discrimination. PALPA-Word and Nonword Minimal Pairs
Job: Identify the sounds/phonemes
Routes: Heard words, for speech or written production.
Lesion Symptoms: Short term memory for holding onto phonemes impaired.
**This box is not represented in textbook/all route diagrahms.
Testing to Identify: PALPA-Digit Span/Matching Span.*
*Tests also used for auditory output buffer
Job: Is this a familiar or new/false word? Which route do I take?
Routes: Heard words, to speech or writing.
Lesion Symptoms: Word Meaning Deafness
Testing to Identify: BDEA-Auditory Lexical Decision Task. PAL-Auditory Lexical Decision, Auditory Lexical Decision Affixed Words. PALPA-Auditory Lexical Decisions: ImageabilityXFrequency, Auditory Lexical Decision: Morphological Endings.
Job: Pull out learned meaning, IMPORTANT BOX!!!
Routes: Anything needing lexicon, heard, picture, or written.
Lesion Symptoms: Unable to access lexicon/meaning.
*Deep Dysphasia occurs when lesions occur both to the semantic system and in the bypass route.
Testing to Identify: BDAE-Basic Word Discrimination, Word Comprehension with Semantic Distractors, Semantic Probe with Pictures. PAL-Auditory Word Picture Matching, Forced-Choice Attribute Verification, Relatedness Judgment Abstract Words, Relatedness Judgment Affixed Words. PALPA-Spoken Word Picture Matching, Auditory Synonymy Judgement. ??-Semantic Probe Questions
Job: Storage of spoken word forms, do you know what sounds are in this word and how to put them in appropriate sequence?
Routes: In order to say anything/speech production of any input route.
Lesion Symptoms: Impaired word retrieval
Testing to Identify: Picture homophone judgment, rhyme judgment*. *Not a great test.
Job: Assemble and sequence the phonemes for the word production
Routes: In order to say anything/speech production of any input route.
Symptoms: Affects all spoken word tasks. Lesion here has phonological errors and neologisms. Shorter words may be easier than longer words.
Testing to Identify: Effect of number of syllables on word production tasks.
Job: Avoid semantic system and just hear phonemes and repeat phonemes without lexical meaning.
Routes: Indirect/Bypass Route of Word Repetition
Lesion Symptoms:
Testing to Identify:
Job: Picture Recognition
Routes: Picture Naming or Picture Based Reasoning
Lesion Symptoms: Unable to "see" picture.
Would not be able to access the lexicon.
Testing to Identify: PAL-False Animals, Front to Back.
Job: Visual object recognition
Routes:
Lesion Symptoms:
Testing to Identify: