Goldstein (1948) considered that some aphasic patients had an impairment in abstract reasoning. Initially this theory was inspired by his observations that patients might, even in non-verbal tasks, group objects in curious ways—they did not seem to appreciate the (abstract) categories into which they fell. Patients can be absorbed by the concrete details of a task and be unable to distinguish its elements. Goldstein’s concept has been criticised for not being precise, and has received little attention from contemporary researchers, even where they have been concerned with aphasic categorisation.
The grammatical disturbance in the speech of non-fluent aphasic patients. Speech consists mostly of content words, and there are few attempts at syntactic structures; many function words and inflections are missing, and there are few verbs. In inflecting languages such as German or Russian verbs mostly appear in the infinitive and nouns in the nominative. Some (but not all) patients who are agrammatic in speech production also have difficulties in sentence comprehension, where understanding the sentences requires knowledge of their syntactic structures. A variety of very different kinds of difficulties in sentence comprehension and production may have been categorised together as agrammatism.
A difficulty in word finding; most often demonstrated in picture-naming tasks, but often also evident in circumlocutions in spontaneous speech. Some degree of anomia is found in virtually all aphasic patients; where it is the most prominent problem, a patient is said to show anomic aphasia.
Anomia aphasia (amnesic aphasia)
A type of aphasia in which a difficulty in retrieving content words, and sometimes particularly nouns, is the most obvious problem. The difficulty may be confined to speech production, but some patients also have problems in word comprehension. Other aspects of langauge are relatively well-preserved; repetition is good and spoken language is grammatically well-formed, although there may be many circumlocutions.
This refers to a disorder of language following some kind of acquired brain damage. The term excludes disorders in language comprehension or expression that are primarily due to mental disorders, including psychosis, dementia, and confusion. It also excludes disorders that are due to difficulties in sensation (e.g., deafness), or due to difficulties in articulation or its control (dysarthrias). The term is thus intended to include all disorders of language that are primarily due to impairment to the linguistic system itself. The boundaries of this have not been easy to determine in practice; there is, for example, debate on whether a difficulty in organising the movements of articulation (articulatory apraxia) should be considered a primarily motor disorder (and therefore non-aphasic), or a primarily linguistic one (and therefore aphasics).
A term used by Hippocrates to refer to any sudden attack of paralysis or loss of sensatioin as a result of cerebral disease. Equivalent to the modern term stroke.
A term that Broca (1861, 1869) attempted to introduce to describe “loss of the faculty of articulated language.” In aphemia there is very much reduced vocabulary or even speechlessness except for some oaths and neologisms. Ideas, as shown by gestures, are intact, and comprehension is good even for words and sentences that the patient cannot repeat. Broca wanted to distinguish this from “verbal amnesia” in which there is no longer a connection between words and the ideas that they represent. Trousseau(1864) objected to the term “aphemia,” believing, according to Head (1926), that in Greek it meant “infamous”; he introduced his own coining – “aphasia”—which gained general acceptance.
Any disorder of the organisation of movement; the concept was developed by Liepmann (1900). Involuntary movements may be relatively normal, but more deliberate or symbolic acts are disturbed. Apraxia is, most typically, confined to movements of one kind, or one part of the body; hence the sub-categories. A range of different types of apraxia have been proposed: limb apraxia, ideomotor apraxia, ideational apraxia, constructional apraxia, dressing apraxia, etc.
Articulatory apraxia (apraxia of speech)
A difficulty in the organisation of movements of the articulators for the production of speech sounds. There should be no motor difficulty, and speech sounds may be produced correctly in relatively automatic ways (e.g., swearing, counting, singing), but impossible when produced deliberately. Articulatory apraxia is often accompanied by oral apraxia—a defect in the organisation of non-speech mouth movements—and aphasia. There is much debate about whether articulatory apraxia should be considered a language disorder (and therefore a symptom of aphasia), or a disorder of motor control. In many patients, the articulatory disorder is affected by linguistic factors (e.g., syntactic category, word frequency, real word vs non-word); in these cases it would seem unprofitable to ignore the linguistic dimension.
A psychological theory, which can be traced back to Aritotle, but which was first fully developed by the English Empiricists, particularly Hume. Association is the fundamental principle of mental life. Sensations or images can become associated by one of three relations: similarity, contrast, and contiguity. Complex ideas are built up from simple sensations by these laws of association; the early empiricists hoped to reduce these three laws to one—the law of contiguity—and to create a mental mechanics that would rival the physical mechanics that Newton had developed.
Associationism remained the dominating perspective on psychology throughout the nineteenth century (e.g., James Mill, Herbert Spencer, Ebbinghaus) and in the twentieth century was developed into behaviourism, which aimed to explain all behaviour in terms of associations between stimuli and responses.
Speech where the process is initiated by the clinician and completed “automatically” by the patient. This includes all serial speech (i.e., counting, months, etc.) as well as songs, poetry, and cliché completion (as when a patient says “dogs” after the clinician says “It’s raining cats and …”). According to Jackson, this is non-propositional, and therefore not real speech. Automatic speech is often the only speech that very severe global aphasics can produce.
An approach to psychology developed by J.B. Watson (1914) that asserts that psychology should only be concerned with observable behaviour, and should not consider mental events—thoughts, feelings, concepts. It became the dominant approach to psychology in the United States following the Second World War. In its most extreme examples, no internal state of an organism could be discussed. It lead to a largely sterile psychology, which avoided theory; it was strongly concerned with the behaviour of laboratory rats, hoping that investigation of lower animals in controlled situations would yield general principles that could explain the behaviour of humans. Now largely abandoned.
A neo-classical category of aphasia. Spontaneous speech is non-fluent, and sometimes there is a degree of dysarthria and/or articulatory apraxia. Function words and grammatical affixes may be omitted, and syntactic structure simplified or even absent; verbs are often rare and nouns relatively common. Language comprehension is by comparison relatively good, although there may be difficulty with grammatically complex sentences. There are almost always word retrieval problems, evident in both picture-naming and spontaneous speech; repetition is disturbed in line with the disruption of spontaneous speech.
Attempt to explain a word in a roundabout way, or finding a way to avoid using a word. It usually reflects an underlying difficulty in word retrieval.
A category of aphasia in which repetition is disturbed more severely than other functions. Auditory comprehension is reasonably good, although there may be a subtle difficulty with grammatically complex sentences. Speech production is fluent, but there are often phonemic paraphasias; these are usually more prominent in repetition tasks. Shallice and Warrington (1977) argue that there are (at least) two varieties of conduction aphasia: a reproduction disorder causing phonological errors in all speech production tasks; and a limitation in auditory-verbal short-term memory.
A disorder of oral word reading in which (1) the patient cannot read non-words (e.g., GOCK); (2) concrete words are read better than abstract words; (3) function words are read worse than content words; (4) words with grammatical inflections are hard; (5) semantic errors(e.g., CAT→”dog”, AVERAGE→”bad”), morphological errors (e.g., WALKING →”walks”) and visual errors (e.g., WIRE → “wine”) occur. Many, but not all deep dyslexics are also Broca’s aphasic and deep dysgraphics. These patients are thought to read aloud using only a route that involves access to central semantic representations.
An acquired writing difficulty, used to describe a pattern of difficulties in writing words to dictation. Deep dysgraphic patients (1) cannot write non-words to dictation; (2) write concrete words better than abstract words; (3) write function words worse than content words; (4) have difficulty with words with grammatical inflections, and (5) make semantic errors, morphological errors, and visual errors.
A term used by Head (1926) to describe the localisationist neurologists of the nineteenth century – Wernicke, Lichtheim, Broadbent, Bastian etc.—because of their tendency to propose theories that were expressed as diagrams. Head intended the term as an insult.
Direct method (Direct speech training)
An approach to aphasia treatment advocated by Kussmaul, Gatzmann, and Froeschels, in which language is reconstituted by dint of repetition. First the patient has to learn to repeat sounds, then words and later phrases. Patients were typically encourage to use words multimodally; a patient might, for example, hear a word, repeat it, see the written word and copy it; repetition, though, remains the central method of the approach.
The view that there are two fundamental types of substances. All substances are either material or mental, and neither can be reduced to the other. In this it is opposed to reductionism, which holds that all mental events can be reduced to material events, and idealism, which holds that all material event are in fact mental.
A term used by Luria to describe aphasic patients who have difficulty in converting internal speech into spoken narrative, because of , in Luria’s words, “a disturbance in the linear scheme of the sentence”. Comprehension, word retrieval, and repetition are undisturbed, but the patient is at a loss when required to turn his thoughts into language. There is no category that corresponds to dynamic aphasia in other classification systems.
A disorder of articulation. This can be due to either a defect in the organs of articulation (i.e., mouth, tongue, larynx, etc.) or, more commonly in aphasic patients, by impairment to the nerves supplying the organs of articulation. A number of different types of dysarthria are recognised, including spastisc dysarthria (characterised by raised tone in the muscles controlling articulation), flaccid dysarthria (in which there is reduced tone and weakness), dystonic dysarthria (where poorly-controlled writing movements may occur), and ataxic dysarthric (where there is poor coordination of muscle movements). There is no deficit of language. There is debate on whether articulatory apraxia should be described as a variety of dysarthria.
A disorder of reading. The traditional classification of disorders of reading, developed by Dejerine (1892), recognises three kinds of dyslexia, which are distinguished by their accompanying disorders. In dyslexia without dysgraphia (or pure dyslexia), writing is unaffected but reading is disturbed; in dyslexia with dysgraphia, both reading and writing are disturbed, but there is, by comparison, little or no aphasia.. In dysphasic dyslexia, reading, writing, and other langugae modalities are impaired. This classification schema is (broadly) accepted by the neo-classical school.
Impairment in (one or more of ) the prosodic aspects of speech: rhythm, intonation, or stress.
The involuntary repetition (by a patient) of other people’s speech. It is rare in aphasic patients, although it is said to be a feature of “isolation syndrome,” where repetition is the only function which remains (relatively) intact.
Efferent motor aphasia
A category of aphasia proposed by Luria (1947), approximately equivalent to Broca’s aphasia. In this type of motor aphasia there is a defect in the “serial organisation of the spoken word” and phones are not modified according to their phonological context. As patients improve, agrammatism becomes apparent. Efferent motor aphasia (where the problem is a disorder in output) is distinguished from afferent motor aphasia, where articulatory organisation breaks down because of a failure in the use of kinaesthetic feedback for the control of articulation.
In Gestalt psychology, a figure can only be perceived against its ground. That is, in general, mental events need to be considered in their context. This follows directly from the Gestalt thesis that the whole is greater than its parts.
An approach to psychology developed in Germany in the first quarter of the twentieth century that emphasizes that mental events and experience can not be completely analyzed into a series of elements; the whole is more than the sum of the parts. This led to an interest in the way mental events interacted. Goldstein developed a form of gestalt psychology, which he called organismic psychology, which saw the behaviour of an organism as a concerted effort towards particular ends, and saw the importance of maintaining equilibrium. This was reflected in his view of the (damaged or undamaged) brain acting as a whole interacting unit.
An aphasia in which language is very severely affected in all modalities. In the most extreme cases there may be no evidence of any real knowledge of language remaining. Auditory comprehension is usually the least impaired modality.
Paralysis of one side of the body. When caused by damage above the level of the brain stem, the paralysis is on the opposite side of the body from the lesion that causes it. Aphasia, which usually follows damage to the left hemisphere (at least in right-handed people), may be accompanied by a right hemiplegia.
The view that a system is more than the sum of its parts. Applied especially to the opponents of localisationism (e.g., Jackson, Goldstein, and Lashley) who emphasizes that the parts of the brain must be considered to be interacting, and that as result that action of an individual part cannot be separated off.
The sensation caused by movements; kinaesthetic feedbach is important in the control of many movements, especially fine or skilled ones.
The doctrine that specific mental events are localised in specific parts of cerebral tissue. Most usually “faculties” (e.g., acoustic images of words) have been located in paarticular centres. Many localisationists were also reductionists; Wernicke, for example, believed that “central nerve endings are invested with the role of psychic elements,” and associations were represented by nerve fibres. The nineteenth century localisationists were almost all reductionists.
Concerning mental events, thought. Behaviourists felt that mental concepts, including, for example, meaning, were unobservable and therefore could not be part of the concerns of science.
A term used in behaviour therapy to describe giving the patient an example of how to do something that they can imitate.
A term used to describe aphasia in which speech production is much more impaired than comprehension. Patients have non-fluent speech, and often a degree of dysarthria. Although broadly equivalent to the neo-classical Broca’s aphasia, it has often been used to include all kinds of non-fluent aphasia.
An adjective meaning related to memory.
The production of non-existent words in spontaneous speech; most authors distinguish between phonemic paraphaias (which bear a clear phonological relationship to the target word) and neologisms (which do not). Where neologisms are frequent, the patient is said to show neologistic jargon aphasia.
A malignant tumour.
A term introduced by Kleist (1916) to refer to the grammatical errors of fluent aphasics. In general these errors appear to reflect misselection of function words or grammatical affixes, or confusion of syntactic structures; in contrast to agrammatism, omission of function words and affixes is comparatively rare.
The use of an inappropriate word in speech—a word erroneously used—traditionally divided into semantic paraphasias (e.g., naming a CAT as “a dog”), and phonological paraphasias (or phonemic paraphasias, or literal paraphasias), where the error sounds like the target (e.g., naming a CAT as “a cap”). Phonological paraphasias may either be real words, or non-words.
An approach to the treatment of non-fluent aphasics in the early stages of recovery devised by Beyn and Shokhor-Trotskaya (1966), whose aim is to prevent the appearance of agrammatism.
Hughlings Jackson in opposing the localisationists of the mid-nineteenth century protested that language did not consist of sequences of single word, but of the expression of relationships between concepts; that is, using Herbert Spencer’s term, “propositions.”
To speak is not to utter words, it is to propositionise. A proposition is such a relation of words that it makes one new meaning; not by the mere addition of what we call the separate meanings of the several words; the terms in a proposition are modified by each other. Single words are meaningless and so is any unrelated succession of words. The unit of speech is a proposition… Loss of speech is therefore the loss of power to propositionise. (Jackson, 1932,
Jackson went on to argue that aphasic patients may not only have lost the power to express propositions, but that they may also fail to generate propositions internally; from this viewpoint aphasia is a problem of both language and thought. Following on from this Head (1926) claimed that (some) aphasic patients had a general problem in symbolic thought; he abandoned the term “propositionise” because he felt it was too imprecise.
Weisenburg and McBride (1935) used the term “predominantly receptive aphasia” to describe any aphasia where the language comprehension problem was more obvious than the difficulty in language production. “Predominantly” is used to show that they recognise that both comprehension and production are usually affected. In “predominantly expressive aphasia,” production is rather more severely affected than comprehensioin. They also recognise “expressive—receptive aphasia,” where both comprehension and production are severely disturbed (basically the same as global aphasia), and “amnesic aphasia” (anomic aphasic).
Reconstitution of function
A term used by Luria to describe his therapy approach, where an impaired function is performed in a different, roundabout way. Initially the patient has to learn to use the new approach deliberately, but with practice it should become increasingly unconscious and automatic.
A term used to describe aphasia where language comprehension problems are especially prominent; speech production is fluent, and uses a variety of grammatical constructions. Some authors have used the term to describe all fluent aphasias other than anomic aphasia, but Luria uses it much as the neo-classical Wernicke’s aphasia.
A disorder of oral word reading in which (1) words with regular spelling (e.g., FEW, KERNEL) are read much more accurately than words with irregular spelling (e.g., SEW, COLONEL); (2) non-words are read with reasonable accuracy; and (3) many of the errors are phonologically plausible renderings of the letter string (e.g., BEAR→ “beer,” YACHT→ “/j$tNt/”). This is usually interpreted as an impairment in lexical reading, so that the patient is forced to rely on some kind of sub-lexical routine, using for example “grapheme-to-phoneme conversion rules.” Many (but not all) surface dyslexics are also surface dysgraphic.
A pattern of impairment in writing words to dictation in which a patient (1) writes more accurately words whose spelling is uniquely determined by their phonology (e.g., BANK, RIDGE); (2) writes non-words with reasonable accuracy; and (3) makes errors that are orthographically plausible renderings of the words (e.g., “blue”→ BLOO, “yacht” →YOT). These patients are thought to be relying on a sub-lexical routine for word writing as lexical access to specifications of spellings is impaired.
A neo-classical category of aphasia. Wernicke’s aphasics have fluent spontaneous speech in which there are a variety of grammatical constructions; where there are frequent paraphasias and/or neologisms, the speech may be described as jargon. Word comporehension is poor, and repetition is also disturbed.
A word used in the nineteenth and early twentieth century to describe dyslexia; use of the term is often intended to emphasize a similarity with word deafness. Some authors have used the term to descsribe only dyslexia without disgraphia.
A difficulty in word comprehension despite good hearing, at least of non-speech sounds. A relatively rare disorder, it was classically sub-divided into two types: word-sound deafness where there is a primary difficulty in phoneme identification; patients should be able to discriminate non-speech sounds, but are unable to determine whether or not something is a real word. In word-meaning deafness the patient knows that he/she has heard a familiar real word but has no idea of its significance. While many patients describe occasional episodes of word deafness, it is probably very rare as an isolated symptom.