Aphasia A disorder caused by damage to the parts of the brain that control language. It can make it hard to read, or write and to comprehend or produce language.

Developmental Aphasia Approximately 1 in 20 children has symptoms of a language disorder. When the cause is unknown, it is called a developmental language disorder. Language disorders may occur in children with other developmental problems such as autistic spectrum disorders, hearing loss, and learning disabilities. A language disorder may also be caused by damage to the central nervous system, which is called aphasia.

Language disorders are rarely caused by a lack of intelligence.

Acquired Aphasia Result of accident or disease Stroke Tumor Trauma Disease (e.g., Pick’s Disease, AKA frontotemporal dementia) aphasia may occur suddenly or develop over time, depending on the type and location of brain tissue damage.

Paul Broca In 1861, Broca heard of a patient who had a 21-year progressive loss of speech and paralysis but not a loss of comprehension nor mental function. He was nicknamed "Tan" due to his inability to clearly speak any words other than "tan" Paul Broca ’s

When Tan died Broca performed an autopsy. He determined that Tan had a lesion in the frontal lobe of the left cerebral hemisphere. Broca went on to find autopsy evidence from 12 more cases in support of the localization of articulated language.

Broca’s (Expressive) aphasia Type of aphasia, which involves impairments in speech output. Halting, non-fluent speech. Content words are correct but function words (i.e., articles and adjectives) were impaired. Grammatical errors the person knows what he or she wants to say, yet has difficulty communicating it to others.

Broca’s Aphasia cont. Motor speech problems (apraxia)apraxia Broca’s area seems to play a major role in the planning and control of speech behavior Telegraphic Speech consisting of simple three or more word sentences usually comprising at least one noun and verb that adhere to the grammatical standards. Similar to developing speech in children.

Ted Talk of Gabby Gifford Congresswoman Gabrielle ("Gabby") Giffords captured the attention—and deep sympathy—of a nation when she was shot by Jared Lee Loughner in a Safeway parking lot on January 8, 2011, in Tucson. Giffords' injury to her brain's left hemisphere resulted in aphasia.

Carl Wernicke Wernicke noticed that not all language deficits were the result of damage to Broca's area. He found that damage to the left superior temporal gyrus resulted in deficits in language comprehension. This region is now referred to as Wernicke's area, and the associated syndrome is known as receptive aphasia. Carl Wernike 1880’s

ExampleExample of Wernicke's Aphasia Comprehension is impaired Speech is fluent but has little informational value. They speak easily or even abundantly, yet may produce unintended syllables of words. They will experience the same difficulties when writing as when speaking.

Wernicke’s Aphasia cont Fluent function words, but impaired content words. Might have – Random words (Word salad) – Neologisms Neologisms rarely correct errors, seem unaware of errors (anosognosia)

Wernicke's Model Broca’s Area: Speech – Phonemic Movement Programs. Wernicke's Area – Phonological input Lexicon

Wernicke predicted the existence of Conduction Aphasia in which people can understand speech but make errors in repetition. Due to lesion of the connection between Wernicke's and Broca’s areas.Conduction Aphasia Arcuate fasciculus

Conduction Aphasia Comprehension and production are relatively intact. capable of understanding what they are hearing but they will have difficulty repeating display frequent errors during spontaneous speech, such as substituting or transposing sounds. Are aware of their errors, and will show significant difficulty correcting them.

Speech- Phonetic Movement Programs Motor Systems Auditory Analysis Phonological Analysis Speech Input

Lichtheim (1885) Found cases of patients with conduction aphasia partially confirming Wernicke's Model But New forms of Aphasia were identified that required that the model be extended.

Models of Aphasia Wernicke-Lichtheim Model of Aphasia Speech- Phonetic Movement Programs D Motor Systems Auditory Analysis Phonological Analysis B Speech Input Semantic Conceptual Area F C E G A

Boston Aphasia Classifications Broca’s Aphasia - Speech is laborious and grammar can be incorrect. D Wernicke's Aphasia: Comprehension is impaired B. Conduction Aphasia Comprehend and produce speech accurately – difficulty repeating. C

Global Aphasia Both Comprehension and production impaired. most severe type of aphasia. often seen right after someone has a stroke. person is unable to read or write. Generally involves widespread left hemisphere damage

Global Aphasia – neither comprehend nor produce speech. Damage to both Broca’s and Wernicke's areas. B and D Transcortical Motor Aphasia (TMA)– Similar to Broca’s but can’t repeat. G Transcortical Sensory Aphasia (TSA) – Similar to Wernicke's but repetition is preserved. E - exhibit echolalia, or even compulsive repetition of words. echolalia

Isolation Aphasia (Mixed Transcortical Aphasia) – cannot understand or produce speech but can repeat words. E and G Anomic Aphasia – Problems in naming objects across modalities. G or E

Anomic Aphasia Problems recalling words, names, and numbers. often use circumlocutions (speaking in a roundabout way) in order to avoid a name they cannot recall or to express a certain word they cannot remember. can recall the name when given clues. are able to speak with correct grammar

Transient Anomia Might result from: Aneurism (e.g. Ashcroft) Epileptic seizure E.g., A 37-year-old man had episodes of transient anomia for people's names over a period of 6 months. The first episode lasted about 10 min and was restricted to an inability to remember his 2- year-old son's first name. The second, was limited to an inability to recall his daughter's first name for 5 min. (Ghika-Schmid & Nater, 2003)

Ashcroft "The most powerful realization I had during the episode... was a dissociation between the thought and the word or phrase that expresses the thought. The subjective experience consisted of knowing with complete certainty the idea or concept that I was trying to express and being completely unable to find and utter the word that expressed the idea or concept.... The experience was not one of being unable to articulate a word currently held in consciousness. Instead, it was one of being fully aware of the target idea yet totally unable to accomplish what normally feels like a single act of finding-and-saying the word."

Optic anomia Patient JF was impaired when naming visually presented objects but could define them from their spoken names or by touch (Beauvois et al., 1973; 1982; 1985). He could mime the use of the objects so this was not agnosia (i.e. knew what object was). C.f. Tactile anomia e.g., RG could not name objects by touch but could name visually presented objects and pantomime their use (suggesting that he knew what the object was).

Pure Word Deafness No comprehension of speech, No ability to repeat or to write to dictation feel as though they can't hear when someone else is speaking, even if the person speaking is doing so in a loud voice. they have no trouble hearing other sounds, such as a telephone ringing or a door bell. maintain the ability to write spontaneously

Phonagnosia Disturbance in the recognition of familiar voices the impairment of voice discrimination does not suffer from comprehension deficits.

Speech Apraxia Speech Production Disorder People who have it find it difficult or impossible to make certain motor movements, even though their muscles are normal. Due to damage to primary motor cortex. Milder forms of apraxia are known as dyspraxia. affect the articulation of consonants, causing the slurring of speech. in very severe cases, vowels may also be distorted

Prosody Production and Perception Problems producing or interpreting inflections Due to Right frontal lobe damage

Take-home Message Language is very complex Relies on: motor ability phonemics Syntax Semantics