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Degenerative Diseases of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
James A. Mastrianni, Elizabeth A. Harris
Deficits in expressive language function: Halting, effortful speech.Difficulty with articulation or speech apraxia.Paraphasias.Agrammatism (poor sentence structure, omission of connecting words, misordered words).Impaired comprehension of complex sentences.Spared single-word comprehension.Spared object knowledge.Eventual decline in reading and writing.May exhibit swallowing difficulties later in disease.
Children's Brain Trauma
Published in Rolland S. Parker, Concussive Brain Trauma, 2016
Since dementia is a potential outcome of TBI, and race plays a role in expression of its various manifestations, this may be a consideration in differential diagnosis (Gouvier et al., 2002). Examination of a child who is native to a culture using a language significantly distinct from that of the examiner requires care against mistaking characteristics of the language with familiar neuropsychological disorders. Using Japanese as an example, there are differences of syntax, lexicon, orthography, phonology, etc. The major European languages utilize the word order subject-verb-object, while Japanese utilizes subject-object-verb, which might suggest an aphasic disorder. Lateralization of verbal functions, which are dependent upon the visual structure of language, may also be reversed (to the left cerebral hemisphere as opposed to the right). Nevertheless, particular symptoms occur across languages, for example, aphasia (inability to understand or express oneself through language) and agrammatism (speech unconforming to grammatical rules). Acculturation can be categorized as traditional, marginal, bicultural, and assimilated. Particular procedures are normed on groups that may be socioeconomically or ethnically so disparate from the patient (rural and/or international) that they inaccurately indicate functional weaknesses and fewer strengths than they express in their environment. Further, those from rural environments are exposed to different conditions than those in urban environments: patterns of interpersonal violence (including intimate partners), types of neurotoxic exposure, stress, agricultural accidents, lack of medical coverage and treatment). These represent a potential for different preexisting conditions that must be considered in studying examination performance.
Mechanisms of Recovery After Acquired Brain Injury
Published in Barbara A. Wilson, Jill Winegardner, Caroline M. van Heugten, Tamara Ownsworth, Neuropsychological Rehabilitation, 2017
Kolk's theory of preventive adaptation in people with Broca's aphasia (Kolk, 1995) exemplifies behavioural compensation remarkably well. This author put forward the idea that producing a grammatically correct sentence requires time and that agrammatic sentence production by aphasic patients might be due to a timing problem (Kolk and van Grunsven, 1985; Kolk et al., 1985). According to this idea, the elements needed to build a sentence need time to be activated and this activation is subject to decay over time. Another assumption is that elements in a sentence are interdependent, in other words the activation of one element requires the activation of another element, like the subject of a sentence which has to be active in order to activate the right conjugation of a successive verb. In daily situations this time problem is perceptible in the large differences in type of speech output by people with Broca's aphasia. In free conversations, for example, aphasic patients tend to produce agrammatic speech; that is, language that lacks much of the required grammatical morphology but contains few erroneously produced morphemes. In elicited conversations, on the contrary, the speech of aphasic patients is more paragrammatic, with a high number of wrongly selected morphemes and relatively few omissions. Kolk and his collaborators (Haarmann and Kolk, 1992; Hofstede and Kolk, 1994; Kolk and Heeschen, 1990) have convincingly shown that elicited speech mainly reflects the just-described timing problem, whereas the agrammatic character of spontaneous speech is primarily an adaptation to this underlying deficit. In spontaneous speech, aphasic patients have the opportunity to create simpler sentence forms and this message simplification is an adaptive reaction to the capacity overload. In elicited speech and other time pressure situations, preventive adaptation is hardly possible, resulting in more morphological and constructional errors.
Modified script training for nonfluent/agrammatic primary progressive aphasia with significant hearing loss: A single-case experimental design
Published in Neuropsychological Rehabilitation, 2022
Kristin M. Schaffer, Lisa Wauters, Karinne Berstis, Stephanie M. Grasso, Maya L. Henry
A number of studies have indicated that behavioural intervention targeting improved communication is beneficial for individuals with PPA. For individuals with nfvPPA, interventions targeting the core clinical features have proven beneficial, even in the face of disease progression (Hameister et al., 2017; Henry et al., 2013; Henry et al., 2018; Machado et al., 2014; Schneider et al., 1996). Several studies have evaluated treatments for grammatical sentence production. A study by Schneider et al. (1996) examined the outcomes of a treatment utilising verbal and gestural cues that targeted the accurate production of verb tenses within sentences. The authors reported improved performance on trained verb tenses, generalisation to untrained verbs, and some maintenance three months post-intervention. Another study examined training of verb inflections within simple canonical sentences using a cloze technique in one individual with nfvPPA (Machado et al., 2014). The authors found that this intervention resulted in significantly improved performance on trained structures, generalisation to untrained structures, and maintenance of the primary outcome measure one month post-treatment. Hameister et al. (2017) implemented a modified constraint-induced language treatment for two individuals with nfvPPA, which resulted in significantly improved grammatical production, with one participant demonstrating generalisation to untrained items. Taken together, these studies constitute a modest but growing body of evidence for the successful treatment of agrammatism in nfvPPA.
Treatment dose in post-stroke aphasia: A systematic scoping review
Published in Neuropsychological Rehabilitation, 2021
Sam R. Harvey, Marcella Carragher, Michael Walsh Dickey, John E. Pierce, Miranda L. Rose
Aphasia treatments may aim to remediate symptoms of language processing impairment (e.g., anomia, agrammatism) by targeting specific linguistic functions (e.g., word retrieval, syntactic processing) (Simmons-Mackie & Kagan, 2007). Alternatively, intervention may aim to improve how a person communicates with others using pragmatic, functional communication, and social interaction approaches (Simmons-Mackie & Kagan, 2007). Results of meta-analyses demonstrate the effectiveness of interventions targeting language impairment, communication activity and participation, and communication-related wellbeing (Allen et al., 2012; Basso, 2005; Brady et al., 2016; Robey, 1998). However, little is known about how the amount of treatment a person with aphasia receives impacts aphasia recovery following stroke. This knowledge is vital to improve healthcare efficiency and quality of life for people living with aphasia.
Too harts, won sole: Using dysgraphia treatment to address homophone representation
Published in Neuropsychological Rehabilitation, 2020
Polly Barr, Britta Biedermann, Marie-Joseph Tainturier, Saskia Kohnen, Lyndsey Nickels
The participant in this study, CWS, was a 67-year-old right-handed, high school educated, former builder from North Wales. He learnt both Welsh and English before the age of six and still used both regularly. He reported that both pre- and post-stroke, he was equally proficient in English and Welsh (i.e., he had no “dominant” language), however, as this treatment investigates English, only his English naming performance is reported (see Roberts, 2013, for a comprehensive report of his bilingual language abilities). CWS suffered a right frontal infarct in 1997 (18 years prior to this experiment). This resulted in left-sided hemiplegia and crossed-aphasia (aphasia due to right hemisphere damage despite right-handedness) resulting in agrammatic, non-fluent speech. Table 1 shows CWS's language performance on a range of standardized (on English monolinguals) tests. CWS's spoken and written comprehension remains intact along with word and non-word repetition. CWS performed within the control range for spoken object and action naming (Druks & Masterson, 2000). His visual word recognition was just below ceiling and within control performance range. Regular and irregular reading aloud were intact, although he showed severely impaired non-word reading, a symptom pattern that is consistent with phonological dyslexia (see Tainturier, Roberts, & Leek, 2011, for detailed analysis of his reading).