Poster Session 2: Sentence Processing, Syntax, Reading, Writing, Spatial Processing

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POSTER SESSION 2 1. Processing Derivationally Suffixed Words in Agrammatism Stress-Change and Length Effect

Pamela J. Mathews and Loraine K. Obler Ph.D. Program in Speech and Hearing Sciences, Graduate School of the City University of New York

Introduction. In agrammatic aphasia it has been observed that derivational morphology is largely preserved in comparison to inflectional morphology. From this observation has arisen the notion that derivational and inflectional morphology are functionally distinct components of the lexicon, susceptible to differential impairment in brain damage (Miceli & Caramazza, 1988; but see Mathews, 1997). Evidence that some morphologically complex forms, both inflectional and derivational, are stored fully listed in the lexicon, while other forms are constructed as needed comes from studies by Stemberger and McWhinney, 1986, Anshen and Aronoff, 1988, Bradley, 1980, and Libben, 1993. Their results suggest that linguistic factors in addition to the distinction between derivational and inflectional functions might contribute to aphasic difficulties in morphological processing. One agrammatic subject who demonstrated an impairment in the production of a particular linguistic parameter, that of affix-induced change in the phonological properties of a stem and affix, was reported by Libben, 1990. Across production modalities, the subject, J.Z., showed a tendency to produce the underlying linguistic form of the constituents of a multimorphemic word. In some instances he would produce the underlying form of the affix (e.g. repeating irregularity as *inregularity); in other instances maintaining the stress in the position appropriate for the underived form (e.g. repeating ir’reparable as *inre’parable). J.Z.’s error pattern suggested that his performance was inversely related to the complexity of the required derivational processes, i.e. the more processes required by a derived form, the worse J.Z.’s performance. For this particular subject, the length of word was not a factor; J.Z. was able to produce equally long words if affixation did not require the phonological changes, demonstrating no repetition difficulties with words like ‘‘unhappiness, materialism, and ungratefulness’’). Yet word-length has been understood to affect the production of nonfluent aphasics as a rule. In this study we present results from a pilot study that investigated the effects of stress shift and word length on agrammatics’ production of derivationally related words. We asked whether a change in stress assignment

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TABLE 9 Percent Correct Score: Morphological Category by Syllable Length

2-Syllable 3-Syllable 4-Syllable

Base form

No stress change

Stress change

75 100

58 46 19

41 12

makes a derived form (e.g. legality; fruition) more difficult to produce than its morphophonologically simpler relative (e.g. legalize; fruitless). Subject selection. Four mild to moderate agrammatic speakers were recruited, two men and two women. All were right-handed, native monolingual speakers of American English, who had suffered a single left hemisphere CVA, and were at least 2 years postonset. Their ages ranged from 55–63. They had all completed at least high school, and one had completed a fouryear degree. All subjects had previously held high-level white-collar jobs. Method. Three sublists of words were constructed (40 words each) which compared three forms—a base form and two forms derived from that base. The base form was monomorphemic (e.g. magnet, terror), and 1–2 syllables long, (with 2 words of 3 syllables). In the simpler derived form (no-stresschange), the stress fell on the first syllable, identical to that of the base form (e.g. `magnet, `magnetize; `terror, `terrorize). In the other derived form (stress-change), the stress shifted to a different syllable (e.g. mag´netic, ter´rific). There was no consonantal change of the base form involved with the suffixation. Word frequency was balanced across the two derived forms. The sublists were combined, pseudorandomized, and divided into two parts (I and II), and presented to the subjects for reading and repetition. Two subjects read Part I, repeated Part II, then repeated Part I, and read Part II. The procedure was counter-balanced for the other two subjects. Subjects’ responses were tape-recorded, and transcribed. Results. A 2 (task) by 3 (lists) repeated measures ANOVA showed a main effect for list (.003). Post hoc Tukey analyses revealed that the stress-change forms were significantly harder than the base forms (p , .01), while the no stress-change forms were intermediate. Error data showed errors of substitution (e.g. simplicity → simply;) and omission (e.g. legality → legal), as well as frank inability to respond. The stress change was associated with greater difficulty in both reading and repetition tasks. Derived forms almost always involve a lengthening from the base form. Thus, the role of increasing word length was considered in relation to these results, and the reading data were examined for correct responses as a function of the number of syllables. There is a pattern of increasing error with an increase in word length. Comparing, as well, the different morphological categories of the same syllable number, there is also a pattern of increase in error from base to no-stress change to stress-change (see Table 9). First,

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the differential between the base forms and the no-stress-change forms at the 2-syllable level (75%:58% correct) suggests that derivational processes themselves occasion difficulty because neither stress not length changes in these instances. Second, the increase in error between the no-stress-change words and the stress-change words for each syllable level (3-syllable: 41%: 46% correct respectively; 4-syllable: 19%:12% correct respectively) indicates that stress shift increases the difficulty of processing a derived form. Conclusions. We conclude that derivation per se increases the likelihood of error for agrammatics over and above the contributions that increase in word length makes. Our data strongly suggest that when stress change is required for a derived form, additional processing may be required. REFERENCES Anshen, F., & Aronoff, M. 1988. Producing morphologically complex words. Linguistics 26, 641–655. Bradley, D. 1980. Lexical Representation of Derivational Relation. In Juncture. Mark Aronoff and Mary-Louise Kean (Editors). Studia linguistica et philologica 7. Miceli, G., & Caramazza, A. 1988. Dissociation of inflectional and derivational morphology. Brain and Language 35, 24–65. Libben, G. 1993. Are morphological structures computed during word recognition? Journal of Psycholinguistic Research 22, 535–544. Libben, G. 1990. Morphological representations and morphological deficits in aphasia. In Morphology, Phonology and Aphasia. In J.-L. Nespoulous and P. Villiard (Eds.), Springer, New York. Mathews, P. J. 1997. Processing derivational suffixes in agrammatic aphasia (unpublished data). Stemberger, J. P., & McWhinney, B. 1986. Frequency and the lexical storage of regularly inflected forms. Memory and Cognition 14, 638–647.

2. A Test of the Default Strategy of the Trace-Deletion Hypothesis

Alan Beretta and Alan Munn Michigan State University

1. Introduction and hypotheses. The most prominent current hypothesis which claims to organize agrammatic comprehension data in syntactic terms is the Trace-Deletion Hypothesis (henceforth TDH; Grodzinsky 1995). However, the TDH is, in fact, only partially organized in syntactic terms. It posits not only a syntactic deficit—loss of trace—to account for agrammatic performance, but also a default strategy which, in addition to being outside of syntactic theory, even violates fundamental syntactic principles, notably, the Theta Criterion. If agrammatic data are to be used to constrain syntactic theory, it is important to demonstrate that a syntactic account only partially motivated by syntactic theory is incorrect.

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The specific aim of the present study is to isolate the default strategy of the TDH and confront it with data that will either corroborate it or disconfirm it. In syntactic theory, the Theta Criterion states that each theta role is assigned to one and only one argument. The default strategy of the TDH claims that, in certain types of sentences (e.g. passives), agrammatics assign the same role to two different arguments, in direct violation of the Theta Criterion. On these sentences, patients only make a choice regarding which theta role to assign to which NP when forced to do so by a real-world event, for example, a sentence–picture matching task. Typically, sentence-picture matching tasks have the following characteristics: In one picture, actor A is the Agent of an action and actor B is the Theme, while in the other picture, the roles are reversed. Clearly, patients are forced to choose either actor A or actor B as the Agent in a picture even where they have assigned the role of Agent to both actors in the sentence. In the study reported here, a sentence–picture matching task is devised that does not force such a choice to be made, but in which one of the pictures allows both NPs to share the Agent role. This option, which is semantically coherent, makes it possible to freeze the agrammatic representation at a stage where both NPs are assigned the same role. If patients were to select that picture (which would inevitably be the wrong picture), it would constitute powerful support for the default strategy. By contrast, if they were not to select it in preference to other options, the default strategy would be decisively refuted. 2. Method. 2.1. Subjects: So far, three Broca’s aphasics have been tested. On a screening test, they performed above-chance on actives and at chance on passives on a regular sentence–picture matching task. 2.2. Procedures: The experiment permits Agent-Agent assignment in passives to be frozen, if it exists, by making it a semantically coherent option in a sentence-picture matching task. In this task, there are three pictures and three actors in each picture. In each picture there are two Agents of the same action and one Theme. At the same time as they contemplate the pictures, patients hear an active or a passive sentence in which there are two actors, one Agent and one Theme. Since the TDH claims that there are two Agents in the agrammatic representation of the passive, this should have the consequence that, with passive sentences, subjects select the picture in which both of the actors mentioned in the sentence are Agents. Because of the potential for confusion when there is a mismatch between the number of NPs in a sentence and the number of actors in a picture, active sentences with three-actor pictures were used as a control. Since the default strategy does not predict competition for Agenthood in active sentences, subjects should perform above chance in this control condition. Twenty sentences of each type (active and passive) were used in both the screening (two-actor) and experimental tests (three-actor), as well as fillers. All arrays of pictures were randomized, as were all sentences.

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TABLE 10 Control Test for Three-Actor Pictures: Actives Subject WR BJ MG

TDH (correct) option

Incorrect options combined

65% 60% 75%

35% 40% 25%

3. Results. As Table 10 indicates, on active sentences with three-actor pictures, subjects performed above chance, thus eliminating doubt that the three-actor pictures matched with two-actor sentences would simply confuse subjects and produce random performance. Given that all three pictures are relevant, chance is based on performance on 3 options, i.e., 33%. It should be noted that the two incorrect options are combined in Table 10, so the percentages for each incorrect option are very small. Turning to the three-actor passives, as Table 11 shows, subjects did not select the semantically coherent, but mistaken, option that would have allowed them to accommodate two Agents. In fact, they selected this option less frequently than the others. 4. Conclusions. At the time of writing, three subjects had been found who had the right profile. More subjects are currently being tested. However, the results from the three subjects reported here are striking. Subjects perform above chance on the active condition, which means that their performance on the passive condition cannot be dismissed as an artifact of the methodology. Their performance on the passive condition demonstrates that while they are random in choosing between the correct option and the third (incorrect) option, they avoid the option that would be consistent with the default strategy. Given that the task permitted subjects to choose an option that allowed an Agent–Agent representation to be maintained, the fact that they did not show any preference for it, but actually resisted it, indicates clearly that the default strategy does not operate in agrammatic comprehension. This is important because it removes the TDH from contention and leaves the task of using agrammatic data to constrain syntactic theory to accounts that are wholly motivated by syntactic theory and not by an unrelated heuristic.

TABLE 11 Subject WR BJ MG

TDH prediction

Correct option

Third option

10% 10% 20%

55% 45% 35%

35% 45% 45%

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REFERENCE Grodzinsky, Y. 1995. A restrictive theory of agrammatic comprehension. Brain and Language 50, 27–51.

3. Negation in Agrammatism: A Crosslinguistic Comparison

Judith Rispens,* Roelien Bastiaanse,* Ron van Zonneveld,* Gonia Jarema† and Susan Edwards‡ *Graduate School for Behavioral and Cognitive Neurosciences (BCN), University of Groningen, The Netherlands; †Laboratoire The´ophile-Alajouanine, Centre de Recherche de l’Institut de Ge´riatrie de Montre´ al, Canada; and ‡Department of Linguistics, The University of Reading, UK

Introduction. Sentences with a simple negation like ‘‘not’’ in English, ‘‘ne . . . pas’’ in French or ‘‘niet’’ in Dutch may be very complex in terms of syntactic structure. This is illustrated in Figure 13. French ne and English not are functional heads (Neg), whereas French pas and Dutch niet are in the specifier position (Spec,NegP). In French, the finite verb moves to ne, and then ne and the finite verb move to I together: il ne mange pas (he does not eat). In a nonfinite clause pas is lowered and clitisizes with ne, resulting in ne pas manger (do not eat). This clearly shows the relation with verb movement: if the verb moves to I, it ends up between ne and pas; if the verb remains in its base-generated position, it is preceded by ne pas. In spoken language, the clitic ne is often omitted, in written language it is obligatory. In the English example, I (which only lexicalizes with modals and auxiliaries) cannot be lowered to V, as it does in positive sentences. This is not allowed with Neg as an intervening head: *he not eats. If VP is the complement of Neg, and if there is no modal or auxiliary, I lexicalizes with do, the so-called Do-support: he does not eat. In Dutch, the unmarked position of the negation is after the subject and finite verb, in Spec,NegP: hij eet niet: he does not eat, lit: he eats not. Contrary to French and English, there is no relation between the finite verb and negation. The present explorative study focuses on how French-, English-, and Dutch-speaking agrammatics deal with negation in simple declarative sentences. Methods. Two French, two English and three Dutch agrammatics have been assessed with two sentence anagram tasks, one with and one without pictures. For the version without pictures, the constituents of the sentences

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FIGURE 13

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are printed on separate cards (the boy-has-not-congratulated-the girl), and the patient is asked to form a grammatical sentence. Three different constructions have been tested (10 actives, 10 passives, 10 sentences in present perfect simple tense), half of them positive, half negative. In the other version, a picture is shown with two possible direct objects, e.g., a picture of a boy throwing a ball and a stick on the ground. The patient receives the following cards (not all cards need to be used): the boy-does-not-throw(s)-the stick le garc¸on-ne-jette-pas-le baˆton de jongen-gooit-de stok-niet and is asked to form a sentence corresponding to the picture. For comparison with positive sentences, structures such as ‘‘the boy throws the ball’’ were elicited. This test contains 18 items (9 positive and 9 negative active sentences, all in the present simple tense). For scoring, only syntactic errors were taken into account: when the negation was in the correct position, but the thematic roles were reversed, the sentence was considered to be correct. Results. French: Patient 1 makes no errors in the picture version and three errors in negative sentences on the version without pictures (one passive, two present perfect tense: he fills in pas after the main verb). No errors are made on the positive sentences. Patient 2 forms no correct negative sentences on the picture version, but 6/9 positive sentences are correct. In the version without pictures, all negative sentences are ungrammatical with respect to the position of the negation. Half of the positive sentences are incorrectly formed. The French patients are significantly worse at constructing negative sentences (t(7) 5 2.73, p , 0.05). English: The patients’ performance is strikingly similar. They leave out not in all negative sentences in the picture version, but they both insert does several times. All positive sentences are formed correctly. In the version without pictures, patient 1 constructs all and patient 2 all but two negative sentences incorrectly; they consistently put not after the main verb (*the woman has painted not the wall), thus mixing up the relationship between V and Neg. Both patients make only one error on the positive sentences. Only 1/15 positive sentences is ungrammatical for both patients. The English patients are significantly worse at constructing negative sentences (t(7) 5 7.06, p , 0.001). Dutch: Patient 1 makes one ungrammatical negative sentence on the version without pictures, all other sentences are correct, in both versions. Patient 2 performs faultlessly on the picture version, but in the version without pictures, 4/15 positive sentences and 4/15 negative sentences are ungrammatical. Patient 3 makes no errors on the picture version; on the version without pictures all positive sentences are correct. She makes no errors on the negative sentences, but indicates that she cannot construct two of them (no reac-

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tion). Negative and positive sentences are equally difficult for the Dutch agrammatics (t(11) 5 1.91, p . 0.05). Discussion. Negative sentences are more difficult than positive sentences for the French and English agrammatics, but not for the Dutch. One might argue that the Dutch patients are less severely agrammatic and therefore make fewer errors. This, however, cannot be the entire explanation: Dutch patient two makes errors with the positive sentences, even more than French patient 2 and both English patients, but is equally disturbed in positive and negative sentences. The crosslinguistic differences among the data suggest that it is the syntactic status of the negation that makes negative sentences difficult for the French and English agrammatics. In English and French, negation is a functional head, whereas in Dutch, it is a specifier. It is therefore proposed that functional heads, especially if their position in the sentence depends on other functional heads (V and I), are more difficult for agrammatics than specifiers. This advantage for specifiers over functional heads only holds for agrammatic production: in comprehension, English-speaking agrammatics are sensitive to correct movement of functional heads (Grodzinsky & Finkel, 1996). REFERENCE Grodzinsky, Y., & Finkel, L. 1996. Severe grammaticality judgment deficits in agrammatism and in Wernicke’s aphasia. Brain and Language, 55, 50–53.

4. Prepositional Compounds are Sensitive to Agrammatism: Consequences for Models of Lexical Retrieval

Sara Mondini,* Claudio Luzzatti,† Carlo Semenza,‡ and Attilio Calza§ *University of Padova, †University of Milano, ‡University of Trieste and §Ospedale Maggiore of Cremona, Italy

Noun–Noun (N–N) modification is realized in Germanic languages mainly through N–N compounds where the modifier is the more leftward element of the compound. Also in Latin languages, like Italian and French, N–N modification may be realized by means of composition, but the most productive solution is prepositional compounding, a type of N–N phrases that function as complex words where the modifying prepositional phrase is the rightmost element of the compound (e.g. [il [[mulino] N [a vento]PP]] NP, the windmill). The compound status of prepositional compounds (PC) is not unanimously accepted. In fact the N–Prep–N structure does not necessarily

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constitute a unitary lexical element, i.e., a compound: it may also express nonlexical syntactic relations like specification (Genitive Case in Latin or German), an indirect object (Dative Case in Latin or German) or a locative adjunct, etc. Strictly speaking, on the one hand, PCs may be viewed as constituting a system which looks more like lexicalization of syntax rather than a specific, morphological compounding process (Di Sciullo and Williams, 1987; Spencer, 1991). On the other hand, at least in Italian, PCs are most often opaque with respect to the choice of the linking preposition and the presence or absence of the definite article which are semantically unmotivated (a clear example is film in bianco e nero, black and white movie vs film a colori, color movie). The word-status of PCs in comparison with syntactic phrases can be tested by modifying a PC with an adjective. Real compounds do not allow the insertion of an adjective between the head noun and the modifying prepositional phrase. Therefore, when modifying the compound noun sedia a rotelle (wheelchair) with the adjective rotta (brokenfem) the adjective must be located at the end of the compound (sedia a rotelle rotta, broken wheelchair) and not after the head of the compound (*sedia rotta a rotelle). The processing of PCs may be studied by having them named by agrammatic patients: one such investigation is reported here. Case report. M.B. was a 24-year-old Italian male, with 10 years of education, who sustained a vascular lesion in the left fronto-insular areas. An Aachen Aphasia Test demonstrated a Broca’s aphasia with severe agrammatism in his spontaneous speech. Despite his effortful output M.B. had only a mild dysarthria and committed a negligible amount of phonemic paraphasias. He had a moderate impairment in confrontation naming of actions (55/ 146) whereas his naming of objects was good only for simple nouns (110/ 112). However, when tested with complex nouns (derived and compound nouns) his failure was evident (see below). Experimental investigation. The processing of PCs was tested in several tasks (repetition, reading, writing, naming and completion). Naming was tested both on picture confrontation (14 items over three times) and on definition (10 items over two times): in this task PCs were intermixed with simple words and other types of compounds. In a further task (see Luzzatti and De Bleser, 1996) M.B. was required to tell which preposition had to be inserted between the two main elements spoken aloud by the examiner (n 5 104). This task was administered twice. Results. Omission of the linking prepositions was the most frequent error in naming. In the other tasks errors were mostly substitutions of the target preposition (see Table 12). Discussion. Over a series of tasks MB showed problems in the production of the linking preposition in PCs. This happened even with fully lexicalized compound forms where the linking preposition is syntactically and semanti-

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TABLE 12 MB’s Performance in Naming (p 5 Pictures, d 5 Definitions), Completion, Repetition, Reading and Writing on Dictation

Naming 1 (p 1 d) [/24] Naming 2 (p 1 d) [/24] Naming 3 (p) [/14] Completion [/104] Completion [/104] Repetition [/124] Reading [/124] Writing [/44]

Correct preposition

Preposition omitted

Preposition substituted

Null or other

4 9 1 46 44 77 91 23

3 7 4 5 12 6 4 0

0 2 4 40 46 40 25 18

17 6 5 13 2 1 4 3

cally opaque. MB’s performance reveals that these unitary forms are decomposed somewhere along their processing, where they apparently become sensitive to the patient’s agrammatism. It is proposed that lexical retrieval of PCs starts with the activation of whole forms that become decomposed before the access to its phonological representation. Agrammatism would thus encompass a damage to the phonological realization of closed class words also penetrating completely lexicalized locutions. REFERENCES Di Sciullo, A. M., & Williams, E. 1987. On Definition of Word. Cambridge, MA: MIT Press. Luzzatti, C., & De Bleser, R. 1996. Morphological processing in Italian agrammatic speakers. Eight experiments in lexical morphology. Brain and Language, 54, 26–74. Spencer, A. 1991. Morphological Theory. Oxford: Blackwell.

5. The Effect of an Induced Temporal Resource Limitation on Grammatical Processing: Evidence from Dichotic Listening

Kerry Kilborn University of Glasgow

Norman and Bobrow (1975) describe two general constraints that apply to any information processor. A ‘‘resource limitation’’ is imposed by internal constraints (e.g., age, pathology). In contrast, a ‘‘data limitation’’ refers to the status of external input (e.g., noise or speed may degrade input). Despite very different ‘‘etiologies,’’ either limitation can, in principle, produce very

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similar—and very specific—degradations in performance (Kilborn, 1991; 1994). One kind of internal resource limitation that has been implicated in aphasia is a breakdown in the automatic processing of syntactic information (Haarmann & Kolk, 1994; Kilborn & Friederici, 1995). When the normally rapid, automatic processing of syntactic cues is impaired, integrative processes that rely on the timely access to those cues may suffer or fail. This does not imply that access to syntactic information is lost. Even if syntactic representations are largely intact, a temporal disruption in completing linguistic computational processes in real time may lead to a general impairment of integration processes. To examine the generality of the automaticity hypothesis, an unimpaired experimental group carried out a task that involved an internal, temporal resource limitation. We use an on-line word monitoring task designed to isolate the effects of global semantic and syntactic integration processes (Marslen-Wilson & Welsh, 1978). The resource limitation is imposed by dichotic listening conditions. Grammatical function words are presented in the left ear, content words in the right ear. This task takes advantage of the right ear advantage for language tasks (Asbjornsen & Hugdahl, 1995). The right ear advantage derives from the organization of the auditory pathway in the CNS; information entering the right ear arrives at the left hemisphere slightly earlier (estimated 8 ms) than information entering the left ear. Dichotic presentation imposes a selective temporal lag on function words (left ear), while preserving the overall temporal relationship among function and content words across ears. The automaticity hypothesis predicts that realtime integrative processes will be impaired due to a temporal disadvantage in accessing closed class information. In addition to the dichotic experimental group, a control group was presented with the reverse function/content dichotic split. This group serves as a control that the dichotic manipulation itself is not responsible for the results. A second control group was presented with a non-dichotic version of the task. Subjects. Subjects were 29 (8 male, 21 female) right-handed students aged 20–30. All subjects were native English speakers. Two additional groups of 20 control subjects drawn from the same population carried out two other versions of the task. Procedure. Forty sentence pairs in three conditions are presented auditorily in blocks. An auditory target word is heard first, then a sentence pair. Subjects respond when the target word is detected. Normal Prose: *‘‘Church’’

‘‘The vicar was pleased when he saw how many people were at the service. It was unusual for the church to be as full as it was today.’’

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Syntactic Prose: * ‘‘Fire’’ ‘‘The carpet was noisy when he saw how many people were at the case. It was disgraceful for the fire to be as young as it was today.’’ Random Prose: * ‘‘Hospital’’ ‘‘spoiled the was the many station when eat how people were at he table. was the as was for hospital to as nice smelly it be it biting.’’ Results. Control: Non-dichotic version. The main effect of Prose was significant, F(2, 38) 5 42.2, p , 0.0001. Fastest responses were in Normal prose (362 ms), followed by Syntactic (426), followed by Random (470). Each condition was significantly different from the others. (The results from the reverse dichotic control were essentially identical to the non-dichotic controls). Experimental group: There was a main effect of Prose, (F(2, 56) 5 34.8, p , 0.0001). Normal (422 ms) and Syntactic (427 ms) Prose latencies were identical (Scheffe p . 0.1). Random responses (541 ms) were significantly slower than both Normal and Syntactic. The results for both groups, and from a comparison group of fluent aphasics, are shown in Fig. 14. A group by prose interaction was also found, F(2, 47) 5 11.62, p , 0.01. Both groups responded faster to Syntactic than Random prose, but additional facilitation in Normal prose was obtained only in the control group. Discussion. The rapid responses by controls in the Normal prose condition demonstrates the effects of integration of semantic and syntactic information sources in real time. When a temporal mismatch is induced, such that grammatical function words are subject to a short delay in arrival at the left hemisphere relative to content words, sentence processing does not break down across the board. Syntactic cues are still processed, as shown by the faster responses to Syntactic than Random prose by the dichotic group. However, responses to Normal prose are the same as to Syntactic prose. This suggests that failure to integrate quickly may be a general outcome when global processing difficulty is experienced. There is independent evidence that a failure to integrate global information sources may be due to computational pressures, and not a selective central deficit of syntactic information. Similar patterns on this task are reported for non-native speakers, and for normals under a range of cognitive load conditions. Figure 14 also shows results on a similar word monitoring task by Wernicke’s aphasics (from Kilborn, 1994). The similarity in performance among these disparate groups—who do not share an underlying deficit— suggests that comprehension deficits may be accounted for in part by a computational deficit rather than loss, and that such a deficit can be understood in terms of a general reduction in computational resources.

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FIGURE 14

REFERENCES Asbjornsen, A., & Hugdahl, K. 1995. Attentional effects in dichotic listening. Brain and Language, 45, 127–147. Haarmann, H., & Kolk, H. H. 1994. On-line sensitivity to subject-verb agreement violations in Broca’s aphasics: The role of syntactic complexity and time. Brain and Language, 46, 493–516. Kilborn, K. 1994. On-line integration of grammatical information Broca’s and Wernicke’s aphasia. Linguistische Berichte, 6, 219–233. Kilborn, K. 1991. Selective impairment of grammatical morphology due to induced stress in normal listeners: implications for aphasia. Brain and Language, 41, 275–288. Kilborn, K., & Friederici, A. 1994. Cognitive penetrability of syntactic priming in Broca’s aphasia. Neuropsychology, 3(1), 83–90.

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Marslen-Wilson, W. D., & Welsh, A. 1978. Processing interactions and lexical access during word recognition in continuous speech. Cognitive Psychology, 10, 29–63. Norman, D., & Bobrow, T. 1975. On data-limited and resource-limited processes. Cognitive Psychology, 7, 44–64.

6. Morphosyntactic Production Abilities in Anomic Aphasia

Lora Zaroff and Beverly Wulfeck Department of Communicative Disorders, San Diego State University

Elizabeth Bates Departments of Psychology and Cognitive Science, University of California, San Diego

and Judy Reilly San Diego State University

Introduction. Word retrieval requires intact lexical-semantic representations and efficient processing mechanisms. Thus, it is not surprising that naming/word-finding problems are common to all aphasia types (Kohn & Goodglass, 1985; Zingeser & Berndt, 1990). However, unlike other subgroups, anomic aphasics have significant word-finding deficits in the presence of generally intact language. Their anomia is so striking that research has focused almost exclusively upon naming and word finding difficulties. As a result, very little is known about morphosyntactic processing beyond the word or sentence level in anomics. This is unfortunate because results obtained from such studies could contribute to more effective intervention methods as well as provide tests between theories that posit a distinction between grammar and the lexicon, and interactive models that do not. This brings us to the present study. To address whether or not anomic aphasics demonstrate morphosyntactic deficits, grammar and discourse abilities were compared to age-matched controls. To address whether or not performance varies with communicative context, production measures that differ in task constraints were used. Subjects. Nine patients diagnosed with anomic aphasia participated. Each had a documented left hemisphere lesion, secondary to cerebral vascular accident. Normal controls were matched to the patients in age, gender and education. Method. Language production data were obtained using three tasks that contrasted in communicative context:

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1. Conversational speech was elicited using an interview format in which subjects were asked simple questions about their personal history, family, etc. This task is considered to have minimal communicative constraints because probes are of a general nature. 2. Picture description ability was elicited using the Cookie Theft picture (Goodglass & Kaplan, 1983). This task is considered to have moderate communicative constraints because the picture provides the content to be described, however, no specific instructions are given as to what must be said. 3. The Animated Film task (Bates et al., 1995) was used to elicit simple and complex syntax. Subjects described 24 action events involving from one to three characters (humans or animals) engaged in simple intransitive, transitive, locative or dative actions and more complex actions involving agent or object role changes. As such, this task places the most constraints on syntactic options. Transcription, coding and tabulation procedures. Utterances from each subject and task were transcribed, coded and checked for reliability using procedures described in CHILDES (MacWhinney, 1995). Totals were obtained for mean length of grammatical utterances (MLU), total number of utterances (grammatical and ungrammatical), total number of grammatical utterances, total number of ungrammatical utterances, total number of simple grammatical sentences, and total number of complex grammatical sentences and number of grammatical utterances/total number of utterances. Results. Each dependent measure (proportion of grammatical utterances, mean length of utterance, proportion of complex utterances) was analyzed in a 2 3 3 mixed design with group (age-matched controls and anomic aphasics) as a between-subjects variable and context (interview, cookie theft picture description, film) as a within-subjects variable. Grammatical utterance profiles. In this analysis the main effect of group was significant with anomics producing proportionally fewer grammatical utterances compared to the controls. The anomic group produced a range of error types involving verb tense as well as pronoun, article and auxiliary verb omissions. The main effect of context was not significant nor was the interaction of group and context. In sum, groups differed in overall grammatical production, however grammaticality did not vary as a function of task demands. MLU profiles. The second analysis was conducted to determine if the two groups differed in the morphologic richness of their grammatical utterances. Once again, a significant main effect of group was obtained with the control group showing a clear MLU advantage. Neither the main effect of context nor the interaction of group and context was significant, indicating that MLU remained constant for both groups across contexts.

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Syntactic complexity profiles. The proportion of utterances containing complex syntax (e.g., passives, compound coordinates, relative clauses, etc.) was examined. First, the main effect of group was significant, with the control group producing a higher proportion of utterances containing complex syntax compared to the anomic aphasic group. A significant main effect of context was also obtained, with the proportion of syntactically complex utterances increasing as a function of task constraint. Use of complex syntax was lowest in the interview context (least constrained) and highest in the film context (most constrained). Finally, the interaction of group and context was not significant. Although the anomic group produced proportionally fewer complex utterances compared to controls, they were responsive to the need for complex syntax. Discussion. In this study, we investigated morphosyntactic abilities in healthy and anomic adults under differing tasks constraints. Results revealed that anomic aphasics do experience difficulties producing grammatical utterances. Moreover, MLU group differences suggest that even when they are using grammatical sentences, anomics produce fewer grammatical morphemes. Finally, both groups were sensitive to task demands requiring complex syntax and these demands did not trigger greater morphological errors for anomics. This study is only a starting point and more research is needed. For example, we obtained evidence of morphosyntactic errors (e.g., tense and number agreement errors), however many errors were of the omission type. Analyses are underway to determine how word-finding problems interact with the ability to access function words. Also, new studies are planned that permit more fine-grained differentiation of lexical-semantic forms and morphosyntax relationships. Such studies would extend previous work by Zingeser and Berndt (1990) and provide a more complete picture of the relationship between word retrieval and morphosyntactic abilities in anomic aphasia. REFERENCES Bates, E., Harris, C., Marchman, V., Wulfeck, B., & Kritchevsky, M. 1995. Production of complex syntax in normal aging and Alzheimer’s disease. Language and Cognitive Processes, 10, 487–539. Goodglass, H., & Kaplan, E. 1983. The Assessment of Aphasia and Related Disorders. Philadelphia: Lea and Febiger. Kohn, S., & Goodglass, H. 1985. Picture-naming in aphasia. Brain and Language, 24, 266– 283. MacWhinney, B. 1995. The CHILDES System. New York: Academic Press. Zingeser, L., & Berndt, R. 1990. Retrieval of nouns and verbs in agrammatism and anomia. Brain and Language, 39, 14–32.

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7. Serial Position Effects in Aphasics’ Neologisms

Deborah A. Gagnon Widener University and Moss Rehabilitation Research Institute

and Myrna F. Schwartz Moss Rehabilitation Research Institute and Temple University

An important distinction among accounts of neologism production lies in their prediction about the stage(s) of word production at which such errors arise (cf. Fig. 15). An apparent dichotomy in degree of target segment preservation among neologisms has led dual stage theorists to maintain that targetremote neologisms arise at lexical retrieval while target-related neologisms arise at phonological encoding, the stage at which phonemes are selected and inserted into a phonological frame (Buckingham & Kertesz, 1976; Kohn & Smith, 1994). In contrast, single stage theorists assert that all neologisms arise from faulty phoneme selection for insertion into a phonological frame (e.g., Dell, Schwartz, Martin, Saffran, & Gagnon, in press). A number of predictions arise from dual stage accounts, including the presence of two distinct types of neologisms and the association of lexical effects with remote, but not related, neologisms. A previous study by Gagnon and Schwartz

FIG. 15. Dual stage and single stage accounts of neologism production.

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(1996) examined these predictions and found little evidence to support them. The present study looks at one of these predictions—a serial position effect—in greater depth. Dual stage accounts predict that each successive phoneme in a target word stands a lesser chance of being preserved than the one before it for neologisms arising at phonological encoding (cf. Miller & Ellis, 1987) but make no such prediction for neologisms arising at lexical retrieval. A single stage account allows for quantitative, but not qualitative, differences between remote and related neologisms, since they arise from a singular origin. Methods. A corpus of 253 neologisms was obtained from 20 fluent aphasic subjects who were asked to name 175 pictured objects. These neologisms reflect subjects’ first complete (i.e., non-fragmented) response to an object. The corpus was divided into related and remote neologisms using two different criteria: (1) 50% target-neologism segmental overlap (related: .50%; remote: #50%) and (2) the criteria used by Kohn and Smith (1994) in which related neologisms share at least a stressed rime, a consonant cluster, or a syllable onset and coda. A procedure suggested by Wing and Baddeley (1974) for comparing the distribution of preserved segments in five normalized serial positions to chance (the target distribution) was adopted because of the desirable control of word length and preservation opportunity it provides. Target segments were considered preserved only if they appeared in the same serial position in the neologism. Finally, a pseudocorpus of targetneologism pairs was created by randomly re-pairing neologisms with targets as another way of estimating chance segment preservation. Results. The results hold true regardless of which criterion was used to divide the corpus into remote and related neologisms; thus, statistics for the 50% criterion only are reported. For the actual target-neologism pairs, both related and remote segment distribution patterns are different from their respective chance distributions (related: χ 2(4) 5 18.1, p , .002; remote: χ 2(4) 5 23.6, p , .0001). These deviations from chance appear to arise in the word-initial segment position: A comparison of first position preservation to preservation of noninitial positions revealed better-than-chance preservation for first position only (related: χ2 (1) 5 11.0, p , .0009; remote: χ 2 (1) 5 18.7, p , .0001). This confirms a prior finding by Gagnon, Schwartz, Martin, Dell, and Saffran (in press) for good preservation of first position in fluent aphasics’ formal and phonemic paraphasias. The pseudocorpus analysis revealed a different-from-chance preservation pattern for remote neologisms only (χ2 (4) 5 10.5, p , .04; related: p . .8). Unlike the actual corpus, there was no difference between preservation of first position and other positions ( p . .5). Finally, comparison of actual corpus patterns to pseudocorpus patterns revealed that, for the remote neologisms, actual and pseudo pattern differed (χ 2 (4) 5 44.1, p , .0001) while for the related neologisms, actual and pseudo pattern did not differ (p . .3).

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Conclusions. The predictions of the two stage theory are clearly not upheld. On the one hand, some analyses revealed no difference between remote and related neologisms in terms of serial position effects; on the other, differences that were found went against the predicted direction in that they turned up for the remote neologisms instead of the related neologisms. The betterthan-chance preservation of first position segments may reflect a weak serial position effect or may simply reflect something special about the word-initial position. Two qualifications of these conclusions are necessary. First, the data are from a group of fluent aphasic subjects. Individual differences in segment preservation among fluent aphasics are well documented, however (e.g., Kohn & Smith, 1994). Future analyses will examine individual preservation tendencies. Second, it should be noted that these data reflect properties of neologisms generated during naming attempts. Future work will apply these same analyses to neologisms generated during continuous speech to discern what differences, if any, arise in segmental preservation patterns as a result of the differing constraints between these two speaking contexts. REFERENCES Buckingham, H. W., & Kertesz, A. 1976. Neologistic jargon aphasia. In R. Hoops & Y. Lebrun (Eds.), Neurolinguistics. Amsterdam: Swets & Zeitlinger. Dell, G. S., Schwartz, M. F., Martin, N., Saffran, E. M., & Gagnon, D. A. In press. Lexical access in normal and aphasic speakers. Psychological Review. Gagnon, D. A., & Schwartz, M. F. 1996. The origins of neologisms in picture naming by fluent aphasics. Brain and Cognition, 32, 118–120. Gagnon, D. A., Schwartz, M. F., Martin, N., Dell, G. S., & Saffran, E. M. In press. The origins of formal paraphasias in aphasics’ picture naming. Brain and Language. Kohn, S. E., & Smith, K. L. 1994. Distinctions between two phonological output deficits. Applied Psycholinguistics, 15, 75–95. Miller, D., & Ellis, A. W. 1987. Speech and writing errors in ‘‘neologistic jargonaphasia’’: A lexical activation hypothesis. In M. Coltheart, G. Sartori, & R. Job (Eds.), The cognitive neuropsychology of language. Hillsdale, NJ: Erlbaum. Wing, A. M., & Baddeley, A. D. 1980. Spelling errors in handwriting: A corpus and a distributional analysis. In U. Frith (Ed.), Cognitive processes in spelling. New York: Academic Press.

8. Affixational Morphology in Jargonaphasia

Elmera Goldberg and Loraine K. Obler Ph.D. Program in Speech and Hearing Sciences, Graduate Center of the City University of New York

Introduction. The literature supports the notion that the morphological system remains relatively intact in jargonaphasia and that appropriate affixation is the norm (e.g., Buckingham & Kertesz, 1976; Buckingham, 1980; Butter-

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worth, 1992; Panzeri et al., 1990). Unlike non-fluent aphasics, whose speech is characterized by poor use of functors and greater impairment of inflections than derivations (de Villiers, 1974; Miceli & Caramazza, 1988; Tyler & Cobb, 1987), in jargonaphasia, ‘‘Neologistic forms quite often carry normal morphological affixation with predictable morphophonemic realization.’’ (Buckingham, 1977). With respect to differences between inflectional and derivational morphology in jargonaphasia, one point of view is exemplified by Butterworth (1979), who makes no distinction when he claims that the morphological system seems almost perfectly intact. Supporting this is Garrett (1984), who states that at the Positional level, where function words and grammatical morphemes are inserted into the sentence frame, jargonaphasics do not discriminate between inflectional and derivational morphemes. In contrast, Perecman (1989) finds that lexical (derivational) morphology is more likely to be disturbed than grammatical (inflectional) morphology. Buckingham (1981) notes that affixes on neologisms are usually inflectional, not derivational. These questions of affixational processing in aphasia speak to our understanding of normal lexical organization, two views of which are embodied in the Strong and the Weak Lexicalist Hypotheses. The Strong Lexicalist Hypothesis (Jarema & Kehayia, 1992; Miceli & Caramazza, 1988, among others) requires all morphological relations, both derivational and inflectional, to be expressed in morphological component. All morphological processes are thus located in the lexicon, but inflectional and derivational processes constitute autonomous subcomponents of the lexicon. By contrast, Libben (1990) distinguishes between derived and inflected forms, concluding that all derived forms, but only the base forms of regularly inflected verbs, are represented in the mental lexicon. A more recent version of the Weak Lexicalist Hypothesis is reflected in Anshen and Aronoff (1988), who find that certain complex morphological items are stored in the mental lexicon, while others are constructed as needed. The question motivating this study was whether affixational morphology was indeed preserved in jargonaphasia, and if so, to what extent. It may be true that, what affixation there is, is ‘‘appropriate.’’ However, as Menn and Obler (1990) have argued with respect to mild–moderate agrammatic aphasics, ‘‘appropriateness’’ is not the only criterion by which to measure a language faculty. We would also want to know if use and distribution meet expected levels of frequency. Further, we asked whether there was any evidence of a difference between inflectional and derivational affixation. We questioned whether the frequency of affixation is the same in jargonaphasia as it is in nonaphasic speech. Specifically, we asked if there is a difference between the frequency of one type of affixation (inflectional) versus the other type (derivational) compared to those frequencies in normal speech. Answers

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FIG. 16. Percentage of conversational corpus: Derivational and inflectional affixes.

to these questions should provide evidence useful in resolving the issues of lexical organization raised above. Materials and Methods. The data were from the corpus of a jargonaphasic speaker, Mr. C., a 77 year-old male admitted to the hospital on August 18, 1994 for a middle cerebral infarct, presenting with fluent aphasia. The assessment was Wernicke’s aphasia as the result of a focal lesion in the posterior region of the left cerebral hemisphere. Mr. C. was cognitively intact prior to the episode. The investigation consisted of a comparison of inflectional and derivational suffixation from the output of this patient (a 1/2-hour taped interview with the patient yielding a 2750-word corpus) and another aphasic patient, K.C. (Butterworth, 1979, a 2136-word corpus), and the output of nonaphasic speakers (control data collected from an analysis of reported conversational speech in the New York Times [2517-word corpora] and of two control subjects, Mr. S. and Mr. W., in Menn and Obler, 1990 [1763-word corpora]). The speech of the jargonaphasic speakers was categorized as to neologistic and real-word utterances, and the affixational (inflectional and derivational) morphology of each category was tabulated. The speech of the nonaphasic speakers was similarly analyzed. Results. The results of the calculations (see Fig. 16) indicate that in nonaphasic speech, 2.9% of the suffixation was derivational, 12.4% was inflectional. In the jargonaphasic speech, overall suffixation was 1.2% derivational, 5.7% inflectional. Of this, real-word affixation was .7% derivational, 3.7% inflectional. In sharp contrast, in the neologistic utterances, 4.2% bore

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derivational suffixation, 25.5% inflectional suffixation. These means reflect remarkably homogenous patterns within each subject group. Conclusions. What is demonstrated by the data is that there is less affixation overall in the jargonaphasic speech. But because derivations are onequarter as frequent as inflections in normal speech, the most striking difference is in inflectional morphology, where the jargonaphasic average is under one-half that of the nonaphasics. Addressing the question of lexical organization, we see a paradox. On the one hand, in jargonaphasia, both inflectional and derivational affixation are impaired (with respect to frequency), which speaks to their being an integral part of the disturbed system. On the other hand, when the affixations do appear, they are not impaired (as are content words) and they appear with both real and neologistic stems. If derived words were represented in the mental lexicon in full form (Libben, 1990), we would expect the phonological expression of the derivational affix to be impaired along with the impaired stem. That this is not the case speaks against the double standard of the Weak Lexicalist Hypothesis, the separation of inflectional from derivational morphology. Whether this means that morphological processes are located in the lexicon, inflectional and derivational processes constituting autonomous subcomponents of the lexicon (Miceli & Caramazza, 1988, et al.) or that ‘‘morphology is to be found in more than one place . . . in the lexicon . . . and in the syntax.’’ (Anderson, 1982) cannot be determined from the evidence here. What the jargonaphasic data suggest is that morphological affixes are both dependent, in that they rely on stems for their occurrence, and independent, in that they can appear in intact form appended to an impaired stem. REFERENCES Anderson, S. R. 1982. Where’s Morphology? Linguistic Inquiry, 13 (4, Fall), 571–613. Anshen, F., & Aronoff, M. 1988. Producing Morphologically Complex Words. Linguistics 26, 641–655. Buckingham, H. W. 1977. The Conduction Theory and Neologistic Jargon. Language and Speech, 20(2 April–June), 174–184. Buckingham, H. W. 1980. On Correlating Aphasic Errors with Slips-of-the-Tongue. Applied Psycholinguistics, 1, 199–220. Buckingham, H. W. 1981. Where Do Neologisms Come From? In J. Brown (Ed.), Jargonaphasia, Academic Press, New York. Buckingham, H. W., & Kertesz, A. 1976. Neologistic Jargon Aphasia. Neurolinguistics Vol. 3, pp. 8–100. Swets & Zeitlinger B.V. Amsterdam. Butterworth, B. 1979. Hesitation and the Production of Verbal Paraphasias and Neologisms in Jargon Aphasia. Brain and Language, 8, 133–161. Butterworth, B. 1992. Disorders of phonological encoding. Cognition, 42, 261–286. de Villiers, J. 1974. Quantitative Aspects of Agrammatism in Aphasia. Cortex 10(1, March), 36–54. Garrett, M. F. 1984. The Organization of Processing Structure for Language Production: Appli-

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cations to Aphasic Speech. In D. Caplan, A. C. Lecours, & A. Smith, (Eds.), Biological Perspectives on Language. MIT Press, Cambridge, Mass. Jarema, G., & Kehayia, E. 1992. Impairment of Inflectional Morphology and Lexican Storage. Brain and Language, 43, 541–564. Libben, G. 1990. Morphological Representations and Morphological Deficits in Aphasia. In J.-L. Nespoulous & P. Villiard (Eds.), Morphology, Phonology and Aphasia, SpringerVerlag, New York. Menn, L. 1990. Supplement to Chapter 4: English-Language Materials. In Menn & Obler, (Eds.), Agrammatic Aphasia: A Cross-Language Narrative Sourcebook, Vol. 3 (Control Subjects), Benjamins: Philadelphia. Menn, L., & Obler, L. K. 1990. Cross-Language Data and Theories of Agrammatism. Menn and Obler, (Eds.). In Agrammatic Aphasia: A Cross-Language Narrative Sourcebook, Vol. 2, Benjamins: Philadelphia. Miceli, G., & Caramazza, A. 1988. Dissociation of Inflectional and Derivational Morphology. Brain and Language 35, 24–65. Panzeri, M., Semenza, C., Ferreri, T., & Butterworth, B. 1990. Free Use of Derivational Morphology in an Italian Jargonaphasic. In Nespoulous & Villiard (Eds.), Morphology, Phonology and Aphasia, Springer-Verlag, New York. Perecman, Ellen. 1989. Bilingualism and Jargonaphasia: Is There a Connection? Brain and Language 36, 49–61. Tyler, L-K., & Cobb, H. 1987. Processing Bound Grammatical Morphemes in Context: The Case of an Aphasic Patient. Language and Cognitive Processes, 2(3–4), 245–262.

9. Production and Comprehension of Relative Clause Syntax in Nonfluent Aphasia: A Coordinated Study

Weijia Ni,*, † Donald Shankweiler,*, ‡ Katherine S. Harris,*, § and Robert K. Fulbright† *Haskins Laboratories; ‡University of Connecticut, §City University of New York Graduate Center; and †Yale University School of Medicine

Comprehension of sentences containing complex embeddings, such as relative clause constructions, is known to be difficult for many aphasics. Typically, errors occur in comprehending relative clauses, especially object relative clauses, when they are tested by sentence picture matching or acting out (1, 2). There is little explicit information about the production of these structures by nonfluent aphasics. Although these structures rarely occur in spontaneous speech, we wondered if sentence fragments containing relative clauses could be elicited by the techniques that have proven successful in eliciting relative clauses from young children who do not produce them spontaneously (3). Because the results of an elicitation procedure with a nonfluent aphasic were encouraging (4), we undertook a coordinated study of production and comprehension of the same structures in this individual and three additional

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TABLE 13 Production and Comprehension of Relative Clause Structures Elicited Production

MK HO HW JN

Truth-value Judgment

Subj. Rel. (4)

Obj. Rel. (4)

Substitution

Self

Prompt

Self

Prompt

Rel. cl.

4 2 4 —

— — — —

— — — —

1 1 2 —

2 2 — —

Subj. Rel.

Obj. Rel.

Other

Correct/tested

Correct/tested

1 1 1 2

8/8 7/8 7/8 7/8

8/8 8/8 7/8 6/8

nonfluent aphasics with cerebral ischemic infarct. We report results of these psycholinguistic studies together with coordinated MRI scans of the brains. Because any observed impairment in sentence production or comprehension may be complexly determined, it is important to distinguish losses of syntactic knowledge from difficulties in accessing that knowledge and using it. Accordingly, three questions motivated our study: (1) Can relative clause structures be produced by nonfluent aphasics when they are provided with contextual supports using the elicitation procedure? (2) Can these structures be comprehended when tested by the truth value judgment procedure, which, likewise, creates a contextually supporting environment that imposes minimal processing demands? (3) Can individual differences in symptom pattern be related meaningfully to distinctions of lesion site? Subjects. The subjects were four individuals with moderate to severe aphasia, each of whom sustained a single stroke 2–9 years previously. Each has achieved a good adjustment to disability, and each displayed a considerable degree of independence in self-care activities. MK was the most fluent, followed by HO; HW and JN were extremely nonfluent. Method. In the elicited production task, the participant describes a situation acted out with toy figures by an experimenter that would ordinarily call for the use of subject relative or object relative clauses. Similarly, in the truth value judgment task the experimenter describes a scene, using a sentence containing an object relative or a subject relative clause, and the subject has to judge whether or not a picture fits the description. Results. As shown in Table 13, we elicited relative clauses totally or in part from 3 of the 4 subjects. Subject relatives were produced with greater success than object relatives, as was anticipated from earlier studies of comprehension in normal children and language-impaired persons. Attempts to elicit object relatives resulted in many circumlocutions, as by substitution of a co-ordinate structure. Subject relatives were in most cases produced in reduced form (e.g., ‘‘The penny is under the bear . . . holding the fish.’’). But in two individuals a full subject relative was produced as a substitute for an object relative (two each by MK and HO).

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The results for comprehension with the truth value judgment procedure were also striking. In contrast to the results on production, all four subjects scored above chance on both subject relatives and object relatives. These results are at variance with earlier findings based on act out or picture choice tasks. They suggest that the truth-value judgment procedure allows languageimpaired individuals to demonstrate sparing of syntactic abilities that would be masked by traditional procedures for assessing comprehension. Anatomy. The MRI scans show large infarcts confined to the left hemisphere. In all subjects, the infarct involved the face motor region of the precentral gyrus (BA 6), the insula and subinsular region (extreme capsule, claustrum, and external capsule); in one individual, (HO), the infarct was limited to these regions frontally, but included the postcentral gyrus. Three subjects (MK, HW, JN) had additional involvement of Broca’s region (inferior frontal gyrus, BA areas 44, 45). In two subjects (HW,JN), the infarct extended to more posterior structures, including Wernicke’s area (posterior superior temporal gyrus, BA 22) and portions of the posterior sylvian region (supramarginal gyrus, BA 39 and angular gyrus, BA 40). The findings bear out the promise of elicited production and truth value judgment as methods of testing the limits of spared linguistic knowledge. There is evidence of considerable sparing of relative clause syntax in each individual except JN. In view of the size of the infarcted region in these cases, the extent of spared function is telling. It suggests a highly distributed representation of grammatical function within the left hemisphere. REFERENCES 1. Caramazza, A., & Zurif, E. 1976. Brain and Language, 3, 572–582. 2. Lukatela, K., Shankweiler, D., & Crain, S. 1995. Brain and Language, 49, 50–76. 3. Thornton, R. 1996. In: H. Cairns, D. McDaniel, & C. McKee (Eds.), Methods for assessing children’s syntax. Cambridge, MA: MIT Press. 4. Shankweiler, D., Harris, K. S., Ni, W., Byrd, D., & Avrutin, S. 1996. Academy of Aphasia, London.

10. Verb Production in Dutch Agrammatic Patients: Spontaneous Speech in Relation to Verb Retrieval Experiments

Roelien Bastiaanse, Roel Jonkers, and Ron van Zonneveld Graduate School for Behavioral and Cognitive Neurosciences (BCN) University of Groningen, The Netherlands

Introduction. It has repeatedly been shown that agrammatic aphasics have problems producing verbs both in spontaneous speech and in action naming, but it is unclear how these two are related. Therefore, the present study focuses on the following questions:

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(a) How does verb production in agrammatic spontaneous speech deviate from normal spontaneous speech? (b) Is there a relation between verb production of agrammatics in spontaneous speech and in naming experiments? Leading to the central question: (c) What causes the problems with verb production in agrammatic spontaneous speech? To answer these questions, a group study was performed in which verb production of agrammatic aphasics was analyzed with regard to lexical, morphological and syntactic aspects. Methods. Subjects: Eight agrammatic aphasics participated in this study (five male, three female), all aphasic due to a single left hemisphere stroke. Time postonset was minimally 3 months. For comparison of spontaneous speech, a control group of eight healthy speakers was selected, who matched the aphasic subgroup on age, social background and sex. Materials and procedure: The patients were presented with an action naming test and a sentence construction test (among others), containing 60 items each. For each patient and control subject, a spontaneous speech sample was collected. Subjects were asked to talk about the beginning of their illness (for normal controls about their last illness), their hobbies etc. Scoring: The first 300 words of the spontaneous speech sample were transcribed into normal script and the following variables were computed: number and diversity of lexical verbs; clauses containing an inflected verb (copulas and modals included) divided by the total number of clauses containing a verb; number of modals and copulas. Scoring on the action naming test was done quantitatively (1/2); on the sentence construction test, it was scored whether the intended verb was produced, not whether the sentence was correct. Results. Verb production in spontaneous speech of the agrammatics deviates from that of normal controls on two aspects (see Table 14): (1) There is less diversity of the produced lexical verbs (mwu-test: z 5 22.32, p 5 0.02); (2) The proportion of clauses containing an inflected verb is low (mwutest: z 5 22.05, p 5 0.04). The performance on the experiments demonstrates that naming actions, both in isolation and in sentence context, is poor and that there is no difference between the two (t(7) 5 0.57, p . 0.05). Remarkably, there is no relation between the poor performance on the verb retrieval tests and the reduced diversity of verbs in spontaneous speech (naming in isolation—diversity in spontaneous speech: ρ(6) 5 0.34, p . 0.05; verbs in sentences—diversity in spontaneous speech: ρ(6) 5 20.36, p . 0.05).

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TABLE 14 The Results of the Spontaneous Speech Analysis and the Verb Retrieval Tests Experiments Spontaneous speech Number V

ttr V

Vfin /V

mod/cop

Naming (max 5 60)

V in S (max 5 60)

Agrammatics B1 B2 B3 B4 B5 B6 B7 B8 Mean sdv

27 29 33 4 25 21 18 29 23.25 9.11

0.71 0.55 0.76 0.50 0.36 0.42 0.33 0.48 0.52 0.17

0.50 0.51 0.70 0.80 0.69 0.93 0.88 0.93 0.74 0.17

4 7 7 17 16 13 7 23 11.75 6.56

29 29 46 35 18 29 17 31 29.25 9.21

20 25 41 47 29 18 24 47 31.37 11.89

Controls Range Mean sdv

20–33 26.75 3.99

0.67–0.86 0.75 0.09

0.83–1.00 0.91 0.07

4–19 12.62 4.21

Note. For spontaneous speech analysis the following variables were computed: number of verbs; diversity of verbs by a type-token ratio (ttr); proportion of clauses containing an inflected verb on the number of clauses containing a verb (Vfin /V); number of modals and copulas (mod/cop). Verb retrieval was tested in isolation (naming) and in sentence context (V in S). Agrammatics’ scores that fall outside the normal range are given in bold.

Discussion. With regard to the questions (a) and (b) in the Introduction, the following is observed: (a) The spontaneous speech of agrammatic speakers deviates from normal speech in a lower diversity of lexical verbs and a reduced ability to inflect verbs. (b) There is no relation between the low diversity of verbs in spontaneous speech and the poor verb retrieval on the naming tests. The latter is clearly shown by the individual data, as presented in Table 14. B1 has a normal diversity, but is poor at action naming and even poorer at retrieving verbs in sentence context in an experiment, whereas B4 produces an extremely low number (and diversity) of verbs in spontaneous speech, but scores above average in the naming test, and even better in the sentence construction test. These observations lead to the central question: what causes the problems with verbs in the spontaneous speech of agrammatics? The lack of relationship between the diversity of verbs in spontaneous speech and the scores in the experiments implies that poor lexical access to verbs as such cannot ex-

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plain the problems in spontaneous speech. It has been argued before (Bastiaanse et al., 1996) that the problems of Dutch agrammatics with verb inflection are not due to morphological, but to syntactic factors. In a test, agrammatic aphasics are perfectly able to produce inflected verbs, as long as these verbs have not been moved from their base-generated position (as in the Dutch embedded clause). If the inflected verb has been moved from its (final) position V in the VP to the inflectional node I—a movement rule called Verb Second—the percentage of correctly produced inflected verbs drops to 50%. The low proportion in the present study shows again that the ability of Dutch agrammatics to produce inflected verbs in main clauses (in which Verb Second is required) is affected. Modals and copulas are always inflected by the agrammatics (and by the controls). These verbs are assumed to be base-generated in Verb Second position in Dutch (directly in the I-node). This means that no verb movement is required and hence, no problems are expected. Assuming that verb movement to I is the core of the problem for agrammatics, several strategies are open to the patients: (a) do not use lexical verbs (e.g. B4); (b) use a (virtually) normal amount of the same (highly frequent) lexical verbs, but avoid Verb Second (B2, B5, B7); (c) use a (virtually) normal amount and diversity of lexical verbs, but avoid Verb Second (B1, B3); (d) use a normal amount of the same (highly frequent) verbs and compensate Verb Second problems by producing modals and copulas (B6, B8). In conclusion, agrammatics are poor at verb retrieval in experimental tests, both in isolation and in sentence context, but this is not the (only) reason for their deviant verb production pattern in spontaneous speech. It is suggested that a syntactic deficit underlies the verb production problems. For Dutch, this is shown by a reduced ability to apply the movement rule Verb Second, resulting in a low proportion of inflected verbs. Patients’ reactions to this underlying deficit differ and this may explain the different patterns of agrammatic speech that have been observed in other studies. REFERENCE Bastiaanse, R., Jonkers, R., Quak, Ch., & Varela Put, M. 1996. The production of finite and nonfinite verb forms in agrammatism. Paper presented at the Academy of Aphasia, London, 3–5 November.

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11. Language Comprehension in Aphasic and Confusional State Patients as Indexed by the N400

Brigitte Stemmer Kliniken Schmieder, Allensbach, Germany and Centre de Recherche du Centre hospitalier Coˆte-de-Neiges, Montre´ al, Canada

and Wolfgang Witzke, Sieglinde Lacher, and Paul Walter Scho¨nle Kliniken Schmieder, Allensbach, Germany

Aphasic patients differ in their comprehension abilities: whereas some patients comprehend relatively well but have problems producing fluent and well-formed language, the comprehension abilities of other patients are poor although the language they produce is fluent and well-formed. Then there are those patients whose language comprehension and production abilities are both severely impaired. Apart from the language disorder, other cognitive abilities in aphasics are usually relatively well preserved. This is in contrast to patients in a confusional state who are characterized by a disturbance of consciousness, reduced clarity of awareness of the environment, easy distraction by irrelevant stimuli and an accompanied change in cognition (DSMIV). Considering the variability of comprehension abilities in both aphasic and in confusional state patients, the question arises whether there is a neurophysiological marker indicative of varying comprehension abilities. The event-related potential (ERP) technique has been used to investigate the brain’s responses to the processing of linguistic information. A large negativity occurring bilaterally in posterior areas at about 400 ms after presentation of a semantically anomalous cue has been labelled the N400 (Kutas & Hillyard, 1983, Kutas & van Petten, 1994) and appears related to semantic processing. The N400 has, for example, been elicited in response to phonological mismatches, word pairs, random word lists, ambiguous words in context, faces, color patches, or pictures (for an overview see Segalowitz & Chevalier, in press). The goal of our study was to investigate whether the absence or occurrence of the N400 was an indicator of the comprehension abilities in aphasic and confusional state patients. Method. Stimuli: The stimuli consisted of 150 German sentences, 75 of which were German proverbs whose overall familiarity had been established in previous research (Grzybek, 1991). The other 75 sentences were regular sentences derived from proverbs by replacing the last word or phrase of each proverb thus producing a semantically well formed sentence, whose meaning was different from that of the proverb it was derived from (these are termed ‘‘false’’ proverbs).

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Example for a proverb and a ‘‘false’’ proverb: Proverb: Der Apfel fa¨llt nicht weit vom Stamm. (Literal translation: *The apple doesn’t fall far from the stem). ‘‘False’’ proverb: Der Apfel fa¨llt nicht weit vom Tisch. (Literal translation: *The apple doesn’t fall far from the table). Subjects: Subjects were 7 aphasic patients, 6 confusional state patients and 20 right-handed non brain-damaged controls. Tasks: The stimuli were displayed word-by-word in black letters on a white background screen. Each word was presented for 1500 ms with an interword interval of 200 ms and an intertrial interval of 3200 ms. All subjects were instructed to simply look at the words on the screen and to decide silently for themselves whether the words formed a ‘‘correct’’ sentence or not. In case the patient was unable to read, the proverbs were presented auditorily through headphones. In a second session, all subjects (a) did a proverb completion task, and (b) provided the meaning of the proverb by freely interpreting the proverbs (those subjects who were able to do so) and by a multiple-choice task. Example for the proverb completion task: Lu¨gen . . . (Correct completion: . . . haben kurze Beine.) (Literal translation: *Lies have short legs.) Example for the multiple choice task: Lu¨gen haben kurze Beine. 1. Wer lu¨gt, dem werden die Beine abgehackt. (People who lie have their legs chopped off ) 2. Wer lu¨gt, der kommt nicht weit. (Correct interpretation) (People who lie won’t make it very far) 3. Wer kurze Beine hat, der lu¨gt viel. (People who have short legs lie a lot.) Data analysis: EEG activity was continuously recorded from 5 scalp Ag/ AgCl electrodes (Fz, Cz, Pz, C3, C4) with reference to linked earlobes while the subjects were looking at the screen. The averaged ERPs were investigated for occurrence of the N400. Results. The healthy control subjects completed the proverbs correctly, made no errors on the multiple choice task and showed the N400 component. In the proverb completion task 9 of the 13 brain-damaged subjects completed all proverbs correctly and one subject completed 90% correctly (see summary of results in Table 15). The Broca’s aphasics, who also showed the highest AAT comprehension score, were best at giving the correct multiple choice response, the other aphasics made between 40–55% errors. The N400 could be identified in 8 out of all 13 patients. In 2 patients it was

10% 20 yes 102

5% 20 yes 86

AW 20% 20 ? 104

HR 40% 18 no 77

WA b MM 50% 0 yes 59

HB 45% 0 no 28

DC

Global

55% 4 yes 98

NCb KK 45% 20 ?

ML 35% 20 yes

GK 35% 20 no

NS 15% 20 yes

IB

b

a

KE 10% 20 yes

Confusional state patients

MC 5 Multiple Choice. AAT 5 Aachener Aphasia Test. Maximum comprehension score is 120. WA 5 Wernicke Aphasia. NC 5 Nonclassifiable aphasia. c This patient was unable to accomplish the task.

Errors in MCa task No. of correct completions Occurrence of N400 AATb comprehension score

BH

Broca

Aphasic patients Classification acc. to AAT b

TABLE 15 Summary of Results

—c 20 yes

HP

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101

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questionable whether there was an N400 or not and in 3 patients there was no N400. Conclusion. There is a trend such that the fewer errors the aphasic patients made on the multiple choice task and the higher the AAT comprehension score the higher the probability that the N400 component could be identified. Similarly, the better the confusional state patients performed on the multiple choice task the higher the chances that the N400 was produced. These results support the general claim that the N400 is related to semantic processing. In addition, it seems that in brain-damaged individuals the N400 is related to the severity of comprehension problems. However, there were two aphasic patients who did not match this pattern: one showed an N400 despite a high error rate on the multiple choice task and a low comprehension score on the AAT; the other with relatively good AAT comprehension scores showed an N400 component but was unable to complete the proverbs correctly and had a high error rate on the multiple choice task. Finally, there was also a confusional state patient who showed the N400 component although he failed to assign more than one third of the proverbs to their correct interpretation. These observations, together with the fact that the ability to automatically complete proverbs seems independent of the severity of the language or cognitive deficit, suggests that the N400 may only be related to low level comprehension and/or low level cognitive processing. REFERENCES DMS-IV, Diagnostic and statistical manual of mental disorders, fourth edition. 1994. Washington, DC: American Psychiatric Association. Grzybek, P. 1991. Sinkendes Kulturgut? Eine empirische Pilotstudie zur Bekanntheit deutscher Sprichwo¨rter. Wirkendes Wort, 41. Kutas, M., & Hillyard, S. 1983. Event-related potentials to grammatical errors and semantic anomalies. Memory and Cognition, 11, 539–550. Kutas, M. & van Petten, C. K., 1994. Psycholinguistics electrified: Event-related potential investigations. In M. A. Gernsbacher Ed., Handbook of psycholinguistics (pp. 83–143). San Diego: Academic Press. Segalowitz, S. J., & Chevalier, H. In press. Event-related potential (ERP) research in neurolinguistics: II. Language processing and acquisition. In B. Stemmer & H. A. Whitaker (Eds.). Handbook of neurolinguistics. San Diego: Academic Press.

12. Treatment to Improve Sentence Production: A Case Study

Sonia Reichman-Novak* , † and Elizabeth Rochon* ,†, ‡ *Department of Communication Disorders, Baycrest Centre for Geriatric Care ‡Kunin-Lunenfeld Clinical Research Unit, Baycrest Centre for Geriatric Care †Department of Speech-Language Pathology, University of Toronto

Current psycholinguistic theories view semantic and syntactic aspects of verb representation as being closely linked (e.g. Pinker, 1989), with a central

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role often accorded to the verb in sentence processing abilities. Many aphasics have both verb production and sentence processing impairments, and the relationship between verb retrieval and sentence production has been examined recently (Mitchum & Berndt, 1991), where it was found that verb retrieval was necessary but not sufficient to improve sentence production in an aphasic patient. The present study explores this relationship further. We describe a treatment program for a patient with a verb retrieval and sentence production impairment. As in Mitchum & Berndt (1991), treatment to address these impairments was conducted in two phases: verb retrieval was trained in Phase A and passive sentence construction in Phase B. It was predicted that improved verb retrieval would not generalize to untrained verbs in Phase A, and that improved verb retrieval would not lead to improved sentence production after Phase A treatment. Schwartz et al. (1994) have shown limited generalization of treatment effects with a ‘‘mapping’’ therapy approach, in which the relations between the surface syntactic form of the sentence and the underlying meaning form (i.e. thematic roles) of a sentence are trained. In the present study, in which we employed a mapping approach, it was predicted that passive sentence training effects in Phase B would generalize to untrained passive and active sentences. Finally, improvement in narrative output was expected after Phase B but not after Phase A. Method. Case study: D.L. has mixed (fluent/nonfluent) aphasia characterized by a severe verb retrieval impairment and agrammatism. D.L. demonstrated intact noun naming but could not name picturable actions. He demonstrated limited use of grammatical morphemes and his production and comprehension of reversible sentences was impaired. Stimuli and treatment method: Phase A—D.L. was trained to produce 20 picturable action verbs in active form to 100% criterion by repeated presentations. Phase B—Two versions of 15 passive sentences were constructed from 5 each of trained, untrained, and novel verbs, each in three tenses (past, present, future), yielding a stimulus set of 90 sentences. Treatment employed an explicit teaching method adapted from mapping therapy (Schwartz et al., 1994) and grammatical frames therapy (Mitchum & Berndt, 1991). Training was conducted over 16 one-hour sessions and included regular review for maintenance of trained items. Pre- and posttreatment assessment for both phases of treatment entailed the following: (i) a verb naming test in which D.L. named 40 picturable action verbs (20 treatment and 20 control stimuli). This test was administered in Phase A only; (ii) a sentence production test in which D.L. was required to produce active and passive sentences constructed using verbs treated in phase A as well as untreated verbs; (iii) The sentence production test form the Psycholinguistic Assessment of Language (PAL: Caplan, 1992); and (iv) analysis of a video narrative (Saffran et al., 1989). A control subject achieved 95% or higher on the verb naming and sentence production tests.

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Results. Phase A: Naming performance for treated verbs improved from 50% pretreatment to 100% posttreatment (criterion was 100%). Performance for untreated verbs deteriorated from 83% pretreatment to 50% posttreatment. As expected, there was no generalization to our post-treatment sentence production test or the PAL. Analysis of selected measures in a narrative task revealed poorer performance overall posttreatment. Phase B: All passive sentences were trained to 100% criterion. On the posttreatment sentence production test, D.L.’s performance improved overall from 40% on both active and passive sentences pre-treatment, to 85% on actives and 70% on passives posttreatment. Difference scores were calculated for the magnitude of the difference pre- and posttreatment for sentences with verbs that were both treated and untreated in Phase A. For sentences with Phase A treated verbs, difference scores were identical, with 45% improvement for both active and passive sentences. For sentences with verbs that had not been treated in Phase A, the magnitude of improvement was 46% for active sentences and 18% for passive sentences. On the PAL, though overall improvement pre- and posttreatment was slight, D.L.’s performance on passive sentences improved from 67% to 100% pre- vs posttreatment, and from 73% to 84% on dative passive sentences, but deteriorated from 92% to 76% on active sentences. D.L.’s performance appears to have been structure-specific on this test. Results from a narrative task revealed improved performance posttreatment: the overall percentage of utterances that qualified as sentences was 78% pre- and 91% posttreatment; the percentage of sentences that were well-formed was 55% pre- vs 76% posttreatment; number of verbs used was 22 pre- vs 28 posttreatment, and; the proportion of lexical to nonlexical verbs was .27 pre- vs .58 posttreatment. Conclusions. As expected, single verb training did not lead to improved sentence production on any of our measures. ‘Mapping’ from passive to active sentences appears to have been achieved, at least for sentences that contained verbs treated in Phase A. It may also be that prior training of verbs in their active form aided D.L. to produce more active sentences after training on passive sentences. Other findings raise the possibility that at least at some point in sentence treatment, gains made will be structure-specific and will occur at a cost to previously intact abilities. They provide important considerations for theories of intervention. Finally, findings on a narrative production task are suggestive that treatment effects may extend to novel, more ‘‘functional’’ elicitation conditions. REFERENCES Caplan, D. 1992. Language: Structure, processing and disorders. Cambridge, MA: MIT Press. Mitchum, C. C., & Berndt, R. S. 1991. Verb retrieval and sentence construction: Effects of targeted intervention. In G. W. Humphreys & M. J. Riddoch (Eds.). Cognitive neuropsychology and cognitive rehabilitation. London: Erlbaum. Pinker, S. 1989. Learnability and cognition: The acquisition of argument structure. Cambridge, MA: MIT Press.

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Saffran, E. M., Berndt, R. S., & Schwartz, M. F. 1989. The quantitative analysis of agrammatic production: Procedure and data. Brain and Language, 37, 440–479. Schwartz, M. F., Saffran, E. M., Fink, R. B., Myers, J. L., & Martin, N. 1994. Mapping therapy: a treatment programme for agrammatism. Aphasiology, 8(1), 19–54.

13. Hemispatial Influences on Language Performance

Eunhui Lie* and H. Branch Coslett* , † *Moss Rehabilitation Research Institute; and †Department of Neurology, Temple University School of Medicine

Introduction. A critical factor in the evolution of the human brain may be the need to construct an on-line representation of the environment in which stimuli are marked with respect to their spatial location in an egocentric frame. If spatial location is crucial to interactions with the environment, one might expect that spatial systems will influence not only motor and sensory functions but even higher-order cognitive functions, such as language for which there is no explicit spatial component (see Coslett et al., 1993). We report preliminary data from an on-going investigation of spatial effects on language function. We hypothesized that if language function is influenced by spatial systems, subjects would perform less well on language tasks when attending to stimuli presented in a location in which spatial processes are disrupted. Methods. Subjects: Subjects included 10 patients with aphasia subsequent to single, neuroimaging verified left hemisphere lesions. (For further information, see Table 16.) No patients exhibited neglect on line or letter cancellation tasks. Twenty four healthy people between the ages of 43–77 (mean 5 58) served as normal controls on language tasks. Tasks and Procedure: Four language tasks were administered. Naming was assessed with 40 line drawings from the Philadelphia Naming Test. Reading was assessed with 80 words of high and low frequency and imageability (Subtest 31 of the Psycholinguistic Assessments of Language Processing in Aphasia: Kay, Lesser, & Coltheart, 1992). Sentence comprehension was assessed by asking subjects to point to one of two pictures corresponding to an auditorily presented sentence. Synonymy judgment was assessed with 62 word triplets. Two words were visually presented and a third word was auditorily presented, and subjects were asked to indicate which of the visually presented words was closer in meaning to the auditorily presented word. The materials used for naming, reading, and synonymy judgment were presented using a Power Mac computer to record response time. Subjects sat at a table in a quite room. Materials were presented at a distance of 25 in. (64 cm) anterior to and 12.5 in. (32 cm) to the right or left of body line. The experimenter sat next to the patient on the side on which

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stimuli were presented. Each task was presented in 2–4 blocks, and administered in 2–4 sessions. All tasks were given in both right and left hemispaces using an ABBA design. Two tasks were performed to assess the integrity of systems mediating visual and auditory spatial processing. One task, closely modelled after an experiment reported by Treisman and Souther (Exp. 1, Treisman & Souther, 1985), assessed ‘‘preattention’’ and ‘‘attention’’ requiring processes in vision. In the auditory task, patients sat at a horseshoe like table, surrounded by 5 or 7 speakers (2 or 3 speakers in each hemispace and one speaker on the midline) and were asked to indicate the speaker from which a white noise (generated by a computer program, SoundEdit 16 1.0.1) was presented for 250 or 5000 ms. Results. RTs and number of errors were calculated for each subjects in each task. To evaluate hemispatial differences in performance, a ratio score was calculated by dividing RT (or number of errors) for the ipsilesional (left) hemispace by the sum of RTs (or number of errors) for the ipsilesional (left) and contralesional (right) hemispaces. Seven ratio scores were generated (3 scores based on RT data from naming, reading, and synonymy judgment, and 4 scores based on number of errors made on naming, reading, synonymy judgment, and sentence comprehension). Scores deviating from the control mean by 62 sd were considered to be abnormal. Those patients who exhibited significantly worse performance on at least two measures with stimuli presented in the contralesional (right) hemispace were considered to exhibit spatially biased language function. Three patients met this criterion. (See Table 16.) Analysis of the performance on the two spatial tasks revealed that these patients also exhibited hemispatial impairments on these tasks: That is, they performed significantly less well with stimuli in the right hemispace. Conversely, patients who did not display spatial bias in language were less likely to exhibit a hemispatial difference in spatial performance. Interestingly, for all patients who showed spatially biased language performance the lesion involved the parietal lobe. Discussion. Two points deserve emphasis. First, spatially biased language performance is not rare: 30% of patients with aphasia exhibited this bias in this small series. Second, hemispatial influences on language performance are associated with hemispatial impairments in spatial processing. The data are consistent with the hypothesis that even cognitive tasks lacking an explicit spatial dimension are influenced by spatial system. REFERENCES Coslett, H. B., Schwartz, M. F., Goldberg, G., Haas, D., & Perkins, J. 1993. Multi-modal hemispatial deficits after left hemisphere stroke. Brain, 116, 525–554. Kay, J., Lesser, R., & Coltheart, M. 1992. PALPA. East Sussex, UK: LEA. Treisman, A., & Souther, J. 1985. Search asymmetry: A diagnostic for preattentive processing of separable features: Journal of Experimental Psychology: General, 114, 285–310.

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TABLE 16 Patients’ Biographical Information and Data Pt (age: post-onset) (in years) JG (53: JS (54: PW (48: DB (49: IG (77: RD (75: WC (54: AB (50: TR (65: VP (68: a b

Parietal involvement

Hemispatial influence on language tasks

yes

Performance on spatial tasks (better performance on R than L) Visual

Auditory

yes

p , .000

Fisher’s p 5 .0006

yes

yes

n.s.a

Fisher’s p 5 .049

yes

yes

p , .002

Fisher’s p 5 .00026

yes

no

yes

no

n.s.

yes

no

p 5 .0104

yes

no

p , .01

Fisher’s p 5 .00009

no

no

n.s.

n.s.

no

no

p , .01

n.s.

no

no

n.s.

12) 13) 8) —b

n.s.

8) 8) 5)

n.s. —

6) 3) .5) —

8)

Not significant, α 5 .01 for Visual, .05 for Auditory. Data not available.

14. A Category-Specific Deficit of Spatial Representation: The Case of Autotopagnosia

Gianfranco Denes,*, † Jee Yun Cappelletti,* and Alessandra Gallana* *Department of Neurology, University of Padua, Italy, †Department of Neurology, Venice, Italy

Objective. To provide neuropsychological evidence of the existence of distinct supramodal perceptual systems processing body spatial knowledge as opposed to the perception of the position of other objects. Background. Autotopagnosia, i.e., a selective difficulty in pointing to verbal command to one’s body parts, as well as those of the examiner or of a human picture, in presence of intact recognition and naming of the same body parts singled out by the examiner, has been described in a number of

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cases. Such dissociation has led some authors to propose the existence of a specific representation of the spatial relations of the body parts, the Body Schema (see Denes, 1989, for a review). It is not clear, however, if this system is based only in the proprioceptive memory of the body parts, or it is supramodal, involving the perception of the perceived or imagined motion of the body parts, as opposed to other nonbody objects. Quite recently Reed and Farah (1995), using a dual task procedure, showed, in normal subjects, the existence of a specific supramodal system involved in the monitoring of the body parts, that applies to both visual and proprioceptive inputs. Case report. A.D., a 65-year-old, right-handed, retired building surveyor, suffered from a stroke to the left parietal region 6 months previously. The patient presented with minor speech output problems, spared auditory comprehension, complete agraphia. A severe calculation impairment, affecting both facts and procedures, was noted as well as a severe difficulty in nonword reading. Naming was flawless. No oral apraxia was present, while some elements of ideomotor apraxia were found. No difficulties in dressing and in topographic orientation were present. Finally his performances in part– whole analysis revealed preserved abilities to locate parts of complex objects other than bodies (De Renzi and Scotti, 1970). During the testing sessions it became evident that the patient, despite spared naming of body parts, both his and the examiner’s, showed consistent difficulties in pointing to verbal command or on imitation. This fact led to a series of tests about body knowledge and bodily and non bodily spatial abilities. A.D.’s performance in pointing to body parts on verbal command as well as on imitation was severely impaired (mean of errors 18/54, 14/ 108 respectively), while localization of objects on the body was flawless like pointing from memory to the position of the objects localized on the body space (Sirigu et al. 1991). Experimental investigation. A modified version of the test prepared by Reed and Farah (1995) was administered to A.D. and to 11 school and age matched normals subjects (mean age 5 61, SD 5 9.7; mean school 5 8, SD 5 5.8). The first task consisted of a same/different matching task for body or nonbody position memory. In the body task the subject had to compare two poses, the first was taped from a position directly in front of the model while the target pose was taped from a 45° angle to the right of the model. The memory and target poses were either identical (20 pairs) or different in terms of arm or leg position (20 pairs). The presentation order of the pairs was randomized. The nonbody task consisted of pairs of nonverbalizable LEGO block figures photographed in two poses, the second differing from the first by a rotation of 45° on the sagittal plane. In the same tasks (20 pairs) the figure was identical, while in the different test (20 pairs) consisted in altering a portion of the top (red

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TABLE 17 Number and Mean of Error Rate for Memory Position Task Memory position task

D.A.

Control group

Body position discrimination task Lego position discrimination task

19/40 (47.5%) 14/40 (35%)

6.45/40 (16.12%) 13/40 (32.5%)

elements) or bottom (yellow elements) section and leaving the rest of the configuration intact. Results. Table 17 summarizes the mean error score for A.D. and controls. All controls found the body task easier than the other. No significant difference was found between A.D. and normal controls on the nonbody condition (χ2 5 .0055, p . .05; df 5 1). On the other hand, A.D.’s performances in the body condition was significantly worse (χ 2 5 9.83, p , .005; df 5 1) than the perception of the movement of non-verbalizable items (see figure 17). Conclusion. The present study adds a further piece of evidence for the existence of a supramodal body-specific visuospatial representation with its own neural basis, complementing a similar dissociation in the verbal domain where naming and comprehension of body parts can be selectively spared or impaired (Dennis, 1976).

FIG. 17. Results of experimental trials of memory position discrimination task. No significant differences were registered on non-body task performances between D.A. and Control Group, while statistically significant differences were found on the body discrimination task (p , .005).

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REFERENCES De Renzi, E., & Scotti, G. 1970. Autotopagnosia. Fiction or Reality? Report of a case. Archives of Neurology, 23, 221–227. Denes, G. 1989. Disorders of body awareness and body knowledge. In F. Boller & J. Grafman (Eds.), Handbook of Neuropsychology, Vol. 2, pp. 207–229. Amsterdam: Elsevier. Dennis, M. 1976. Dissociated naming and locating of body parts after left anterior temporal lobe resection: an experimental case study. Brain and Language, 3, 147–163. Reed, R., & Farah, M. J. 1995. The psychological Reality of the body schema: A Test With Normal Participants. Journal of Experimental Psychology: Human Perception and Performances, 2(2), 334–343. Sirigu, A., Grafman, J., Bressler, K., & Sunderland, T. 1991. Multiple representations contribute to body knowledge processing: evidence from a case of autotopagnosia. Brain, 114, 629–642.

15. Processing Double Letters in the Graphemic Output: A Neuropsychological Case Study

Cristina Pelizon,* Carlo Semenza,* and Tim Shallice† *University of Trieste, Italy, †SISSA, Trieste, and University College London

Graphemic representations are increasingly regarded as mental objects that do not merely consist of a linear sequence of graphemes or abstract letter identities but are rather built in a more complex fashion reflecting different aspects of the graphemic structure. One of these aspects concerns the status of double letters. Neuropsychological evidence has been recently provided in favor of the hypothesis that double letter sequences are encoded as a single grapheme identity token with quantity information being processed separately (Miceli, Benvegnu`, Capasso, & Caramazza 1995; Tainturier & Caramazza, 1996). The case of patient OC described here, whose dysgraphia is distinguished by duplication errors, adds further evidence in favor of this hypothesis. Case report. OC is a 67-year-old woman with 5 years of formal education, who conducted a small independent business. She suffered an ischemic lesion in the left semiovale area, after which her main complaint concerned a severely reduced ability in writing. Her spontaneous speech was affected only by occasional word finding problems (no paraphasias) and her linguistic comprehension was excellent (she hardly committed any errors in currently used batteries); in particular her phonemic discrimination was perfect (including distinguishing geminate from non-geminate consonants). She failed however in the longer orders of the Token Test (26/36). Repetition and naming were perfect. Her verbal short term memory was very moderately reduced (verbal span: 4), while her supraspan learning of words was normal.

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Her reading was flawless with no problems in orally producing geminate information. Other cognitive functions were normal. Writing and oral spelling. OC’s writing was exclusively affected by errors at the single grapheme level. No clear, visual, morphological or semantic errors were identified. The experimental study has been made on a corpus of 600 (4–10 letters long) words (506 on dictation and 94 in written naming of pictures) and 119 (4–9 letters long) legal nonwords presented one at time. Before writing nonwords OC was required to repeat them aloud (which she always did correctly). A total of 194 (32%) errors was observed for real words (W) while 35 (29%) of errors was observed for non-words (NW). Errors were classified as substitutions (12% W; 35% NW), deletions (11% W; 37% NW), transpositions (2% W; 0% NW), duplications (63% W; 28% NW), mixed (12% W; 0% NW). Duplication errors resulted in illegal combinations of graphemes (e.g. ‘‘ciurmma’’) 20% of the times. Noticeably they were almost twice as many on short (65%) than on long (37%) words. No length effect was observed for words: OC made about as many errors with 4–6 letter long words as she did with 7–10 letter long ones. The same was true for nonwords. A certain grammatical class effect was found (nouns: 29% of errors; verbs: 52%; adjectives: 29%; function words: 35%). Errors on verbs were however equally distributed between the root and the inflection (this may explain the odd grammatical effect since complex words access the graphemic buffer in a decomposed form). No concreteness effect was detected (errors: 38% for concrete, 34% for abstract words); a small effect of graphemic complexity was present for words (errors: 46% for simple—CVCVCV—and 55% for complex words), that widened for nonwords (16% for simple and 55% for complex). Incidence of errors in position 1–8 was also calculated: OC never made errors in positions 1 and 8 and made over 60% of errors in the 3rd position; in the other positions she failed between 8% and 12% of the times. There was no difference in the incidence of errors on geminates and consonant groups in the same word position: although deletions were more frequent on geminates, their small number in the corpus makes it impossible to judge whether this prevalence is significant. Oral spelling was also studied: OC made 46 errors over 72 words (65%), classifiable as follows: substitutions (4%), deletions (7%), transpositions (2%), insertions (4%), duplications (57%), and mixed (26%). Discussion. The most striking feature of OC’s performance (and the one of direct interest for the present work) is the very unusual proportion of duplications in writing (but not in pronouncing) and in spelling of real words. This anomalous production may be interpreted as reflecting a compensatory strategy whereby the patient, who has lost, as a consequence of her brain damage, the information about the number of graphemes, but not of their identity, resorts to doubling letters. This happens especially when the word

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is short, even at the cost of producing illegal sequences. Since duplications appear overwhelming also in oral spelling, it must be concluded that doubling information is independently represented not only at a peripheral, premotor level, as suggested by the patient recently described by Venneri, Cubelli and Caffara (1994), whose oral spelling was good, but also at a more abstract orthographic level. REFERENCES 1. Tainturier, M., & Caramazza, A. 1996. The status of double letters in graphemic representations. Journal of Memory and Language, 35, 53–73. 2. Miceli, G., Benvegnu`, B., Capasso, R., & Caramazza, A. 1995. Selective deficit in processing double letters. Cortex, 31, 161–171. 3. Venneri, A., Cubelli, R., & Caffarra, P. 1994. Perseverative dysgraphia: A selective disorders in writing double letters. Neuropsychologia, 32, 923–931.

16. Positional Effects in Dyslexic ‘‘Visual Errors’’: Constraints on the Interpretation of Word Substitutions

Rita Sloan Berndt and Anne N. Haendiges University of Maryland School of Medicine

Many of the errors produced by patients with acquired dyslexia involve the substitution of an incorrect word for a target word or nonword. Some such errors, involving semantic overlap between target and response, have been subjected to a variety of analyses and interpretations. Less attention has been given to word substitutions that have no apparent semantic basis. So-called ‘‘visual’’ errors are those in which there is substantial orthographic overlap between target and response (at least 50% of target letters are reproduced in the response in the same relative order, e.g., Reaction → ration). Although visual errors are prevalent among the responses of patients with Deep and Phonological Dyslexia, it is not clear what aspects of orthographic similarity among words trigger the substitution of related words. This study sought to examine the relationships between target and substitution errors in an attempt to identify potential sources of failed lexical access. Procedures. As part of an on-going study of oral reading performance in patients with nonlexical reading impairments (i.e., patients with Deep and Phonological Dyslexia), an error analysis was carried out on patients’ incorrect responses to 299 word and 53 nonword stimuli. Twelve right-handed patients with left hemisphere damage secondary to CVA, who presented with a range of aphasic and dyslexic symptoms, contributed a total of 944 errors for analysis (see Berndt et al., 1996, for description of patients and stimulus words). Errors were classified using a binary decision system that evaluated

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FIG. 18. Proportion of target letters retained by letter position in visual errors when scored from (a) left to right and (b) right to left.

each target/error pair for semantic, orthographic, phonologic and morphologic overlap. Reliability between two independent scorers was .95 across all decision categories. Results. Five of the 12 patients produced morphologically unrelated visual errors as a frequent error type (.25% of errors met the criterion given above), and these data were further analyzed. Targets and visual errors were compared letter-by-letter, and the frequency that target letters were reproduced in the response was calculated for each letter position. Of 838 target letters in 166 visual errors, patients retained 53% of target letters in the same position in the response. Figure 18 shows the results for each letter position (a) when targets and responses were aligned and scored from left-to-right and (b) from right-to-left (N of targets/position in parentheses). Although this dual scoring procedure suggests that the strong letter position effects favoring early (left-most) positions (shown in a) are unlikely to reflect an alignment artifact, the data were also scored for relative position preservation with comparable effects. To investigate the generality of this pattern for dyslexic patients with lefthemisphere lesions, similar analyses were carried out (a) on all semantically unrelated word responses of the five patients, including ‘‘unrelated’’ word responses to words (N 5 137) and lexicalizations of nonwords (N 5 111); (b) on the visual errors (N 5 214) of the entire group of 12 patients, and (c) on a published corpus of visual errors (N 5 116) from two extensively studied patients with Deep Dyslexia (Coltheart, 1980, App. 2). In all cases, marked effects were found favoring left-most letter positions, with a monotonic decline across early letter positions leveling off toward the ends.

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Discussion. When patients with acquired reading disorder substitute words that ‘‘look like’’ the word stimulus they are attempting to read, it seems clear that the beginnings of words are much more likely to be retained in the substituted word than are the ends of words. This characteristic error type has been discussed previously as indicating the presence of ‘‘right neglect dyslexia’’ (e.g. Warrington, 1991), and it has been argued that letter position effects favoring word initial letters represents a mirror image of the pattern found in ‘‘left neglect dyslexia,’’ which tends to preserve the ends of words. There are some important differences in the pattern and prevalence of left vs. right neglect dyslexia, however, that suggest that different types of processing deficits may be operating. Left neglect dyslexia (secondary to focal right hemisphere damage) occurs within the context of generalized left neglect, and is reported quite frequently following unilateral right hemisphere damage. Right neglect dyslexia (following left hemisphere damage) has been more rarely studied; patients are typically free from generalized neglect for objects in space and ‘‘neglect’’ only when presented with strings of letters. Word substitution errors that retain the initial letter positions of the target have been interpreted as reflecting attentional processes operating over visually perceived space (Warrington, 1991) or over an internal word representation with a natural ‘‘left side’’ and ‘‘right side’’ (Caramazza & Hillis, 1990). An alternative hypothesis is that the tendency to substitute words overlapping targets in initial letter positions reflects an exacerbation of biases that are present in the normal procedures for gaining access to lexical entries from print. Numerous lines of evidence point to the importance of early letter positions in the normal processing of print in English (Bruner & O’Dowd, 1957; Lima, 1993). Further, normal subjects’ errors to pattern-masked letter strings viewed at very short durations (Humphreys et al., 1990) retain targets’ letters in initial positions much more often than in later positions. These (and other) findings are consistent with a model of orthographic lexical access in which activation of words is graded across letter positions from left to right. Pathological disruption of such graded activations following left hemisphere damage might be expected to spare preferentially those letter positions with strongest activation levels. The precise mechanisms involved, e.g., suboptimal activation across the entire representation, exacerbated decay of a normally-activated representation, etc., are currently being investigated with a computational model of word recognition that employs graded activation functions across letter positions. REFERENCES Berndt, R. S., Haendiges, A. N., Mitchum, C. C., & Wayland, S. W. 1996. An investigation of nonlexical reading impairments. Cognitive Neuropsychology, 13, 763–801. Bruner, J., & O’Dowd, D. 1958. A note on the informativeness of parts of words. Language and Speech, 1, 98–101.

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Caramazza, A., & Hillis, A. 1990. Levels of representation, co-ordinate frames and unilateral neglect. Cognitive Neuropsychology, 7, 391–445. Coltheart, M. 1980. Deep Dyslexia. London: Rutledge & Kegan Paul. Humphreys, G. W., Evett, L. J., & Quinlan, P. T. 1990. Orthographic processing in visual word identification. Cognitive Psychology 22, 517–560. Lima, S. D. 1993. Word-initial letter sequences and reading. Current Directions in Psychological Science, 2, 139–142. Warrington, E. K. 1991. Right neglect dyslexia: A single case study. Cognitive Neuropsychology, 8, 193–212.

17. Deep Dyslexia and Dysgraphia in a Broca’s Aphasic

Venu Balasubramanian University of Wisconsin–River Falls

Introduction. The present study describes deep dyslexia (DD) in a Broca’s aphasic and discusses the symptoms of this client in the context of the patient’s overall linguistic impairments. The need for such investigation was identified in previous studies (Friedman & Perlman, 1982). This study further explores the possibility that cases with relatively less extensive lesions of the left hemisphere will not evidence the prototypic syndrome of DD reported in earlier literature (Glosser & Friedman, 1990; Coltheart, 1987). Needless to say such variants will undermine the hypothesis of right hemisphere compensatory mechanisms posited to account for the symptoms of DD. Furthermore, this study investigates the prediction that there can be parallel deficits across two or more modalities of language performance in deep dyslexics (Nolan & Caramazza, 1982; Rapcsak, Beeson, & Rubens, 1991). For instance, DD can be accompanied by deep dysgraphia. Case history. LK, a 45-year-old white male high school science teacher, suffered a stroke on 8.3.92 and consequently developed right hemiplegia and severe aphasia. In the postacute stage, LK learned to use his left hand for writing. A CT scan done approximately six months after the onset revealed regions of infarct involving the left temporal region extending up to a portion of the left frontal lobe. Clinical speech-language Evaluation. At 14 months postonset, LK’s performance on Boston Diagnostic Aphasia Examination was resembling the profile of Broca’s aphasia. Subsequently, other standardized test batteries such as Apraxia Battery for Adults (ABA), Reading Comprehension Battery for Aphasia (RCBA), and a Short Version of Token Test were also administered. On the ABA, LK’s speech evidenced mild verbal apraxia of speech. LK obtained an overall score of 80% on the RCBA. A moderate degree of auditory comprehension impairment was evident from his performance on

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TABLE 18 LK’s Performance on Lexical Decision, Reading and Writing Tasks: Percentage Correct Responses Word identification: imageability & frequency (PALPA 25) Lexical decision: regularly inflected words (PALPA 26) Lexical decision: Derivational words (PALPA 26) Identification of regular words (PALPA 27) Identification of irregular words (PALPA 27) Homophone identification (PALPA 28) Oral reading: letter length (PALPA 29) Oral reading: high imagery & high frequency (PALPA 31) Oral reading: high imagery & low frequency (PALPA 31) Oral reading: high frequency & low imagery (PALPA 31) Oral reading: low frequency & low imagery (PALPA 31) Nouns, adjectives, verbs, & functors: (PALPA 32) all were read at Spelling-sound regularity: regular words (PALPA 35) Spelling-sound regularity: irregular words (PALPA 35) Non word reading (PALPA 36) Writing: letter length (PALPA 39) Writing: imagery & frequency (PALPA 40) Writing: grammatical classes (PALPA 41) Writing: lexical morphology (PALPA 43) Writing: spelling regularity (PALPA 44)

100% 93% 86% 93% 86% 43% 87% 90% 60% 50% 30% 35% 80% 63% 20% 16% 22.5% 10% 3.3% 30%

the Token Test. LK’s verbal description of complex pictures and recall of narratives were characterized by symptoms of agrammatism, reduced lexical retrieval and semantic paraphasias. Additionally, LK demonstrated significant problems in the use of appropriate inflectional forms of verbs and nouns. The inflection of irregular verbs for tenses was more impaired than the inflection of regular verbs. Analyses of reading and writing. In the Fall of 1996, a number of tests from the Psycholinguistic Assessment of Language Processing in Aphasics (PALPA, Kay, Lesser & Coltheart, 1992) had been used to assess LK’s reading and writing. The results of this assessment are summarized in Table 18. Coltheart’s (1994) word list was used to assess reading of orthographically regular and irregular words. LK’s performance on most of the letter discrimination tasks was within normal limits (PALPA 18–21). Only on two tasks, letter naming and sounding (PALPA 22) and spoken letter-written letter matching (PALPA 23), LK’s performance dropped to 68 and 88% accuracy levels, respectively. LK’s overall performance on the lexical decision tasks was good. The homophone decision task proved to be the hardest lexical decision task for LK. He also identified 30% nonwords as words (PALPA 25 and 26). A noteworthy feature of LK’s oral reading performance was the lack of grammatical class effect (PALPA, 32). LK read the derivational, regularly and irregularly in-

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flected words at 73, 60, and 20% accuracy levels, respectively (PALPA 34). On the homophone reading task, LK’s performance reached 40% accuracy level (PALPA 38). In reading orthographically irregular words, LK’s semantic paralexias accounted for 9.3% of his total errors, where as semantic paralexias accounted for 4.1% of his total errors in reading regular words (Coltheart 1994 word list). LK’s writing to dictation was severely impaired. Furthermore, there were no clear signs of deep dysgraphia. No semantic substitutions were seen in his writing. Although, LK was able to write 22.5% of dictated words, all the correctly written words were high imagery and high frequency words (PALPA 40). The grammatical class and lexical morphology tasks were the hardest writing tasks for LK (PALPA 41, PALPA 43). His performance on spelling regularity task was better than his performance on all other writing tasks (PALPA 44). Discussion. DD may not always occur in its pure form. The lack of grammatical class effect in LK’s oral reading and lexical decision performance clearly support the view that DD can take more than one form (Nolan & Caramazza, 1982; Glosser & Friedman, 1990). The occurrence of semantic paralexias may be prompted by phonological processing deficits. This position is supported by the observation that LK produced significantly more semantic paralexias in reading orthographically irregular words than in reading regular words. The right hemisphere compensatory mechanism does not seem to explain the profound writing deficits in LK, although the word stimuli used in both reading and writing tasks of PALPA are nearly the same. LK’s poor performance in writing may reflect the limits of right hemisphere potentials for compensation. Alternately, all the symptoms of LK may have resulted from lesions of different components of the language processing system controlled by the left hemisphere. Morphological errors in language production, lexical decision, oral reading and writing appear to indicate a modality-free general linguistic impairment.

REFERENCES Coltheart, M. 1987. Deep dyslexia: a review of the syndrome. In M. Coltheart, K. E. Peterson, & J. C. Marshall. (Eds.) Deep dyslexia. 2nd ed. London: Routledge. Coltheart, M., & Rastle, K. 1994. Serial processing in reading aloud: evidence for dual models of reading. Journal of Experimental Psychology: Human Perception and Performance, 22, 1197–1211. Friedman, R. B., & Perlman, M. B. 1982. On the underlying causes of semantic paralexias in a patient with deep dyslexia. Neuropsychologia, 20, 559–568. Glosser, G., & Friedman, R. B. 1990. The continuum of deep/phonological alexia. Cortex, 26, 343–359. Kay, J., Lesser, R., & Coltheart, M. 1992. Psycholinguistic Assessment of Language Processing in Aphasia. Hove, England: Erlbaum.

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Nolan, K. A., & Caramazza, A. 1982. Brain and Language, 16, 237–264. Rapcsak, S. Z., Beeson, P. M., & Rubens, A. 1991. Brain and Language, 41, 510–530.

18. Treatment for Pure Alexia Employing Two Distinct Reading Mechanisms

Rhonda B. Friedman and Susan Nitzberg Lott Georgetown Institute for Cognitive and Computational Sciences, and Department of Neurology, Georgetown University Medical Center

Introduction. It has been suggested that patients with pure alexia have access to two distinct mechanisms for reading. One mechanism relies on rapid whole word recognition, while the other relies on a slower, letter-byletter decoding strategy. Rapid whole word reading was demonstrated in two patients with pure alexia, who demonstrated improved recognition of words that had been trained repeatedly using tachistoscopic presentations (Lott & Friedman, 1994, 1995). This improved speed of reading trained words did not generalize to untrained words. Another patient with pure alexia was shown to improve his speed and accuracy of reading following training that focused on a speeded letter-by-letter reading approach (Lott & Friedman, 1996). This improvement, in contrast to the results of the tachistoscopic presentation approach, did generalize to untrained words. The current study incorporates features of both of these approaches, in an attempt to maximize the efficiency of reading in normal situations. The strategy was to use the whole word recognition approach to train patients with pure alexia to rapidly recognize those words that most frequently appear in text. As this approach does not generalize to untrained words, and it is too cumbersome to learn all words in the language this way, the letter-by-letter reading approach was employed as a strategy for increasing the speed of reading words of lower frequency of occurrence. Case History. FT is a 65-year-old, right-handed woman who sustained a left intracranial hemorrhage approximately 2 years prior to initiation of this study. She underwent a left occipital craniotomy for evacuation of the hematoma and subtotal left occipital lobectomy. MRI administered postoperatively revealed residual hemorrhage and local mass effect, but no midline shift. She presented with a right hemianopia and pure alexia. Method. Stimuli: The stimuli for the tachistoscopic word recognition phase consist of the 120 most frequently occurring words in the Francis–Kucera word count (1982), and their matched control words. Control words are of the same length as the original words, and share the same initial three letters. Stimuli for the speeded letter-by-letter reading phase consist of the letters of the alphabet; nonpronounceable letter strings; and words. Stimuli for the

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hybrid phase consist of 120 sentences; 50% to 70% of the words in each sentence are the trained sight words from phase one, while the remaining words were not trained. Procedure: The first stage of therapy focuses on training the 240 sight words (six sets of 40 words each) via a tachistoscopic word recognition technique (Lott and Friedman, 1994 and 1995). To ensure that the trained words are recognized in broader contexts than the 40 word sets in which they were trained, in the next stage of the therapy two sets of 40 words are combined, and the 80 words are randomly presented in the same format as before. If performance drops below 90% under these conditions, training is implemented until the 90% level is achieved. Finally, all 240 words are combined into one long set, and therapy proceeds, as necessary, until 90% performance is reached under these conditions. The second stage of therapy trains speeded letter-by-letter reading as previously described by Lott and Friedman (1996). The final stage of therapy trains the patient to combine both strategies in sentence reading. The patient is encouraged to rapidly identify the trained sight words, and to use speeded letter-by-letter reading for all other words. Results. To date, FT has completed the sight word phases of treatment. Her reading of the sight words improved from 65% to 93%. Performance on initially trained sets was maintained during training on subsequent sets. When words were tested in sets of 80, however, performance dropped to 86%. After treatment in sets of 80 words, performance rose to 93%. When all 240 words were tested together performance dropped back to 85%. After training all 240 words together, performance again rose to 91% correct. FT’s reading of sentences composed entirely of the trained sight words became considerably faster, from 9.4 to 7.7 seconds per sentence, without any loss in accuracy. Her speed of reading sentences composed of a combination of trained sight words and untrained words also improved, however, not as dramatically (from 10.2 to 9.8 s per sentence). Discussion. FT’s acquisition of the 240 sight words successfully improved her speed of sentence reading. Improvement was most pronounced on sentences containing only trained words, and was present, but less pronounced, on sentences that contained untrained as well as trained words. These data suggest that the treatment effect for this phase of the therapy is item-specific, as we predicted. We suggest that this specificity may be due to the fact that there is no conscious strategy being used during the tachistoscopic presentation treatment. In contrast, the speeded letter-by-letter reading strategy does utilize a conscious strategy that can then be applied to any orthographic stimulus. The speeded letter-by-letter reading phase is currently underway and the results will be discussed in terms of FT’s ability to toggle between the two different reading approaches in order to effect even greater reading improvement.

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REFERENCES Lott, S. N., & Friedman, R. B. 1994. Treatment for pure alexia via the information superhighway. Brain and Language, 47, 524–527. Lott, S. N., & Friedman, R. B. 1995. Semantic treatment for pure alexia revisited. Brain and Language, 51, 54–56. Lott, S. N., & Friedman, R. B. 1996. A speeded letter-by-letter reading treatment for pure alexia. Brain and Language, 55, 20–22. ARTICLE NO. BL971912