Ch 7 Adult Language Impairments October 20 2011 Does not exclusively include adults although most frequent can also include kids acquired Language Development Through the Lifespan Unless the is neuropathology adults continue to refine communication skills Use Adults are skilled conversationalists Refine conversation do not necessarily learning new things Can adjust to individual settings Effectively repair communication breakdowns between speaker and listener Narratives improve until the seventies can add more outside information Content Some words fade and others are added 30 000 60 000 words in average adult vocabulary Specialized vocabulary continues to develop Environment often affects vocabulary Deficits in accuracy and speed of word retrieval naming Form Continue to acquire some aspects of syntax See more prefixes irregular verbs 1 Complex sentence construction declines with advanced age Written language more complex than oral language Comprehension of complex syntax increases from adolescence to middle age comprehension decreases with advanced age Aphasia Literally without language 1 stroke likelihood that language severely impaired in the future increases Strokes cause death to effected brain tissue The younger the person who has a stroke the better chance of recovery but also has to do with health prior to stroke Affects over 1 million people in the U S May affect listening speaking reading and writing Range in severity mild profound Related to cause location extent age of brain injury age general health of patient Patterns of behavior can be used to categorize by type syndrome No federal legislation for adult impairments unlike what they have for kids Expressive deficits Reduced vocabulary Omission addition of words Stereotypic speech certain phrases still in language that become stereotypic usually see swear curse words Can tie use of that phrase to certain situations Delayed or reduced output of speech cid 224 increase in processing time Hyperfluent speech rapid speech but may be incoherent and might include cluttering 2 Word substitutions Language comprehension deficits cannot understand the entire sentence Impaired interpretation of linguistic information Cannot comprehend intonation changes or rhythmic changes Concomitant Deficits Hemiparesis weakness on one side of the body in which strength and control are greatly reduced can still move the muscles Hemiplegia paralysis on one side of the body Hemisensory impairment loss of ability to perceive sensory information on one side of the body i e numbness or tingling on that side of the body no feeling of pain or touch Hemianopsia blindness in the right visual field Will affect reading ability Dysphagia swallowing or chewing problems Pareisis and or sensory impairment involving the neck and face May also have drooling or gagging Agnosia a sensory deficit accompanying some aphasias that makes it difficult for the client to understand incoming sensory information Specifically auditory or visual information Agrammatism omission of grammatical elements May omit short unstressed words i e articles or prepositions May omit morphological endings i e plural s or past tense ed Agraphia difficulty writing may be full of errors and poorly formed Unable to write what they are able to say Agrammatism jargon and neologisms may be present in written language and spoken language Alexia reading problems unable to recognize even common words they use in their speech and writing 3 Paraphasia and neologisms may also be present Anomia difficulty naming things Usually great struggle Know what they want to say but cannot find the appropriate word An incorrect responses may continue to be produced even when the person recognizes it is incorrect Jargon meaningless irrelevant speech with typical intonation patterns babbling motor component is fine but difficulty with output May contain neologisms Responses often long and syntactically correct although containing nonsense Neologism creation of new and nonsensical words Paraphasia word substitutions found in clients who may talk fluently and grammatically Associations to the intended word may be based on meaning i e truck for car on similar sounds i e tar for car or on some other relationship Verbal stereotype an expression repeated over and over Sometimes an obscene word or expletive or a neologism Types of Aphasia Fluent Aphasias comprehension and speech issues not motor issue memory retrieval problems Word substitutions neologisms and often verbose verbal output hyperfluent speech Often posterior lesions in left hemisphere back part of left hemisphere temporal lobe Wernicke s Aphasia able to produce long strings of sentences but producing it without pauses turn taking no awareness of listening unaware of speech difficulty Fluent or hyperfluent speech Verbal paraphasia or unintended words and neologisms Sentences formed by strings of unrelated words jargon Auditory and visual problems mild severe 4 Problem with naming problem with reading and or writing Anomic Aphasia naming difficulties Occipital lobe damages and some temporal lobe damage Memory problems Severe anomia in both speech and writing Disruptions in speech fluency because of naming difficulties word retrieval difficulties Generally only mild comprehension problems Conduction Aphasia anomic issues and poor repetitive and imitation Many attempted self repairs Transcortical Sensory Aphasia conversation and spontaneous speech like Wernicke s area but filled with word errors Impaired ability to repeat or imitate word phrases and sentences Subcortical Aphasia lesions occur deep inside the brain without involvement of the cerebral cortex Verbal paraphasia or word substitutions Lack of nouns and severe anomia Poor auditory comprehension Echolalic speech Fluent expressive speech Paraphasia and neologisms Repetition unaffected Auditory and reading comprehension relatively unaffected Cognitive deficits and reduced vigilance 5 Site of lesion often in or near the frontal lobe effects motor processing and programming Nonfluent Aphasia Motor programming and speech intelligibility diminished Slow labored speech word retrieval and syntactic problems Broca s Aphasia produce short sentences No compound or complex sentences drop word endings Function words articles prepositions missing from speech Anomia Writing is slow and labored Articulation and chronological errors Transcortical Motor Aphasia impaired speech especially in conversation Deficits in