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FSU SPA 2001 - Ch. 7 Adult Language Impairments

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October 20, 2011Does not exclusively include adults (although most frequent), can also include kids — acquired!Language Development Through the LifespanUnless the is neuropathology, adults continue to refine communication skillsUseAdults are skilled conversationalistsRefine conversation, do not necessarily learning new thingsCan adjust to individual settingsEffectively repair communication breakdowns between speaker and listenerNarratives improve until the seventies — can add more outside informationContentSome words fade and others are added30,000-60,000 words in average adult vocabularySpecialized vocabulary continues to developEnvironment often affects vocabularyDeficits in accuracy and speed of word retrieval/namingFormContinue to acquire some aspects of syntaxSee more prefixes, irregular verbsComplex sentence construction declines with advanced ageWritten language more complex than oral languageComprehension of complex syntax increases from adolescence to middle age; comprehension decreases with advanced ageAphasiaLiterally “without language”1 stroke = likelihood that language severely impaired in the future increasesStrokes cause death to effected brain tissueThe younger the person who has a stroke, the better chance of recovery, but also has to do with health prior to strokeAffects over 1 million people in the U.S.May affect listening, speaking, reading, and writingRange in severity (mild-profound)Related to cause, location/extent/age of brain injury, age/general health of patientPatterns of behavior can be used to categorize by type/syndromeNo federal legislation for adult impairments, unlike what they have for kidsExpressive deficits:Reduced vocabularyOmission/addition of wordsStereotypic speech: certain phrases still in language that become stereotypic (usually see swear/curse words)Can tie use of that phrase to certain situationsDelayed or reduced output of speech  increase in processing timeHyperfluent speech: rapid speech but may be incoherent and might include clutteringWord substitutionsLanguage comprehension deficits — cannot understand the entire sentenceImpaired interpretation of linguistic informationCannot comprehend intonation changes or rhythmic changesConcomitant DeficitsHemiparesis: 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 bodyHemisensory 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 abilityDysphagia: swallowing or chewing problemsPareisis and/or sensory impairment involving the neck and faceMay also have drooling or gaggingAgnosia: a sensory deficit accompanying some aphasias that makes it difficult for the client to understand incoming sensory informationSpecifically auditory or visual informationAgrammatism: omission of grammatical elementsMay 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 formedUnable to write what they are able to sayAgrammatism, jargon, and neologisms may be present in written language and spoken languageAlexia: reading problems — unable to recognize even common words they use in their speech and writingParaphasia and neologisms may also be presentAnomia: difficulty naming things. Usually great struggleKnow what they want to say but cannot find the appropriate wordAn incorrect responses may continue to be produced even when the person recognizes it is incorrectJargon: meaningless/irrelevant speech with typical intonation patterns; babbling (motor component is fine, but difficulty with output)Responses often long and syntactically correct although containing nonsenseMay contain neologismsNeologism: creation of new and nonsensical wordsParaphasia: word substitutions found in clients who may talk fluently and grammaticallyAssociations 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 relationshipVerbal stereotype: an expression repeated over and overSometimes an obscene word or expletive or a neologismTypes of AphasiaFluent Aphasias: comprehension and speech issues (not motor issue), memory/retrieval problemsWord substitutions, neologisms, and often verbose verbal output, hyperfluent speechOften posterior lesions in left hemisphere (back part of left hemisphere) — temporal lobeWernicke’s Aphasia: able to produce long strings of sentences but producing it without pauses, turn-taking (no awareness of listening), unaware of speech difficultyFluent or hyperfluent speechVerbal paraphasia or unintended words and neologismsSentences formed by strings of unrelated words (jargon)Auditory and visual problems (mild-severe)Problem with naming; problem with reading and/or writingAnomic Aphasia: naming difficultiesOccipital lobe damages and some temporal lobe damageMemory problemsSevere anomia in both speech and writingDisruptions in speech fluency because of naming difficulties/word retrieval difficultiesGenerally only mild comprehension problemsConduction Aphasia: anomic issues and poor repetitive and imitationMany attempted self-repairsTranscortical Sensory Aphasia: conversation and spontaneous speech like Wernicke’s area, but filled with word errorsImpaired ability to repeat or imitate word phrases and sentencesVerbal paraphasia or word substitutionsLack of nouns and severe anomiaPoor auditory comprehensionEcholalic speechSubcortical Aphasia: lesions occur deep inside the brain without involvement of the cerebral cortexFluent expressive speechParaphasia and neologismsRepetition unaffectedAuditory and reading comprehension relatively unaffectedCognitive deficits and reduced vigilanceNonfluent AphasiaMotor programming and speech intelligibility diminishedSlow, labored speech, word retrieval and syntactic problemsSite of lesion often in or near the frontal lobe — effects motor processing and programmingBroca’s Aphasia: produce short sentencesNo compound or complex sentences; drop word endingsFunction words (articles, prepositions) missing from speechAnomiaWriting is slow and laboredArticulation and chronological errorsTranscortical Motor Aphasia: impaired speech, especially in


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