WEBSITE-Neurolinguistic terminology

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Abstract attitude

Goldstein (1948) considered that some aphasic patients had an impairment

in abstract reasoning. Initially this theory was inspired by his

observations that patients might, even in non-verbal tasks, group

objects in curious ways---they did not seem to appreciate the (abstract)

categories into which they fell. Patients can be absorbed by the

concrete details of a task and be unable to distinguish its elements.

Goldstein's concept has been criticised for not being precise, and has

received little attention from contemporary researchers, even where they

have been concerned with aphasic categorisation.

Agrammatism

The grammatical disturbance in the speech of non-fluent aphasic

patients. Speech consists mostly of content words, and there are few

attempts at syntactic structures; many function words and inflections

are missing, and there are few verbs. In inflecting languages such as

German or Russian verbs mostly appear in the infinitive and nouns in the

nominative. Some (but not all) patients who are agrammatic in speech

production also have difficulties in sentence comprehension, where

understanding the sentences requires knowledge of their syntactic

structures. A variety of very different kinds of difficulties in

sentence comprehension and production may have been categorised together

as agrammatism.

Anomia

A difficulty in word finding; most often demonstrated in picture-naming

tasks, but often also evident in circumlocutions in spontaneous speech.

Some degree of anomia is found in virtually all aphasic patients; where

it is the most prominent problem, a patient is said to show anomic aphasia.

Anomia aphasia (amnesic aphasia)

A type of aphasia in which a difficulty in retrieving content words, and

sometimes particularly nouns, is the most obvious problem. The

difficulty may be confined to speech production, but some patients also

have problems in word comprehension. Other aspects of langauge are

relatively well-preserved; repetition is good and spoken language is

grammatically well-formed, although there may be many circumlocutions.

Aphasia

This refers to a disorder of language following some kind of acquired

brain damage. The term excludes disorders in language comprehension or

expression that are primarily due to mental disorders, including

psychosis, dementia, and confusion. It also excludes disorders that are

due to difficulties in sensation (e.g., deafness), or due to

difficulties in articulation or its control (dysarthrias). The term is

thus intended to include all disorders of language that are primarily

due to impairment to the linguistic system itself. The boundaries of

this have not been easy to determine in practice; there is, for example,

debate on whether a difficulty in organising the movements of

articulation (articulatory apraxia) should be considered a primarily

motor disorder (and therefore non-aphasic), or a primarily linguistic

one (and therefore aphasics).

Apoplexy

A term used by Hippocrates to refer to any sudden attack of paralysis or

loss of sensatioin as a result of cerebral disease. Equivalent to the

modern term stroke.

Aphemia

A term that Broca (1861, 1869) attempted to introduce to describe " loss

of the faculty of articulated language. " In aphemia there is very much

reduced vocabulary or even speechlessness except for some oaths and

neologisms. Ideas, as shown by gestures, are intact, and comprehension

is good even for words and sentences that the patient cannot repeat.

Broca wanted to distinguish this from " verbal amnesia " in which there is

no longer a connection between words and the ideas that they represent.

Trousseau(1864) objected to the term " aphemia, " believing, according to

Head (1926), that in Greek it meant " infamous " ; he introduced his own

coining -- " aphasia " ---which gained general acceptance.

Apraxia

Any disorder of the organisation of movement; the concept was developed

by Liepmann (1900). Involuntary movements may be relatively normal, but

more deliberate or symbolic acts are disturbed. Apraxia is, most

typically, confined to movements of one kind, or one part of the body;

hence the sub-categories. A range of different types of apraxia have

been proposed: limb apraxia, ideomotor apraxia, ideational apraxia,

constructional apraxia, dressing apraxia, etc.

Articulatory apraxia (apraxia of speech)

A difficulty in the organisation of movements of the articulators for

the production of speech sounds. There should be no motor difficulty,

and speech sounds may be produced correctly in relatively automatic ways

(e.g., swearing, counting, singing), but impossible when produced

deliberately. Articulatory apraxia is often accompanied by oral

apraxia---a defect in the organisation of non-speech mouth

movements---and aphasia. There is much debate about whether

articulatory apraxia should be considered a language disorder (and

therefore a symptom of aphasia), or a disorder of motor control. In

many patients, the articulatory disorder is affected by linguistic

factors (e.g., syntactic category, word frequency, real word vs

non-word); in these cases it would seem unprofitable to ignore the

linguistic dimension.

Associationism

A psychological theory, which can be traced back to Aritotle, but which

was first fully developed by the English Empiricists, particularly

Hume. Association is the fundamental principle of mental life.

Sensations or images can become associated by one of three relations:

similarity, contrast, and contiguity. Complex ideas are built up from

simple sensations by these laws of association; the early empiricists

hoped to reduce these three laws to one---the law of contiguity---and to

create a mental mechanics that would rival the physical mechanics that

Newton had developed.

Associationism remained the dominating perspective on psychology

throughout the nineteenth century (e.g., Mill, Herbert Spencer,

Ebbinghaus) and in the twentieth century was developed into

behaviourism, which aimed to explain all behaviour in terms of

associations between stimuli and responses.

Automatic speech

Speech where the process is initiated by the clinician and completed

" automatically " by the patient. This includes all serial speech (i.e.,

counting, months, etc.) as well as songs, poetry, and cliché completion

(as when a patient says " dogs " after the clinician says " It's raining

cats and ... " ). According to , this is non-propositional, and

therefore not real speech. Automatic speech is often the only speech

that very severe global aphasics can produce.

Behaviourism

An approach to psychology developed by J.B. (1914) that asserts

that psychology should only be concerned with observable behaviour, and

should not consider mental events---thoughts, feelings, concepts. It

became the dominant approach to psychology in the United States

following the Second World War. In its most extreme examples, no

internal state of an organism could be discussed. It lead to a largely

sterile psychology, which avoided theory; it was strongly concerned with

the behaviour of laboratory rats, hoping that investigation of lower

animals in controlled situations would yield general principles that

could explain the behaviour of humans. Now largely abandoned.

Broca's aphasia

A neo-classical category of aphasia. Spontaneous speech is non-fluent,

and sometimes there is a degree of dysarthria and/or articulatory

apraxia. Function words and grammatical affixes may be omitted, and

syntactic structure simplified or even absent; verbs are often rare and

nouns relatively common. Language comprehension is by comparison

relatively good, although there may be difficulty with grammatically

complex sentences. There are almost always word retrieval problems,

evident in both picture-naming and spontaneous speech; repetition is

disturbed in line with the disruption of spontaneous speech.

Cirmumlocution

Attempt to explain a word in a roundabout way, or finding a way to avoid

using a word. It usually reflects an underlying difficulty in word

retrieval.

Conduction aphasia

A category of aphasia in which repetition is disturbed more severely

than other functions. Auditory comprehension is reasonably good,

although there may be a subtle difficulty with grammatically complex

sentences. Speech production is fluent, but there are often phonemic

paraphasias; these are usually more prominent in repetition tasks.

Shallice and Warrington (1977) argue that there are (at least) two

varieties of conduction aphasia: a reproduction disorder causing

phonological errors in all speech production tasks; and a limitation in

auditory-verbal short-term memory.

Deep dyslexia

A disorder of oral word reading in which (1) the patient cannot read

non-words (e.g., GOCK); (2) concrete words are read better than abstract

words; (3) function words are read worse than content words; (4) words

with grammatical inflections are hard; (5) semantic errors(e.g.,

CAT? " dog " , AVERAGE? " bad " ), morphological errors (e.g., WALKING ? " walks " )

and visual errors (e.g., WIRE ? " wine " ) occur. Many, but not all deep

dyslexics are also Broca's aphasic and deep dysgraphics. These patients

are thought to read aloud using only a route that involves access to

central semantic representations.

Deep dysgraphia

An acquired writing difficulty, used to describe a pattern of

difficulties in writing words to dictation. Deep dysgraphic patients

(1) cannot write non-words to dictation; (2) write concrete words better

than abstract words; (3) write function words worse than content words;

(4) have difficulty with words with grammatical inflections, and (5)

make semantic errors, morphological errors, and visual errors.

Diagram makers

A term used by Head (1926) to describe the localisationist neurologists

of the nineteenth century -- Wernicke, Lichtheim, Broadbent, Bastian

etc.---because of their tendency to propose theories that were expressed

as diagrams. Head intended the term as an insult.

Direct method (Direct speech training)

An approach to aphasia treatment advocated by Kussmaul, Gatzmann, and

Froeschels, in which language is reconstituted by dint of repetition.

First the patient has to learn to repeat sounds, then words and later

phrases. Patients were typically encourage to use words multimodally; a

patient might, for example, hear a word, repeat it, see the written word

and copy it; repetition, though, remains the central method of the

approach.

Dualism

The view that there are two fundamental types of substances. All

substances are either material or mental, and neither can be reduced to

the other. In this it is opposed to reductionism, which holds that all

mental events can be reduced to material events, and idealism, which

holds that all material event are in fact mental.

Dynamic aphasia

A term used by Luria to describe aphasic patients who have difficulty in

converting internal speech into spoken narrative, because of , in

Luria's words, " a disturbance in the linear scheme of the sentence " .

Comprehension, word retrieval, and repetition are undisturbed, but the

patient is at a loss when required to turn his thoughts into language.

There is no category that corresponds to dynamic aphasia in other

classification systems.

Dysarthria

A disorder of articulation. This can be due to either a defect in the

organs of articulation (i.e., mouth, tongue, larynx, etc.) or, more

commonly in aphasic patients, by impairment to the nerves supplying the

organs of articulation. A number of different types of dysarthria are

recognised, including spastisc dysarthria (characterised by raised tone

in the muscles controlling articulation), flaccid dysarthria (in which

there is reduced tone and weakness), dystonic dysarthria (where

poorly-controlled writing movements may occur), and ataxic dysarthric

(where there is poor coordination of muscle movements). There is no

deficit of language. There is debate on whether articulatory apraxia

should be described as a variety of dysarthria.

Dyslexia

A disorder of reading. The traditional classification of disorders of

reading, developed by Dejerine (1892), recognises three kinds of

dyslexia, which are distinguished by their accompanying disorders. In

dyslexia without dysgraphia (or pure dyslexia), writing is unaffected

but reading is disturbed; in dyslexia with dysgraphia, both reading and

writing are disturbed, but there is, by comparison, little or no

aphasia.. In dysphasic dyslexia, reading, writing, and other langugae

modalities are impaired. This classification schema is (broadly)

accepted by the neo-classical school.

Dysprosody

Impairment in (one or more of ) the prosodic aspects of speech: rhythm,

intonation, or stress.

Echolalia

The involuntary repetition (by a patient) of other people's speech. It

is rare in aphasic patients, although it is said to be a feature of

" isolation syndrome, " where repetition is the only function which

remains (relatively) intact.

Efferent motor aphasia

A category of aphasia proposed by Luria (1947), approximately equivalent

to Broca's aphasia. In this type of motor aphasia there is a defect in

the " serial organisation of the spoken word " and phones are not modified

according to their phonological context. As patients improve,

agrammatism becomes apparent. Efferent motor aphasia (where the problem

is a disorder in output) is distinguished from afferent motor aphasia,

where articulatory organisation breaks down because of a failure in the

use of kinaesthetic feedback for the control of articulation.

Figure

In Gestalt psychology, a figure can only be perceived against its

ground. That is, in general, mental events need to be considered in

their context. This follows directly from the Gestalt thesis that the

whole is greater than its parts.

Gestalt psychology

An approach to psychology developed in Germany in the first quarter of

the twentieth century that emphasizes that mental events and experience

can not be completely analyzed into a series of elements; the whole is

more than the sum of the parts. This led to an interest in the way

mental events interacted. Goldstein developed a form of gestalt

psychology, which he called organismic psychology, which saw the

behaviour of an organism as a concerted effort towards particular ends,

and saw the importance of maintaining equilibrium. This was reflected

in his view of the (damaged or undamaged) brain acting as a whole

interacting unit.

Global aphasia

An aphasia in which language is very severely affected in all

modalities. In the most extreme cases there may be no evidence of any

real knowledge of language remaining. Auditory comprehension is usually

the least impaired modality.

Hemiplegia

Paralysis of one side of the body. When caused by damage above the

level of the brain stem, the paralysis is on the opposite side of the

body from the lesion that causes it. Aphasia, which usually follows

damage to the left hemisphere (at least in right-handed people), may be

accompanied by a right hemiplegia.

Holism

The view that a system is more than the sum of its parts. Applied

especially to the opponents of localisationism (e.g., ,

Goldstein, and Lashley) who emphasizes that the parts of the brain must

be considered to be interacting, and that as result that action of an

individual part cannot be separated off.

Kinaesthesis

The sensation caused by movements; kinaesthetic feedbach is important in

the control of many movements, especially fine or skilled ones.

Localisationism

The doctrine that specific mental events are localised in specific parts

of cerebral tissue. Most usually " faculties " (e.g., acoustic images of

words) have been located in paarticular centres. Many localisationists

were also reductionists; Wernicke, for example, believed that " central

nerve endings are invested with the role of psychic elements, " and

associations were represented by nerve fibres. The nineteenth century

localisationists were almost all reductionists.

Mentalist

Concerning mental events, thought. Behaviourists felt that mental

concepts, including, for example, meaning, were unobservable and

therefore could not be part of the concerns of science.

Modelling

A term used in behaviour therapy to describe giving the patient an

example of how to do something that they can imitate.

Motor aphasia

A term used to describe aphasia in which speech production is much more

impaired than comprehension. Patients have non-fluent speech, and often

a degree of dysarthria. Although broadly equivalent to the

neo-classical Broca's aphasia, it has often been used to include all

kinds of non-fluent aphasia.

Mnestic

An adjective meaning related to memory.

Neologisms

The production of non-existent words in spontaneous speech; most authors

distinguish between phonemic paraphaias (which bear a clear phonological

relationship to the target word) and neologisms (which do not). Where

neologisms are frequent, the patient is said to show neologistic jargon

aphasia.

Neoplasm

A malignant tumour.

Paragrammatism

A term introduced by Kleist (1916) to refer to the grammatical errors of

fluent aphasics. In general these errors appear to reflect misselection

of function words or grammatical affixes, or confusion of syntactic

structures; in contrast to agrammatism, omission of function words and

affixes is comparatively rare.

Paraphasia

The use of an inappropriate word in speech---a word erroneously

used---traditionally divided into semantic paraphasias (e.g., naming a

CAT as " a dog " ), and phonological paraphasias (or phonemic paraphasias,

or literal paraphasias), where the error sounds like the target (e.g.,

naming a CAT as " a cap " ). Phonological paraphasias may either be real

words, or non-words.

Prevention method

An approach to the treatment of non-fluent aphasics in the early stages

of recovery devised by Beyn and Shokhor-Trotskaya (1966), whose aim is

to prevent the appearance of agrammatism.

Propositional speech

Hughlings in opposing the localisationists of the mid-nineteenth

century protested that language did not consist of sequences of single

word, but of the expression of relationships between concepts; that is,

using Herbert Spencer's term, " propositions. "

To speak is not to utter words, it is to propositionise. A proposition

is such a relation of words that it makes one new meaning; not by the

mere addition of what we call the separate meanings of the several

words; the terms in a proposition are modified by each other. Single

words are meaningless and so is any unrelated succession of words. The

unit of speech is a proposition... Loss of speech is therefore the loss

of power to propositionise. (, 1932, p. 159---160)

went on to argue that aphasic patients may not only have lost

the power to express propositions, but that they may also fail to

generate propositions internally; from this viewpoint aphasia is a

problem of both language and thought. Following on from this Head

(1926) claimed that (some) aphasic patients had a general problem in

symbolic thought; he abandoned the term " propositionise " because he felt

it was too imprecise.

Emphasis on the propositional aspect of language therefore stresses the

use of language to communicate ideas, and the idea that sentences have

conceptual structure.

Receptive aphasia

Weisenburg and McBride (1935) used the term " predominantly receptive

aphasia " to describe any aphasia where the language comprehension

problem was more obvious than the difficulty in language production.

" Predominantly " is used to show that they recognise that both

comprehension and production are usually affected. In " predominantly

expressive aphasia, " production is rather more severely affected than

comprehensioin. They also recognise " expressive---receptive aphasia, "

where both comprehension and production are severely disturbed

(basically the same as global aphasia), and " amnesic aphasia " (anomic

aphasic).

Reconstitution of function

A term used by Luria to describe his therapy approach, where an impaired

function is performed in a different, roundabout way. Initially the

patient has to learn to use the new approach deliberately, but with

practice it should become increasingly unconscious and automatic.

Sensory aphasia

A term used to describe aphasia where language comprehension problems

are especially prominent; speech production is fluent, and uses a

variety of grammatical constructions. Some authors have used the term

to describe all fluent aphasias other than anomic aphasia, but Luria

uses it much as the neo-classical Wernicke's aphasia.

Surface dyslexia

A disorder of oral word reading in which (1) words with regular spelling

(e.g., FEW, KERNEL) are read much more accurately than words with

irregular spelling (e.g., SEW, COLONEL); (2) non-words are read with

reasonable accuracy; and (3) many of the errors are phonologically

plausible renderings of the letter string (e.g., BEAR? " beer, " YACHT?

" /j$tNt/ " ). This is usually interpreted as an impairment in lexical

reading, so that the patient is forced to rely on some kind of

sub-lexical routine, using for example " grapheme-to-phoneme conversion

rules. " Many (but not all) surface dyslexics are also surface dysgraphic.

Surface dysgraphia

A pattern of impairment in writing words to dictation in which a patient

(1) writes more accurately words whose spelling is uniquely determined

by their phonology (e.g., BANK, RIDGE); (2) writes non-words with

reasonable accuracy; and (3) makes errors that are orthographically

plausible renderings of the words (e.g., " blue " ? BLOO, " yacht " ?YOT).

These patients are thought to be relying on a sub-lexical routine for

word writing as lexical access to specifications of spellings is impaired.

Wernicke's aphasia

A neo-classical category of aphasia. Wernicke's aphasics have fluent

spontaneous speech in which there are a variety of grammatical

constructions; where there are frequent paraphasias and/or neologisms,

the speech may be described as jargon. Word comporehension is poor, and

repetition is also disturbed.

Word blindness

A word used in the nineteenth and early twentieth century to describe

dyslexia; use of the term is often intended to emphasize a similarity

with word deafness. Some authors have used the term to descsribe only

dyslexia without disgraphia.

Word deafness

A difficulty in word comprehension despite good hearing, at least of

non-speech sounds. A relatively rare disorder, it was classically

sub-divided into two types: word-sound deafness where there is a primary

difficulty in phoneme identification; patients should be able to

discriminate non-speech sounds, but are unable to determine whether or

not something is a real word. In word-meaning deafness the patient

knows that he/she has heard a familiar real word but has no idea of its

significance. While many patients describe occasional episodes of word

deafness, it is probably very rare as an isolated symptom.

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