Paragrammatisms

The neurobiology of sentence production: A narrative review and meta-analysis

Although there is a sizeable body of literature on sentence comprehension and processing both in healthy and disordered language users, the literature on sentence production remains much more sparse. Linguistic and computational descriptions of expressive syntactic deficits in aphasia are especially rare. In addition, the neuroimaging and (psycho) linguistic literatures operate largely separately. In this paper, I will first lay out the theoretical lay of the land with regard to psycholinguistic models of sentence production. I will then provide a brief narrative overview and large-scale meta-analysis of the neuroimaging literature as it pertains to syntactic computation, followed by an attempt to integrate the psycholinguistic models with the findings from functional and clinical neuroimaging. Finally, I provide a brief overview of the literature surrounding expressive syntactic deficits and propose a path forward to close some of the existing gaps.

The role of the left posterior temporal cortex in speech monitoring

Speech monitoring abilities vary among individuals with stroke-induced aphasia, with brain lesion location as a potential factor. Left posterior temporal cortex (pLTC) regions are thought to be central to lexical access. We tested whether pLTC lesions affect the medial frontal action monitoring system, as indexed by the Error-Related Negativity (ERN), which has been implicated in inner speech monitoring. Electroencephalography was recorded during picture naming in 11 individuals with pLTC lesions (4 from each of two institutions included in EEG analyses), 7 with lesions sparing the pLTC (6 included), and 20 matched controls (14 included). Individuals with pLTC lesions were slower and less accurate than other groups. Individuals with lesions sparing the pLTC showed the expected ERN; individuals with pLTC lesions did not. Therefore, the medial frontal monitoring mechanism may be compromised when regions central to lexical access are damaged, indicating that pLTC-medial frontal interactions may support inner speech monitoring.

The Flu-ID: A New Evidence-Based Method of Assessing Fluency in Aphasia

PURPOSE

Assessing fluency in aphasia is diagnostically important for determining aphasia type and severity and therapeutically important for determining appropriate treatment targets. However, wide variability in the measures and criteria used to assess fluency, as revealed by a recent survey of clinicians (Gordon & Clough, 2022), results in poor reliability. Furthermore, poor specificity in many fluency measures makes it difficult to identify the underlying impairments. Here, we introduce the Flu-ID Aphasia, an evidence-based tool that provides a more informative method of assessing fluency by capturing the range of behaviors that can affect the flow of speech in aphasia.

METHOD

The development of the Flu-ID was based on prior evidence about factors underlying fluency (Clough & Gordon, 2020; Gordon & Clough, 2020) and clinical perceptions about the measurement of fluency (Gordon & Clough, 2022). Clinical utility is maximized by automated counting of fluency behaviors in an Excel template. Reliability is maximized by outlining thorough guidelines for transcription and coding. Eighteen narrative samples representing a range of fluency were coded independently by the authors to examine the Flu-ID's utility, reliability, and validity.

RESULTS

Overall reliability was very good, with point-to-point agreement of 86% between coders. Ten of the 12 dimensions showed good to excellent reliability. Validity analyses indicated that Flu-ID scores were similar to clinician ratings on some dimensions, but differed on others. Possible reasons and implications of the discrepancies are discussed, along with opportunities for improvement.

CONCLUSIONS

The Flu-ID assesses fluency in aphasia using a consistent and comprehensive set of measures and semi-automated procedures to generate individual fluency profiles. The profiles generated in the current study illustrate how similar ratings of fluency can arise from different underlying impairments. Supplemental materials include an analysis template, extensive guidelines for transcription and coding, a completed sample, and a quick reference guide.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.27078199.

Automating Intended Target Identification for Paraphasias in Discourse Using a Large Language Model

PURPOSE

To date, there are no automated tools for the identification and fine-grained classification of paraphasias within discourse, the production of which is the hallmark characteristic of most people with aphasia (PWA). In this work, we fine-tune a large language model (LLM) to automatically predict paraphasia targets in Cinderella story retellings.

METHOD

Data consisted of 332 Cinderella story retellings containing 2,489 paraphasias from PWA, for which research assistants identified their intended targets. We supplemented these training data with 256 sessions from control participants, to which we added 2,415 synthetic paraphasias. We conducted four experiments using different training data configurations to fine-tune the LLM to automatically "fill in the blank" of the paraphasia with a predicted target, given the context of the rest of the story retelling. We tested the experiments' predictions against our human-identified targets and stratified our results by ambiguity of the targets and clinical factors.

RESULTS

The model trained on controls and PWA achieved 50.7% accuracy at exactly matching the human-identified target. Fine-tuning on PWA data, with or without controls, led to comparable performance. The model performed better on targets with less human ambiguity and on paraphasias from participants with fluent or less severe aphasia.

CONCLUSIONS

We were able to automatically identify the intended target of paraphasias in discourse using just the surrounding language about half of the time. These findings take us a step closer to automatic aphasic discourse analysis. In future work, we will incorporate phonological information from the paraphasia to further improve predictive utility.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.24463543.

Grammatical Parallelism in Aphasia: A Lesion-Symptom Mapping Study

Sentence structure, or syntax, is potentially a uniquely creative aspect of the human mind. Neuropsychological experiments in the 1970s suggested parallel syntactic production and comprehension deficits in agrammatic Broca's aphasia, thought to result from damage to syntactic mechanisms in Broca's area in the left frontal lobe. This hypothesis was sometimes termed overarching agrammatism, converging with developments in linguistic theory concerning central syntactic mechanisms supporting language production and comprehension. However, the evidence supporting an association among receptive syntactic deficits, expressive agrammatism, and damage to frontal cortex is equivocal. In addition, the relationship among a distinct grammatical production deficit in aphasia, paragrammatism, and receptive syntax has not been assessed. We used lesion-symptom mapping in three partially overlapping groups of left-hemisphere stroke patients to investigate these issues: grammatical production deficits in a primary group of 53 subjects and syntactic comprehension in larger sample sizes (N = 130, 218) that overlapped with the primary group. Paragrammatic production deficits were significantly associated with multiple analyses of syntactic comprehension, particularly when incorporating lesion volume as a covariate, but agrammatic production deficits were not. The lesion correlates of impaired performance of syntactic comprehension were significantly associated with damage to temporal lobe regions, which were also implicated in paragrammatism, but not with the inferior and middle frontal regions implicated in expressive agrammatism. Our results provide strong evidence against the overarching agrammatism hypothesis. By contrast, our results suggest the possibility of an alternative grammatical parallelism hypothesis rooted in paragrammatism and a central syntactic system in the posterior temporal lobe.

Precision fMRI reveals that the language-selective network supports both phrase-structure building and lexical access during language production

A fronto-temporal brain network has long been implicated in language comprehension. However, this network's role in language production remains debated. In particular, it remains unclear whether all or only some language regions contribute to production, and which aspects of production these regions support. Across 3 functional magnetic resonance imaging experiments that rely on robust individual-subject analyses, we characterize the language network's response to high-level production demands. We report 3 novel results. First, sentence production, spoken or typed, elicits a strong response throughout the language network. Second, the language network responds to both phrase-structure building and lexical access demands, although the response to phrase-structure building is stronger and more spatially extensive, present in every language region. Finally, contra some proposals, we find no evidence of brain regions-within or outside the language network-that selectively support phrase-structure building in production relative to comprehension. Instead, all language regions respond more strongly during production than comprehension, suggesting that production incurs a greater cost for the language network. Together, these results align with the idea that language comprehension and production draw on the same knowledge representations, which are stored in a distributed manner within the language-selective network and are used to both interpret and generate linguistic utterances.

Sign language aphasia

Signed languages are naturally occurring, fully formed linguistic systems that rely on the movement of the hands, arms, torso, and face within a sign space for production, and are perceived predominantly using visual perception. Despite stark differences in modality and linguistic structure, functional neural organization is strikingly similar to spoken language. Generally speaking, left frontal areas support sign production, and regions in the auditory cortex underlie sign comprehension-despite signers not relying on audition to process language. Given this, should a deaf or hearing signer suffer damage to the left cerebral hemisphere, language is vulnerable to impairment. Multiple cases of sign language aphasia have been documented following left hemisphere injury, and the general pattern of linguistic deficits mirrors those observed in spoken language. The right hemisphere likely plays a role in non-linguistic but critical visuospatial functions of sign language; therefore, individuals who are spared from damage to the left hemisphere but suffer injury to the right are at risk for a different set of communication deficits. In this chapter, we review the neurobiology of sign language and patterns of language deficits that follow brain injury in the deaf signing population.

The dual stream model of speech and language processing

The Wernicke-Lichtheim-Geschwind model of the neurology of language has served the field well despite its limited scope. More recent work has updated the basic architecture of the classical model and expanded its scope. This chapter briefly reviews the Wernicke-Lichtheim-Geschwind model and points out its shortcomings, then describes and motivates the dual stream model and how it solves several empirical shortcomings of the classical model. The chapter also (i) underscores how the dual stream model relates to the organization of nonlinguistic cortical networks, integrating language systems with the broader functional-anatomical landscape, (ii) describes recent work that further specifies the computational architecture and neural correlates of the dorsal speech production system, and (iii) summarizes recent extensions of the architectural framework to include syntax.

Intellectual awareness of naming abilities in people with chronic post-stroke aphasia

Anosognosia, or lack of self-awareness, is often present following neurological injury and can result in poor functional outcomes. The specific phenomenon of intellectual awareness, the knowledge that a function is impaired in oneself, has not been widely studied in post-stroke aphasia. We aim to identify behavioral and neural correlates of intellectual awareness by comparing stroke survivors' self-reports of anomia to objective naming performance and examining lesion sites. Fifty-three participants with chronic aphasia without severe comprehension deficits rated their naming ability and completed a battery of behavioral tests. We calculated the reliability and accuracy of participant self-ratings, then examined the relationship of poor intellectual awareness to speech, language, and cognitive measures. We used support vector regression lesion-symptom mapping (SVR-LSM) to determine lesion locations associated with impaired and preserved intellectual awareness. Reliability and accuracy of self-ratings varied across the participants. Poor intellectual awareness was associated with reduced performance on tasks that rely on semantics. Our SVR-LSM results demonstrated that anterior inferior frontal lesions were associated with poor awareness, while mid-superior temporal lesions were associated with preserved awareness. An anterior-posterior gradient was evident in the unthresholded lesion-symptom maps. While many people with chronic aphasia and relatively intact comprehension can accurately and reliably report the severity of their anomia, others overestimate, underestimate, or inconsistently estimate their naming abilities. Clinicians should consider this when administering self-rating scales, particularly when semantic deficits or anterior inferior frontal lesions are present. Administering self-ratings on multiple days may be useful to check the reliability of patient perceptions.

Towards a New Model of Verbal Monitoring

As all human activities, verbal communication is fraught with errors. It is estimated that humans produce around 16,000 words per day, but the word that is selected for production is not always correct and neither is the articulation always flawless. However, to facilitate communication, it is important to limit the number of errors. This is accomplished via the verbal monitoring mechanism. A body of research over the last century has uncovered a number of properties of the mechanisms at work during verbal monitoring. Over a dozen routes for verbal monitoring have been postulated. However, to date a complete account of verbal monitoring does not exist. In the current paper we first outline the properties of verbal monitoring that have been empirically demonstrated. This is followed by a discussion of current verbal monitoring models: the perceptual loop theory, conflict monitoring, the hierarchical state feedback control model, and the forward model theory. Each of these models is evaluated given empirical findings and theoretical considerations. We then outline lacunae of current theories, which we address with a proposal for a new model of verbal monitoring for production and perception, based on conflict monitoring models. Additionally, this novel model suggests a mechanism of how a detected error leads to a correction. The error resolution mechanism proposed in our new model is then tested in a computational model. Finally, we outline the advances and predictions of the model.

Brain structures and cognitive abilities important for the self-monitoring of speech errors

The brain structures and cognitive abilities necessary for successful monitoring of one's own speech errors remain unknown. We aimed to inform self-monitoring models by examining the neural and behavioral correlates of phonological and semantic error detection in individuals with post-stroke aphasia. First, we determined whether detection related to other abilities proposed to contribute to monitoring according to various theories, including naming ability, fluency, word-level auditory comprehension, sentence-level auditory comprehension, and executive function. Regression analyses revealed that fluency and executive scores were independent predictors of phonological error detection, while a measure of word-level comprehension related to semantic error detection. Next, we used multivariate lesion-symptom mapping to determine lesion locations associated with reduced error detection. Reduced overall error detection related to damage to a region of frontal white matter extending into dorsolateral prefrontal cortex (DLPFC). Detection of phonological errors related to damage to the same areas, but the lesion-behavior association was stronger, suggesting the localization for overall error detection was driven primarily by phonological error detection. These findings demonstrate that monitoring of different error types relies on distinct cognitive functions, and provide causal evidence for the importance of frontal white matter tracts and DLPFC for self-monitoring of speech.

The Cortical Organization of Syntax

Syntax, the structure of sentences, enables humans to express an infinite range of meanings through finite means. The neurobiology of syntax has been intensely studied but with little consensus. Two main candidate regions have been identified: the posterior inferior frontal gyrus (pIFG) and the posterior middle temporal gyrus (pMTG). Integrating research in linguistics, psycholinguistics, and neuroscience, we propose a neuroanatomical framework for syntax that attributes distinct syntactic computations to these regions in a unified model. The key theoretical advances are adopting a modern lexicalized view of syntax in which the lexicon and syntactic rules are intertwined, and recognizing a computational asymmetry in the role of syntax during comprehension and production. Our model postulates a hierarchical lexical-syntactic function to the pMTG, which interconnects previously identified speech perception and conceptual-semantic systems in the temporal and inferior parietal lobes, crucial for both sentence production and comprehension. These relational hierarchies are transformed via the pIFG into morpho-syntactic sequences, primarily tied to production. We show how this architecture provides a better account of the full range of data and is consistent with recent proposals regarding the organization of phonological processes in the brain.

Temporal and Episodic Analyses of the Story of Cinderella in Latent Aphasia

Purpose The purpose of this study was to improve our understanding of the language characteristics of people with latent aphasia using measures that examined temporal (i.e., real-time) and episodic organization of discourse production. Method Thirty AphasiaBank participants were included (10 people with latent aphasia, 10 people with anomic aphasia, and 10 neurotypical control participants). Speech material of Cinderella narratives was analyzed with Praat software. We devised a protocol that coded the presence and duration of all speech segments, dysfluencies such as silent and filled pauses, and other speech behaviors. Using these durations, we generated a range of temporal measures such as speech, articulation, and pure word rates. Narratives were also coded into episodes, which provided information about the discourse macrostructure abilities of the participants. Results The latent aphasia group differed from controls in number of words produced, silent pause duration, and speech rate, but not articulation rate or pure word rate. Episodic organization of the narratives was similar in these 2 groups. The latent and anomic aphasia groups were similar in most measures, apart from articulation rate, which was lower in the anomic group. The anomic aphasia group also omitted more episodes than the latent aphasia group. Conclusions The differences between latent aphasia and neurotypical controls can be attributed to a processing speed deficit. We propose that this deficit results in an impaired ability to process information from multiple cognitive domains simultaneously.

Agrammatism and Paragrammatism: A Cortical Double Dissociation Revealed by Lesion-Symptom Mapping

The fundamental distinction of grammatical deficits in aphasia, agrammatism and paragrammatism, was made over a century ago. However, the extent to which the agrammatism/paragrammatism distinction exists independently of differences in speech fluency has not clearly been investigated. Despite much research on agrammatism, the lesion correlates of paragrammatism are essentially unknown. Lesion-symptom mapping was used to investigate the degree to which the lesion correlates of agrammatism and paragrammatism overlap or dissociate. Four expert raters assessed videos of 53 right-handed patients with aphasia following chronic left-hemisphere stroke retelling the Cinderella story. Consensus discussion determined each subject's classification with respect to grammatical deficits as Agrammatic, Paragrammatic, Both, or No Grammatical Deficit. Each subject's lesion was manually drawn on a high-resolution MRI and warped to standard space for group analyses. Lesion-symptom mapping analyses were performed in NiiStat including lesion volume as a covariate. Secondary analyses included speech rate (words per minute) as an additional covariate. Region of interest analyses identified a double dissociation between these syndromes: damage to Broca's area was significantly associated with agrammatism, p = 0.001 (but not paragrammatism, p = 0.930), while damage to the left posterior superior and middle temporal gyri was significantly associated with paragrammatism, p < 0.001 (but not agrammatism, p = 0.873). The same results obtained when regressing out the effect of speech rate, and nonoverlapping lesion distributions between the syndromes were confirmed by uncorrected whole brain analyses. Our results support a fundamental distinction between agrammatism and paragrammatism.

Inflectional Morphology in Fluent Aphasia: A Case Study in a Highly Inflected Language

Inflectional morphology difficulties are typically reported in non-fluent aphasia with agrammatism, but a growing number of studies show that they can also be present in fluent aphasia. In agrammatism, morphological difficulties are conceived as the consequence of impaired phonological encoding and would affect regular verbs more than irregular verbs. However, studies show that inflectional morphology difficulties concern both regular and irregular verbs, and that their origin could be more conceptual/semantic in nature. Additionally, studies report more pronounced impairments for the processing of the past tense compared to other tenses. The goal of this study was to characterize the impairment of inflectional morphology in fluent aphasia. RY, a 69-year-old man with chronic fluent aphasia completed a short neuropsychological and language battery and three experimental tasks of inflectional morphology. The tasks assessed the capacity to select the correct inflected form of a verb based on time information, to access the time information included in an inflectional morpheme, and to produce verbs with tense inflection. His performance was compared to a group of five adults without language impairments. Results showed that RY had difficulties selecting the correct inflected form of a verb, accessing time information transmitted by inflectional morphemes, and producing inflected verbs. His difficulties affected both regular and irregular verbs, and verbs in the present, past, and future tenses. The performance also shows the influence of processing limitations over the production and comprehension of inflectional morphology. More studies of inflectional morphology in fluent aphasia are needed to understand the origin of difficulties.

Cortical and structural-connectivity damage correlated with impaired syntactic processing in aphasia

Agrammatism in aphasia is not a homogeneous syndrome, but a characterization of a nonuniform set of language behaviors in which grammatical markers and complex syntactic structures are omitted, simplified, or misinterpreted. In a sample of 71 left-hemisphere stroke survivors, syntactic processing was quantified with the Northwestern Assessment of Verbs and Sentences (NAVS). Classification analyses were used to assess the relation between NAVS performance and morphosyntactically reduced speech in picture descriptions. Voxel-based and connectivity-based lesion-symptom mapping were applied to investigate neural correlates of impaired syntactic processing. Despite a nonrandom correspondence between NAVS performance and morphosyntactic production deficits, there was variation in individual patterns of syntactic processing. Morphosyntactically reduced production was predicted by lesions to left-hemisphere inferior frontal cortex. Impaired verb argument structure production was predicted by damage to left-hemisphere posterior superior temporal and angular gyrus, as well as to a ventral pathway between temporal and frontal cortex. Damage to this pathway was also predictive of impaired sentence comprehension and production, particularly of noncanonical sentences. Although agrammatic speech production is primarily predicted by lesions to inferior frontal cortex, other aspects of syntactic processing rely rather on regional integrity in temporoparietal cortex and the ventral stream.

Neural encoding and production of functional morphemes in the posterior temporal lobe

Morphemes are the smallest meaning-carrying units in human language, and are among the most basic building blocks through which humans express specific ideas and concepts. By using time-resolved cortical stimulations, neural recordings, and focal lesion evaluations, we show that inhibition of a small cortical area within the left dominant posterior–superior temporal lobe selectively impairs the ability to produce appropriate functional morphemes but does not distinctly affect semantic and lexical retrieval, comprehension, or articulation. Additionally, neural recordings within this area reveal the localized encoding of morphological properties and their planned production prior to speech onset. Finally, small lesions localized to the gray matter in this area result in a selective functional morpheme-production deficit. Collectively, these findings reveal a detailed division of linguistic labor within the posterior–superior temporal lobe and suggest that functional morpheme processing constitutes an operationally discrete step in the series of computations essential to language production.

Functional morphemes allow us to express details about objects, events, and their relationships. Here, authors show that inhibiting a small cortical area within left posterior superior temporal lobe selectively impairs the ability to produce functional morphemes but does not impair other linguistic abilities.

Regularity and beyond: Impaired production and comprehension of inflectional morphology in semantic dementia

Studies on inflectional morphology in semantic dementia (SD) have focused on the contrast between the regular and the irregular English past-tense. These studies aimed to contrast the claims of single- and dual-mechanism theories. However, both theories can account for impaired production of irregular verbs observed in SD. According to the dual-mechanism theory, this impairment is related to word-retrieval difficulties, while according to single-mechanism theory it is the consequence of semantic impairment. However, authors suggest that it is time to envision a broader role for semantic memory in the production of semantically encoded aspects of inflectional morphology. This study reports the performance of 10 French-speaking patients with SD in three tasks of inflectional morphology. Their performances were compared to those of a group of 20 age-, gender- and education-matched adults without cognitive impairment. Results show that SD patients had difficulties producing tense and person inflection in verbs and pseudo-verbs, whether regular or pseudo-regular. In a second task in which participants were directly exposed to regularity manipulations, SD patients tended to choose a more typical or predictable alternative over a correctly inflected verb. Results of the third task show that their difficulties in producing semantically encoded aspects of inflection, such as tense, are related to difficulties to understand the semantic content conveyed by inflectional morphemes. Overall, these results support the claim that semantic impairment can cause morphological deficits that do not only affect irregular verbs, but that also have impacts on the production and comprehension of semantic information conveyed by inflectional morphemes.

Verb and sentence production and comprehension in aphasia: Northwestern Assessment of Verbs and Sentences (NAVS)

BACKGROUND

Verbs and sentences are often impaired in individuals with aphasia, and differential impairment patterns are associated with different types of aphasia. With currently available test batteries, however, it is challenging to provide a comprehensive profile of aphasic language impairments because they do not examine syntactically important properties of verbs and sentences.

AIMS

This study presents data derived from the Northwestern Assessment of Verbs and Sentences (NAVS; Thompson, 2011), a new test battery designed to examine syntactic deficits in aphasia. The NAVS includes tests for verb naming and comprehension, and production of verb argument structure in simple active sentences, with each examining the effects of the number and optionality of arguments. The NAVS also tests production and comprehension of canonical and non-canonical sentences.

METHODS & PROCEDURES

A total of 59 aphasic participants (35 agrammatic and 24 anomic) were tested using a set of action pictures. Participants produced verbs or sentences for the production subtests and identified pictures corresponding to auditorily provided verbs or sentences for the comprehension subtests.

OUTCOMES & RESULTS

The agrammatic group, compared to the anomic group, performed significantly more poorly on all subtests except verb comprehension, and for both groups comprehension was less impaired than production. On verb naming and argument structure production tests both groups exhibited difficulty with three-argument verbs, affected by the number and optionality of arguments. However, production of sentences using three-argument verbs was more impaired in the agrammatic, compared to the anomic, group. On sentence production and comprehension tests, the agrammatic group showed impairments in all types of non-canonical sentences, whereas the anomic group exhibited difficulty primarily with the most difficult, object relative, structures.

CONCLUSIONS

Results show that verb and sentence deficits seen in individuals with agrammatic aphasia are largely influenced by syntactic complexity; however, individuals with anomic aphasia appear to exhibit these impairments only for the most complex forms of verbs and sentences. The present data indicate that the NAVS is useful for characterising verb and sentence deficits in people with aphasia.

Is comprehension necessary for error detection? A conflict-based account of monitoring in speech production

Despite the existence of speech errors, verbal communication is successful because speakers can detect (and correct) their errors. The standard theory of speech-error detection, the perceptual-loop account, posits that the comprehension system monitors production output for errors. Such a comprehension-based monitor, however, cannot explain the double dissociation between comprehension and error-detection ability observed in the aphasic patients. We propose a new theory of speech-error detection which is instead based on the production process itself. The theory borrows from studies of forced-choice-response tasks the notion that error detection is accomplished by monitoring response conflict via a frontal brain structure, such as the anterior cingulate cortex. We adapt this idea to the two-step model of word production, and test the model-derived predictions on a sample of aphasic patients. Our results show a strong correlation between patients' error-detection ability and the model's characterization of their production skills, and no significant correlation between error detection and comprehension measures, thus supporting a production-based monitor, generally, and the implemented conflict-based monitor in particular. The successful application of the conflict-based theory to error-detection in linguistic, as well as non-linguistic domains points to a domain-general monitoring system.

Adapting to conversation as a language-impaired speaker: changes in aphasic turn construction over time

Using the methodology and findings of conversation analysis, we analyze changes in the talk of a man with aphasia (a language disorder acquired following brain damage) at two points in his spontaneous recovery period in the first months post-stroke. We note that in the earlier conversation (15 weeks post-stroke) two of the turn constructional methods he particularly makes use of are replacement (a form of repair) and extension. By the time of the latter conversation (30 weeks poststroke) these methods are less prevalent, while another repair operation, insertion, is now used in a particular way not seen in the earlier conversation. We suggest that these methods are means by which the aphasic speaker adapts his limited linguistic resources to the demands of constructing a turn-at-talk in conversation in order to lessen the extent of repair and delay with the turn and thus lessen the exposure of his linguistic noncompetence and his identity as 'different', 'disabled', or 'language impaired'. These turn constructional methods are dynamic and change as the speaker recovers. We suggest that communication disorders such as aphasia can be problematic not only because of difficulties they can cause in conveying information or producing other social actions, but also because they can create difficulties in the presentation of self in everyday life.

Language processing: functional organization and neuroanatomical basis

Earlier formulations of the relation of language and the brain provided oversimplified accounts of the nature of language disorders, classifying patients into syndromes characterized by the disruption of sensory or motor word representations or by the disruption of syntax or semantics. More recent neuropsychological findings, drawn mainly from case studies, provide evidence regarding the various levels of representations and processes involved in single-word and sentence processing. Lesion data and neuroimaging findings are converging to some extent in providing localization of these components of language processing, particularly at the single-word level. Much work remains to be done in developing precise theoretical accounts of sentence processing that can accommodate the observed patterns of breakdown. Such theoretical developments may provide a means of accommodating the seemingly contradictory findings regarding the neural organization of sentence processing.

Effect of lexical cues on the production of active and passive sentences in Broca's and Wernicke's aphasia

This study compared the sentence production abilities of individuals with Broca's and Wernicke's aphasia in an attempt to explore the extent to which impaired lexical retrieval impedes sentence production. The ability to produce active and passive reversible and non-reversible sentences was examined when varying amounts of lexical information was provided. The results showed that both Wernicke's and Broca's aphasic individuals were impaired in passive sentence production and that these difficulties were not overcome when lexical cues (the relevant nouns and uninflected verb) were provided. However when auxiliary and past tense morphemes were provided along with the verb stem, production of passive sentences improved drastically for both groups. Analysis of error patterns, however, revealed differences between the two groups, suggesting that Broca's aphasic subjects may find passive sentences difficult due to problems with retrieving the relevant grammatical morphemes. Subjects with Wernicke's aphasia may have been unable to automatically access the passive sentence structure.

School is fun at recess: informal analyses of written language for students with learning disabilities

The purpose of an informal analysis of written language is to identify what writers can do as well as what they find difficult about writing. This article reviews the varied components of written language, suggests informal means for assessment, and summarizes the cognitive and linguistic factors that influence varied aspects of writing performance. Two informal evaluation scales are presented that stress the interconnection between oral and written language processes.

Speech errors in Alzheimer's disease: reevaluating morphosyntactic preservation

Researchers studying the speech of individuals with probable Alzheimer's disease (PAD) report that morphosyntax is preserved relative to lexical aspects of speech. The current study questions whether dividing all errors into only two categories, morphosyntactic and lexical, is warranted, given the theoretical controversies concerning the production and representation of pronouns and closed-class words in particular. Two experiments compare the speech output of 10 individuals with Alzheimer's disease to that of 15 healthy age- and education-matched speakers. Results of the first experiment indicate that the pattern of errors in the speech of participants with mild PAD reflects an across-the-board increase in the same types of errors made by healthy older speakers, including closed-class and morphosyntactic errors. In the second task, participants produced a grammatical sentence from written stimuli consisting of a transitive verb and two nouns. Only adults with Alzheimer's disease had difficulties with this task, producing many more closed-class word errors than did healthy older adults. Three of the participants with PAD produced nearly agrammatic speech in this task. These 3 people did not differ from the rest of the PAD group in age, education, working memory, or degree of semantic impairment. Further, error rates on the two tasks were highly correlated. We conclude that morphosyntax is not preserved in the speech output of individuals with PAD, but is vulnerable to errors along with all aspects of language that must be generated by the speaker. We suggest that these results best support a model of speech production in which all words are represented by semantic and grammatical features, both of which are vulnerable to failures of activation when there is damage or noise in the system as a result of pathology, trauma, or even divided attention.

Language representation in the human brain: evidence from cortical mapping

The manner in which the human brain processes grammatical-syntactic and lexical-semantic functions has been extensively debated in neurolinguistics. The discreteness and selectivity of the representation of syntactic-morphological properties in the dominant frontal cortex and the representation of the lexical-semantics in the temporo-parietal cortex have been questioned. Three right-handed adult male neurosurgical patients undergoing left craniotomy for intractable seizures were evaluated using various grammatical and semantic tasks during cortical mapping. The sampling of language tasks consisted of trials with stimulation (experimental) and without stimulation (control) from sites in the dominant fronto-temporo-parietal cortex The sampling of language implicated a larger cortical area devoted to language (syntactic-morphological and lexical-semantic) tasks. Further, a large part of the fronto-parieto-temporal cortex was involved with syntactic-morphological functions. However, only the parieto-temporal sites were implicated with the ordering of lexicon in sentence construction. These observations suggest that the representation of language in the human brain may be columnar or multilayered.

Sentence production by aphasic patients in a constrained task

Sixty aphasic patients and 55 normal control subjects were tested on a sentence production protocol that required subjects to produce specific sentence types from semantic representations. Normal subjects produced the expected targets with great reliability. Analysis of the patients' performance indicated that patients had difficulty producing both grammatical forms and thematic roles. Patients had more trouble producing grammatical elements than content words, and showed differential difficulty on sentence types that had more grammatical elements and in which the order of thematic roles was non-canonical. The results provide evidence regarding the processing load imposed by different components of the sentence production process.

Why does monitoring fail in jargon aphasia? comprehension, judgment, and therapy evidence

Many people with jargon aphasia seem unaware of their speech disorder. The first section of this paper reports data from four subjects which indicate that self-monitoring can fail even when subjects' input skills are apparently adequate to detect their errors. Explanations for this dissociation have attributed monitoring failure to a deficit in auditory feedback, or to a resource limitation which prevents concurrent speaking and monitoring. Section 2 reports a series of naming and judging experiments with one of the subjects which rule out these explanations. These show that the subject can detect his neologisms when he is repeating, but not when he is naming. These results suggest that his monitoring difficulties arise when he is accessing phonology from semantics. Section 3 presents a study which supports this inference, since it shows that semantically focused intervention yields improvements in self-monitoring. It is concluded (1) that monitoring failure can arise from deficits within the production process which preclude comparison of actual with intended output, and (2) that this deficit is best explained within a connectionist model in which monitoring is performed by feedback mechanisms in the word production process.

Phonological errors in aphasic naming: comprehension, monitoring and lexicality

This paper investigates the production of phonological errors in aphasic naming, examining the relationship between these errors and deficits in comprehension. The predictions of Dell and O'Seaghda's (1991) computational model of speech production were tested by lesioning. The set of lesioned models demonstrated a strong correlation between proportion of phonologically related errors in naming and comprehension accuracy. In contrast, no correlation between proportion of phonological errors in naming and comprehension accuracy was found for a group of fifteen aphasics. This paper also examines monitoring behaviours, such as the presence of self-corrections and interrupted responses, again finding no relationship with auditory comprehension. There was also no evidence for a lexical bias in the phonological errors for these aphasic subjects. Phonologically related errors were argued to be words only by chance; this was supported by the fact that they occurred more frequently on short words than long words, and that the proportion of real word errors was not significantly different to that observed in a pseudocorpus of errors. We conclude that a production-based monitor would be compatible with these results but that any comprehension-based monitor is not reliably employed by some or all of the aphasic subjects examined here. Additionally, these data are incompatible with models of language processing where speech input and output share the same processing components.

An aspect of sentence processing in Alzheimer's disease: quantifier-noun agreement

We assessed sentence processing in Alzheimer's disease (AD) with measures of sentence-picture matching, grammaticality judgments of sentences, and sentence completion. The results demonstrated significant and consistent difficulty with a grammatical feature of sentences on all three experiments. This impairment could not be explained by factors such as sentence length, dementia severity, or a short-term memory deficit and was independent of difficulty interpreting the meanings of words. We hypothesize that AD patients are impaired at appreciating the conceptual relations that underlie certain grammatical features of sentences.

Parallels and divergences in the acquisition and dissolution of language

Analyses of the relation between the acquisition and dissolution of language have typically focused on whether or not the forms of language dysfunction that result from brain damage correspond to specific stages of language acquisition: the Regression Hypothesis. These analyses have not met with great success: although there are a number of superficial similarities between aphasic disorders and different stages of the immature linguistic system, there are also important differences. I will suggest that a focus on the behavioral similarities between language acquisition and dissolution is unlikely to be productive. A more productive course would be to focus, instead, on the general principles that constrain the acquisition and dissolution of language.

Disorders of sentence production

Many process contribute to the speech production system. Brain damage can lead to a wide variety of disorders of the spontaneous production of sentences. Different symptoms of a sentence construction disorder, such as agrammatic and paragrammatic speech errors, are briefly described. An explicit model of the grammatical processes is proposed, and it is shown how the symptoms can be explained in terms of selective impairments to components of the model. The construction of subject-verb agreement in speech is treated in detail.

Morphological errors and the representation of morphology in the lexical-semantic system

Neuropsychological studies support the hypothesis that morphology is represented autonomously, both at the level of word meaning and at the level of word form. In output processes, morphologically organized semantic information activates lexical representations of roots and affixes, which are composed before production. In input processes, the stimulus is parsed along the morphological dimension, to access root and affix lexical representations, which in turn activate morphologically organized semantic information. Inflectional and derivational morphology are represented independently in the lexicon. Inflected words are fully decomposed; derived words are decomposed into base form+inflection. In aphasia, morphological errors in transcoding tasks always co-occur with semantic and/or phonemic errors. Morphological errors in transcoding tasks require combined damage to morphological representations in the semantic-lexical system and to sublexical conversion procedures; they co-occur with semantic errors when also root representations are damaged. The co-occurrence of morphological and phonemic errors can be accounted for by several hypotheses, but its theoretical meaning is still uncertain.

Disorders of phonological encoding

Studies of phonological disturbances in aphasic speech are reviewed. It is argued that failure to test for error consistency in individual patients makes it generally improper to draw inferences about specific disorders of phonological encoding. A minimalist interpretation of available data on phonological errors is therefore proposed that involves variable loss of information in transmission between processing subsystems. Proposals for systematic loss or corruption of phonological information in lexical representations or in translation subsystems is shown to be inadequately grounded. The review concludes with some simple methodological prescriptions for future research.

Disorders of lexical selection

Errors in lexical processing are commonplace in language pathologies resulting from brain injury or disease. This discussion considers some of the major recent developments in the interpretation of such errors. The focus is on behavioral systems, rather than neuroanatomical or neurophysiological issues. The objective is to comment on some plausible mutual implications of generally attested pathologies and normal models of lexical retrieval for production, particularly with respect to the roles of semantic and syntactic categories.

The production of grammatical morphology in Broca's and Wernicke's aphasics: speed and accuracy factors

A group of Broca's aphasics (BA), Wernicke's aphasics (WA) and normal controls participated in a CLOZE experiment which required the oral production of various types of free and bound morphemes. Results provided support for the hypothesis that BA and WA share the same underlying impairment in the production of grammatical morphology. The relative difficulty of the various free and bound morpheme types was the same for BA and WA. This appeared to be the case not only in an analysis of the number of errors but also in an analysis of response times. The same analyses furthermore revealed no significant differences in the absolute levels of performance of BA and WA. Finally, it was found that BA and WA show the same relative contribution of within- and across-category substitutions of free morphemes. For bound morphemes, there was a slight difference between BA and WA, in that BA exclusively produced within-category substitutions while WA also produced some across-category substitutions.