Five chronically aphasic subjects were trained on a computerized iconographic communication system (C-VIC). Their performance in producing single sentences, scripts, and narratives was assessed using both spoken English and C-VIC. The requisite vocabulary necessary and the narrative complexity of the target productions were controlled. Subject performance using C-VIC indicates that the ability to construct discourse at the macrostructural level is largely intact. Despite significant improvements in spoken production after C-VIC training, especially at the single sentence level, the subjects’ spoken discourse remains severely impaired by their failures at the microlinguistic level. These results point to the limits of currently available approaches to the remediation of aphasia and suggest avenues for future research.
Weinrich M , Shelton JR, Cox DM, McCall D.Remediating production of tense morphology improves verb retrieval in chronic aphasia. Brain Lang1997; 58:23-45.
2.
Steele RD , Weinrich M, Wertz RT, Kleczewska MK, Carlson GS. Computer-based visual communication in aphasia. Neuropsychologia1989;27:409-426.
3.
Weinrich M , Boser KI, McCall D.Representation of linguistic rules in the brain: evidence from training an aphasic patient to produce past tense verb morphology. Brain Lang1999;70:144-158.
4.
Weinrich M , Boser KI, McCall D, Bishop V.Training agrammatic subjects on passive sentences: implications for syntactic deficit theories. Brain Lang2001;76:45-61.
5.
Weinrich M , Shelton JR, McCall D, Cox DM. Generalization from single sentence to multisentence production in severely aphasic patients. Brain Lang1997;58:327-352.
6.
Berndt, RS , Mitchum, C.Cognitive neuropsychological approaches to the treatment of language disorders. Neuropsychol Rehabil1995;5:1-16.
7.
Jacobs BJ , Thompson CK. Cross-modal generalization effects of training noncanonical sentence comprehension and production in agrammatic aphasia. J Speech Lang Hear Res2000;43:5-20.
8.
Jacobs BJ . Social validity of changes in informativeness and efficiency of aphasic discourse following linguistic specific treatment (LST). Brain Lang2001;78:115-127.
9.
Armstrong E.Aphasic discourse analysis: the story so far . Aphasiology2000;14:875-892.
10.
Ross KB , Wertz RTR. Comparison of impairment and disability measures for assessing severity of, and improvement in, aphasia. Aphasiology1999;13: 113-124.
11.
Garrett, M.Levels of processing in sentence production. In: Butterworth B, editor. Language Production. Vol. 1. New York: Academic Press; 1980. p. 177-220.
12.
Levelt WJM . Speaking: from intention to articulation. Cambridge (MA): MIT Press; 1989.
13.
Dell GS , O’Seaghdha PG. Stages of access in language production. Cognition1992;42:287-314.
14.
Shelton JR , Weinrich M, McCall D, Cox DM. Differentiating globally aphasic patients: data from in-depth language assessments and production training using C-VIC. Aphasiology1996;10:319-342.
15.
Weinrich M , McCall D, Shoosmith L, Thomas K, Katzenberger K, Weber C.Locative prepositional phrases in severe aphasia. Brain and Language1993;45:21-45.
16.
Weinrich M , McCall D, Weber C, Thomas K, Thornburg L.Training on an iconic communication system for severe aphasia can improve natural language production. Aphasiology1995;9:343-364.
17.
Goodglass H , Kaplan E.The assessment of aphasia and related disorders. Philadelphia: Lea & Febiger; 1983.
18.
Glosser G , Deser T.Patterns of discourse production among neurological patients with fluent language disorders. Brain Lang1990;40:67-88.
19.
Clark H.Discourse in production. In: Gernsbacher MA, editor. Handbook of psycholinguistics. London: Academic Press; 1994. p. 985-1019.
20.
Thorndyke PW . Cognitive structures in comprehension and memory of narrative discourse. Cognitive Psychology1977;9:77-110.
21.
Labov, W.The transformation of experience in narrative syntax. In: Labov W, editor. Language and the inner city. Philadelphia: University of Pennsylvania; 1972.
22.
Wegner ML , Brookshire RH, Nicholas LE. Comprehension of main ideas and details in coherent and non-coherent discourse by aphasic and nonaphasic listeners. Brain Lang1984;21:37-51.
23.
Yasuda K , Nakamura T, Beckman B.Comprehension and storage of 4 serially presented radio news stories by mild aphasic subjects. Brain Lang2000;75:399-415.
24.
Ulatowska HK , North AJ, Macaluso-Haynes S.Production of narrative and procedural discourse in aphasia. Brain Lang1981;13:345-371.
25.
Ulatowska HK , Weiss-Doyell A, Freeman-Stern R, Macaluso-Haynes S.Production of narrative discourse in aphasia. Brain Lang1983;19:317-334.
26.
Berko-Gleason J , Goodglass H, Olber L, Green E, Hyde M, Weintraub S.Narrative strategies of aphasics and normal speaking subjects. J Speech Hear Res1980;23:370-382.
27.
Bond S , Ulatowska H, Macaluso-Haynes S, May E.Discourse production in aphasia: relationship to severity of impairment. In: Brookshire R, editor. Clinical aphasiology conference proceedings. Minneapolis (MN): BRK; 1983.
28.
Coelho CA , Clarkson JV, Elia D.Longitudinal assessment of narrative discourse in a mildly aphasic adult. Clin Aphasiol1994;22:145-155.
29.
Weinrich M , Steele RD, Carlson GS, Kleczewska M, Wertz RT, Baker E.Processing of visual syntax in a globally aphasic patient. Brain Lang1989;36:391-405.
30.
Schank RCC , Abelson R.Scripts, plans goals, and understanding: an inquiry into human understanding. Hillsdale (NJ): Lawrence Erlbaum; 1977.
31.
Beldarrain MG , Graffman J, Pascual-Leone A, Garcia-Monco JC. Procedural learning is impaired in patients with prefrontal lesions. Neurology1999;52:1853-1860.
Marshall J , Pring T, Chiat S.Verb retrieval and sentence production in aphasia. Brain Lang1998;63:159-183.
34.
Ulatowska HK , Allard L, Bond Chapman S.Narrative and procedural discourse in aphasia. In: Joanette Y, Brownell HH, editors. Discourse ability and brain damage: theoretical and empirical perspectives. New York: Springer-Verlag; 1990. p. 180-198.
35.
Nicholas LE , Brookshire RH. A system for quantifying the informativeness and efficiency of the connected speech of adults with aphasia. J Speech Hear Res1993;36:338-350.
36.
Saffran EM , Berndt RS, Schwartz MF. The quantitative analysis of agrammatic production: procedure and data. Brain Lang1989;37:440-479.
37.
Kay J , Lesser R, Coltheart M.PALPA: psycholinguistic assessments of language processing in aphasia. New York: Psychology Press; 1992.
38.
Zingeser LB , Berndt RS. Retrieval of nouns and verbs in agrammatism and anomia. Brain Lang1990;39:14-32.
39.
Saffran EM , Schwartz MF, Linebarger M, Martin N, Bochetto P.The Philadelphia sentence comprehension battery. Unpublished test battery; 1988.
40.
Mitchum C , Haendiges A, Berndt RS. Model-guided treatment to improve written sentence production: a case study. Aphasiology1993;7:71-109.
41.
Shelton JR , Weinrich M.Further evidence of a dissociation between output phonological and orthographic lexicons: a case study. Cognitive Neuropsychol1997;14:105-129.
42.
Armus SR , Brookshire, RHNicholas LE. Aphasic and non-brain-damaged subjects’ knowledge of scripts for common situations. Brain Lang1989;36:518-529.
43.
Sirigu A , Cohen L, Zalla T, Vanechkout P, Dubois B, Agid Y.Distinct frontal regions for processing sentence syntax and story grammar. Cortex1998;34:771-778.
44.
Crozier S , Sirigu A, Lehericy S, van de Moortele P-F, Pillon B, Grafman J, et al.Distinct prefrontal activations in processing sequence at the sentence and script level: an fMRI study. Neuropsychologia1999;37:1469-1476.
45.
Stemmer B.Discourse studies in neurologically impaired patients: a quest for action . Brain Lang1999;68:402-418.
46.
Gold BT , Kertesz A.Preserved visual lexicosemantics in global aphasia: a right-hemisphere contribution?Brain Lang2000;75:359-373.
47.
Linebarger MC , Schwartz MF, Romania JR, Kohn SE, Stephens DL. Grammatical encoding in aphasia: evidence from a “processing prosthesis.”Brain Lang2000;75:416-427.
48.
Holland VM . Translating linguistic research into teaching: precaution and promise in the application of natural language processing. In: Murphy-Judy KA, editor, Sanders R, series editor. The convergence of language teaching and research using technology: CALICO Monograph Series, Vol. 4 Durham (NC): 1997, 52-65.
49.
Crerar MA , Ellis AW, Dean EC. Remediation of sentence processing deficits in aphasia using a computer-based microworld. Brain Lang1996;52:229-275.
50.
Bara BG , Tirassa M, Zettin M.Neuropragmatics: neuropsychological constraints on formal theories of dialogue. Brain Lang1997;59:7-49.
