Phonemic Discrimination in Sensory Aphasia

Abstract

In a series of recent studies we have been attempting to isolate the various factors that comprise (Albert, 1972; Albert, Goldblum, Hecaen, & Benson, 1971; Dubois, Hecaen, Cunin, Daumas, Lervill-Anger, & Marcie, 1970; Hecaen, 1969; Hecaen, Dubois, & Marcie, 1967; Hecaen, Dubois, & Marcie, 1968). This paper is a preliminary report of results with a test designed to demonstrate deficits in the discrimination of spoken language in sensory aphasia. (In this paper the term refers to the clinical syndrome of fluent, paraphasic speech with impairment of written and oral language comprehension, naming, and repetition.) Hecaen and co-workers (1968, 1969) have described three major varieties of sensory aphasia, recognizing that these three forms may be associated in any individual case, but with variable intensity. In the first type of sensory aphasia the predominant clinical picture approaches that of pure word deafness; the major defect is in the reception of verbal signs. Verbal paraphasias and neologisms are present in spontaneous speech, although the basic idea to be expressed may be maintained. Repetition is impossible. Somewhat preserved, however, is the comprehension of written language. Spontaneous writing ability is present; copying is intact; but writing to dictation is impossible. The second variety is defined by the presence of a predominant deficit in verbal comprehension for both written and oral language. Spontaneous speech is incoherent, with incomplete sentences and with loss of the basic idea to be expressed. Verbal paraphasias are frequent. Repetition of nonsense syllables, words, and sentences is relatively preserved. Writing to dictation is only mildly to moderately impaired, whereas spontaneous writing is marked by numerous paragraphic errors.