Agrammatic Broca's Aphasia Research Articles

A Comparison of Two Treatment Approaches for Agrammatic Broca's Aphasia: Script Therapy vs. Verb Network Strengthening Treatment

A Comparison of Two Treatment Approaches for Agrammatic Broca's Aphasia: Script Therapy vs. Verb Network Strengthening Treatment

Verb-production treatment in multilingual aphasia: Cross-linguistic generalization or inhibition?

Verb-production treatment in multilingual aphasia: Cross-linguistic generalization or inhibition?

A Computational Evaluation of Sentence Processing Deficits in Aphasia.

Individuals with agrammatic Broca's aphasia experience difficulty when processing reversible non-canonical sentences. Different accounts have been proposed to explain this phenomenon. The Trace Deletion account (Grodzinsky, 1995, 2000, 2006) attributes this deficit to an impairment in syntactic representations, whereas others (e.g., Caplan, Waters, Dede, Michaud, & Reddy, 2007; Haarmann, Just, & Carpenter, 1997) propose that the underlying structural representations are unimpaired, but sentence comprehension is affected by processing deficits, such as slow lexical activation, reduction in memory resources, slowed processing and/or intermittent deficiency, among others. We test the claims of two processing accounts, slowed processing and intermittent deficiency, and two versions of the Trace Deletion Hypothesis (TDH), in a computational framework for sentence processing (Lewis & Vasishth, 2005) implemented in ACT-R (Anderson, Byrne, Douglass, Lebiere, & Qin, 2004). The assumption of slowed processing is operationalized as slow procedural memory, so that each processing action is performed slower than normal, and intermittent deficiency as extra noise in the procedural memory, so that the parsing steps are more noisy than normal. We operationalize the TDH as an absence of trace information in the parse tree. To test the predictions of the models implementing these theories, we use the data from a German sentence-picture matching study reported in Hanne, Sekerina, Vasishth, Burchert, and De Bleser (2011). The data consist of offline (sentence-picture matching accuracies and response times) and online (eye fixation proportions) measures. From among the models considered, the model assuming that both slowed processing and intermittent deficiency are present emerges as the best model of sentence processing difficulty in aphasia. The modeling of individual differences suggests that, if we assume that patients have both slowed processing and intermittent deficiency, they have them in differing degrees.

Finite verb inflections for evidential categories and source identification in Turkish agrammatic Broca's aphasia

This study presents the pioneering data on the neurological representation of grammatically marked evidentials with regard to their dissolution in agrammatic Broca's aphasia. Across two tasks, we investigated the production of finite verb inflections for evidential categories and identification of the information sources these evidential categories are mapped on in Turkish individuals with agrammatic aphasia. In Turkish, information source is grammatically marked for three different past contexts: direct perception, reportative, and inferential. The following research questions were explored: (1) is inflection for different evidential categories equally affected in Turkish agrammatic aphasia? (2) Is identifying the categories of information source impaired? Turkish agrammatic speakers and non-brain-damaged speakers (NBDs) were tested with a production and a source identification tasks. Our findings demonstrate that in Turkish agrammatic speakers the direct perception evidential was more affected in production than the inferential and reportative evidentials. However, the agrammatic speakers retained the ability to identify the source for the direct perception. We argue that information source values conveyed by evidential forms are impaired in agrammatic aphasia. These findings are discussed on the basis of earlier studies to time reference and tense in agrammatism.

Sentence production in Swahili–English bilingual agrammatic speakers

Background: It has been argued that agrammatic speakers' production of sentences in derived order is impaired (The Derived Order Problem Hypothesis, DOP-H), and that the underlying deficit in bilingual individuals with agrammatic Broca's aphasia may cause different surface manifestations in the languages when they differ in terms of their grammatical morphology. The current study presents results of a study on sentence production in Swahili-English bilingual agrammatic speakers. The two languages, Swahili and English, differ significantly in terms of their verbal morphology. Aims: The current study tested the production of sentences in base and derived orders of arguments in the two languages of Swahili-English bilingual agrammatic speakers. Methods & Procedures: Eight agrammatic and eight non-brain damaged individuals participated in the study. A sentence elicitation test was used to examine the production of sentences in base and derived word orders in Swahili and English. The base order condition consisted of active and subject-cleft sentences, whereas the derived order condition tested passive and object-cleft sentences. Outcomes & Results: The non-brain-damaged individuals performed at ceiling in both languages. The agrammatic speakers' results, however, show sentences in derived order condition and were more difficult to produce than those in base order, similarly across the two languages irrespective of their morphological differences. Moreover, the embedded sentences were also more difficult to produce than simple sentences for agrammatic speakers. Conclusions: The current data partially support the DOP-H and provide new insight into sentence production deficit of bilingual individuals with agrammatic Broca's aphasia. The findings are discussed with respect to the theories of sentence production in agrammatic speakers.

Characterising agrammatism in Standard Indonesian

Background: The spontaneous speech of speakers of Standard Indonesian (SI) with agrammatic Broca's aphasia has not yet been characterised, although there are features of SI that are relevant for the discussion of agrammatic speech. This research was supported by a doctoral scholarship given to Harwintha Yuhria Anjarningsih by the Ministry of National Education of the Republic of Indonesia. The authors would like to thank Lise Menn and two anonymous reviewers for their very helpful comments on an earlier version of this paper. We thank Jelita Lesar, Rizky Ariyanto, Tyas Charunisa, Yunitha Pusparani, and Risha Amalia for assistance in collecting data from the NBDs and Wuryanto Aksan, Euis Helmy, Zulkarnaen Yasin, Ira Wirjono, and Vivin Dianca for assistance at the hospitals where the Broca participants were met. We also thank Katherine McCurdy for her helpful comments on the manuscript. Aims: The purpose of this study was to find the characteristic features of agrammatism in SI. SI is spoken by about 200 million people and it is important for clinical and rehabilitation purposes to characterise agrammatism in SI. Methods & Procedures: A total of 21 adults (6 with Broca's aphasia and 15 without history of neurological problems) participated in the study; 300 words of a spontaneous speech sample from each participant underwent syntactic and morphological analyses. The study focused on the defining characteristics of SI agrammatic speech, analysing syntactic and morphological variables. Outcomes & Results: The study showed that some characteristics of agrammatic speech in Indo-European languages are also found in SI (slower speech rate, shorter MLU, simpler sentence structure, fewer syntactic particles). However, there are also results that are typical for SI agrammatic speech (normal/above normal verb production, overuse of inflectional affixes compared to derivational ones, normal production of sentences with non-canonical word order, such as passives). Conclusions: For the first time, features of SI agrammatic speech are described. Agrammatic SI can be characterised by a low speech rate and the production of short sentences, just as in other languages. However, several characteristics that have been reported for other languages (e.g., reduced use of verbs) have not been found for SI agrammatic speech, whereas there are agrammatic characteristics in SI that have not been mentioned before for other languages (e.g., reduced number of derivational morphemes, combined with normal number of inflectional morphemes and good access to passive structures). It is argued that this is inherent to the structure of SI. The value of the variables for clinical purposes is discussed.

The interpretation of stressed and non-stressed pronouns in Spanish language breakdown

Background: Earlier research has indicated that patients with agrammatic Broca's aphasia have problems with constraints on the intra-sentential interpretation of object pronouns, incorrectly allowing them to refer to the subject of the same sentence. However, these studies do not show how agrammatic patients deal with constraints on the extra-sentential interpretation of pronouns. Also, studies that did investigate patients' extra-sentential interpretation of pronouns were on English and Dutch, languages with a pronominal system that differs substantially from the pronominal system of Romance languages, such as Spanish. Aims: To test Spanish agrammatic patients on the interpretation of stressed and non-stressed subject and object pronouns in coordinated structures (the Spanish counterparts of sentences such as “First the girl pushed the mother, and than she / SHE pushed the boy”), in order to investigate whether they exhibit the same referential preferences as non-brain-damaged individuals and English- and Dutch-speaking patients. Methods & Procedures: In the present study seven Spanish patients with agrammatic Broca's aphasia and six non-brain-damaged adults were tested with a picture selection task on their interpretation of non-stressed and stressed pronouns in coordinated sentences. Patients were presented coordinated sentences and were shown four pictures, one on the left page, three on the right page. The left page picture represents the first conjunct of the test sentence, the right page represent the two theoretically possible referents of the pronoun (subject of the first conjunct, or object of the first conjunct) and a non-related picture. The patient's task was to indicate out of the three pictures the one that correctly represented the meaning of the second conjunct of the test sentence. Outcomes & Results: Agrammatic individuals exhibit difficulties with the interpretation of non-stressed object pronouns, and even more difficulties with the interpretation of contrastively stressed pronouns. An additional finding is that they tend to prefer subjects as the antecedents of pronouns. Conclusions: We claim that patients' problems with the interpretation of pronouns are not the result of missing syntactic knowledge, but are due to patients' limited ability to keep syntactic configurations in their syntactic working memory. We argue that their preference for subjects as antecedents for pronouns reflects a fall-back strategy in agrammatic patients when, as a result of limited processing resources, syntax-based interpretative operations fail.

Training verb and sentence production in agrammatic Broca's aphasia

Background: Many aphasic speakers have problems producing verbs at both the word and the sentence level. A treatment programme called ACTION (Bastiaanse, Bunge, & Perk, 2004; Bastiaanse, Jonkers, Quak, & Varela Put, 1997) has been developed to train verb production of both fluent and non-fluent aphasic speakers. It consists of four levels: single verbs, filling in infinitives, filling in finite verbs, and sentence construction. For the present study the efficacy of the programme for agrammatic speakers with Broca's aphasia was tested. Aims: The aim of the study was to measure the effects of treatment with ACTION on non-trained infinitives and finite verbs, and to analyse the generalisation effects on spontaneous speech and verbal communication in daily life. Methods & Procedure: ACTION was used to train 11 agrammatic patients with Broca's aphasia, following the multiple baseline across behaviours design. The patients were tested weekly on untreated items. Two follow-up assessments were done, 1 and 3 months post-treatment. Generalisation to related and unrelated materials was measured with subtasks of the Aachen Aphasia Test (AAT). Spontaneous speech was analysed, and verbal communication was measured before and after treatment and 3 months post-treatment by the Amsterdam-Nijmegen Everyday Language Test (ANELT). Outcomes & Results: There was improvement on the untrained infinitives and finite verbs. The improvement on infinitives was relatively minor; finite verbs, which were more impaired than the infinitives prior to treatment, improved up to the level of the infinitives. The improvement generalised to the related tasks of the AAT, but not to the unrelated task; verbal communication improved significantly. This improvement was reflected in relevant variables of spontaneous speech (mean length of utterances, proportion of finite verbs and verb diversity), but not in an unrelated variable (diversity of nouns). Conclusions: Treatment with ACTION resulted in better production of finite verbs. The effects generalised to spontaneous speech. Most importantly, it was shown that communication in daily life improved.

Automatic processing of wh- and NP-movement in agrammatic aphasia: Evidence from eyetracking

Individuals with agrammatic Broca's aphasia show deficits in comprehension of non-canonical wh-movement and NP-movement sentences. Previous work using eyetracking has found that agrammatic and unimpaired listeners show very similar patterns of automatic processing for wh-movement sentences. The current study attempts to replicate this finding for sentences with wh-movement (in object relatives in the current study) and to extend it to sentences with NP-movement (passives). For wh-movement sentences, aphasic and control participants' eye-movements differed most dramatically in late regions of the sentence and post-offset, with aphasic participants exhibiting lingering attention to a salient but grammatically impermissible competitor. The eye-movement differences between correct and incorrect trials for wh-movement sentences were similar, with incorrect trials also exhibiting competition from an impermissible interpretation late in the sentence. Furthermore, the two groups exhibited similar eye-movement patterns in response to passive NP-movement sentences, but showed little evidence of gap-filling for passives. The results suggest that aphasic and unimpaired individuals may generate similar representations during comprehension, but that aphasics are highly vulnerable to interference from alternative interpretations (Ferreira, F. (2003). The misinterpretation of noncanonical sentences. Cognitive Psychology, 47(2), 164–203).

Binding in agrammatic aphasia: Processing to comprehension

Background: Theories of comprehension deficits in Broca's aphasia have largely been based on the pattern of deficit found with movement constructions. However, some studies have found comprehension deficits with binding constructions, which do not involve movement. Aims: This study investigates online processing and offline comprehension of binding constructions, such as reflexive (e.g., himself) and pronoun (e.g., him) constructions in unimpaired and aphasic individuals in an attempt to evaluate theories of agrammatic comprehension. Methods & Procedures: Participants were eight individuals with agrammatic Broca's aphasia and eight age-matched unimpaired individuals. We used eyetracking to examine online processing of binding constructions while participants listened to stories. Offline comprehension was also tested. Outcomes & Results: The eye movement data showed that individuals with Broca's aphasia were able to automatically process the correct antecedent of reflexives and pronouns. In addition, their syntactic processing of binding was not delayed compared to normal controls. Nevertheless, offline comprehension of both pronouns and reflexives was significantly impaired compared to the control participants. This comprehension failure was reflected in the aphasic participants' eye movements at sentence end, where fixations to the competitor increased. Conclusions: These data suggest that comprehension difficulties with binding constructions seen in agrammatic aphasic patients are not due to a deficit in automatic syntactic processing or delayed processing. Rather, they point to a possible deficit in lexical integration.

Verb production and word order in Russian agrammatic speakers

Background: Verb production has been shown to be impaired in individuals with agrammatic Broca's aphasia. Several theories have linked this deficit to problems with the implementation of grammatical information that the verb contains. In particular, the number and type of arguments associated with a verb were suggested as causes of production difficulties in agrammatic speakers. The influence of these two factors on agrammatic production has been investigated in English and Dutch (Bastiaanse & Van Zonneveld, 2005; Thompson, 2003). Aims: The present study focuses on exploring these factors in a structurally different language. Russian, with its rich morphology and relatively free word order, is of interest because it enables not only testing of earlier advanced hypotheses on agrammatic production, but also specification of them at some essential points. Methods & Procedures: A sentence production priming paradigm was used that was based on the method developed by Thompson, Lange, Schneider, and Shapiro (1997) which allows a particular verb and sentence construction to be elicited. Six conditions included sentences with different numbers of arguments (one or two), different types of thematic role mapping (direct or indirect), and different word order (basic or scrambled). The test contained 60 items, 10 items per condition. In all, 16 individuals with agrammatic aphasia and 16 non‐brain‐damaged individuals participated in the study. Outcomes & Results: Cross‐linguistic significance of the earlier advanced hypotheses was demonstrated: the increased number of verb arguments and syntactic operations concerning constituent movement cause production problems for Russian agrammatic speakers. Moreover, the data show that agrammatic speech difficulties are related to the number of arguments explicitly mentioned in a sentence, to the number of operations applied to the syntactic structure of a produced sentence, and to changing the base‐generated position of a constituent (not to the order of the constituents per se). Conclusions: The study provides further evidence that verb production is selectively impaired in agrammatic aphasia. This deficit is related to the implementation of the grammatical information that a verb contains and the syntactic operations applied to basic structures.

Psych verb production and comprehension in agrammatic Broca's aphasia

This study examined the factors that affect agrammatic sentence production by testing eight agrammatic aphasic participants' comprehension and production of active and passive sentences using two types of English psych verbs, those with an Experiencer-marked subject (Subject-Experiencer (SubExp)) and those with an Experiencer-marked object (Object-Experiencer (ObjExp)). The Argument Structure Complexity Hypothesis (ASCH, [ J. Neuroling. 16 (2003) 151]) posits that the verb (and sentence) production difficulties observed in agrammatic aphasia can be attributed, at least in part, to the argument structure properties of verbs, with verbs that are marked for more complex argument structure (in terms of the number and type of arguments) presenting greater difficulty than those with less complex argument structure entries. Based on previous linguistic analyses of psych verbs, ObjExp psych verbs are more complex than SubjExp verbs. Therefore, we predicted that the former would present greater production (but not comprehension) difficulty than the latter. Results showed above chance comprehension of all sentence types, with the exception of SubjExp passive constructions, in which the subject position is occupied by a non-Experiencer argument. In active sentence production, ObjExp verbs were more impaired than SubjExp verbs. However, the opposite pattern was noted for passive sentence production. While all participants had difficulty producing passive sentences of both types, they showed better performance on ObjExp verbs, as compared to SubjExp verbs, in which the Experiencer is in the subject position. Further, agrammatic aphasic speakers showed a preference for producing actives for SubjExp verbs and passives for ObjExp verbs, indicating that the thematic role requirements of selected verbs (e.g., Experiencer, Theme) influence production patterns, as they do in normal speakers. These data, as well as the error patterns seen in our patients, support the ASCH and suggest that sentence production, disrupted in agrammatic aphasia, is impaired to a greater extent when the argument structure properties of the verb increase in complexity.

A comparison of two theoretically driven treatments for verb inflection deficits in aphasia

Errors in the production of verb inflections, especially tense inflections, are pervasive in agrammatic Broca's aphasia (*The boy eat). The neurolinguistic underpinnings of these errors are debated. One group of theories attributes verb inflection errors to disruptions in encoding the verb's morphophonological form, resulting from either a general phonological deficit or a morphological affixation impairment. A second group of theories attribute verb inflection errors to disruptions that arise during sentence formulation, either for syntactic reasons or due to impairments in making fine semantic distinctions between inflectional variants of a verb (+PAST→ate, hugged; +FUTURE→will eat, will hug). These morphophonological and morphosemantic accounts were evaluated by comparing the efficacy of two treatment protocols that exclusively targeted either morphophonological operations or morphosemantic distinctions. Using a single participant design, it was found that aphasic individuals who received morphosemantic treatment showed significant improvement in accurate production of trained and untrained verb inflections in sentence contexts. In contrast, individuals who received morphophonological treatment failed to show improvements in accuracy of sentence production, although the number and diversity of inflected verbs increased. The differential outcomes suggest that morphosemantic impairments contribute to verb inflection deficits in agrammatic aphasia to a greater extent than morphophonological impairments, at least in this group of participants.

Judgment of functional morphology in agrammatic aphasia

Individuals with agrammatic Broca's aphasia show deficits in production of functional morphemes like complementizers (e.g., that and if) and tense and agreement markers (e.g., –ed and –s), with complementizers often being more impaired than verbal morphology. However, there has been comparatively little work examining patients’ ability to comprehend or judge the grammaticality of these morphemes. This paper investigates comprehension of complementizers and verb inflections in two timed grammaticality-judgment experiments. In Experiment 1, participants with agrammatic Broca's aphasia and grammatical-morphology production deficits ( n=10) and unimpaired controls ( n=10) heard complement clause sentences, subject relative clause sentences, and conjoined sentences. In Experiment 2, the same participants heard sentences with finite auxiliaries, sentences with finite main verbs, and sentences with uninflected verbs. Results showed above-chance accuracy in aphasic participants’ judgments for complementizer sentences in Experiment 1, but chance performance for verb inflections in Experiment 2. This pattern held regardless of whether the verb inflections were affixes or free-standing auxiliaries. Implications of these results for theories of agrammatic morphological impairments, including feature underspecification accounts [Wenzlaff, M., & Clahsen, H. (2004). Tense and agreement in German agrammatism. Brain and Language, 89, 57–68; Burchert, F., Swoboda-Moll, M., & De Bleser, R. (2005a). Tense and agreement dissociations in German agrammatic speakers: Underspecification vs. hierarchy. Brain and Language, 94, 188–199] and hierarchical structure-based accounts [Friedmann, N., & Grodzinsky, Y. (1997). Tense and agreement in agrammatic production: Pruning in the syntactic tree. Brain and Language, 56, 397–425; Izvorski, R., & Ullman, M. (1999). Verb inflection and the hierarchy of functional categories in agrammatic anterior aphasia. Brain and Language, 69, 288–291], are discussed.

Canonicity effects as grammatical phenomena

The existence of a split in agrammatic Broca's aphasics’ comprehension of semantically reversible sentences with canonical vs. non-canonical word order have been explored in deep in the last decades. In this paper we present and discuss a new approach to canonicity effects that derives the asymmetry in a principled way from the Relativized Minimality approach to locality in syntax. The approach takes both processing and representational considerations into account thus avoiding problems, such as variation and complexity, encountered in non-integrated accounts. New data from a series of tests on both comprehension and production with an agrammatic Broca's aphasic patient are presented and discussed in light of the new proposal. Reduction of these asymmetries to a special case of the more general theory of locality allows generalizations to be made, which might be extended over different populations.

Production and comprehension of wh-questions in German Broca's aphasia

Current proposals suggest that agrammatic speakers have severe deficits in producing and understanding wh-questions. Whereas the CP layer is assumed to be pruned such that wh-questions can no longer be produced, for comprehension it has been suggested that the agrammatic deficit leads to a deletion of movement traces in syntactically derived sentences. We present data from three experiments testing the production and comprehension of wh-questions in nine German agrammatic Broca's aphasics. In an elicitation and a repetition task we find that complete and grammatical wh-questions can be produced by German agrammatic aphasics, thus indicating that the CP layer can still be projected. The results of a picture-pointing task show, however, that deficits in the comprehension of wh-questions ( who and which N questions) are common. A closer analysis reveals a variety of error patterns in our subjects. The additive effects that non-canonical word order and the discourse-linking of a referential NP ( which N) exert on the comprehension performance of our subjects cannot be captured by current syntactic deficit accounts on agrammatism.

Syntactic and pragmatic aspects of determiner and pronoun production in Dutch agrammatic Broca's aphasia

Background: Agrammatic aphasic individuals produce a lower than normal number of pronouns and determiners in their spontaneous speech. Interestingly, linguistically these two types of functional categories have some properties in common. In Dutch, the language that was studied, both categories depend on case, both are marked for gender, and both carry pragmatic information. These properties relate to different levels of linguistic processing. Case is a syntactic property, gender is lexically specified for determiners, and semantically for pronouns (in Dutch), and the pragmatic function relates to the distinction between definiteness and indefiniteness; that is, whether something refers to information already introduced in the discourse or to new information respectively. We thank Arlette Sjerp for carrying out part of the speech analyses. Aims: The aim of this study was therefore to find out if and how far each of these properties (case, gender, and pragmatic information) contributes to the problems agrammatic speakers have with the production of determiners and pronouns. Methods & Procedures: We analysed spontaneous speech samples of eight Dutch‐speaking agrammatic aphasic individuals with regard to the omission and production rates of determiners and pronouns, taking into account the different linguistic properties. Outcomes & Results: The analyses revealed that the syntactic property of determiners and pronouns, case, contributes most to the agrammatic problems. Gender information seems to be unproblematic. Finally, our aphasic speakers omitted relatively more indefinite determiners than definite determiners. It is not completely clear yet whether this is related to a problem with indefinites. The error analysis shows that pragmatic information as such seems to be unimpaired. Conclusions: The syntactic aspects of determiners and pronouns play an important role in the problems agrammatic speakers have with these elements. More detailed research may be needed to investigate the distinction between indefiniteness and definiteness in determiners. Our results suggest that the production of determiners and pronouns should always be treated with a focus on their syntactic property: their dependency on case‐assigning categories.

Treatment of Underlying Forms in a discourse context

Background: Previous research indicates that Thompson and colleagues' (Thompson, 2001; Thompson & Shapiro, 2005) Treatment of Underlying Forms (TUF) can efficiently remediate agrammatic sentence‐processing deficits. The theoretical basis of TUF is that training production of complex, noncanonical sentence structures can concomitantly improve production of untrained, syntactically related but simpler sentence structures. Whereas this generalisation to untrained syntactic forms has been well established within constrained, sentence‐level tasks, which exploit the same response modality used during training, TUF's generalisation potential in terms of cross‐modal effects and discourse‐level improvements requires further exploration. Aims: DM, a 52‐year‐old male with an agrammatic Broca's aphasia profile, was provided with a modified version of TUF, which targeted his writing skills and included a Discourse Training Module that allowed direct rehearsal of targeted syntactic frames within a discourse context. The hypotheses tested were as follows: (a) DM would improve his written production of trained sentence structures and demonstrate generalisation to untrained exemplars of targeted sentence structures as well as untrained, syntactically related syntactic structures; (b) written sentence production treatment would facilitate gains in DM's spoken production of trained and related, untrained sentence structures; and (c) DM would exhibit improved sentence production abilities in discourse post‐treatment. Methods & Procedures: A single subject, multiple baseline across‐behaviours design was implemented to evaluate acquisition of trained sentence types (object‐ and subject‐extracted embedded who‐question sentences), to discern generalisation to untrained sentence types (object‐ and subject‐extracted matrix questions, passives) and discourse, or both, and to identify maintenance of treatment effects. Each week, DM completed two 90‐minute sessions of modified TUF as well as written sentence production homework. Outcomes & Results: DM displayed a pattern of sentence acquisition typical of TUF recipients, generalising gains in complex sentence production to the production of untrained, less complex, theoretically related structures. Gains in written production generalised to spoken production of the same structures, and improvements across predominately pragmatic versus morphosyntactic discourse variables were also noted. Conclusions: The treatment outcomes of a modified, written version of TUF were comparable to those in previous studies (e.g., Ballard & Thompson, 1999), and indicated that training written sentence production can evoke substantial cross‐modal generalisation to speech. Despite inclusion of a Discourse Training Module, pragmatic versus morphosyntactic aspects of DM's discourse showed most improvement. Therefore, continued investigation of TUF is recommended to determine whether it can efficiently treat structural aspects of discourse production, or what modifications will ensure generalisation to discourse contexts in a broader spectrum of aphasic patients.

Slower-than-normal syntactic processing in agrammatic Broca's aphasia: Evidence from Dutch

Studies of agrammatic Broca's aphasia reveal a diverging pattern of performance in the comprehension of reflexive elements: offline, performance seems unimpaired, whereas online—and in contrast to both matching controls and Wernicke's patients—no antecedent reactivation is observed at the reflexive. Here we propose that this difference characterizes the agrammatic comprehension deficit as a result of slower-than-normal syntactic structure formation. To test this characterization, the comprehension of three Dutch agrammatic patients and matching control participants was investigated utilizing the cross-modal lexical decision (CMLD) interference task. Two types of reflexive-antecedent dependencies were tested, which have already been shown to exert distinct processing demands on the comprehension system as a function of the level at which the dependency was formed. Our hypothesis predicts that if the agrammatic system has a processing limitation such that syntactic structure is built in a protracted manner, this limitation will be reflected in delayed interpretation. Confirming previous findings, the Dutch patients show an effect of distinct processing demands for the two types of reflexive-antecedent dependencies but with a temporal delay. We argue that this delayed syntactic structure formation is the result of limited processing capacity that specifically affects the syntactic system.

Sentence production with verbs of alternating transitivity in agrammatic Broca's aphasia

Bastiaanse, Koekkoek And Van Zonneveld (2003) hypothesized that individuals with Broca's aphasia have problems with sentences in which the verb and its arguments are not in their base position. The present study is meant to test this hypothesis with the help of verbs with alternating transitivity: transitive: the boy breaks the glass; intransitive or unaccusative: the glass breaks. Superficially seen, the latter sentence is less complex (subject–verb) than the first (subject–verb–object), but from a theoretical point of view, the unaccusative reading ( the glass breaks) is more complex, because the theme is in subject position, which is not the base position. A production test was presented to patients with Broca's aphasia and with anomic/Wernicke's aphasia, in which transitive and unaccusative sentences with the same verbs were elicited. The results show that broca patients are significantly better in producing the transitive sentences than the unaccusative ones, whereas there is no difference for the patients with anomic/wernicke's aphasia. Furthermore, an error analysis reveals that the large majority of the errors made by the patients with Broca's aphasia are transitive sentences while the picture depicts the unaccusative reading. This pattern does not occur in the patients with anomic/Wernicke's aphasia. The results are taken as support for the hypothesis that sentences in which the verb and its arguments are not in their base position are difficult for patients with broca's aphasia.