Aphasia

by

Christos Salis, Jessica Obermeyer, Susan Edwards

• LAST REVIEWED: 22 April 2020
• LAST MODIFIED: 22 April 2020
• DOI: 10.1093/obo/9780199772810-0052

Introduction

Aphasia is a language disorder acquired subsequent to brain damage that affects production and understanding of spoken and written language in varying degrees and patterns associated with the size and site of the lesion (see Symptoms and Neurological Correlates). Written and online examples of aphasic speech are available (see Aphasic Language Data Sets). Brain damage is usually in the left cerebral cortex, with the left temporal and frontal lobes being especially vulnerable (see Symptoms and Neurological Correlates). Profiles of deficits vary in the extent that levels of language, phonology (see Phonemic and Phonetic Characteristics), lexis (see Nouns, Verbs, Closed-Class Words), and syntax (see Sentence Comprehension and Sentence Production) are involved, in varying degrees and patterns, although lexical access problems are found in most types of aphasia. These deficits give rise to problems in connected speech and conversation (see Discourse). Variations in the types of language deficit found in aphasia led to the notion of syndromes and the search for associations between types of language deficits and sites of lesion (see Historical Overviews). Two well-described syndromes are Broca’s and Wernicke’s aphasia. Broca’s aphasia is characterized by syntactic deficits in output but with relatively retained understanding of language. Most experimental research has been in this type of aphasia. In Wernicke’s aphasia, understanding is impaired and lexical semantics are compromised, whereas syntax is relatively intact. Aphasia is found in all languages (see Across Languages) and in children who have passed the early stages of language development and subsequently have impaired language following brain damage.

General Overviews and Textbooks

The overviews and tests listed here are suitable for undergraduate students or early stage researchers interested in aphasia. Caplan 1996, although published some time ago, still provides an excellent overview of psycholinguistic aphasia at the time of publication. Goodglass 1993 is a classic text from an aphasia lab that has had considerable influence on research and clinical work in aphasia (see Developments in the 20th and 21st Centuries). Whitworth, et al. 2014 provides an introduction to understanding the wide variety and complexity of aphasic symptoms and deficits. The book covers all modalities of language (reading, writing, speaking, understanding) and presents a cognitive neuropsychological approach to assessment and treatment. Helm-Estabrooks, et al. 2014 is a comprehensive overview of assessment and treatment approaches, targeted at speech and language therapists and other clinicians. This third edition includes a DVD with clinical materials and example videos. Hillis 2015 is an edited collection of papers from researchers working in different disciplines and approaching aphasia from different perspectives (cognitive neuropsychology, linguistics, neurology, neuroimaging, and speech and language therapy). Different modalities of language are covered with a focus on specific tasks (e.g., reading, understanding meaning, naming). LaPointe 2011 provides broad coverage that includes both specific symptoms and deficits, as well as contemporary approaches that include cultural, quality of life, and treatment concerns. Paquier and van Dongen 1993 describes acquired aphasia in children who, previous to brain damage, were exhibiting normal language development. Further papers on this topic are in the same issue of the journal in which this article appears. Coppens, et al. 1998 discusses factors such as literacy, hand dominance, and bilingualism, which influence language abilities in aphasia.

• Caplan, David. 1996. Language, structure, processing, and disorders. Cambridge, MA: Massachusetts Institute of Technology Press.

  DOI: 10.7551/mitpress/4127.001.0001

  This is an informative text on aphasia, written for students from all educational backgrounds. Caplan explains models and theoretical concepts used in the field. He links selected linguistic theories and data from experimental psycholinguistic and online brain studies to aphasic disorders. A good example of interdisciplinary aphasic research.

• Coppens, Patrick, Yvan Lebrun, and Anna Basso. 1998. Aphasia in atypical populations. Mahwah, NJ: Lawrence Erlbaum.

  This is a rare multiauthor text on aphasia in atypical populations (for example, illiterate individuals, left-handers) and aphasia in bilingual speakers. Although this text presupposes background knowledge of language processing and neuropsychology, it is nevertheless fairly accessible. Suitable for graduate students.

• Goodglass, Harold. 1993. Understanding aphasia. San Diego, CA: Academic Press.

  Written by one of the 20th-century giants of aphasia, the text provides descriptions of aphasia syndromes that were widely adopted, despite limitations, as well as a historical context. Suitable for undergraduates and newcomers to the field. Although this view is still held, many researchers have doubted the usefulness of the syndromes described.

• Helm-Estabrooks, Nancy, Martin L. Albert, and Marjorie Nicholas. 2014. Manual of aphasia and aphasia therapy. 3d ed. Austin, TX: Pro-Ed.

  A comprehensive introduction to aphasia for clinicians and those interested in diagnosis and treatment. For undergraduates and other newcomers to the field.

• Hillis, Argye E., ed. 2015. The handbook of adult language disorders. 2d ed. New York: Psychology Press.

  Papers by researchers and experts on various acquired language problems found in or associated with aphasia. Highly recommended for detailed coverage of specific cognitive and language deficits that arise in aphasia.

• LaPointe, Leonard L., ed. 2011. Aphasia and related neurogenic language disorders. 4th ed. New York: Thieme.

  An overview split into three sections. The first provides a foundation in aphasia (e.g., brain anatomy, aphasia theory and models, quality of life, multilingualism and aphasia); the second, an overview of assessment and treatment focusing on specific skills and treatment methods (e.g., word retrieval, reading and writing, assistive technology); and the third includes related disorders (e.g., dementia, traumatic brain injury). Highly recommended for a solid background to aphasia.

• Paquier, Phillippe, and Hugh van Dongen. 1993. Current trends in acquired childhood aphasia. Aphasiology 7.5: 421–440.

  The authors discuss the rare cases of aphasia acquired in childhood, including when language disorders are associated with cerebral seizures. The journal issue in which this article appears contains other papers on childhood aphasia, and Paquier’s introduction to the issue provides a context for the topic.

• Whitworth, Anne, Janet Webster, and David Howard. 2014. A cognitive neuropsychological approach to assessment and intervention in aphasia: A clinician’s guide. 2d ed. Hove, UK, and New York: Psychology Press.

  DOI: 10.4324/9781315852447

  A detailed presentation of how language and cognition can be impaired in aphasia, and a model for how to assess and understand observed deficits. Most useful for students in neuropsychology or speech and language therapy/pathology who want to assess and treat aphasia. This text is written from a specific theoretical approach.