Aphasia; Acquired Alexia and Agraphia

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Alexia = ? Agraphia = ?: Alexia = Reading
Agraphia = Writing
Do most aphasics have alexia or agraphia?: Most aphasics have BOTH alexia AND agraphia.
"Usually part of the aphasia syndrome but can exist separately. Usually from a small, left-hemisphere inferior parietal lobe lesion involving the angular gyrus.
What is Acquired Alexia?: -Lang. based disorder highly associated with aphasia
-Some aphasics will benefit from the written word, as in Wernicke's, and some may not.
-In some cases, you can show a written word to get a verbal response
What is Deep Dyslexia?: -Impaired greapheme-phoneme conversion
-**Reads only content words**
-More difficulty with functor words (either omitted of misread as another functor word)
-Damage to mapping input to semantics
-Semantic errors ("tall" for "long"). May be called PARALEXIAS
-Strong word superiority effect
-Strong Concreteness
-Tends to omit inflectional and derivational errors ("entertain" for "entertainment")
-May have errors based on visual similiarity ("crown" for "crowd")
-Great difficulty with nonsense words
-More difficulty with verbs and adjectives than nouns
-Poor ability to select a work from a semantically related list
-Promarily reads from a whole-word approach
-Most Broca's Aphasics have this
What is Phonological Dyslexia?: -Exists on a continuum from deep to surface dyslexia (a "recovering" deep dyslexic)
-Occasional difficulty reading grammatical functor words
-Poor ability to apply grapheme-phoneme rules to read pseudowords
-Familiarity strong factor
-**Few semantic Errors**
-Reading impariment-mild
-Read words easier
What is Surface Alexia?: -Spelling sound regularity
-Can read nonwords/functor words better than content words
-Use of grapheme-to-phoneme conversion
-Frequent regularization errors ("choir" pronounced "choyer") - apply phonetic rules when the shouldn't apply them
What is Alexia without Agraphia?: -Person can't read what they write well. Usually occurs with right visual field deficirs. May also have difficulty naming visually presented colors (color Agnosia)
-Reads letter-by-letter (every single letter read out loud before word is read)
-No semantic errors
-Disassociation b/t occipital association cortex and the dominant angular gyrus
-Very obsolete, small lesion
-Typically do not have any other aphasia symptoms
-Can write words, but can't read what they wrote
When assessing Alexia without Agraphia, what things should you keep in mind?: -Do not confuse reading orally with reading comprehension
-Note error types or do an error analysis to try to discern the type of alexia
When assessing reading, what factors do you need to consider?: -Word Frequency or occurance
-Part of speech
-Emotional Valence
-Personal Relevancy
-Syntactic Complexity
-Length of word
-Degree of interference required for interpretation
-Concreteness/Imagability
-Regularity of Spelling
-Morphological and syntactic complexity
When reading aloud, what factors do you need to consider?: -Personally relevant names
-Words with emotional valence
-Concrete nouns and verbs
-Abstract nouns and verbs
-Grammatical words
-Numbers and letters (Arabic & Roman)
-Phrases/sentences with sunstantive words
-Phrases/sentences with functor words
-Nonsense words
When assessing reading comprehension, what factors do you need to consider?: -Match word with picture or oject
-May want to present target words vertically to minimize the problems of hemianopsia or inattention to one side
-Should include phonemically and semantically related words
-May want to read a command
-Sentence comprehension with 4 choices
-Paragraph comprehension with 4 choices
True/False: Typically with aphasics, writing is better than speech.: Typically, what one hears verbally will be what one sees graphically. Broca's aphasics will write primarily nouns or first letter words. Posterior lesion aphasic may write with a variety of paraphasic errors.
"What comes out of the mouth comes out of the pen."
What is the definition of Agraphia?: -An acquired writing disorder characterized by errors in spelling, semantics, or syntax and poor construction of the physical features of the written word.
-Language-based disorder closely associated with aphasia.
When assessing writing, what factors do you need to consider?: -Word frequency or occurrence
-Part of speech
-Emotional valence
-Personal relevancy
-Syntactic complexity
-Length of word
-Degree of inference required for interpretation
-Concreteness/imagability
-**Regularity of spelling**
-Morphological and syntactic complexity
What are the 4 types of agraphia?: 1. Apraxic Agraphia
2. Deep Dysgraphia
3. Surface Dysgraphia
4. Phonological Dysgraphia
What is Apraxic Agraphia?: -Inability to use a writing tool to form graphic symbols when a model is provided.

-May be part of ideomotor apraxia or constructional apraxia
-Imparied ability to form letters wven when copying
-Better ability to spell with anagrams or a typewriter or to spell aloud
-Difficulty in controlling and producing the graphomotor patterns required for writing
What is Deep Dysgraphia?: -Produces spelling errors that are semantically related but not phonologically related (ie "school" for "class")

-Best at writing concrete nouns vs abstract nouns or verbs
-Impaired phoneme-to-grapheme conversion
-**Can not write functor words**
What is surface dyslexia?: -Makes phonetic spelling errors (ie "skool" for "school") because of an over reliance on phoneme-to-grapheme conversion
-Impaired whole word lexical route
-Can write pseudowords "flig"
What is phonological dysgraphia?: -Uses a lexical-semantic whole word spelling approach
-Relative preservation of ability to write real words
-Unable to write pseudowords "fling" vs "flig"

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