Abstract
The singularly most uniquely human attribute is language. Such a bold statement is difficult to make, but profoundly true. Many species possess communication skill and communication among some species is elaborate and facilitates complex social relationships and interactions; however, the extent and sophistication of human use of representational language is truly unique. Language is so intertwined into what it is to be human that its complexity is often overlooked as a prerequisite skill in neuropsychological assessment.
At its simplest, language can be conceptualized as expressive and receptive language functions. While typically residing in the left hemisphere (referred to as the dominant hemisphere because of the propensity of language to develop even if damage occurs to normal language centers), bilateral representation and right hemisphere representation of language occurs both naturally and secondarily in response to early cerebral injury that affects the typically dominant left hemisphere (see (Table 7.1) for relative frequencies of hemispheric language dominance). See also Chaps. 3 and 12.
The evaluation of the patient with language deficits first requires a review of the assessment of language and the definition of some terms. We will first review the basic aspects to evaluate speech and define terms describing different types of speech problems. We will then return to evaluating various speech problems commonly encountered in the clinic.
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Appendix A
Appendix A
Acute Assessment of Language and Prosody
Receptive language and prosody | Response | Correct |
Simple receptive language | ||
Simple Yes/No question | ||
Is it winter? | _________ | _________ |
Are you in a hospital? | _________ | _________ |
Complex Yes/No question | ||
Are cows carnivorous? | _________ | _________ |
Would a nice person express complements? | _________ | _________ |
Receptive comprehension of commands | ||
Simple | ||
one StepPoint to the door | _________ | _________ |
two StepLook up and then look down | _________ | _________ |
Complex | ||
SequencedTouch your arm and then touch your ear | _________ | _________ |
ReversedPoint to the door after you point to the chair | _________ | _________ |
Reading (Read and/or comply) | ||
I feel good today | _________ | _________ |
Point to each person in the room | _________ | _________ |
Prosody | ||
Simple Prosody (statement or question) | ||
I’m going to town! (spoken as a statement) | _________ | _________ |
I’m going to town? (spoken as a question) | _________ | _________ |
Emotional Prosody (expressed emotion) | ||
That is wrong. (Spoken Angrily) | _________ | _________ |
That is wrong. (Spoken sadly) | _________ | _________ |
That is wrong. (Spoken happily) | _________ | _________ |
Expressive language and prosody | ||
Naming | ||
Simple objects | ||
What is this? (Point to shirt) | _________ | _________ |
What is this? (Point to pen) | _________ | _________ |
Complex naming | ||
What is this? (Point to sleeve or cuff of shirt) | _________ | _________ |
What is this? (Point to point or tip of pen) | _________ | _________ |
Repetition | ||
Single word | ||
Desk, chair, light | _________ | _________ |
Simple Statement | ||
I would like some ice cream | _________ | _________ |
Complex Statement No ifs, ands or buts | _________ | _________ |
Writing | ||
Simple | ||
Write his/her name | _________ | _________ |
Write name of watch | _________ | _________ |
Write a sentence | _________ | _________ |
Verbal Fluency (60 seconds, record number) | ||
Phonemic fluency (ie. words beginning with the letter r) | _________ | _________ |
Semantic fluency (ie. Animals) | _________ | _________ |
Expressive Prosody | ||
Say, “I’m going to work.” | ||
Phrase as if sad | _________ | _________ |
Phrase as if angry | _________ | _________ |
Discourse/spontaneous expressive speech | ||
Structured | ||
Show a picture; ask patient to describe what is happening | _________ | _________ |
Unstructured | ||
Ask patient what he/she did/does | ||
for work and give the details. | _________ | _________ |
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Scott, J.G., Schoenberg, M.R. (2011). Language Problems and Assessment: The Aphasic Patient. In: Schoenberg, M., Scott, J. (eds) The Little Black Book of Neuropsychology. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-76978-3_7
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