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Cynthia M. Shewan
Whether an aphasic patient understands what is said auditory and linguistic message components (Figure 1).
appears to be influenced by many factors in addition to This applies to aphasic patients functioning in everyday
the message itself, among them: how the material is pres- situations and in the clinical setting.
ented, what the situational context is, the nature of the
response required, the individual's cognitive functioning,
his/her motivation, and the location and extent of the
cerebral lesion_ Of course, the individual engaged in the
comprehension task is also important. The nature of PSYCHOLOGICAL PRESENTATION
auditory comprehension problems in adult aphasic indi- VARIABLES VARIABLES
viduals is indeed complex, but we are making headway_
To paraphrase Shakespeare, To understand or not to
understand is a complex question.
Researchers now generally agree that all aphasic
patients demonstrate auditory comprehension problems_
Of less consensus is whether all comprehension prob- Figure 1. Dimensions influencing auditory compre-
lems are similar in type. hension of a linguistic message.(reprinted with
permission).
Whenever we communicate with an aphasic patient,
during testing or in conversation, some of the time we talk Processing Auditory Stimuli:
and the patient listens. These interactions require that the
aphasic person understand our linguistic messages. Perceptual Data
Whether that understanding takes place is influenced by Auditory perceptual deficits do not appear to be the
many factors operating in the situation, including auditory major contributing factors to aphasic patients' inability to
perception, auditory comprehension, and factors which understand auditory messages. The auditory perceptual
influence auditory comprehension. problems may involve discrimination, recognition, and/or
Presumably, the ultimate goal of processing mes- temporal ordering, using verbal or nonverbal material,
sages is to comprehend them, that is, to assign approp- and may be found among several aphasic types. How-
riate meaning to them. Take the message "Gotcha". ever, the disociation betweeen perceptual problems and
What does it mean? Interpretation depends upon linguistic comprehension problems in many aphasic patients pre-
aspects, context, and extralinguistic variables. Said by a cludes using perceptual problems as the explanatory
parent to a young child, "Gotcha" represents "I've got cause for comprehension deficits. Recognizing a "towel
you, you're not going to fall". Used in the context of rack" as a "motorcycle", as one of our aphasic clients did,
playing a game of tag, or changed slightly to "Caughtcha", probably represented a semantic confusion that did not
it means "Tag, you're it". Said by an adult during conver- involve a failure of perceptual processing.
sation, it might mean "I understand what you said", or, in
another context with a different intonation pattern, it Processing Auditory Language:
might mean "You fell into the trap I set for you". Uttered Understanding the Linguistic Input
during a game of cowboys and rustlers, "Gotcha" repres- Comprehension of spoken language requires indi-
ents "Bang, bang, you're dead". The point of this example vidual processing of the linguistic components· phonol-
is to illustrate that whether a person understands or fails ogy, semantics, and syntax - as well as interactive pro-
to understand depends on many dimensions of the com- cessing among them.
munication situation as well as the processing of the
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sia. Cortex, 8, 382-394. pause time on auditory·verbal comprehension of adult aphasic
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plex sentences in children and aphasics: A test of the regression speech and linguistic stress on auditory paragraph comprehen·
hypothesis. In A. Caramazza & E.B. Zurif (Eds.), Language sion of aphasic individuals (Abstract). In RH. Brookshire (Ed.),
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