The Fragile Brain

The Fragile Brain

Speech and Language

Most common causes of damage to the brain               

Stroke (also called cerebrovascular accident or CVA): brain is deprived of oxygen because of a blocked major artery, a blood vessel ruptures and blood is spilled on or in brain tissue, preventing necessary oxygen from reaching that portion of the brain, etc  Some diseases like multiple sclerosis (damage to white matter/central nervous system), dementia, etc.  Trauma, tumors, and hydrocephalus (build up of cerebral spinal fluid in brain).  Traumatic brain injury  Some possible causes for developmental abnormalities in the brain  Genetics (e.g. Down Syndrome, Williams Syndrome)  Fetal damage (e.g. from excessive alcohol intake by mother, drugs, etc.)  Disease (early epileptic seizures can interfere with normal brain development)

Some possible causes for developmental abnormalities in the brain 

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Genetics (e.g. Down Syndrome, Williams Syndrome) Fetal damage (e.g. from excessive alcohol intake by mother, drugs, etc.) Disease (early epileptic seizures can interfere with normal brain development)

Brain damage may not always affect language Phineas Gage Foreman of railway construction gang. In 1848 while working on a railway, an accidental explosion caused a tamping iron bar to shoot through his head (entered under his left cheek bone) and land 25-30 yards behind him.  Except for personality changes, language not affected. 

Speech vs. language impairments not all speech disturbances are aphasia  Stephen Hawking can’t speak but can still lecture through other means: knowledge of language intact) 

Speech vs. language impairments  

Language impairment:

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Language knowledge, or some aspect of it, is impaired. Difficulties must be in ability to comprehend, repeat or produce meaningful speech, but are not caused by simple sensory or motor deficits.

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Aphasia: a language deficit caused by damage to the brain 

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Many types of aphasia, but two very important ones: Broca’s aphasia (a type of non-fluent aphasia) Wernicke’s aphasia (a type of fluent aphasia)

Speech samples: Broca’s aphasics

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Patient trying to describe the Cookie Jar Theft

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woman …/pa/ no…cleaning …plate … water …pouring …ground…two kids … boy …stool …wobbling stool …give … take it …cookies (samples from Varlokosta & Edwards 2002)

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produce slow, laborious, hesitant speech with little intonation (dysprosody)

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have obvious articulation difficulties (speech apraxia)

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produce many phonemic paraphasias (speech errors that result from phonemic substitution and omissions, e.g. ‘likstip’ for ‘lipstick’).

Wernicke = Fluent Aphasia 

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Fluent aphasics have no difficulty producing speech (it is fluent), but have a great deal of difficulty selecting, organising and monitoring their own language production (Broca’s aphasics are aware of their own language difficulties, Wernicke’s aphasics generally unaware of their deficit).

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Wernicke’s aphasics produce speech that typically sounds very good: there are no long pauses; sentence intonation normal; function words used appropriately; word order usually syntactically correct.

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But the person rarely makes any sense.

Speech samples: Wernicke’s aphasics Yes, well, that’s a .. that’s the ordinary karmiebrayzie and the boy’s falling over up here …up here the …but his…on here .. he’s made a terrible …and she’s tried to push that and she shouldn’t done should she …but I can’t see the boy he’s been around the first time to get hold of her before she’s gone really but er…but stupid really…all the water going down here which should be wrong, you see…I can see that part …then she got XX and he’s got …but there’s nothing here and er…and she’s got this…trying out down here …so he fall over and fall in the water I imagine terrible 

Behavioural/ Social    

Attention Deficit Oppositional Disorder Antisocial Disorder Conduct Disorder

ADD (ADHD) 

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Chronic disability of impulsivity, performance appropriatness Most commonly diagnosed disorder Huge comorbidity with other disorders More males than females

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Highly variable performance Weak short-term memory Impaired sense of time – hindsight or foresight Poor planning Trying harder = frustration Impulsive, not aggressive Blurts out answers, comments can be socially inappropriate Doesn’t learn from mistakes

Academic     

Dyslexia Writing disorder Math Disabilities Visual Problem Memory Difficulty

Personality Disorders     

Avoidance/Paranoid Learned Helplessness Depression Anxiety/Distress Obsessive Disorder

Our response? Bring about changes in the brain: Caring for the brain? Global enrichment? Plasticity? Remedy specific skills?

Options for Educators   

Ignore Accommodate Intervine