Problems With The Classical Aphasic Syndromes

A major limitation of the classical syndromes is that they stay at arm's length from the linguistic details of language impairments. The classical aphasic syndromes basically reflect the relative ability of patients to perform entire language tasks (speaking, comprehension, etc.), not the integrity of specific operations within the language processing system. This is not to say that there are no linguistic or qualitative descriptions of language in the characterizations of the classical aphasic syndromes, only that they are incomplete and unsystematic.

A second problem with these syndromes is that they do not classify many aphasic patients very well. In practice, most applications of the clinical taxonomy result in widespread disagreements as to a patient's classification and/or to a large number of "mixed" or "unclassifiable." The criteria for inclusion in a syndrome are often arbitrary: How bad does a patient's comprehension have to be called a Wernicke's aphasic instead of a conduction aphasic or a global aphasic instead of a Broca's aphasic? Part of the problem is that patients can only be assigned to a single syndrome instead of being thought of as having multiple deficits.

A third problem that the classical aphasic syndromes face is that they are not as well correlated with lesion sites as the theory claims they should be. The correlations do not apply to many types of lesions, such as various sorts of tumors, degenerative diseases, and others. The classical syndromes are only related to lesion sites in cases of rapidly developing lesions, such as stroke; even in these types of lesions, they are not related to acute and subacute phases of the illness. Even in the chronic phase of diseases such as stroke, as many as 40% of patients have lesions that are not predictable from their syndromes according to some studies.

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Adult Dyslexia

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