Science of Aphasia 5 Cross Linguistic Aspects of Aphasia ...

How autonomous is orthographic encoding? The role of syntax
Tobias Bormann & Gerhard Blanken
Psycholinguistik, University of Erfurt
Introduction
Based on detailed studies of patients, it has been suggested that written production may occur independently of
phonological processes. Firstly, patients have been observed with preserved written naming despite severe oral
naming difficulties (e.g., Blanken, 1990; Bub & Kertesz, 1982; Hier & Mohr, 1977). Secondly, patients have
been reported who make different semantic errors in subsequent oral and written naming tasks (Miceli et al.,
1997, 1999; Rapp et al., 1997). From this observation of superior written naming of single words, the idea of
autonomous orthographic production processes has been generalized to the production of phrases and sentences
(e.g., Caramazza, 1997).
A review of the literature, however, demonstrates that this strong concept of orthographic autonomy receives
weak support at best. Only two cases have been reported with better preserved written production of phrases and
sentences. The majority of patients with superior written naming hardly demonstrate any preserved syntax in the
written modality. Moreover, EB (Levine et al., 1982), who has been claimed to have lost all inner phonology and
still be able to write sentences, is now considered “severly dysarthric” (Caplan & Waters, 1995, p. 192). The
other patient, GG (Miceli et al., 1983), was tested on a very limited set of items only, and few details are
reported.
Patient Background
We will present data from a patient with superior written naming: AB, a former journalist born 1958, suffered
from a CVA and presented with fluent aphasic speech and very mild signs of apraxia of speech. His written
naming was much better than his oral naming (55/60 versus 30/60 correct). He was almost completely unable to
write nonwords to dictation but did not show semantic errors or particular problems with verbs and function
words. In writing as in speaking, he named actions as well as objects, and correctly wrote 25 of 30 function
words to dictation. AB thus did not suffer from deep agraphia.
Methods and Results
AB was tested on four tasks of phrase and sentence production: description of the Cookie theft-picture,
production of sentences, noun phrases and idioms. For the Cookie Theft-picture, AB’s oral production was
paragrammatic: a total of 267 words include all syntactic categories of words and numerous complete sentences.
A high rate of phrases were correct, verbs appeared in second position in main clauses and sentence final
position in sub-clauses. In contrast, his written production was limited to 13 nouns lacking words from all other
syntactic categories.
In a sentence production task, AB produced 8 grammatically correct sentences for 10 pictures in speaking. In
writing, he seemed to copy his previous oral response. Nevertheless, he produced only two correct sentences
which bore great similarities with his oral response.
In a task of naming a picture with the word’s determiner, AB chose the wrong determiner for six words. In a
subsequent written response, he used the wrong determiner in five of these instances. Thus, he again seemed to
copy his previous oral response instead of writing independently.
Finally, AB was dictated idioms to write. He was unable to do so writing only nouns although he acknowledged
that he knew these idioms.
Discussion
In neither task did AB show better results in the written production at the level of phrases and sentences. Instead,
whenever possible, AB seemed to copy his oral response. This is unexpected if we assume complete
independence of orthographic production processes from phonology. AB showed superior written to oral lexical
access and used a pencil in his spontaneous communication frequently. Written superiority was, however,
limited to concrete nouns. His written production was extremely poor in syntactic organization in contrast to his
paragrammatic oral output. This fits with previous reports of patients with preserved written naming.
Thus we suggest that the notion of completely autonomous orthographic processes is premature and not
supported by the available data. Instead, we will claim that syntactic processes as employed in writing sentences
may depend on intact phonological output processes and that written autonomy may be restricted to single word
production, an idea advanced earlier by Bub and Kertesz (1982; cf. Margolin, 1984; Tainturier & Rapp, 2000).