Morphosyntax in down’s syndrome: is the extended optional infinitive hypothesis an option?
Melanie Ring and Harald Clahsen
Department of Linguistics, University of Essex

This paper examines the question of whether language impairment in Down’s syndrome (DS) can be characterized in terms of the same linguistic markers that were identified for Specific Language Impairment (SLI). The specific proposal we will assess is that English-speaking adolescents with DS are more impaired in tense-related grammatical morphemes than in non-tense-related morphemes, a dissociation that has been argued to explain the linguistic profile of individuals with SLI. We tested 8 adolescents with DS and various groups of unimpaired children matched for mental age to the DS participants in four elicitation tasks examining the past tense, noun plurals, and comparative adjectives. We found that non-tense related morphemes are affected in a similar way to tense-related morphemes in DS indicating that the linguistic impairment in DS is broader than in SLI and not restricted to the finiteness cluster.

The Comprehension of Number and Gender Information on Pronouns in Dutch Broca’s aphasia
Nada Vasić and Esther Ruigendijk
UiL OTS, Utrecht University, the Netherlands

The comprehension of pronouns is selectively impaired in agrammatic patients (e.g. Grodzinsky et al., 1993, Ruigendijk et al. in press). The present study aims at discerning between two theoretical models (Reflexivity, by Reinhart & Reuland, 1993 and Primitives of Binding by Reuland, 2001) by examining the agrammatic ability to use morphosyntactic features of number and gender when interpreting pronouns. It is possible that this type of information on the pronoun if accessible to the agrammatic patients could aid them in the comprehension. We examined six agrammatic speakers with a grammaticality judgment task. The results show that agrammatic patients do have access to the number and gender information on the pronoun and do use it when deciding on the referent for the pronoun. Our results indicate that morphosyntactic information can be accessed in agrammatism and used to aid the comprehension. We argue that these results can be explained within Reuland’s Primitives of Binding theory in combination with the often-made claim in the literature regarding the limitation of processing resources in agrammatic speakers.

Wh-questions in agrammatism: a movement deficit?
Ineke van der Meulen¹, Roelien Bastiaanse² and Johan Rooryck²
¹Universiteit Leiden Centre for Linguistics (ULCL), 
²Graduate School of Behavioral and Cognitive Neurosciences (BCN), Groningen University

Agrammatic Broca patients suffer from a language deficit related to syntactic movement. These patients have difficulties producing and comprehending sentences derived through syntactic movement. However, patients’ performance on wh-questions shows an intriguing pattern. These constructions involve movement of the wh-word. Still, patients’ comprehension of wh-questions seems to be intact, whereas their production is severely impaired. This raises the question whether the operation of wh-movement is only impaired in patients’ production and does not affect patients’ comprehension. This question is examined in several experiments on French-speaking Broca patients. French allows the wh-word either to remain in its base position or to move. Therefore, French forms a unique environment to examine the effect of wh-movement. The results show that wh-movement affects both the production and comprehension abilities of Broca patients. These results are discussed in light of therapy studies on wh-questions in Broca’s aphasia.

Breakdown at the morphological level in agrammatism
Ria De Bleser¹, Frank Burchert¹ and Philip Rausch²
¹Potsdam University, Germany,
²University of Vienna, Austria

In this study, we intend to take a closer look at the morphological deficit observed in agrammatism from the two perspectives of language production and language comprehension. In order to be able to assess the influence of the syntactic context on the patients’ ability to correctly produce and comprehend morphological material, we administered several tests to a group of Germanspeaking agrammatic patients. Some of these tests aimed at assessing the agrammatic subjects’ morphological abilities in production and comprehension in morpholexical tasks (such as structural analysis of compounds and nominal plural formation), whereas others were intended to provide information on the patients’ capacity to make use of morphology in syntactic contexts of differing degrees of complexity (case assignment in prepositional phrases, noun phrases, canonical and non-canonical sentences; interpretation of ambiguously and unambiguously case-marked constituents in canonical and non-canonical position). The results show that the agrammatic patients were generally able to exploit morphology in both production and comprehension in the morpholexical tasks and in local or canonical syntactic structures. Performance deteriorated, however, when the production or interpretation of morphological markers depended on more complex syntactic configurations. We argue that the breakdown of morphology in agrammatism must thus be considered as the consequence of an underlying syntactic deficit and that the results further provide neurolinguistic evidence for theories of Lexical Morphology.

Different levels of lexical processing – evidence from an fMRI study with normal subjects and aphasic patients
Marion Grande, Francesca Longoni, Verena Hendrich, Frank Kastrau and Walter Huber
Neurolinguistics at the Dept. of Neurology, Aachen University of Technology (RWTH), Germany

Psycholinguistic models assume different levels of lexical processing: the conceptual, the lemma- and the lexeme level. The aim of the present study was to disentangle the neural substrates of these different levels in normal subjects and to investigate mechanisms of functional reorganisation of lexical processing in two aphasic patients. 14 young, right-handed, native speakers of German participated in the fMRIstudy consisting of three different decision tasks each focussing particularly on one level of lexical processing. Additionally we examined two aphasic patients (RK and WR) with left hemisphere lesions. In the normal subjects we found activation for the concept condition in the anterior part of Broca’s area (BA 45) and the frontal operculum (BA 47), for the lemma condition activation was observed in the posterior part of Broca’s area (BA 44) and the lexeme condition revealed an increase in BOLD response in both the anterior and the posterior part of Broca’ area (BA 45 and 44). Behavioural data show that the lemma task was by far the most difficult for both patients. They showed no left inferior frontal activation during this task. Instead activation was observed in left perilesional (RK) and right frontal and parietal areas (WR) respectively.

Linguistic procedure in ‘awake neurosurgery’
Erik Robert
General Hospital Maria Middelares, Department of Neurogenic Speech and Language Pathology & General Hospital Sint-Lucas, Department of Neurosurgery - Ghent, Belgium

By means of a metaphoric introduction on the linguistic evaluation during awake neurosurgery, we show that the purpose of the procedure is total tumour removal (particularly gliomas) without causing morbidity or handicap. In-depth linguistic evaluations, mainly based on a selection of PALPA, AAT and specific “home-made” language tasks, are performed in the preoperative phase to obtain anatomoclinical correlations (functional and structural MRI results and linguistic findings). Pre-operatively, it is of utmost importance to evaluate the patient’s abilities (psychological status) to undergo an awake surgical intervention. In addition, the patient should be trained by means of a detailed scenario of instructions to make him familiar with the intra-operative procedures. The operative linguistic evaluation is based on an individual adaptation (filter) of linguistic test results. During this evaluation, the neurosurgeon stimulates the cortex with a bipolar stimulator. An intensive cooperation between the patient, the aphasiologist and the neurosurgeon is achieved under anesthesiological control. During the procedure a second aphasiologist constructs a colour map of the results. Spontaneous speech is the proof of the pudding in this procedure. Post-operative linguistic evaluations according to a standard protocol are repeated after one week, 6 months and 1 year and 6 months. This specific language procedure seems to offer unique opportunities to reduce the risk of permanent language impairments during an awake craniotomy in functionally important language areas. Follow-up and long-term evaluation of language functions refines the insight in the linguistic and non-linguistic sequellae.

GAWH : Global Aphasia Without Hemiparesis Review and case study
Marleen Corijn
Maria Middelares/Sint-Jozef Hospital, Department of Neurogenic Speech- and Language Pathology, Ghent, Belgium

Global aphasia without hemiparesis (GAWH) is a rare, but very interesting syndrome from the point of view of the dissociation between unimpaired motor function and severe linguistic dysfunction. In such cases, dual lesions in the left cerebral hemisphere would be expected, sparing the motor areas but affecting both anterior and posterior perisylvian language areas. But, several studies show that a dual lesion is not necessary to cause a GAWH. We present a study which demonstrates this, in which patient MVS showed a global aphasia despite the presence of only an anterior lesion. This global aphasia evolved over 1 year to a non-specific aphasia with good writing and repetition. Neurocognitive linguistic assessment at 4 months post onset with the PALPA (Bastiaanse et al, 1995) provided the basis for therapy guidelines.

Reintegrating aphasics into employment.Chances – Limitations – Resources
Martina Hielscher-Fastabend and Kerstin Richter
University of Bielefeld, Germany

Aphasia therapy should not be limited to linguistic and communicative capacities in the social context; therapeutic offers for younger patients should focus on language and communicative job demands to enhance their chance for occupational reintegration after stroke. This article gives some data on long-term reintegration of young aphasic patients having been treated in a rehabilitation center near Bielefeld and it stresses the relevance and necessity of rehabilitation programs beside stepwise reintegration. Only 64% of 25 patients being recommended for stepwise occupational reintegration by an expert team following very sharp criteria for residual symptoms were successful in their former job. Job-oriented therapy and training before reintegration into employment may give additional support for a successful reintegration, but individual therapeutic coaching on the job and the use of modern technology and resources may help patients with even moderate aphasic symptoms in their occupational environment. Two case studies lend support for such a problem-oriented therapeutic coaching approach and illustrate successful strategies for the reintegration process.