THE POSSIBLE EXISTENCE OF PHONEMIC READING IN THE
PRESENCE OF BROCA’S APHASIA: A CASE REPORT
TERRY GOLDBERG and DAVID BENJ,WINS
Department

of Pediatrics.

Wayne

State University

School

of Medicine,

Detroit.

Michigan,

U.S.A.

Abstract-This
case study examined phonemic reading and reading comprehension
in the presence of
Broca’s aphasia. The patient. T.B., a 16 yr old male, suffered an occlusion of the middle cerebral artery.
Spontaneous
speech was limited, naming difficulties were apparent, and comprehension
was mildly
impaired. Though the patient could read only a small number of words aloud. he was able to read
silently for comprehension
on a standardized
instrument. Moreover, T.B. was able to match orallypresented pseudowords
to their written analogs, a tinding which suggests that phonemic processing
for nonlexical material was to some degree intact. The results were contrasted to the rrading patterns
usually reported to be present in “frontal” alexia and deep dyslexia. The possible existence of a
dissociation between phonemic processing in reading and speech behavior as well as its mechanism
was discussed.

INTRODUCTION
THE VUESTION of whether the comprehension
of written words requires phonological
mediation
is of continuing
interest to psycholinguists
and experimental
psychologists.
Support for the position comes from the existence of a mechanism which operates both to
produce and receive speech signals [l]. Support also comes from findings that covert
“sounding
out” aids comprehension
of difficult material [2] and that proofreaders
make
more errors on unpronounced
as opposed to pronounced
letters [3]. Also, GLUSHKO [4]
found that “exception” words and pseudowords
took longer to read aloud than regular
words and pseudowords
and that regular but inconsistent
words took longer to pronounce
than regular consistent words. He proposed that words and pseudowords
are read aloud
using similar kinds of orthographic
and phonological
knowledge. The presence of an “inner
voice” has been an oft-reported
phenomenon.
However, there is a considerable
body of
evidence to the contrary. Much of the work is based on investigations
of reaction times to
lexical decision tasks [S, 61 and shadowing tasks [7]. Certainly the existence of Iogogram
systems of writing (Chinese, Japanese Kal~ji) speaks against an invariant speech recoding
hypothesis. Theories in which there is flexible dual encoding (dependent upon the difficulty of
the passage, instructional
technique, and experience of the reader) are promising [6].
Alexia in the presence of aphasia has been intensively studied [8,9]_ More recently, studies
of aphasic reading patterns have attempted to delineate phonological
and nonphonological
reading routes. BENSON[lo], on the basis of the clinical features in 61 patients with relatively
pure Broca’s aphasia and attendant anterior pathology, proposed that a form ofalexia can be
distinguished
from the two types recognized by DEJERINE [1 11. Patients were abIe to read
single words correctly but were unable to name individual letters of words and had difficulty
comprehending
written sentences.
BENSON [lo] suggested they read by visual gestalt.
Sequencing and ability to interpret grammatic structure were also impaired. PATTERSONand
541

M-\RCt:L [ 121 found that two patients with Broca’s aphasia could repeat nonwords but were
unsuccessful in their attempts to read them. Also. on a lexical decision task. the patients were
not slowed by nonwords homophonic
to real words. These patients. stated the authors, had
visual access to the internal lexicon. S-\FFR.&Kand MARIU [ 13) reported on a nonphonological route from print to meaning. They stated that phonemic dyslexia is a result of isolating a
mechanism
which recognizes orthographic
structures from another, damaged mechanism
involved in grapheme-to-phoneme
conversion.
Their patient. V.S., retained a reading
vocabulary estimated at 16,500 words but had difficulty reading nonsense words, recognizing
rhymes and homophones,
and accessing lexical entries from homophonic
equivalents.
Performance
appeared to proceed by matching letter strings with meanings. Interestingly,
the patient was able to match orally presented pseudowords with their written analogs at the
7090 level. The retention of this ability in a context of severe language deficits is not easily
explained. K.F., a patient with phonemic dyslexia studied by SH,.\LLICE and WA~RISGTOS
[ 143, was better able to orally read concrete nouns than abstract nouns. Also, he was largely
unable to read function words. Errors were of the “visual” variety. K.F. uas not tested on
pseudoword reading. S.\FFRA’: [ 151 has further stated that the reading of deep dyslexics is not
configurational
but is based on orthographical
regularities
in letter strings. The model,
however, has difficulty accounting
for reading (or matching) of pseudowords.
ALBERT er nl. [ 161 stressed the necessity to assess silent reading comprehension,
as well as
expressive output in aphasia. Their patient. J.H.. was unable to sound out written words he
could not immediately
identify. Yet, while the phonemic
element of the written word
appeared to be lost to him, the whole word as a visual configuration
had semantic value. J.H.
showed he understood
the meaning of words in a number of challenges. The findings
demonstrated
that the inability to name a symbol is not a sufficient test of reading and that
phonemic and semantic processes may be distinguished
in the processing ofwritten language.
It has been suggested that the right hemisphere might support reading abilities using a
different, visual-spatially
oriented process. YAX~AD~RI[ 173 found that Kclnji logographic
reading was relatively well preserved after a left hemisphere injury rendered Karm reading
dysfunctional.
However, ELMAN et al. [ 181 found that the concreteness of Kmji nouns effects
the direction of lateral asymmetry.
The distinction
between reading aloud and the ability to comprehend
written material is
essential. Patients with deficits in expressive language may have relatively stronger abilities
in the comprehension
of visually processed materials [19, 201. The present case, reported
below, not only highlights this distinction but demonstrates
that despite expressive aphasia,
naming difficulties, and a mild comprehension
deficit, the patient, T.B., was able to match
unfamiliar
written pseudowords
to their spoken analogs.

PATIENT

INFORMATION

Thr patient. a 15.6 yr old white male, was in good health until the date ofadmlsslon. AI school. after running track,
he became Itmp. especially on the right side of his body. collapsed, and was taken to a communlt> hospital. Though
conscious, he was unresponsive to verbal stimuli. but responsive to painful stimuli. His spssch was sparse and
described as “slurred”. Transferred to Children’s Hospital of Michigan. he ~\as awake and alert but did not follow
verbal commands or answer questlons. HISspeech consisted of single words. usually Inapproprrate.
Weakness ofthc right side of the body and the right face were present. Sensation was diminished on the right side.
A Babinski r&x
was present on ths right side and a right hemmnopia uas also present. On the day after admission,
the patlent became more responsive and alert and was able to comprshsnd simple commands. The patient has
continued to improve in the neurological and linguistic areas. After one week the patient v.as transferred to the
rehabilitation
unit where he received dail) speech, occupational and physical therapy, and special education.

THE

POSSIBLE

EXISTENCE

OF PHOFEYIC

REtADlNG

IN THE

PRESENCE

OF BROCA’S

APHASIA

FIG 1. Left internal carotid arteriogram
demonstrating
a basal occlusive disease of the middle
cerebral artery (MCA) and posterior cerebral artery (PCA).
The arrow indicates an occlusion at the base of the left MCA. The artery supplies the greater
portion of the convexity of the cerebrum as well as the basal ganglia and internal capsule. Superior,
inferior and medial regions are unaffected.
The second arrow indicates a diminished flow and distal occlusions (including a branch to the
inferior temporal lobe) of the left PCA. Infarcted regions include the posterior pole, the medial
posterior third of the left hemisphere, and the inferior portion of the temporal lobe. Branches to the
basal ganglia and midbrain would also be affected.

549

THE

POSSIBLE

EXISTENCE

OF PHONEMIC

READING

IN THE

PRESENCE

OF BROCA’S

APHASIA

551

A number of studies were completed three days after the onset of the symptoms. No hematological
or CSF
abnormalities
were found. An arteriogram
revealed complete occlusion of the left middle cerebral artery 5-6 mm
from its origin (see Fig. 1). The left posterior cerebral artery’s flow was diminished and distal branches were
occluded. The etiology of the occlusions was unknown. Collateral flow into the left middle and posterior arterial
territories occurred via hypertrophied
leptomeningial
feeders from the left anterior cerebral artery complex. The
angiographic
pattern was similar to that reported in other basal occlusive arterial vascular diseases [Zl]. An E.E.G.
showed random irregular slow waves and rhythmic discharges of 3 to 4 Hz in the posterior left cerebral hemisphere.
Occasional
sharp discharges in the parietal, occipital, and temporal regions were noted. The CT scan revealed
displacement of the lateral ventricles rightward and a hypodense area deep within the left cerebral hemisphere in the
region of the thalamus, basal ganglia and internal capsule.
The patient’s birth history was unremarkable.
At 3 yr of age he had a febrile seizure. School achievement was fair.
The patient had never been retained, nor had he received special education services. However, his mother thought
him to be one or two grades behind in reading.

NEUROPSYCHOLOGICAL

TESTING

Neuropsychological
testing took place over a two week period, commencing approximately
three weeks after the
cerebrovascular
accident. The patient was alert, oriented and cooperative
throughout.
He was not distracted by
extraneous stimuli and was able to work in a goal-directed
manner.
Spontaneous
speech was limited. Phrases were short and usually telegraphic.
Infrequent literal and verbal
paraphasias
were noted. Gross word finding difficulties were apparent. Comprehension
of spoken language was
good on simple material and more complex material that did not involve prepositions
and conjunctions.
Shortly
after the stroke, the Porch Index of Communicative
Abilities in Children [22] was administered.
In general, verbal
and written responses were wrong, unrelated, unintelligible,
or perseverative.
However, T.B. was able to match
written words to objects, though he was unable to follow written directions involving prepositional
phrases.
When seen initially for neuropsychological
testing, the patient had no difficulty performing praxic tasks, including
those of an ideational nature. The Purdue Pegboard Test [23], an instrument used to assess lower level psychomotor
performance,
was administered.
Nonpreferred
left hand skill was within normal limits. Unsurprisingly,
preferred
right hand performance
was markedly subnormal
at three standard deviations below the mean. On the Double
Simultaneous
Stimulation Test [24], performance
was inconsistent. On twenty challenges, four errors were made.
The patient performed between a 7.5 and 8.5 yr level on the Right-Left Orientation
Test of the McCarthy Scales
[25]. Finger gnostic abilities were unimpaired. A right hemianopia was diagnosed upon confrontation
of the visual
fields, but no right-biased
error pattern on visual spatial material was noted.

Testing of Language Abilities
Comprehension
The patient was administered
the Peabody Picture Vocabulary Test [26], a measure of
receptive vocabulary in which the person is asked to point to one of four pictures which best
“describes” an orally-presented
word. Peabody Mental Age was 11.33, IQ was 77 and
percentile was six. On the Token Test-Part
V [27], the patient successfully followed 12 of 22
commands (e.g. Touch the blue circle with the red rectangle). Longer, sequenced commands
proved most difficult for T.B. Normal subjects above the age of 10 rarely commit more than
two errors. T.B.‘s performance
on the Auditory Discrimination
Test [28] was within the
average range, at percentile 50. Thus, T.B. was able both to discriminate
sameness or
difference and access the phonological
concept underlying such distinctions. (T.B. responded
by pointing to the printed words “same” or “different”.)
Expressive language
Visual-oral naming. In general, naming was severely impaired upon visual confrontation.
Spontaneous
expressive speech was limited and phrases were short and stereotyped.
No
circumlocutions
were apparent.
A sample of T.B.‘s expressive language is presented in
Table 1.
A naming test [29] consisting of 30 items was administered.
T.B. was able to verbally

TERRY GOLDBERG and DAVID BESJA,WINS

552

Table
Visual stimulus
TAT card
Farm scene

TAT card
Harbor scene
TAT card
Man embracing woman
Clothes on line (picture)
Shovel (picture)

I. Expressive

language

samples
Language

sample

She’s going to school. That girl . other one. Watching him. The man is
watching.
I can’t say tt. The house. I can’t say it. (Points). The house. The
house. Urn
that’s it.
Boats. The house. The bridge. The girl. The sun. They’re using them. I don’t
know. Holding a barrel. Whatever.
The man. The lady. I can’t say no more. Arm. I can’t say nothin!
The clothes. I
out and drv.
You use the shovel..
to
.-in the
I can’t say it.

identify eight of 30 colors, utensils, body parts and household items. The Oldfield-Wingfield
Picture Naming Test [30] was administered
with similar results. T.B.‘s most frequent reply
was, after briefly initiating a sound, “No, I can’t say it”. Thus, he misidentified 32 of the 36
pictures. When cued phonetically
after failures on the first 18 pictures, he succeeded on four
more items. Contextual cueing did not lead to great accuracy. Over the second half of the test,
contextual cueing led to a single additional
success. Follow-up phonetic cueing led to no
further accurate responses. Paraphasic
errors were infrequent.
Serial speech. When asked to recite the days of the week, T.B. said, “Monday, Tuesday,
Wednesday, Thursday, Friday, Saturday,” then stopped. After the cue, “One more,” he said,
“Sunday.” Alphabet recital was disturbed. After proceeding from A to T flawlessly, T.B.
hesitated and then said, “U, R, S, T, E, V, E.” T.B. was able to count from 1 to 20 without
undue difficulty. Verbal fluency, as assessed by requesting the patient to name words in a
given semantic category, elicited markedly impaired performance.
Written

language

Reading

aloud. The patient
was administered
Level II Reading of the Wide Range
Achievement
Test [31]. He had no difficulty visually matching upper-case letters, though
naming letters was quite difficult for him. Six of thirteen were correct. T.B. was able to read
the words “milk” and “in” aloud but no others before the test was discontinued
after 12
consecutive failures. His grade level was 1.7 and percentile was 0.06.
The Peabody Individual Achievement Test-Reading
Recognition subtest [32] elicited a
performance
level of Grade 0.03 (below percentile 1). T.B. could match letters and words
visually. Because T.B. could only name one of six letters, the test was discontinued.
Comprehension in reading. Of five simple written commands (e.g. Touch your right eye),
T.B. performed all flawlessly. The PIAT Reading Comprehension
subtest [32] elicited a
performance at the Grade 3.2 level (slightly below percentile 1). The patient had some facility
matching (via a pointing response) a written sentence to that one picture of four which best
corresponded
to the written sentence. On the written version of Part V of the Token Test,
T.B. was able to follow 14 of 22 commands
(which represented a slight increase over aural
performance).
To further test the patient’s ability to match oral, visual and written stimuli, he was
requested to match a written stimulus to another stimulus. When matching a written word to
one of the three spoken words, T.B. worked without error on all five items. For example,

THE POSSIBLE EXISTENCE OF PHONEMIC

READING

IN THE PRESENCE 0~ BROCA’S

APHASIA

553

presented with the written word “comb”, three words-“come”,
“has” and “comb”-were
spoken by the examiner. The patient was then asked to indicate whether the first, second, or
third was equivalent to the written stimulus. Reversal of the above task in which one word or
letter presented orally was to be matched to one of three written words (one visually
confusable, one phonetically confusable, and one dissimilar to the target) also elicited
flawless performance. Moreover, the patient had no difficulty matching a single picture to the
one of four words to which it corresponded. Performance on ten consecutive items adapted
from the Peabody Picture Vocabulary Test (binocular through globe) was perfect.
The discrepancy between the patient’s expressive output and the ability to read silently for
comprehension was striking. For instance, on the WISC-R Information subtest [333, in
which the person is asked to respond verbally to questions regarding commonplace
knowledge, T.B. obtained a Scaled Score of 1. When the test was adapted so the patient had
to select his answer from one of four written responses to a question, T.B. obtained a Scaled
Score of 10. In fact, he was able to answer such questions as, “Who discovered the electric
light bulb?’ and “Name the two countries that border the United States”, in this way.
Pseudoword reading. To determine if the patient could read nonfamiliar words that were
orthographically regular, T.B. was presented with pseudowords spoken by the examiner.
T.B. was asked to point to one of four written words which best correspond to the initial
spoken stimulus. T.B. worked at the 80% level ($). For instance, after”lork” was spoken, T.B.
pointed to the written version, disregarding “bork”, “lark” and “nep”. (One of the choices
rhymed with the target word, the other was different only in its medial vowel, while the third
was unlike the target word. Order of alternatives was random.) When the format was
changed so that T.B. had to indicafe which of 10 written pseudowords was being spoken,
performance fell only slightly to the 70% level.
Graphic and spelling skills. The patient was able to copy written material only with
difficulty. Sometimes he used his left hand, but in general preferred his right, paretic hand.
The patient’s productions are pictured in Fig. 2. Regarding written fluency, the patient was
requested to write as many words as he could in a given semantic category. He produced a
maximum of five. Written spelling of spoken words on the Wide Range Achievement Test
was at a Grade 2.4 level (percentile 1). Though T.B. could spell such words as “circle” and
“shout”, he could not undertake more difficult items (e.g. “heaven” or “educate”). The patient
was easily able to point out the written version if they were spelled aloud by the examiner. He
could not spell aloud even simple words that were spoken to him.
Verbal memory

Requested to repeat digits, the patient was able to vocalize three digits after the examiner
had done so. When asked to point to written numbers, the patient’s digit span increased to
five. The patient’s ability to repeat sentences was severely impaired, below the level of a 6 yr
old. He was able to repeat a sentence ofsix but not eight syllables. Long-term verbal store was
apparently intact, as performance on an adaptation of the WISC-R Information subtest was
within normal Iimits.
Testing of Visual Spatial Abilities

The WISC-R Performance tests were administered and T.B. obtained a Performance IQ of
80 (percentile 9). Scaled scores were as follows: Picture Completion-+
Picture
Arrangement-+
Block Design-8, Object Assembly-12, and Coding-3.
T.B.‘s performance on the Raven Coloured Progressive Matrices [343, a test of nonverbal

TERRY GOLDBERGand DAVID BENJAMISS

554
Copying

In an attempt
Right

such data

hand:

I studied
Left

to collect

three

types

of pencil

hand:

Dictation

The

grass

is green over the hill

Right

hand:

Left

hand:

FIG. 2. Graphic productions.

visual synthesis and ideational reasoning, was above the mean level of the performance of an
11 yr old (the ceiling of the test). The same held true for T.B.‘s work on the Southern
California Figure-Ground
Test [35] in which masked embedded figures had to be matched
to an array of target shapes. It should be noted that both the Raven and Figure-Ground
tests
involve only a minimal motor component
in the response mode. On the Benton Visual
Retention Test [36], T.B.‘s immediate visual memory was in the Defective range. He was able
to reproduce five designs without error. The patient had no difficulty copying any of the
designs, including those on which he erred during the memory administration.

THE

POSSIBLE

EXISTE\CE

OF PHONEMIC

READING

IN THE

PRESESCE

OF BROCA‘S

APWSIA

555

DISCUSSION
Alexia cannot be defined as the inability to name written material. The patient described
above, T.B., was unable to read linguistic material aloud but was able to read silently and
comprehend
written sentences, as well as indicate which written pseudoword corresponded
to its spoken analog.
In summary. the patient’s spontaneous
speech was limited. Vocalizations involved short phrases and single words.
Overall, the patient‘s comprehension
was mildly impaired.
While his performance
on the Token Test was
subnormal,
he was able to understand
questions about commonplace
information.
match pictures to orally
presented
words on a receptive vocabulary
task, and follow spoken directions.
Also auditory
phonetic
discrimination
was intact. Naming abilities upon visual confrontation
were severely impaired.
The patient could read only a small number of words aloud. PIAT Reading Recognition performance was below
percentile 1. However, T.B. was able to read silently for meaning as PIAT Reading Comprehension
(in tvhich a
sentence was first read silently. then matched to one of four pictures) was approximately
at percentile I. T.B. could
also match a written word to one of four spoken words and a spoken word to one of four written words. Moreover.
T.B. was able to indicate which of an array of unfamiliar one- and two-syllable pseudowords
corresponded
to its
spoken version at a level well above chance performance.
The patient’s ability to spell aurally received words was minimal and appeared to reflect his naming difficulties.
Written spelling was at a somewhat higher level, and graphic abilities for copying visually presented material were
better still.
Verbal repetition of digits was grossly defective. However, the patient’s performance
increased considerablyfrom three to five digits-when
he was allowed to point to numberssequentially.
His ability on a sentence repetition
task was also severely limited. Verbal tluency in spoken and written response modes was defective as well.

The patient can be considered to be manifesting Broca’s aphasia and, because of his age, he
can be considered adult in regard to language lateralization
[37]. The amount of speech on
the part of the patient was limited and it was dysfluent and telegraphic in nature with a
disturbed
grammatic
structure.
Severe naming difficulties primarily
involved defining
articulation
programs rather than semantic retrieval. (Anomia occurs with some frequency
in frontal, as well as temporal, lesions [38].) T.B.‘s retrieval deficits could be attributed
neither to phonetic discrimination
recognition or end-point articulation
problems. Auditory
phonetic discrimination
was intact; speech was intelligible
and only slightly dysarthric.
Rather, the patient’s error pattern appeared
to represent
a breakdown
in the motor
programming
of phonemic articulation.
The region dependent
upon the middle cerebral
artery includes the frontal speech area, the sensorimotor
strip, and the lateral aspect of the
temporal lobe. The clinical profile and the presumed extent of the infarction conformed
closely to motor aphasia that MOHR [39] has termed a syndrome of the upper division of the
left middle cerebral artery.
JACKSON [403 reported that writing is disturbed
in nearly every case of aphasia and that the
degree of writing defect varies with the degree of speech defect. S~IITH [41] reported that
writing is typically more disturbed than speech in aphasia. The present case differs somewhat,
in that the patient’s writing (in copying and spelling) was at a level greater than oral reading.
Also, the patient could write words he could not say.
The discrepancy between reading capacity as indicated by routine testing procedures and
T.B.‘s capacity to read silently and demonstrate
comprehension
of material has been
commented upon. The patient’s ability to process pseudowords with the possible implication
that they were being matched to an articulatory
command program suggests unsuspected
compensatory
potential, given the verified damage to Broca’s area. That the supplementary
motor area, which lies outside the region of the middle cerebral artery, takes on the role of an
encoder in reading might be considered.
Regional cerebral blood flow studies have
demonstrated its activity in reading and internal speech 142,433. Electrical stimulation ofthe
area during speech leads to vocal arrest; damage to transient or permanent aphasia.

556

TERRYGOLDBERG
and D-\VIDBEUJ~VIN

In short. the results suggest that when challenged by an orthographically
regular nonword
with no lexical address, the patient was able<0 initially match a sound trace or its acousticphonemic equivalent to the phonemic analo g generated by the visual graphemic array: (It
was unlikely that an aurally received pseudoword generated a representation
ofa letter array,
which could then be matched to a written target word. If this were so, T.B.‘s spelling would
probably have been better.) Even when confronted by individual letters, the patient could not
name a majority of them. Yet, phonemic elements which he could not express still had
analytic value for him. SAFFRAS [13] stated that an important
characteristic
of deep or
phonemic dyslexia is the inability to read nonsense words or real word homophones.
Those
deep dyslexic patients described in the literature [ 12-153 tend to show considerably
worse
performance
than T.B. on tasks requiring
non-lexical
translation
from grapheme
to
phoneme, but their reading comprehension
is at least as good as T.B.‘s and their oral reading
better. In addition, phonemic dyslexics have great difficulty reading functor and abstract
words. While T.B.‘s reading of real words might involve use of orthographic
regularities or
(less probably) configurational
cues, his reading of orthographically
regular letter strings
that were meaningless
suggests the availability
of a phonological
route. Certainly, T.B.‘s
reading of real words might have been mediated by knowledge of orthographic
rules.
Phonemic processing in expressive language and phonemic processing in silent reading
may be distinct, at least in this aberrant situation. DEROUESNEand B~AUVOIS [44] made a
similar point. They stated that though some patients make phonemic paraphasias
when
speaking, they are able to point out written pseudowords
upon request. Since the patients
could carry out phonemic
processing
necessary for analytic reading, they believed a
dissociation
between phonemic processing in reading and speech behaviour was present.
Though T.B. might be considered to have sustained a frontal alexia, he did not read by
visual gestalt. Like a large minority of frontal alexics, T.B. was able to comprehend
written
sentences, though prepositions
and conjunctions,
as well as sequencing, proved difficult for
him.
The argument could be advanced that the pattern of spared and impaired abilities noted in
T.B. simply derives from the recovery process and is transient.
If one is in agreement,
however, with the objectivity of the findings, then the phenomenon
might be considered
“actual” and so it requires an explanation
irrespective of the time period in which it occurred.
It is possible that the condition
might also exist in a stable form. At the present time it is
unknown whether the profile observed will continue to evolve or remain static. Another issue
concerns the equivalence of the tests. Some were standardized,
others were not. The results of
widely used instruments
were reported in percentile form so that comparisons
could be made
more easily, though it is recognized that equating scores based on distinct standardization
groups is less than optimal. The validity of the measures developed for clinical use hinges on
the fact that the assessment instruments
required different modes of response, though their
actual content appeared to be of similar or, in selected instances, precisely the same difficulty.
It remains to be seen whether the findings delineated above will be replicated in other patients
with occlusions of the left middle cerebral artery.

,4ckno&rlgemenrs-We
wish to thank Dr MICH~EI.
NIGRO for allowing us to examine his patient and providing us
with neurological results and MS JEANNIE SLOWLY for administering and interpreting the PICAC test of linguistic

functioning.

THE POSSIBLEEXISTENCEOF PHONEMICREADI>G IN THE PRESE\CE OF BROC4.S .APH.ASI.a

557

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TERRY

BE\J.AVINS

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RESUHE
-_____

Chez “o sujee pr6sentant tune aphasle de aroca, on
la lecture vhon6mlque et la compr@hensfon du mat&r1e1
lu.
Le malade,
T.S.,
.I; gar~on de lk ans souffre
d’une
occlusfon
de l’atc&re
cerehrsle
moyenns. Le Langage sporItanE
Qtatt
1lmlrE avec des diEEiculc&s de d&wmlnat(on et une comR(en que le mllade ne pat
prehension
falblement
perturb&.
llre
.3 volx hauce qu’un pelt
nombre de m)Cs. (1 pouvait lice
et comprendte ce qu’tl
Ilsalr.
En outre, T.6.
s~lencleusement
6LaIt capable d’apairer
des logatones pr6sentis ocalamenc avec
a

exam Ii&

avec le type de lecture
hablcuellemenc
rOsu1 cats
CO"ZCR*Ce"t
ec dans la dyslexir
proEonrencontr6 dans l’alexle
“frontaled?.
possible
d’une
dlssoclaclon
e”Lre
le trait+i’exls~ence
ment pho&mlque dans la lecture et le comporrement de langage.
a(ns( que 9es m6canismes, SW% dkxut$s.

Zusammenfassung:

In dieser

Fallstudie

bei

Brow-Aphasie

einen

VerschluR

wurde

das

phonematische

untersucht.
der

Lesen

Dei- Patient

A. cerebri

media.

T. B.,

und das

Spontansprechen

es bestanden

Benennungsstdrungen,

das

Sprachverst?indnis

der

Patient

Zahl

van WGrtern

Lijsung

van Aufgaben

der
ihrem

Lage.

Dartiber

Schriftbild

eine

bei einem
hinaus

war

zuzuordnen.

Verarbeiten

nichtlexikalischen

Ergebnisse

wurden

bei “frontaler”

kleine

dem

Alexie

standardisierten
T. B.

fshig,

Dieser

Befund

Materials

Leseverhalten
und Tiefendyslexie

Dissoziation

zwischen

phonematischer

und deren

Mechanismen

diskutiert.

laut

Test
akustisch
zeigt,

16 Jahre

war

Obwohi

nur

Lesesinnversttidnis

mXnnlxh,

war

m2Rig

lesen

konnte.

dargebotene
daR das

beeintrgchtigt.
war

er zur
in

PseudowGrter

phonematische

AusmaO

gegenubergestellt.

das

vorliegt.

erlitt

auf LesesinnverstPdnis

in gewissem

Verarbeitung

alt,

eingeschrankt.

intakt

war.

Die

normalerweise

Es wird

eine

beim

Lesen

m6gliche
und Sprechen