In the article, we consider literal paraphases with aphasia. What do such deviations mean?
Paraphase is a feature of aphasia (loss of speech), the characteristic symptoms of which are disturbed utterances, replacing correct syllables, letters and words with incorrect ones. At the same time, the patient replaces the correct words in the sentence with completely unnatural and incomprehensible in a specific use and in a specific situation. In addition, with this pathology, there is a significant acceleration of speech, which contributes to significant difficulties in understanding the conversation.
Many are interested in the fact that these are literal and verbal paraphases.
Neurological aspect of the disease
The occurrence of literal paraphase can be due to a number of neurological reasons and can be observed in people of various ages. The causes of the development of such a disorder in adult patients include various lesions of the cerebral cortex:
- cerebrovascular accident;
- injuries
- infectious pathologies affecting the brain;
- consequence of thromboembolism;
- cysts and other neoplasms of the brain;
- rupture of aneurysm.
In childhood, damage to the speech center of the brain, which can occur as a result of:
- maternal injuries during pregnancy;
- fetal hypoxia;
- spontaneous abortion;
- asphyxia of the newborn;
- birth injuries;
- intrauterine infection;
- somatic diseases of the mother at the stage of bearing the fetus.
The basis of literal paraphase is a violation of the neuropsychological or neurophysiological background - this may be a disorder of praxis, phonemic hearing, articulatory apparatus, which, in turn, leads to impaired speech, perception, writing, reading, and counting.
Other types of paraphase
There are only three main types of literal paraphase, but there is no clear line between them, since the forms can be combined with each other. Thus, the literal form of pathology is closely related to its types: verbal and mirror. Verbal paraphases are phenomena in which one word in speech is replaced by another, and these words are in the same associative field. For example, instead of the word “elbow”, they say “knee”, “chair” - “table”, etc.
A similar phenomenon is often observed with acoustic-mnestic aphasia and is distinguished by the ability to reproduce words and the inability to repeat three or four words at once, related in meaning. In such patients, an increase in speech activity may be noted, or vice versa, its inhibition is manifested. Difficulties caused by the semantic fuzziness of words, partial or complete misunderstanding of their meaning, contribute to the repeated use of paraphases: replacing letters in words, words in a sentence, combining several words together (example: “knife” - knife and fork). Incorrect use of pronouns, changes in nouns in number and gender, inflections of verbs may also occur.
Literal paraphase manifests itself in the form of replacing a sound or letter in a word with another. There is a similar phenomenon both in writing and in oral speech. Depending on the degree and area of the lesion, the pathological condition can acquire different features. Thus, in the case of sensory aphasia, sounds are replaced by phonemically close ones (“b” to “p”, “c” to “z”). In the case of motor aphasia, sounds are being replaced by similar ones (“l” to “n”, “m” to “b”).
A patient with such a disease can not only confuse sounds, but also rearrange letters in one word. Often it is difficult for him to build a sentence if it is necessary to search for relevant words. Thus, speech itself slows down, with fragments of phrases and repetition of words. When writing, significant deviations are also observed: its correctness and hand movements are violated. An example is a voice - an ear, a holos, a voice, etc.
The paraphase that occurs against the backdrop of alalia (deep lack of speech due to damage to the cerebral cortex) is characterized by the loss of previously present speech, in addition, there is damage to the centers of the brain responsible for speech during intrauterine development.
Mirror paraphase is characterized by the fact that the patient pronounces the end and beginning of the word correctly, and its middle - from right to left. It is characteristic that people who are inherent in such a disease very quickly read words that are written in a mirror, and read them correctly. In certain cases, the word is read as if it is divided into several parts, where the last and first parts are pronounced correctly, and the middle not only flips over, but also doubles.
Examples
When considering types of literal paraphase in speech therapy, such deviations can be observed:
- If the word sounds - “rook”, then in the verbal form of paraphase, a person will designate this word as “swift”, “woodpecker”, “raven”.
- In literal form - “doctor”, “luck”, “grak”, “grap”.
- With a mirror - “garach”, “garch”.
Correction and restoration of speech functions
Treatment of any form of paraphase, including literal, as well as any varieties of aphasia, consists in the use of neurorehabilitation (compensation and restoration of higher mental functions, in particular speech). The system of therapeutic measures usually includes:
- physiotherapy;
- occupational therapy;
- drug treatment;
- psychotherapy
- rehabilitation classes in the field of speech therapy;
- psychological and social methods and adaptation.
Custom scan
Currently, medical specialists prescribe a special scan for patients with literal paraphase, according to the information results of which it is possible to precisely determine the areas of brain damage and their degree, and then proceed with the appropriate treatment, during which not only the causes of their occurrence are eliminated, but also an opportunity to prevent further development of the pathological process.
Speech recovery today is carried out by a neuropsychologist or a speech therapist-aphasiologist. The greatest effectiveness is shown by classes, to which the use of nootropic medications is connected:
- "Phenotropil";
- "Neotropil";
- Encephabol;
- "Cerebrolysin."
Family member training
However, the correction of literal paraphase does not end there either: all members of the patient's family must undergo special training from a speech therapist-aphasiologist, receive some instructions on the features of treatment and rehabilitation of the patient. Thus, only comprehensive measures can contribute to significant positive results. The time of therapy can significantly drag out over time - sometimes even up to five years, however, despite the modern methods and treatment techniques, no specialist can guarantee an absolute result. Even the most advanced technology in certain cases cannot restore the ideal state of speech.
Conclusion
Thus, a fairly common phenomenon, literal and other types of paraphase, when a person changes letters in words, uses them incorrectly in meaning - this is a signal to consult a qualified doctor who, after special diagnosis, can determine a specific factor for damage to the cerebral cortex and prescribe therapy and rehabilitation. This is especially important in childhood, when some parts of the brain are still continuing their formation processes.