The Fragile Brain

8/14/2019 The Fragile Brain

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The Fragile BrainThe Fragile Brain


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Speech and LanguageSpeech and Language


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Most common causes of

damage to the brain Stroke (also called cerebrovascular accident or CVA): brain is deprived of oxygen because of a blocked major artery, a blood vessel ruptures and

blood is spilled on or in brain tissue, preventing necessary oxygen from reaching that portion of the brain, etc Some diseases like multiple sclerosis (damage to white matter/central nervous system), dementia, etc. Trauma, tumors, and hydrocephalus (build up of cerebral spinal fluid in brain). Traumatic brain injury Some possible causes for developmental

abnormalities in the brain Genetics (e.g. Down Syndrome, Williams Syndrome) Fetal damage (e.g. from excessive alcohol intake by mother, drugs, etc.) Disease (early epileptic seizures can interfere with normal brain development)


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Some possible causes fordevelopmental

abnormalities in the brain

Genetics (e.g. Down Syndrome,Williams Syndrome)

Fetal damage (e.g. from excessivealcohol intake by mother, drugs, etc.)

Disease (early epileptic seizures can

interfere with normal braindevelopment)


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Brain damage may not always affectlanguage

Phineas Gage

Foreman of railwayconstruction gang. In 1848

while working on arailway, an accidentalexplosion caused a tampingiron bar to shoot throughhis head (entered under hisleft

cheek bone) and land 25-30yards behind him.

Except for personalitychanges, language notaffected.


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Speech vs. language

impairments not all speech

disturbances areaphasia

Stephen Hawkingcant speak but can still

lecture through othermeans:

knowledge oflanguage intact)


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Speech vs. languageimpairments

Language impairment: Language knowledge, or some aspect of it,

isimpaired.

Difficulties must be in ability to

comprehend, repeat or producemeaningful speech, but are not caused bysimple sensory or motor deficits.


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Aphasia: a language deficit caused bydamage to the brain

Many types of aphasia, but two veryimportant ones:

Brocas aphasia (a type of non-fluentaphasia)

Wernickes aphasia (a type of fluent

aphasia)


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Speech samples: Brocas aphasics

Patient trying to describe the Cookie Jar Theft

woman /pa/ nocleaning plate water pouring groundtwo kids boy stool wobbling stool give

take it cookies (samples from Varlokosta & Edwards 2002)


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produce slow, laborious, hesitant speech

with little intonation (dysprosody)

have obvious articulation difficulties

(speech apraxia)

produce many phonemic paraphasias(speech errors that result from phonemic

substitution and omissions, e.g. likstip forlipstick).


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Wernicke = Fluent AphasiaWernicke = Fluent Aphasia

Fluent aphasics have no difficultyproducing speech (it is fluent), but have a

great deal of difficulty selecting,organising and monitoring their ownlanguage production

(Brocas aphasics are aware of their own

language difficulties, Wernickes aphasicsgenerally unaware of their deficit).


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Wernickes aphasics produce speech

that typically sounds very good:there are no long pauses; sentenceintonation normal; function wordsused appropriately; word order

usually syntactically correct.

Butthe person rarely makes anysense.


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Speech samples: Wernickes aphasics

Yes, well, thats a .. thats the ordinary karmiebrayzieand the boys falling over up here up here the buthison here .. hes made a terrible and shes tried to

push that and she shouldnt done should she but I

cant see the boy hes been around the first time to gethold of her before shes gone really but erbut stupid

reallyall the water going down here which should bewrong, you seeI can see that part then she got XXand hes got but theres nothing here and erand

shesgot thistrying out down here so he fall over and fallin the water I imagine terrible


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Behavioural/ SocialBehavioural/ Social

Attention DeficitAttention Deficit

Oppositional DisorderOppositional Disorder

Antisocial DisorderAntisocial Disorder

Conduct DisorderConduct Disorder


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ADD (ADHD)ADD (ADHD)

Chronic disability of impulsivity,Chronic disability of impulsivity,

performance appropriatnessperformance appropriatness

Most commonly diagnosed disorderMost commonly diagnosed disorder Huge comorbidity with otherHuge comorbidity with other

disordersdisorders

More males than femalesMore males than females


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Highly variable performanceHighly variable performance

Weak short-term memoryWeak short-term memory Impaired sense of time hindsight orImpaired sense of time hindsight orforesightforesight

Poor planningPoor planningTrying harder = frustrationTrying harder = frustration Impulsive, not aggressiveImpulsive, not aggressive Blurts out answers, comments can beBlurts out answers, comments can be

socially inappropriatesocially inappropriate Doesnt learn from mistakesDoesnt learn from mistakes


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AcademicAcademic

DyslexiaDyslexia

Writing disorderWriting disorder

Math DisabilitiesMath Disabilities

Visual ProblemVisual Problem

Memory DifficultyMemory Difficulty


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Personality DisordersPersonality Disorders

Avoidance/ParanoidAvoidance/Paranoid

Learned HelplessnessLearned Helplessness

DepressionDepression

Anxiety/DistressAnxiety/Distress

Obsessive DisorderObsessive Disorder


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Our response?Our response?

Bring about changes in the brainBring about changes in the brain::

Caring for the brain?Caring for the brain?

Global enrichment?Global enrichment?

Plasticity?Plasticity?

Remedy specific skills?Remedy specific skills?


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Options for EducatorsOptions for Educators

IgnoreIgnore

AccommodateAccommodate

IntervineIntervine

The Fragile Brain

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