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The relative contribution of gesture to communication in aphasia : a case study Hirsch, Fabiane Monique

Abstract

Communication involves the use of many modalities. Communication modalities used for expressing information include speech, gesture, writing, and others. Although speech is usually considered the primary modality for expression of information, other modalities, such as gesture, are often integral parts of communicative exchanges. The purpose of this study was to examine the expressive communication ability, through different modalities, in an aphasic subject who demonstrated exceptional use of gesture in spontaneous conversation. Findings were discussed within the context of two hypotheses: (1) a central organizer exists which coordinates the output modalities; and (2) the modalities are differentially impaired for this subject, but symbolic functioning is relatively intact. This investigation involved a single subject. Videotapes were made of the subject describing sequences of pictures. Modality use (speech, gesture, or written) was restricted in different attempts at sequence description, so that the subject described each sequence in each individual modality and in all possible combinations of modalities. Judges observed the videotapes of the subject (and written material produced by the subject, when writing was allowed), and recorded the information they perceived. The information recorded by the judges was the data used for analysis of the subject's communicative ability through different modalities. Findings supported differential impairment of modalities for this subject. Communication through speech was more severely impaired than communication through gesture or writing. Symbolic functioning appeared to be relatively intact. Coordination of the output modalities was demonstrated. It was proposed that a central organizer is responsible for this coordination. A brief outline of how such a central organizer might function is presented. Clinical implications of the findings are discussed.

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