Lecturer:

Rizki Amelia, M.Pd

Psycholinguistics
Language disorder: Brocas Aphasia

Name of members:
Suciati Anandes
11214201482
Class E/6

State Islamic University Of Sultan Syarif Kasim Riau

Faculty Of Education And Teachers Training
English Education Department
2015

PREFACE

Alhamdulillahhirabbil Alamin, the writer have finished writing this

paper. The writer should not forget Allah Almighty, The Lord of the universe
Who has given his guidance and blessings, which finally the writer could
complete and keep this paper existing. This paper entitles: Psycholinguistics :
Language disorder: Brocas Aphasia.
This paper was one of the duties and requirements to complete
Psycholinguistics Final term. Thanks to Mrs. Rizki Amelia, M.Pd and all of
writers friends who have supported for finishing this task.
Finally, the writer realizes that this paper is still far from perfection.
Therefore, readers comments, criticisms, and constructive suggestions will be
highly appreciated.
The writer expect this may be useful for all of us, and to contribute ideas
for the readers, especially the expected goals can be achieved, Aamiin.
Pekanbaru, June 8th, 2015

The Writer

Table of contents
Preface 2
Table of contents 3
Chapter I

Introduction 4

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Formulation of the problem

Purpose of the report

Chaper II6
Aphasia 6
Incident and prevalence
Sign and symptoms
Causes

7
7

Kind of Aphasias
Brocas Aphasia

10

12

Historical of Brocas Aphasia 12

Stories of Brocas Aphasia Patients 13
Communicate with an brocas aphasic person
Chaper III
Conclusion
References

15

16
16
17

CHAPTER I
A. Introduction
The human brain is well protected by the skull. Yet there are a
number of possible ways for the brain to become injured. When the
brain is injured, the problem of the patient will vary depending on the
extent and location of the damage. A particular injury might cause
only visual problems or problems only in moving certain sets of

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muscle. The injuries of particular interest to us in this paper are those

that cause problems with language. Language processing refers to
the way human beings use words to communicate ideas and feelings,
and how such communications are processed and understood. Thus it
is how the brain creates and understands language. Most recent
theories consider that this process is carried out entirely by and inside
the brain.
This is considered one of the most characteristic abilities of the
human species perhaps the most characteristic. However very little is
known about it and there is huge scope for research on it. Most of the
knowledge acquired to date on the subject has come from patients
who have suffered some type of significant head injury, whether
external (wounds, bullets) or internal (strokes, tumors, degenerative
diseases).
The patient who has brain (head) injury and gets problems with
language will cause language disorder. Language disorders or
language impairments are disorders that involve the processing of
linguistic information. Problems that may be experienced can involve
grammar (syntax and/or morphology), semantics (meaning), or other
aspects of language. These problems may be receptive (involving
impaired language comprehension), expressive (involving language
production), or a combination of both. Examples include specific
language impairment and aphasia, among others. Language disorders
can affect both spoken and written language, and can also affect sign
language; typically, all forms of language will be impaired. Note that
these are distinct from speech disorders, which involve difficulty with
the act of speech production, but not with language.
Language disorder, known as aphasias, are presumed to have
as their cause some form of damage to some specific site in the
hemisphere where language is

located. Such damage causes

characteristics problems in spontaneous speech, as well as in the

understanding of speech and writing. An extensive study in 1967 by

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Benson served to upport the traditional distinction that aphasias are

generally classifiable into two groups, Brocas aphasia and Wernikes
aphasia, by finding abnormalities in the two areas. Brocass aphasia is
located in the frontal lobe of the left hemisphere and wernickes area
is in the temporal lobe of that left hemisphere. 1 In this paper we will
discuss more deeply about Brocas aphasia.
B. Formulation of the problem
There are some problems which are going to discuss in this
paper:
a.
b.
c.
d.

What is aphasia?
What is Brocas aphasia?
Who is patient of Brocas aphasia?
What are the treatments, symptoms, and study case about
Brocas aphasia?

C. Purpose of the report

Based on the formulation of the problem above, the purpose of
this report can be conclude as follows:
a. The historical of brocas aphasia.
b. The cause of brocas apahsia.
c. To find out the treatments, symptoms and ways to handle
people who has brocas aphasia.

CHAPTER II
A. Aphasia
1 Steinberg D, Danny. 1993. An Introduction to Psycholinguistics. p. 186

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The word Aphasia is derived from the Greek word aphatos,

meaning speechless. Mentions of Aphasia in Greek Medicine are
evident in which speechlessness accompanied convulsions are
documented as resulting in paralysis of the right side of the body. 2
Aphasia is an acquired neurogenic language disorder resulting from
an injury to the brain, most typically the left hemisphere that affects
all language modalities. Aphasia is not a single disorder, but instead is
a family of disorders that involve varying degrees of impairment in
four primary areas:
spoken language expression

spoken language comprehension,

written expression, and

reading comprehension.

A person with aphasia often has relatively intact nonlinguistic

cognitive skills, such as memory and executive function skills,
although these and other cognitive deficits may co-occur with
aphasia. Sensory deficits such as auditory and visual agnosia and
visual field deficits (e.g., hemianopia or visual field cuts) may also be
present.
Because categorizing aphasia subtypes can be difficult, there is
debate over the terminology used to classify aphasia. While no single
classification

system

is

completely

adequate,

some

common

classifications of aphasia are based on the location of brain damage

or the patterns of impaired language abilities in fluency of verbal
expression, auditory comprehension, repetition, and word retrieval.
Sometimes the terms motor aphasia and sensory aphasia (or nonfluent and fluent aphasia) are used. See the common classifications of
aphasia adapted from Aphasiology: Disorders and Clinical Practice
(Davis, 2007).

2 Damasio, A. R. 1998. Signs of aphasia (In M. T. Sarno. Acquired aphasia

(3rd ed.). pp. 25-41. San Diego: Academic Press.

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It should be noted that a person's symptoms may not fit neatly

into a single aphasia type. Further, the initial presenting symptoms
can change with recovery, and consequently, the classification that
fits most accurately may shift. This is particularly true as a person's
communication improves. In addition, symptoms can co-occur with
other speech and language impairments such as dysarthria and/or
apraxia of speech, which can complicate assessment and treatment.
The outcome of aphasia is difficult to predict given the wide
variability of symptoms. Aphasia outcome varies significantly from
person to person, depending upon the lesion location and the severity
of the brain insult. The most predictive indicator of long-term recovery
is initial aphasia severity, along with lesion site and size (Plowman,
Hentz, & Ellis, 2011). Other factors that are often considered
regarding prognosis include the person's age, gender, education level,
and other comorbidities. When examined more closely, however,
these factors do not appear to be strong predictors of the extent of
recovery.
a. Incident and prevalence
The "incidence" of aphasia refers to the number of new cases
identified in a specified time period. It is estimated that there are
80,000 new cases of aphasia per year in the United States (National
Stroke Association, 2008).
"Prevalence" of aphasia refers to the number of people who are
living with aphasia in a given time period. The National Institute of
Neurological

Disorders

and

Stroke

(NINDS)

estimates

that

approximately 1 million people, or 1 in 250 in the United States today,

suffer from aphasia (NINDS, n.d.).
Fifteen percent of individuals under the age of 65 experience
aphasia; this percentage increases to 43% for individuals 85 years of
age and older (Engelter et al., 2006). No significant differences have
been found in the incidence of aphasia in men and women. However,

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some data suggest differences may exist by type and severity of

aphasia. For example, Wernicke's and global aphasia occur more
commonly in women and Broca's aphasia occurs more commonly in
men (Hier, Yoon, Mohr, & Price, 1994; National Aphasia Association,
2011).
b. Sign and symptoms
Aphasia symptoms vary across individuals, with some of the
variation being related to the neural regions that are damaged and to
the extent of that damage. Signs and symptoms may or may not be
present in individuals with aphasia and may vary in severity and level
of disruption to communication. Signs and symptoms may also vary
depending on the speaking situation. For example, a person may
need to pause frequently to find words during a conversation that
requires a higher level of complexity and precision, but then may
have no apparent difficulties when exchanging small talk. Examples of
common signs and symptoms of aphasia are listed below.
Verbal Expression Impairments
Common verbal expression impairments include
o
o
o
o
o

Difficulty finding words (anomia)

Speaking with effort or haltingly
Speaking in single words (e.g., names of objects)
Speaking in short, fragmented phrases
Omitting smaller words like "the," "of," and "was" (telegraphic

speech)
o Putting words in the wrong order
o Substituting sounds and/or words (e.g., bed is called "table" or
dishwasher a "wishdasher")
o Making up words (e.g., jargon)
o Fluently stringing together nonsense words and real words, but
leaving out or including an insufficient amount of relevant content.
Auditory Comprehension Impairments
Common auditory comprehension impairments include

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o Difficulty understanding spoken utterances

o Providing unreliable answer to "yes/no" questions
o Failing to understanding complex grammar (e.g., the dog was
chased by the cat.)
o Requiring extra time to understand spoken messages (e.g., like
translating a foreign language)
o Finding it very hard to follow fast speech (e.g., radio or television
news)
o Misinterpreting subtleties of language (e.g., takes the literal
meaning of figurative speech such as "it's raining cats and dogs.")
o Lacking awareness of errors.
Very often, a person with aphasia experiences both expressive
and receptive difficulties, but each to varying degrees. In addition, the
person with aphasia may have similar (parallel) difficulties in written
expression and reading comprehension (Dyslexias).
Reading Comprehension Impairments (Alexia)
Common reading comprehension impairments include
o
o
o
o
o

Difficulty comprehending written material

Difficulty recognizing some words by sight
Inability to sound out words
Substituting associated words for a word
Difficulty reading non-content words (e.g., function words such as
to, from, the).

Written Language Impairments (Agraphia)

Common written language impairments include
o
o
o
o
o
o

Difficulty writing or copying letters, words, and sentences

Writing single words only
Substituting incorrect letters or words
Spelling or writing nonsense syllables or words
Writing run-on sentences that don't make sense
Writing sentences with incorrect grammar.
c. Causes
Aphasia is caused by damage to the language centers of the

brain. In most people, these language centers are located in the left
hemisphere, but aphasia can also occur as a result of damage to the

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right hemisphere; this is often referred to as crossed aphasia to

denote that the right hemisphere is language dominant in these
individuals. Common causes of aphasia are
o Stroke
Ischemic: blockage that disrupts blood flow to a region of the

o
o
o
o
o

brain
Hemorrhagic:

ruptured

blood

vessel

that

damages

surrounding brain tissue

Traumatic brain injury
Brain tumors
Brain surgery
Brain infections
Other neurological diseases (e.g., dementia).
Stroke is the most common cause of aphasia. According to the

National Aphasia Association (2011), about 25% to 40% of stroke

survivors experience aphasia. Approximately 35%-40% of adults
admitted to an acute care hospital with a diagnosis of stroke are
diagnosed with aphasia by the time they are discharged (Dickey et
al., 2010; Pedersen, Jorgensen, Raaschou, & Olsen, 1995).
d. Kind of Aphasias
The theory of language localization gained furthur credit with
significant findings attributed to French physician: Pierre Paul Broca in
the 1860s. The beginning of comprehensive Aphasia understanding
came with Paul Brocas research and subsequent description of his
patient Laborgne's brain. In 1861, Broca published Remarques sur le
sige de la facult du langage articul: suivies d' une observation
d'aphmie in which he evidences for the localization of articulate
speech in the frontal lobe. Upon Leborgnes death, Broca performed
an autopsy and determined that the damage was suffered to the third
convolution of the left frontal lobe, which is now commonly referred to
as Brocas area. Stemming from his influential findings, was a
revolution in medical and physiological thinking as it pertained to the
brain and the establishment of cerebral localization.
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Less than a decade later, Wernicke identified sensory aphasia

as being localized to the temporal lobe. Ludwig Lichtheim then
branched off of Wernickes model, naming five other types of aphasia,
pure word deafness, conduction aphasia, apraxia of speech, trans
cortical motor aphasia, and trans cortical sensory aphasia. As the
mid-20th century approached, professionals specializing in language
began searching for a revised model of understanding normal and
abnormal language functioning. One professional by the name of
Norman Geschwind formed the Geschwind model. Revisiting language
localization

theories,

the

model

describes

the

interconnecting

functions of a normally working human brain to produce speech and

language comprehension. Aphasias were viewed as occurring along
these

interconnecting

comprehension,

resulting

lines,
in

disrupting
various

spoken

symptoms.

speech

or

Although

the

Geschwind model was a great contribution to the understanding of

language, problems with it have been uncovered in recent years and
a straying away from this understanding of language functioning has
occurred.

The following table separates the different types of aphasias,

identifies the area of the brain affected and then names the deficits
incurred by each.
Disorder

Site of Lesion

Spontaneou

Speech

Repetitio

Namin

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Nonfluent

Comprehensio
n
Relatively intact

Poor

Poor

Nonfluent

Poor

Poor

Poor

Nonfluent

Relatively intact

Intact

Poor

Fluent

Poor

Poor

Poor

Fluent

Relatively intact

Poor

Intact

Fluent

Relatively intact

Intact

Poor

Fluent

Poor

Intact

Poor

s Speech
Brocas
aphasia
Global
aphasia
Transcortical
motor
aphasia

Wernickes
aphasia

Conduction
Aphasia

Anomic
Aphasia

Transcortical
sensory
aphasia

Left frontal
cortex rostral to
base of motor
cortex
Anterior and
posterior
language areas
Areas anterior
and superior to
Brocas areas
Posterior part of
the superior and
middle left
temporal gyrus
and left
temporoparietal
cortex
Temporoparietal
region, above and
below posterior
Sylvian fissure
Posterior part of
the superior and
middle left
temporal gyrus
and left
temporoparietal
Posterior to
Wernickes area
around boundary
of occipital lobe

B. Brocas Area (Brocas Aphasia)

Broca's area is a region in the frontal lobe of the left hemisphere (the dominant
hemisphere) of the hominid brain with functions linked to speech production. Language
processing has been linked to Broca's area since Pierre Paul Broca reported impairments
in two patients. The approximate region he identified has become known as Broca's
area, and the deficit in language production as Broca's aphasia, also called expressive
aphasia. There are three main functions of Brocas area3, as follows:
3 Luciano Fadiga and Laila Craighero. 2006. "Hand Actions and Speech
Representation In Broca's Area". pp. 486490.

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Language Comprehension
Action recognition and production
Speech-associated gestures

(Related to motor cortex)

Regarding about the symptoms of Brocas Aphasia are also the same like another
aphasias. They have the same symptoms and also treatments (see page 8). The stroke
Broca's area (shown in red)

patients have an opportunity to heal from the aphasias if they get treatments

sequently.
a. Historical of Brocas Area
In a recent study (1861), the preserved brains of
both Leborgne and Lelong (patients of Broca) were
reinspected using high-resolution volumetric MRI. The
purpose of this study was to scan the brains in three
dimensions and to identify the extent of both cortical and
subcortical lesions in more detail. The study also sought to locate the exact site of the
lesion in the frontal lobe in relation to what is now called Broca's area with the extent of
subcortical involvement.

Leborgne (Tan) (51 years old)

Leborgne was a patient of Broca's. Almost

completely unable to produce any words or phrases, he

was able to repetitively produce only the word tan or
tan-tan. After his death, a lesion was discovered on the
surface the left frontal lobe (tumor).

Lelong (84 years old)

Lelong was another patient of Broca's. He also

exhibited reduced productive speech. He could only say five words oui (yes), non (no),
tois (from trois, or three; Lelong used it to mean any number whatsoever), toujours
(always), and Lelo (his attempt to say his own name). At autopsy,
a lesion was also found in the same region of lateral frontal lobe
as in Leborgne. These two cases led Broca to believe that speech
was localized to this particular area.

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Examination of the brains of Broca's two historic patients with high-resolution

MRI has produced several interesting findings. First, the MRI findings suggest that
other areas besides Broca's area may also have contributed to the patients' reduced
productive speech. This finding is significant because it has been found that, though
lesions to Broca's area alone can possibly cause temporary speech disruption, they do
not result in severe speech arrest. Therefore, there is a possibility that the aphasia
denoted by Broca as an absence of productive speech also could have been influenced
by the lesions in the other region. Another interesting finding is that the region, which
was once considered to be critical for speech by Broca, is not precisely the same region
as what is now known as Broca's area. This study provides further evidence to support
the claim that language and cognition are far more complicated than once thought and
involve various networks of brain regions.

b. Story of Brocas aphasia patient

Sarah Scott (impressive recovery from Broca's Aphasia)
Reading an English text aloud in the classroom, then 18 year old Sarah suddenly

suffered a stroke. Later it will be found that the stroke was most likely caused by a
patent foramen ovale. In short, a hole in the heart, which has not been previously
detected. Unfortunately this is not such a rare case after all. We all heard stories of
young people in their teens or late teen years, dying as a result of a heart failure and a
subsequent stroke. Sarah however, was lucky enough to survive and recover. However,
she did not recover fully as she was left with Broca's Aphasia, which is named after the
French 19-century surgeon Paul Broca. He was the first to identify Broca's Area, a brain
structure central for the production of speech.

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So it does not come as a surprise that Broca's Aphasia is a speech disorder which
leaves the patient unable or impaired in producing
language (oral and written). Interestingly, patients who
communicated in sign language before the onset of
Broca's Aphasia are also impaired in their production
of sign language. In this case Sarah Scott spoke
affluent, halting and with a poor grammatical sentence
building after her stroke. Since then she has made an
Sarah Scott

impressing recovery thanks to her great willpower and

persistence and thanks to a great support by friends, family and the research experts.
Although one might think that damage to Broca's Area might be the sole
underlying cause of Broca's Aphasia it is only true in a classical understanding.
Nowadays we know that related language structures may also contribute to the
condition. In addition, Broca's Aphasia may not only be caused by a stroke. A brain
tumor, cerebral hemorrhage or an extradural hematoma might just as well cause a
similar disorder. In certain cases the patient might not even be able to express one single
word. The original patient on which Paul Broca founded his observations was not able
to produce any other word than "tan". Hence, since then he is known in medical school
books as the patient "Tan". Generally, it is important to note that the patients are not
impaired in their intelligence and normally do know what they want to say, but are
unable to do so.
For more info about the progress of sarah scott can be seen on youtube :
https://www.youtube.com/user/SymphUK/videos?view=0&flow=grid

Gugun Gondrong

Gugun gondrong was diagnosed who has bacteria in his brain (2008). He did an surgery
in Singapore and lost some of the frontal lobe (replaced with
metal plate) and get little distraction with his vision. After
surgery, Gugun got difficulties to speak, He just could speak
single word and slowly. After getting treatment, he gets some
progress in speaking. He can connect the words even still have
trouble to pronounce it.

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Many aphasics do slowly recover their language ability as their brains remarkably resilient organs - heal from their injuries. Speech therapy and the support of
friends and family members help immeasurably in the healing process. Most will never
regain the level of language function they enjoyed before their injury, but any
improvement in their ability to communicate, improves their quality of life.
c. Communicate with an brocas aphasic person
Remember that the patients intelligence has not decreased. Always keep in mind that
the aphasia is probably very frustrating for the patient too, and they are trying to
communicate effectively.
General Guidelines:
Try to communicate in a quite environment with no distraction (turn of the TV,
Radio, and limit the number of people talking at one time)
Do not use baby talk, talk to person in normal tone, loudness and intonation.
Use shorter, simple statement and questions, rephrase if the person do not
understand.
You can pause often when talking, giving the person time understand and
respond.
Use other forms of communication to reinforce your words (i.e. gesture, facial
expressions, pointing, written words, and pictures)
Accept any form of communication from the person with aphasia.
When asking a question to the person you can use YES or NO questions, give
them choice.

CHAPTER III

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A. Conclusion
The brocas aphasia is located in left hemisphere. The left hemisphere of the
brain seems to control most language functions, including speaking, writing and
comprehension. The right hemisphere handles more spatial things, including the
recognition of letters and melodies. Broca's area - which is, specifically, the third frontal
convolution in the left hemisphere - is in a region of the brain responsible for most of a
person's language functions. One of the characteristics of Broca's aphasia is that its
sufferers know that they have a problem. I, personally, cannot imagine the frustration of
having feelings and ideas to express, and knowing that, despite my best efforts, I could
not express them. Some other language disorders, such as Wernicke's aphasia, are more
merciful: Wernicke's sufferers are oblivious to the fact that their speech is
incomprehensible.
The symptoms of brocas aphasia is cannot recall words to communicate; broken
and jumbled speech. Some Broca's aphasics can still make themselves understood,
although their speech is slow and halting. Others lose the ability even to pronounce
different words; instead, they repeat one word (such as "tan" or "toto") over and over
again. Their intonation is generally flat - they do not raise and lower their voices as
people do in normal conversation. The aphasia affects gestures and writing as well as
speech, so sufferers have great trouble communicating.
Many aphasics do slowly recover their language ability as their brains remarkably resilient organs - heal from their injuries. Speech therapy and the support of
friends and family members help immeasurably in the healing process. Most will never
regain the level of language function they enjoyed before their injury, but any
improvement in their ability to communicate, improves their quality of life.

References
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Damasio, A. R. 1998. Signs of aphasia In M. T. Sarno (Ed.), Acquired aphasia (3rd ed.).
San Diego: Academic Press
Dronkers NF, Plaisant O, Iba-Zizen MT, & Cabanis EA. 2007. Paul Broca's historic
cases: high resolution MR imaging of the brains of Leborgne and Lelong.
Brain : a journal of neurology NSB: 1432-41 PMID: 17405763
Neely, J. H. 1977. Semantic priming and retrieval from lexical memory: Roles of
inhibition less spreading activation and limited capacity attention. Journal of
Experimental Psychology: General. Retrieved on June 2016.
Tesak, J., & Code, C. 2008. Milestones in the history of aphasia: Theories and
protagonists. New York: Psychology Press.
http://neuralethes.blogspot.com/2013/02/brocas-aphasia-story-of-sarah-scott.html
http://en.wikipedia.org/wiki/Language_disorder
http://www.webmd.com/brain/aphasia-causes-symptoms-types-treatments?page=2

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