Traumatic Aphasia Scheme

While others might speak of aphasias in general, Luria presents his own organizational schema. First of all, he groups aphasias into three basic groups according to severity: (1) Total Aphasia is characterized by a total block of production and/or comprehension of speech. The disturbance is severe and lasts at least two or three weeks. (2) Well Expressed Aphasia includes those cases where the symptoms are relatively severe but do not involve a total block of speech activity. (3) Subtle, Slight Aphasia involves cases wherein the disturbance is not always evident at all times. It may appear most strongly only during instances of emotional disturbance or fatigue ( Luria, 1970b, pp. 34-35). Because initial trauma to the brain often results in a temporary disturbance of speech activity, Luria is emphatic that judgments with respect to symptoms and severity should be made only during the residual stage, which is the period 2 to 5 months after the trauma.
In addition to grouping by severity, Luria follows the classification schema that was encountered in earlier articles: acoustic aphasia, afferent motor aphasia, efferent motor aphasia, frontal dynamic aphasia, and semantic aphasia.
Of particular interest with respect to the focus of this book is a section wherein Luria, with his usual attention to philosophical bases of research, precedes his presentation of specific types of aphasia with a consideration of "The Structure of Speech Activity." In this brief section, he presents his explanation of when speech phylogenetically became intrinsically linked to thought:
The isolated words of which verbal speech consisted in its earliest stages of development were capable of reflecting separate signs or primitive concepts, but they could not express even elementary thoughts. The meaning of a word shifted depending upon the situation and was nonexistent outside certain situations. Whereas words possessed a nominative function from the beginning, the predicative function derived only from the concrete setting in which they were uttered. A decisive change occurred when speech went from consisting of individual words to consisting of elementary grammatical sentences, when instead of a single word there arose a pair or group of words related to one another, i.e., when the first "syntax" appeared.
The revolution which occurred at this phase in the development of language was truly phenomenal . . . . verbal speech became capable not only of designating an object, but also of formulating a thought. Verbal speech was still bound up with other forms of expression such as gesture and intonation, but with the development of written language thought came to be expressed altogether by means of language and speech became fully capable of performing the predicative function. Speech became an independent system of codes. ( Luria, 1970b, p. 83)
Because the development and structure of speech is so complex, Luria maintains that any consideration of its disturbance cannot be simplified and considered to be merely
disturbances or the speech images of words or . . . the inability to pronounce words. The basic forms of speech disturbances must result from defects in the systems of connections which are concealed behind the word on one hand and in the disintegration of the predicative function of speech on the other. The whole sense of verbal statements resides in this function. Similarly, the cerebral mechanisms which underlie speech processes cannot be at-