Analiza narativnog diskursa kod osoba sa afazijom

Abstract

Afazija se uglavnom ispoljava oštećenjem više modaliteta jezičke funkcije, sa varijacijama u težini poremećaja. U nekim slučajevima su podjedanko oštećeni svi jezički modaliteti, u drugim dolazi do značajnog oštećenja nekih modaliteta dok drugi ostaju relativno očuvani. Cilj ove studije je da se analiziraju i uporede jezičke sposobnosti u govornom i pisanom narativnom diskursu kod ispitanika sa različitim afazičkim sindromima. Uzorak je činilo 30 subjekata sa afazijom vaskularne etiologije, starosne dobi od 45 -77 godina. Dijagnoza afazije je postavljena na osnovu Bostonske baterije testova za afazije (BDAE). Nakon određivanja tipa afazije, usledilo je prikupljanje podataka za potrebe ovog rada. U istraživanju je korišćen subtest „Krađa kolača“ iz BDAE. Od ispitanika je traženo da usmenim putem opiše sliku „Krađa kolača“, a zatim da napiše tekst koji se odnosi na pomenutu sliku. Rezultati su pokazali da se u govornom i pisnom diskursu ispoljavaju slični simptomi oštećenja jezičke funkcije. Oštećenje narativnog diksursa ispitanika sa fluentnim afazijama se razlikuje od oštećenja koje se javlja kod nefluenntih afazičkih sindroma. Ovaj nalaz može biti od značaja u diferencijalnoj dijganostici i tretmanu afazija.

Aphasia is mostly manifested by impairment in several language modalities, with variations in severity of the disorder. In some cases all language modalities are equally impaired; in others it results in considerable impairments of some modalities while others remain. The aim of this study is to compare language abilities in narrative discourse and in written narrative production of patients with different aphasic syndromes. The sample consisted of 30 patients with aphasia of vascular etiology, aged from 45 to 77 years. Aphasia was assessed using the Boston Diagnostic Aphasia Examination (BDAE). After having determined the type of aphasia, we started to collect the data for this research. In this study the “Cookie Theft” picture from BDAE was used. Patients were asked to describe the “Cookie Theft” orally and afterwards to write a text referred to this picture. The results show that in some types of aphasia significantly more severe deficits appeared in written than in oral language. Accordingly, some patients with transcortical motor aphasia demonstrate total agraphia, while in narrative discourse they show certain linguistic abilities. Qualitative analysis shows that in some aphasic syndromes, similar symptomatology in written and in oral language is observed. The results show that there is significant discrepancy between language abilities in narrative discourse and in written narrative production of patients with some aphasic syndromes. This finding, as well as correspondence of symptoms in these language modalities could have significance in differential diagnostics and in rehabilitation of aphasia.