Affiliations: Department of Neurology, Oregon Health and Science
University, Portland, OR, USA | Behavioral Neuroscience, Oregon Health and Science
University, Portland, OR, USA | Biomedical Engineering, Oregon Health and Science
University, Portland, OR, USA | Oregon Health and Science University, Otolaryngology
(ENT), Portland, OR, USA
Note: [] Correspondence to: Chris Gibbons, Ph.D., Oregon Health and
Science University Mail Code: CDRC, 707 S.W. Gaines Street, Portland, OR
97239-3098, USA. Tel.: +1 503 494 0378; Fax: +1 503 494 2859; E-mail:
gibbons@ohsu.edu
Abstract: We describe a 57 year old, right handed, English speaking man
initially diagnosed with progressive aphasia. Language assessment revealed
inconsistent performance in key areas. Expressive language was reduced to a few
short, perseverative phrases. Speech was severely apraxic. Primary modes of
communication included gesture, pointing, gaze, physical touch and leading.
Responses were 100% accurate when he was provided with written words, with
random or inaccurate responses for strictly auditory/verbal input. When
instructions to subsequent neuropsychological tests were written instead of
spoken, performance improved markedly. A comprehensive audiology assessment
revealed no hearing impairment. Neuroimaging was unremarkable. Neurobehavioral
evaluation utilizing written input led to diagnoses of word deafness and
frontotemporal dementia, resulting in very different management. We highlight
the need for alternative modes of language input for assessment and treatment
of patients with language comprehension symptoms.
Keywords: Word deafness, augmentative communication
