The Japanese journal of neuropsychology

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ArticleTitle	Cognitive neuropsychological assessment of acquired communication disorders -theory based refinement of diagnostic procedures-
Language	J
AuthorList	Sumiko Sasanuma
Affiliation	International University of Health and Welfare
Publication	Japanese Journal of Neuropsychology: 20 (3), 164-169, 2004
Received
Accepted
Abstract	The symptom patterns of communication disorders exhibited by neurological patients tend to be far from simple or straightforward. These symptom complexes in fact are what amount to behavioral manifestations of dynamic functional reorganizations taking place in the CNS of each patient. For the assessment of these symptom complexes to be clinically relevant and valid, consultations with cognitive models as a theoretical framework should prove to be useful. As an example of this approach, a theoretical account of letter-by-letter reading (LBL) by Behrmann et al. (1998) is presented, that reconciles two discrepant findings associated with this syndrome: (1) a lower level letter identification deficit (manifested typically by LBL) and (2) higher-order effects of lexical/semantic variables (manifested by above-chance performance on lexical decision and semantic categorization tasks). Adopting the framework of the Interactive Activation Model of letter and word perception (IAM; McClelland & Rumelhart 1981, Rumelhart & McClelland 1982), Behrmann and her colleagues have presented a unitary account of LBL that in spite of a deficit in early letter processing the degraded orthographic information can still feed forward and higher order lexical/semantic effects may still feed back and influence the reading performance of the patients. Clinical implications of theory-based approaches as diagnostic procedures -e.g. bridging to hypotheses-testing intervention strategies, and predicting/specifying the key issues that need to be clarified by further research- are discussed.
Keywords	cognitive neuropsychological approach, computational cognitive models, theory-based refinement of diagnostic procedures, hypothesis testing therapeutic intervention