Models of praxis have posited two major components, production and conceptual. Conceptual praxis disorders may occur in two domains: associative knowledge (tool-action associations such as hammer pound; tool-object associations such as hammer nail) and mechanical knowledge such as knowing the advantage that tools afford. Patients with Alzheimer's disease not only have conceptual apraxia (CA) but can dissociate CA from language deficits and from praxis production deficits (ideomotor apraxia). These findings suggests that knowledge about tools (action semantics) is independent of verbal semantics as well as movement representations. To learn if conceptual praxis knowledge is stored in one hemisphere (right or left) and if associative and mechanical conceptual praxis knowledge can be dissociated, we studied 29 right-handed subjects with unilateral strokes. Ten had left-hemisphere damage with no ideomotor apraxia. Eleven had left-hemisphere damage with ideomotor apraxia. There were eight right-hemisphere-damaged controls and 10 normal controls. These subjects were given tests for conceptual apraxia. There was a significant difference between groups, the left-hemisphere group with ideomotor apraxia being most impaired on both the associative and mechanical CA tests. There was a trend for associative and mechanical knowledge to be dissociated. Although conceptual praxis representations are stored in the left hemisphere, analysis of lesion sites did not reveal where in the left hemisphere they may be stored.
A critical professional issue in speech—language pathology and audiology is the current shortage of researchers. In this context, the most effective methods for training graduate students in research must be identified and implemented. This article describes a problem-based approach to teaching research methods. In this approach, the instructor poses complex clinical problems and students work cooperatively to define relevant questions, evaluate resources, and find solutions. Students develop understanding of experimental designs through problem solving and descriptions of their clinical research designs in group discussions or class debates. Through research training based on clinical problems, students learn to integrate clinical questions with research questions and to link the dual professional roles of clinician and researcher.
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