Why Does Monitoring Fail in Jargon Aphasia? Comprehension, Judgment, and Therapy Evidence

Assessing anosognosia: a critical review

“…Failures in error detection may result from various causes, including the patients' inability to accurately compare the actual with the intended output (Marshall et al, 1998). In line with this hypothesis, some studies (Shuren et al, 1995;Marshall et al, 1998;Maher et al, 1994) have reported on patients whose detection of speech errors was better when they were asked to listen to their own previously tape-recorded performance (off-line condition), than they did while speaking (on-line condition). In particular, Maher et al (1994) systematically investigated error detection ability in one aphasic patient (case AS) during on-line and off-line conditions.…”

“…Therefore, the association of unawareness with jargon and sensory aphasia, and the fact that monitoring relies on intact comprehension, has led researchers to maintain that poor comprehension would prevent accurate monitoring and discovery of the deficit (e.g., Boller et al, 1978;Wernicke, 1874;Heilman, 1991). Other studies, however, reported that some anosognosic patients could recognise their own speech errors when listening to their recorded performance (Shuren et al, 1995;Marshall et al, 1998) or if the errors were attributed to other persons (Alajouanine, 1956;Kinsbourne & Warrington, 1963;Maher et al, 1994), suggesting other possible causes for anosognosia than a comprehension deficit.…”

“…The error detection method (Marshall et al, 1998) has been used in several studies to assess explicit awareness of aphasia (see Table 3). Patients are typically asked to detect their errors during the description of a complex scene or during a naming task (e.g.…”

“…Patients are typically asked to detect their errors during the description of a complex scene or during a naming task (e.g. Alajouanine, 1956;Gainotti, 1972;Maher et al, 1994;Marshall et al, 1998).…”

“…However, findings in the literature and various theories (e.g. McGlynn & Schacher, 1989;Levine, 1990;Weinstein, 1991;Turnbull & Solms, 2007;Marshall et al, 1998;Maher et al, 1994) suggest that common mechanisms (e.g. monitoring deficits or motivational denial) may be responsible for unawareness of various deficits.…”