漢語失語症病人閱讀障礙之歷程研究

Abstract

閱讀是一般成人相當重要的生活技 能。牽涉到一連串複雜的認知過程，常在 失語症時一併受損。本研究針對各種類型 失語症患者,施予各種與閱讀能力有關之 測驗，包括相似字形的分辨、簡繁字體的 配對、同音字的配對、單字的命名、單字 及句子的理解等測試。結果發現幾乎所有 的失語症患者皆有閱讀能力之障礙。一般 而言前區患者雖常有文字命名的困難，但 多仍保有單字甚或句子的部分理解能力； 而後區病患單字理解能力的個人差異則較 大。 在閱讀的認知歷程分析方面，本研究 中之失語症患者仍能正確的區分出外形相 近的不同文字，顯示其字形之視覺分析過 程正常。且大多數患者仍能從事簡繁字體 之配對，尤其是前區的失語症患者；反之， 幾乎所有失語症患者都無法症從事同音異 字的配對，這顯示他們在字的語音存取上 有障礙。上述結果可以支持形音直接轉換 在中文的閱讀並非主要途徑之理論。

Reading competence is an important prerequisite for many adult functional activities. It is a learned skill that engages a complex set of cognitive procedures. By virtue of its complexity, it is vulnerable to disruption with many different kinds of brain damage, especially aphasia. This study investigated the reading disabilities in Chinese aphasic patients by giving them a series of reading related tasks, including discrimination between visually similar words, matching between different scripts of single words, homophone matching task, single word naming task, single word and sentence comprehension tasks. The results showed that almost all aphasic patients had some degree of reading disabilities. In general, although anterior or Broca’s aphasic patients often had difficulty in naming single words (alexia), they often preserved the ability to understand single words or even simple sentences. While posterior or Wernicke’s aphasic patients had more variable ability in terms of their ability in single word comprehension. In the aspect of analysis of the cognitive processes in the reading disability, it was found that all aphasic patients in this study could distinguish between different characters with similar orthography, which suggested that they retained normal ability in orthographic visual analysis. Furthermore, most aphasic patients, especially those of anterior lesions, could match the simplified script form of a single character with its visually dissimilar, complex script form. In contrast, none could perform the homophone matching task. These findings might be able to support the hypothesis that direct grapheme-phonetic conversion is not an important route in Chinese character or word reading.