Although descriptions of fluent aphasia vary, as we have seen, there is one characteristic that is generally agreed to be central, a lexical, semantic deficit. Speakers with fluent aphasia show confusion in their word selection and they have problems with comprehending individual words, and this is thought to be the main reason for their failure to comprehend spoken and written language. Equally, even a casual examination of fluent aphasic speech reveals that production is seriously hampered by lexical errors and word-finding difficulties. The lexical deficit alone, however, will not account for all the problems manifested, and we have considered reports by Butterworth and Howard, Niemi, Goodglass, Christiansen and Gallagher, Caplan and Luzzatti and their research teams, by Blumstein and hers and, in the previous chapter, work by Edwards and Bastiaanse. All these studies have revealed that we can find evidence of grammatical errors in fluent aphasia. In this chapter we will consider data collected from one speaker with fluent aphasia by way of illustrating some of the problems encountered in Wernicke's aphasia. We will examine aspects of his lexical difficulties and consider how far observed difficulties in his continuous speech reflect deficits in syntax as well as in the lexicon. Results from the VAST that have been discussed in chapters 3 and 6 will now be examined in more detail for this subject.
This chapter will start by giving a description of the lexical accessing problems the speaker has in everyday speech and in test situations.