DISORDER OF ATTENTION

The only disorder of attention is attention deficit. Before discussing this disorder we have to get an idea of what is span of attention. Attention span is the amount of time that a person can concentrate on a task without becoming distracted. Most educators and psychologists agree that the ability to focus one’s attention on a task is crucial for the achievement of one’s goals.

Focused attention

It is a short-term response to information that attracts attention. The attention span for this level is very brief with a maximum span that may be as short as 8 seconds. An example for this level of attention is attention given to a ringing telephone, or other unexpected occurrence. After a few seconds it is likely that the person will look away, return to a previous task, or engage in something else.

Sustained attention

It is the level of attention that produces the consistent results on a task over time. If the task is handling fragile objects, such as washing delicate crystal glasses and dishes by hand, then the person showing sustained attention will stay on task and will not break any dishes, but a person who loses focus of attention may break glass or may stop washing the dishes to do something else.

Most healthy teenagers and adults are unable to sustain attention on one thing for more than about 20 minutes at a time, although they can choose repeatedly to re-focus on the same thing. This ability to renew attention permits people to pay attention to things that last for more than 20 minutes, such as viewing long movies or reading books.

Attention span

Attention span is the measure of sustained attention or the time spent continuously on a task. It varies with age. Older children are capable of longer periods of attention than younger ones. The type of activity affects the span of attention measured as time-on-task. People are generally capable of a longer attention when they are doing something that they find enjoyable or intrinsically motivating. Attention is also increased if the person is able to perform the task fluently, compare to a person who has difficulty performing the task. If the person is interested in learning a task the attention span will be longer. Fatigue, hunger, noise and emotional stress reduce attention span measured as time-on-task.  Common estimates for sustained attention to a freely chosen task range from about 5 minutes for a two-year-old child, to a maximum of around 20 minutes in older children and adults.

A take-home point: Persons suffering from generalized anxiety disorder [GAD] often complain that they cannot concentrate for long in a task. This is not a disorder of attention but inability to sustain attention due to the stress of the anxiety disorder.

A test of attention span everybody can administer

Many different tests for attention span have been used in different populations and in different times. Some tests measure short-term, focused attention abilities. Others provide information about how easily distracted the test-taker is. These tests are administered by the professionals. Variability in test scores can be produced by small changes in the testing environment. For example, test-takers will usually remain on task for longer periods of time if the examiner is visibly present in the room than if the examiner is absent.

A test everybody can administer is asking the person to count down from 100 by subtracting 2, 3, 4, 5 or 7 depending on the age of the test-taker. If the he/she can reach the lowest level of the count without mistakes without any distraction one can assume that his span of attention is within normal limit.

Attention span in modern society

Famous educator Neil Postman wrote in his book, Amusing Ourselves to Death, that the attention span of humans is decreasing as modern technology, especially television, increases. Internet browsing may have a similar effect because it enables users to easily move from one page to another. Most internet users spend less than one minute on the average website.

Attention deficit disorder (ADD or ADHD)

ADD is a developmental disorder. It is characterized primarily by attentional problems and most commonly associated with hyperactivity. So it is often called attention deficit hyperactivity disorder or ADHD.

ADHD is the most commonly studied and diagnosed psychiatric disorder in children, affecting about 3 to 5 percent of children globally and diagnosed in about 2 to 16 percent of school aged children. It is a long standing or chronic disorder with 30 to 50 percent of those individuals diagnosed in childhood continuing to have symptoms into adulthood. Adolescents and adults with ADHD tend to develop coping mechanisms to compensate for some or all of their impairments. ADHD is diagnosed two to four times more frequently in boys than in girls, though studies suggest this discrepancy may be partially due to subjective bias of referring teachers.

ADHD and its diagnosis and treatment have been considered controversial since the 1970s. The controversies have involved clinicians, teachers, policymakers, parents and the media. Topics of controversy include ADHD's causes, and the use of stimulant medications in its treatment. Most healthcare providers accept that ADHD is a genuine disorder. 

Different types of ADHD

 It is a developmental disorder in which certain traits such as impulse control lag in development. Using magnetic resonance imaging [MRI] of the prefrontal cortex of brain, this developmental lag has been estimated to range from 3 to 5 years.

A combination in varying degrees of inattention, hyperactivity, and impulsivity is the key behavior pattern of ADHD. The symptoms of ADHD are especially difficult to define because it is hard to draw the line at where normal levels of inattention, hyperactivity, and impulsivity end and clinically significant levels requiring intervention begin. In a psychiatric conference the famous cartoon character Denis the Menace was typed as a case of ADHD by a psychiatrist. But I differed. In my opinion Denis is only a smart child not a case of ADHD.

Signs and symptoms of ADHD

To be diagnosed with ADHD, symptoms must be observed in two different settings such as home and school for six months or more and to a degree that is greater than other children of the same age.

ADHD has three subtypes:

1.    Predominantly hyperactive-impulsive

2.    Predominantly inattentive

3.    Combined hyperactive-impulsive and inattentive. Most children with ADHD have the combined type.

Predominantly hyperactive-impulsive type symptoms may include:

1.     Fidget and squirm in their seats
2.     Talk nonstop
3.     Dash around, touching or playing with anything and everything in sight
4.     Have trouble sitting still during dinner, school, and lesson time
5.     Constantly in motion
6.     Have difficulty doing quiet tasks or activities.

Manifestations primarily of impulsivity:

1.     Be very impatient
2.     Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences
3.     Have difficulty waiting for things they want or waiting their turns in games

Predominantly inattentive type symptoms may include:

1.     Be easily distracted, miss details, forget things, and frequently switch from one activity to another
2.     Have difficulty maintaining focus on one task
3.     Become bored with a task after only a few minutes, unless doing something enjoyable
4.     Have difficulty focusing attention on organizing and completing a task or learning something new or trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities
5.     Not seem to listen when spoken to
6.     Daydream, become easily confused, and move slowly
7.     Have difficulty processing information as quickly and accurately as others
8.     Struggle to follow instructions.

Most people exhibit some of these behaviors, but not to the degree where such behaviors significantly interfere with a person's work, relationships, or studies—and in the absence of significant interference or impairment, a diagnosis of ADHD is normally not appropriate. The core impairments are consistent even in different cultural contexts.

Symptoms may persist into adulthood for up to half of children diagnosed with ADHD. This rate is difficult to estimate, as there are no official diagnostic criteria for ADHD in adults.  The signs and symptoms of ADHD in adults may differ from those during childhood and adolescence due to the adaptive processes and avoidance mechanisms learned during the process of socialization.

Management

ADHD management usually involves some combination of administration of medicines, behavior modifications, lifestyle changes, and counseling.

Associated problems

Inattention and "hyperactive" behavior are not the only problems in children with ADHD. Anxiety and depression are some of the disorders that can accompany ADHD. Academic studies and research in private practice suggest that depression in ADHD appears to be increasingly prevalent in children as they get older. The rate of increase is higher in girls than in boys. Where an emotional disorder complicates ADHD, it would be prudent to treat the mood disorder first, but parents of children with ADHD often wish to have the ADHD treated first, because the response to treatment is quicker.

Attention and Executive Attention

Attention refers to selecting certain information from among many and focusing mental resources on those selected. Our sensory systems are continually bombarded by sights, sounds, smells and other signals from outside world. At the same time, we remember events that just occurred seconds ago and events from distant past. Along with these memories there are mental pictures of events only imagined to occur in the present or in future.

From moment to moment only one stream of thought is kept in the focus of consciousness to the exclusion of others. Only one internal or external event dominates consciousness, and others are barely noticed or not noticed at all. This process of selection of information at mental level is called attention. The mental faculty of attention allows us to focus on what is important at the moment and to ignore the rest. If our attention fails we are perplexed by a plethora of information and become unable to function.

Consider some everyday situations in which attention is important. When you carry on a conversation with someone, there are numerous irrelevant background stimuli. The sights and sounds of a nearby television, the distant roar of a flying jet, the songs of birds outside the window, the pressure of clothing on the skin, and the pain of recently injured finger all compete for your attention. In conversations, it is further necessary to divide attention or shift attention from listening, on the one hand, to speaking on the other.

Now, consider carrying on your conversation on a cell phone while driving a car. It is necessary to ignore some distractions, such as the car radio and the sounds of traffic in order to focus on the speech production and comprehension. At the same time the task of driving also demands attention. Perception of road, other cars and pedestrians is essential for driving. Steering and braking also demand attention, particularly when traffic is heavy. Thus, to drive a car and carry on a telephone conversation at the same time requires that attention be divided among multiple tasks, each of which can be highly demanding at a given moment in time. Not surprisingly, inattention is a leading cause of traffic accidents. Therefore prohibition by law, of cell phone talks while driving is essential to reduce the number of traffic accidents.

Selective attention

FILTER  MODEL OF ATTENTION

Theories on attention are divided into two groups. The first group, called filter theories, assumes that attention operates as a filter that blocks the processing of some stimuli and allows the processing of others. In other words attention is selective. The filter theories were designed to explain how selective attention operates.  Selective attention may result from filtering of the unattended channel. Another possibility is that the unattended information is attenuated rather than filtered entirely.  

Divided attention

The second group of theories assumes that the person actively chooses stimuli for further processing by allocating a portion on or more limited pools of attentional capacity. These theories are called capacity theories. The capacity theories address the question how the mind concentrates on a particular stimulus. Here the attention is conceived as a mental effort. The more a task requires of a limited pool of available capacity, the more mental effort the person exerts. For example, try to solve these two arithmetic problems in mind:

(a) 6 x 6 =?

    (b) 32 x 16 =?

Clearly, problem b demands more mental effort.  

CAPACITY MODEL OF ATTENTION

Experiment to prove this theory: While a person solves a series of either easy or hard multiplication problems presented over headphones, the person is given a secondary task of detecting the random appearance of a light on a panel in front. The instruction given to the person is to concentrate on the multiplication tasks. He has to press a button each time when the light appears. It was proved that while the person was solving the harder problems he did not press the button, showing that he could not attend to the light appeared in the panel on the front.

Automatic processes

STROOP  EFFECT

John Ridley Stroop in 1935 devised an ingenious test to study automatic reading. While reading the words in different colours shown in the picture, colour terms occur automatically and effortlessly. The colour terms (e.g. RED, YELLOW, BLUE, GREEN, and RED) are printed in incompatible colours. For example the first word BLACK appears in red colour and so on. The task is to say aloud the colour of the ink while ignoring the meaning of the word itself. While doing it the word recognition, one aspect of fluent reading, occurs automatically. It is exceedingly difficult to ignore the meaning of the word BLACK when it appears in red colour. The correct response “red” competes with the habitual response of the word black. Errors and delays in responding of the word BLACK when it appears in red are the usual result. This is called Stroop effect.

Word recognition illustrates one of many processes that have become automatic because of extensive practice, maturation and skill development. Walking, running, riding a bicycle and typing on a key board are among the many motor skills that people automatize. Many mental skills also become automatic and are carried out effortlessly. Automatic process occurs unintentionally, unconsciously and operates without depleting attentional capacity. Put differently, automatic processes are often called preattentive.  On the other hand controlled processes are intentional, conscious and demanding of attention.

Practice and Automaticity

A process or a set of processes used in a particular skill, such as typing, becomes automatic only after extensive practice. Certain processes may be so basic for human learning and survival that they are genetically programmed to operate through maturation and interaction with environment. Motor skill exemplifies processes that achieve automaticity through genetic programming in addition to practice. Learning to crawl, walk and run is not simply a matter of practice. At birth there is a reflex to move the arms and legs in a crawling movement. This reflex disappears after about three months. Some species are programmed to walk moments after birth to ensure their survival. Humans adopt a more leisurely pace with the infant wholly dependent on the mother and father for survival. The effortlessness and automaticity that we see in the motor skill of an older child running while at play is only partly due to practice.

Basic mental processes may also be genetically programmed or hard wired in the nervous system. These should appear early in development and acquire relatively little learning to become fully operational. Age, culture, intelligence, educational attainment and other factors that strongly influence consciously controlled processes are unimportant for innate automatic processes.

Executive attention

This refers to a supervisory attentional system that inhibits inappropriate responses and activates appropriate ones.  Its function is to control our thoughts and behaviours in adaptive ways. Imagine leaving a parking lot to drive home in the evening. If your usual routine is to drive straight home, then executive attention is needed to intervene and activate the thought of going first to, say, a grocery store . The automatic response of driving home must be inhibited or else it will control behaviour. Executive attention is always needed when (i) planning or making decisions, (ii) correcting errors, (iii) the required response is novel or not well-learned; (iv) conditions are dangerous.

MRI Picture of anterior cingulate gyrus

The Stroop task described above is an excellent example where active executive attention is required to give correct responses. Brain imaging studies conducted during the Stroop task test have established that the anterior part of the cingulated gyrus, a region in the frontal lobe of the brain is the location of executive attentional system, inhibiting the automatic response and selecting the correct response.

Cognitive aspects of language - Reading disability

Two years ago a boy of 9 years studying in the fourth class of an English medium school was brought to me for correction of his scholastic backwardness and behavioural abnormalities such as disobedience, temper tantrums and reluctance to go to school. Previously he was diagnosed by a clinician as ‘childhood schizophrenia’ and given a psychotropic drug. The condition did not improve even after six months’ medication. On examination he was found to be suffering from reading disability (dyslexia) and associated emotional problems.

Treatment for dyslexia consists of using educational tools to enhance the ability to read. Medicines and counseling are usually not used to treat dyslexia. An important part of treatment is educating the child and the family about the condition.  

Reading disability or dyslexia is the most common form of learning disability. Dyslexia is a Specific Learning Disability [SLD]. A child with dyslexia cannot read correctly and comprehend accurately what is read. Dyslexia is different from reading difficulties resulting from other causes such as deficiency with vision or hearing, or from poor or inadequate reading instruction. National Institute of Neurological Disorders and Stroke [NINDS]  under National Institute of Health, USA defines dyslexia as follows: “Dyslexia is brain-based type of disability that specifically impairs person’s ability to read. These individuals typically read at levels significantly lower than expected despite having normal intelligence.”

The features of disorder varies from person to person but the common characteristics among people with dyslexia are difficulty with sound processing, spelling, and/or rapid visual-verbal responding. In children these deficiencies are expressed as scholastic backwardness and behavioural abnormalities.

When the onset of dyslexia is in adulthood, it usually occurs as a result of brain injury or with the onset of dementia. Dyslexia can be inherited in some families, and recent studies have identified a number of genes that may predispose an individual to develop dyslexia

Dyslexia is not an intellectual disability. Cognition of an individual develops independently. Therefore Intelligence Quotient (IQ) and dyslexia are not interrelated.

Characteristics of dyslexia

I. Symptoms in Preschool-aged children

It is difficult to identify dyslexia before the child begins school. Parents who keenly observe their children may notice the following symptoms:

1.    Delays in speech

2.    Slow learning of new words

3.    Difficulty in rhyming words as in nursery rhymes

4.    Knowledge of letters does not improve

5.    Letter reversal or mirror writing. Example: "Я" instead of “R”

II. Symptoms in early primary school children

1.    Slow in learning the alphabet

2.    Inability to associate sounds with the letters that represent them. In other words sound-symbol correspondence is difficult

3.    Difficult to identify rhyming words or lack of phonological awareness

4.    Inability to segment words into phonemes or sound blocks (lack of phonemic awareness)

5.    Naming-speed deficit: naming-speed refers to how quickly an individual can tell the names of a set of familiar objects. For example a student may be shown 50 patches of different colours and asked to name the colours quickly. Individuals with dyslexia find it difficult to name even the familiar colours.

6.    Inability to distinguish between similar sounds in words and mixing up sounds in polysyllabic words. Examples: “aminal” for animal, “cutbis” for biscuit

III Symptoms in older primary school children

1.    Slow or inaccurate reading

2.    Very poor spelling which is called dysorthographia.

3.    Very slow in reading out loud, reading words in the wrong order, skipping words and sometimes saying a word similar to another word.

4.    Difficult to associate individual words with their correct meanings

5.    Difficult to keep time when doing certain task

6.    Children with dyslexia fails to see similarities and differences in letters and words, and may be unable to sound out pronunciation of an unfamiliar word

7.    Tendency to omit or add letters or words when writing and reading.

IV Symptoms in secondary school children and adults

Some people with dyslexia are able to disguise their weaknesses, even from themselves. Many students reach higher education before they encounter the threshold at which they are no longer able to compensate for their leaning disability. At this stage dyslexic people are identified by writing that does not seem to match their level of intelligence. Dyslexic people often substitute similar-looking, but unrelated, words in place of the ones intended. Examples: what/want, say/saw, help/held, fell/fall, to/too, who/how etc.

Associated disabilities and disorders

Many other learning disabilities often occur in association with dyslexia, but it is not clear whether these learning disabilities share the same neurological causes with dyslexia. These disabilities include:

Dysgraphia: This disorder expresses itself primarily through writing or typing. Dysgraphia is often multifactorial. It may be due to impaired letter-writing automaticity and impaired visual word form which makes it more difficult to retrieve the visual picture of words from long term memory, required for spelling.

Dyscalculia: It is a neurological condition characterized by a problem with basic sense of number and quantity. People with this disorder often can understand very complex mathematical concepts and principles but have inability to memorize basic mathematical facts involving addition and subtraction.

Attention deficit disorder: Dyslexia is often associated with ADD and ADHD. These are dealt with separately.

Cluttering: This is a disorder of speech fluency. Both rate and rhythm of speech are defective resulting in erratic, non-rhythmic, rapid and jerky spurts of words that usually contain faulty phrasing.

Causes of dyslexia

Researchers have and are evolving many theories on the causes of the dyslexia. These theories are not mutually contradictory but enlightening on the different causative factors of this disorder.

Effect of language orthography

The complexity of a language’s orthography can be a significant contributing factor to the difficulties experienced by dyslexic readers. Orthography is the writing system of a language. There are deep orthographies and shallow orthographies. Arabic and English are examples of deep orthographies that do not have a one-to-one correspondence between sound blocks (phonemes) and the letters that represent them. Shallow orthographies have a one-to-one relationship between graphemes (meaningful letter blocks) and phonemes and the spelling of words is very consistent. This type of writing is called phonetic orthography. Most of the East European languages like Albanian, Bosnian, Bulgarian etc. and many Asian languages are phonographic. Most of the Indian languages including Malayalam have phonemic orthographies.  Deep orthographies contribute more to the difficulties of a dyslexic reader. Logographic writing systems like Japanese and Chinese characters have graphemes that are not directly linked to their pronunciation pose different types of dyslexic difficulty.

From a neurological perspective, different types of writing system, for example alphabetic as compared to logographic writing systems, require different neurological pathways in order to read, write and spell. Because different writing systems require different parts of the brain to process the visual notation of speech, children with reading problems in one language might not have a reading problem in a language with a different orthography. The neurological skills required performing the tasks of reading, writing, and spelling can vary between different writing systems and as a result different neurological deficits can cause dyslexic problems in relation to different orthographies.

Incidentally, the boy who was brought to me two years back is having not much reading problem with his native language Malayalam.

Aggravating conditions

Dyslexia is attributed to neurological factors that influence the individual's ability to read, write, and spell written language.The following conditions may be contributory or overlapping factors, as they can lead to reading disability:

1. Aphasia - neurologically based speech disorders, which can cause alexia (acquired dyslexia).
2. Attention deficit hyperactivity disorder - A disorder that occurs in between 12% and 24% of those with dyslexia.
3. Auditory processing disorder - A condition that affects the ability to process auditory information. Auditory processing disorder is a listening disability. Some children can acquire auditory processing disorder as a result of experiencing otitis media, a condition characterized by bacterial infection with fowl smelling discharge.
4. Developmental dyspraxia - A neurological condition characterized by a marked difficulty in carrying out routine tasks involving balance, fine-motor-control, difficulty in the use of speech sounds, problems with short term memory and organization are typical of dyspraxics.
5. Specific language impairment (SLI) - A developmental language disorder that can affect both reading and writing. SLI is defined as “pure” language impairment, meaning that is not related to or caused by other developmental disorders, hearing loss or acquired brain injury.

Management

There is no cure for dyslexia. But dyslexic individuals can learn to read and write with appropriate educational support. Early intervention is very helpful. Stress and anxiety contribute to the difficulties of dyslexic. So stress management and alleviation of anxiety are essential.  

A cognitive technique for undergraduates is reading the first and the last sentences of each paragraph first, comprehending them and then reading the whole paragraph. This technique enhances the comprehension of the entire paragraph. It has been found that training focused towards visual language and orthographic issues yields longer-lasting gains than mere oral phonological training.

Cognitive aspects of language - Language Death

Loss of language is a psycho-social process at the individual or social level whereas loss of speech is a neurological disorder. At social level the loss of a language is called language death.

In 1992 a prominent US linguist stunned the academic world by predicting that by the year 2100, 90% of the world's languages would have ceased to exist.

In linguistics, language death or language extinction is a process that affects communities speaking a given language. The level of linguistic abilities that speakers possess of a given language is decreased; eventually resulting in no speakers of that language exists. Language death may affect any language including dialects.

Language death should not be confused with language attrition (also called language loss) which describes the loss of proficiency in a language at the individual level.

Types of language death

Language death may manifest itself in one of the following ways:

1. 1.    Gradual language death
2. 2.    Bottom-to-top language death: a language begins to change in a low level of the society such as the home.
3. 3.    Top-to-bottom language death: a language begins to change in a high level of the society such as the government.
4. 4.   Linguicide (also known as sudden language death, language death by genocide, physical language death, biological language death)

The most common process leading to language death is one in which a community of speakers of one language becomes bilingual in another language, and gradually shifts allegiance to the second language until they cease to use their original language or what is called in India as mother tongue. This is a process of assimilation which may be voluntary or may be forced upon a population. Speakers of some languages, particularly regional or minority languages may decide to abandon them based on economic or utilitarian grounds, in favour of languages regarded as having greater utility or prestige. This process is gradual and can occur from either bottom-to-top or top-to-bottom.

Languages with a small, geographically isolated population of speakers can also die when their speakers are wiped out by genocide, disease, or natural disaster.

Moribund state of language

A language is often declared to be dead even before the last native speaker of the language has died. If there are only a few elderly speakers of a language remaining, and they no longer use that language for communication, then the language is dead in effect. A language that has reached such a reduced stage of use is generally considered moribund.

Globalization, development, and language extinction

Elizabeth Malone of the National Science Foundation USA says: “As "globalization" increases, so does the loss of human languages. People find it easier to conduct business and communicate with those outside their own culture if they speak more widely used languages like Chinese, Hindi, English, Spanish or Russian. Children are not being educated in languages spoken by a limited number of people. As fewer people use local languages, they gradually die out.

At least 3,000 of the world’s 6,000-7,000 languages (about 50 percent) are about to be lost. Why should we care? Here are some reasons.

·       The enormous variety of these languages represents a vast, largely unmapped terrain on which linguists, cognitive scientists and philosophers can chart the full capabilities—and limits—of the human mind.

·       Each endangered language embodies unique local knowledge of the cultures and natural systems in the region in which it is spoken.

These languages are among our few sources of evidence for understanding human history.”
Those who primarily speak one of the world’s major languages may find it hard to understand what losing one’s language can mean. Some may even feel that the world would be better off if everyone spoke the same language. In fact, the requirement to speak one language is often associated with violence. Repressive governments forbid certain languages and cultural customs as a form of control.

As economic and cultural globalization and development continue to push forward, growing numbers of languages will become endangered and eventually, extinct. With increasing economic integration on national and regional scales, people find it easier to communicate and conduct business in the dominant languages of world commerce: English, Chinese, and Spanish.

The study of endangered languages also has implications for cognitive science because languages help illuminate how the brain functions and how we learn. “We want to know what the diversity of languages tells us about the ways the brain stores and communicates experience,” says peg Barrett, NSF division director for behavioral and cognitive sciences.

Dead Languages and Normal Language Change

Linguists distinguish between language "death" and the process where a language becomes a "dead language" through normal language change, a linguistic phenomenon analogous to pseudo-extinction. This happens when a language in the course of its normal development gradually morphs into something that is then recognized as a separate, different language, leaving the old form with no native speakers. Thus, for example, Old English may be regarded as a "dead language", with no native speakers, although it has never "died" but instead simply changed and developed into Middle English, Early Modern English and Modern English. The process of language change may also involve the splitting up of a language into a family of several daughter languages, leaving the common parent language "dead". This has happened to Latin, which (through Vulgar Latin) eventually developed into the Romance languages. Such a process is normally not described as "language death", because it involves an unbroken chain of normal transmission of the language from one generation to the next, with only minute changes at every single point in the chain.

Language attrition

Language attrition is the loss of a first or second language or a portion of that language by individuals. Speakers who routinely use more than one language may not use either of their languages. The mental lexicon of the unused language is erased from the long term memory store and the individual loses that language.

Emotional problems

The loss of a native language is often experienced as something profoundly moving, disturbing or shocking, both by those who experience it and by those who witness it in others: “To lose your own language was like forgetting your mother, and as sad, in a way”, because it is “like losing part of one’s soul” is how Alexander McCall Smith puts it (The Full Cupboard of Life, p. 163).

Aphasia

Speech Centers of Brain

Aphasia is an impairment of language ability. This class of language disorder ranges from having difficulty remembering words to being completely unable to speak, read, or write.

Aphasia disorders usually develop quickly as a result of head injury or stroke, but can develop slowly from a brain tumor, infection, or dementia, or can be a learning disability such as dysnomia or faulty memory of names.

It was thought that two areas viz. Broca’s and Wernicke’s in the brain are the main centers for speech. But researches had proved that speech is controlled by the coordinated action of wider areas in various lobes of the cerebral cortex. Therefore, the area and extent of brain damage determine the type of aphasia and its symptoms. Aphasia types include Broca's aphasia, non-fluent aphasia, motor aphasia, expressive aphasia, receptive aphasia, global aphasia and many others.

How to identify aphasia?

People with aphasia may experience any of the following behaviors due to an acquired brain defect.

1. inability to comprehend language
2. inability to pronounce, not due to muscle paralysis or weakness
3. inability to speak spontaneously
4. inability to form words
5. inability to name objects
6. poor enunciation or act of speaking
7. excessive creation and use of personal new words (neologism)
8. inability to repeat a phrase
9. persistent repetition of phrases
10. paraphasia (substituting letters, syllables or words)
11. agrammatism (inability to speak in a grammatically correct fashion)
12. dysprosody (alterations in inflexion, stress, and rhythm)
13. incomplete sentences
14. inability to read
15. inability to write
16. limited verbal output
17. difficulty in naming