Recovery of spoken language processing in a 6-year-old child following a left hemisphere stroke: A longitudinal study

Abstract

We report the case of a girl (D.B.) who at the age of 6 years and 7 months suffered a stroke to the left hemisphere leaving her initially mute. We monitored the recovery of D.B.'s spoken language processing over more than 2 years, using a cognitive neuropsychological approach. The initial period of mutism was followed by a rapid reappearance of vocabulary, suggestive of the recovery of previous language, rather than relearning. Early spoken language was non-fluent with pronounced word-finding difficulties, and marked by semantic and phonological paraphasias and distorted intonation, but 2 years later appeared to have recovered to normal. Confrontation naming was impaired on first testing, but was facilitated by phonemic cueing, indicating once again a difficulty with lexical access rather than lexical loss. Two years later, naming ability had recovered to an average normal level. From the first, comprehension of single words was found to be intact and early problems with sentence comprehension recovered to a superior level over the course of 2 years. Written language processing, however, remained severely impaired. We suggest that detailed longitudinal studies which investigate the nature and extent of the language disorder in individual cases, offer a principled method for the study of patterns of recovery from acquired childhood aphasia.