Verbal planning in a case of 'Dynamic Aphasia': An impairment at the level of macroplanning

Patients with 'dynamic aphasia' exhibit reduced spontaneous speech despite well preserved basic language functions. This disorder may allow insights into the conceptual preparation of messages. Various cognitive approaches have located the patients' impairment at the level of preverbal message generation, including verbal planning, loss of inhibition of lexical concepts, and, most recently, generation of sequences of novel thoughts. We report the case of HK who presented with dynamic aphasia. The study had two goals: first, as HK was assessed over a longer period of time, changes in his performances could be documented which were relevant for the interpretation of the underlying disorder. The present study is the first to document changes across time and improvements of some of the skills involved in language production. Second, further investigations were carried out to clarify HK's underlying deficits. He was unimpaired on a number of 'verbal planning' tasks which argues for the preservation of those specific processes of verbal planning which Levelt (1989) termed 'microplanning'. It is suggested that HK's performance may be best described as an impairment at the level of 'macroplanning'. The deficit may lie in the generation of novel thoughts though minor modifications of this recent approach are being suggested.