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Journal of Memory and Language 41, 3–29 (1999) Article ID jmla.1999.2637, available online at http://www.idealibrary.com on Independence of Input and Output Phonology in Word Processing and Short-Term Memory Randi C. Martin, Mary F. Lesch, and Michael C. Bartha Rice University Recently, theorists have suggested a close relation between the codes activated during language processing and those involved in STM. In order to further investigate this relationship, we examined the performance of an anomic patient, MS, to determine whether he would exhibit the same impairment in retrieving phonology from semantics in short-term memory that he shows in picture naming. The results indicated a similar pattern of performance in naming and in STM tasks requiring retention of output phonological codes (those involved in production). However, MS performed at a high level on STM tasks requiring the retention of input phonological codes (those involved in perception). The findings support the following conclusions: semantic information contributes to STM, input and output phonological codes are separable and maintained in separate buffers, and the same pathway that underlies retrieval of phonology from semantics in naming underlies feedback from semantics in list recall. © 1999 Academic Press In contrast to earlier models of short-term memory (STM) which have focused solely on the role of phonological and/or articulatory codes (e.g., Baddeley, 1986), more recent conceptions of short-term memory also incorporate a role for lexical and semantic representations. These “language-based” models of STM have emphasized the close relation between the representations and processes involved in word perception and production and those involved in short-term memory (Martin & Lesch, 1996; Martin, Shelton, & Yaffee, 1994; Martin & Romani, 1994; N. Martin & Saffran, 1992, 1997; N. Martin, Saffran, & Dell, 1996). The purpose of the present study was twofold: (a) to investigate the relation between word perception and production and short-term memory and (b) to investigate the possible distinction between the phonological codes involved in perception and production. CONCEPTIONS OF WORD PRODUCTION AND COMPREHENSION In order to lay out the relationship between word processing and short-term memory, it is necessary to consider current conceptualizations of the representations and processes involved in word production and comprehension (see Fig. 1). In production, the speaker begins with a concept to be conveyed which is encoded semantically. The semantic representation is used to select a lexical representation to convey the intended concept and then this lexical representation must be encoded phonologically prior to the onset of articulation. In spoken word comprehension, the reverse sequence occurs. Acoustic information is translated into a phonological representation which encodes phoneme identity and order. This phonological representation then activates a lexical representation which is connected to semantic information corresponding to that word. It should be noted that in the language production and comprehension literature, there is considerable debate concerning the nature of the lexical representation. Some researchers (see This research was supported by NIH DCD Grant DC00218 to Rice University. We thank MS for all the time and effort that he has given to this project and his family for their cooperation. Michael C. Bartha is now at the Cognitive Neuroscience Laboratory, Baylor College of Medicine, Houston, Texas. Correspondence concerning this article should be addressed to Randi C. Martin, Psychology Department - MS 25, Rice University, 6100 Main Street, Houston, Texas, 77005-1892. Electronic correspondence may be sent to [email protected]. 3 0749-596X/99 $30.00 Copyright © 1999 by Academic Press All rights of reproduction in any form reserved. 4 MARTIN, LESCH, AND BARTHA FIG. 1. Levels of representation in speech perception and production. Levelt, 1989) assume that lexical representations contain lexical semantic features (which are distinguished from conceptual semantic features) as well as syntactic information, such as word class, subcategorization frame, and grammatical gender (for languages where gender is relevant). Other researchers (e.g., Levelt, Roelofs, & Meyer, in press) make no distinction between conceptual and lexical semantics (both are represented at the semantic level) and assume that the lexical representation contains only syntactic information. Finally, other researchers (e.g., Dell, Schwartz, Martin, Saffran, & Gagnon, 1997) assume that the lexical node is essentially empty and serves only as a placeholder to connect all the information (phonological, semantic, syntactic, graphemic) that pertains to a particular word (for yet another position, see Miozzo & Caramazza, 1997). In the present discussion, we will take the latter view. Interactive activation models such as the TRACE model of word perception (McClelland & Elman, 1986) and the speech production model proposed by Dell (1986; Dell & O’Seaghdha, 1992) incorporate these different levels of representations and assume feedforward and feedback connections between levels. For example, in Dell and O’Seaghdha’s (1992) model of speech production (Fig. 2), semantic features are connected to lexical representations, which are connected to phonemes. Activation flows through the network in response to activation at the semantic level. For example, suppose that the production task involves picture naming and the object to be named is “lion.” The process of picture recognition would lead to the activation of semantic features of the pictured object. Activation of these semantic features would result in a spread of activation from the semantic level to the lexical level, and the appropriate lexical node would become most activated. However, there would also be weaker activation of other lexical representations that share semantic features (e.g., tiger, cat). Activation of these lexical representations would lead to activation of the target word’s constituent phonemes and to weak activation of the constituent phonemes of the semantically related words. The model also includes feedback from the lexical to the semantic level and from the phoneme to the lexical level. Thus, since the lexical node for “lion” will be most activated from the semantic input, feedback from the lexical node to the semantic level will tend to reinforce activation of the appropri- FIG. 2. Dell & O’Seaghdha’s (1992) model of speech production (from Martin & Lesch, 1996). INDEPENDENCE OF INPUT ate semantic features. Similarly, since the phonemes of “lion” will be the most activated, feedback from the phoneme nodes will reinforce activation of the appropriate lexical node. However, some inappropriate nodes will be activated from feedback as well, but to a lesser degree. Thus, the partial activation of the lexical node for “tiger” would feed activation back to a semantic feature for “has stripes,” and the activation of the phonemes for “lion” will cause lexical nodes with similar constituent phonemes (e.g., “line”) to receive some degree of activation. An issue that arises when considering models of language processing is whether the phonological forms involved in perception and production are different. Some models of speech perception and speech production implicitly assume a separation of input and output phonological forms. For example, the modular model of speech production proposed by Roelofs, Meyer, and Levelt (1996; see also Levelt, Roelofs, & Meyer, in press) assumes that in word production a single lexical semantic/syntactic representation (termed “lemma”) is chosen prior to access to a lexical phonological representation (termed “lexeme”). In this model there is no feedback from the lexeme level to the lemma level. In order to avoid such feedback, it is necessary to assume a separation between input and output phonological forms. If they were one and the same, then activation of the lexemic representation should lead to automatic spread of activation back to the lemma level. A number of other theorists have argued on the basis of neuropsychological studies and experimental studies with normal subjects that the phonological forms involved in perception and production are different (e.g., Howard & Franklin, 1990; Monsell, 1987; Shallice, McLeod, & Lewis, 1985). For example, Shallice et al. (1985) demonstrated that there was relatively little interference between reading words aloud (processing output phonology), and detecting a specific name in a speech stream (processing input phonology) whereas there was massive interference between shadowing one message and detecting a name in another (both require 5 processing input phonology). If there are separate input and output phonological forms, then it would seem to follow that the forms used in perception are more closely related to acoustic specifications, whereas the forms used in production are more closely related to articulatory specifications. For example, Jusczyk’s (1993) model of speech perception assumes that acoustic features are abstracted from the input and weighted according to their importance for making distinctions in that language. On the production side, Levelt (1989) suggested that syllable size units are used in production and these consist of the articulatory phonetic features for each syllable. RELATION BETWEEN LANGUAGE PROCESSING AND SHORT-TERM MEMORY Our conception of the theoretical underpinnings of memory span performance assumes that there is a direct relation between the representations and processes involved in word perception and production and those involved in short-term memory. Thus, according to our approach phonological, lexical, and semantic representations are activated in both language processing as well as in verbal short-term memory. We further assume that: (1) all levels of representation in short-term memory depend on the activation of long-term representations within semantic memory (the knowledge store for information about words) and (2) these representations are activated at encoding and this activation is maintained during retention. Two different possible instantiations of this approach are shown in Fig. 3. In Fig. 3a, there is one short-term memory buffer into which all the levels of representation for each lexical item are copied. This approach bears some similarity to the programmable blackboard model of visual working memory presented by McClelland (1986). In Fig. 3b, there are separate buffers for phonemic and lexical–semantic representations. This approach is similar to the model presented by Barnard (1985) for verbal short-term memory. In either approach, we assume that the long-term knowledge store for verbal information (on the left side) is connected to the buffers 6 MARTIN, LESCH, AND BARTHA FIG. 3. Models of short-term memory incorporating separate lexical–semantic and phonological buffers. (a) One buffer containing interactive representations. (b) Separate buffers with interactions only in the long-term knowledge store. such that activated information from the knowledge store continues to activate information in the buffers and the activated information in the buffers feeds back to keep the representations in long-term knowledge store activated. It may seem redundant to assume both persisting activation in the long-term knowledge store and the existence of storage buffers. However, it is unclear how persisting activation in the long-term store could serve to represent list information—in particular, how such activation could be used to differentiate repetitions of the same item in a list (e.g., a list such as “chair leaf chair book”). There are additional reasons to prefer the model in Fig. 3b over that in 3a. First, the presence of several representations in the same buffer, as in Fig. 3a, would seem to suggest that these representations could interact, but it is not clear that such an assumption is necessary. Second, the separation of the buffers provides a more natural means of accounting for the selective impairment in phonological or lexical– semantic retention that has been uncovered in brain-damaged patients (e.g., Martin et al., 1994, see below for further discussion). Third, there are data from animal studies indicating that separate areas of the brain are involved in maintaining different visual features of an ob- INDEPENDENCE OF INPUT ject (such as shape vs. location) over a delay (Wilson, Scalaidhe, & Goldman-Rakic, 1993). There are also some neuroimaging data from humans suggesting separate brain areas involved in working memory for spatial vs. object information, though so far there has been a lack of consistency in the anatomical localization of these areas across studies (e.g., Baker, Frith, Frackowiak, & Dolan, 1996; Smith, Jonides, Koeppe, Awh, Schumacher, & Minoshima, 1995). Thus, these findings suggest that different brain areas are involved in the maintenance of different types of information pertaining to the same stimulus, and those brain areas involved in maintenance differ from the areas involved in the primary processing of these types of information. Rather than assuming that the different levels of representation in the short-term memory buffer can interact, we assume, as in Dell and O’Seaghdha’s (1992) model and the related approach to short-term memory presented by N. Martin and Saffran (1992, 1997), that representations in the knowledge structure continue to interact after an item has been presented such that there is feedforward and feedback of activation between the different levels. Since activation in the knowledge structure at different levels serves to activate the representations in the buffers, the contents of the buffer(s) will reflect the interactions in the knowledge structure. For instance, if high frequency items have stronger lexical activations in the knowledge structure, then high frequency items will tend to have higher activations in the buffer. For word list recall, lexical representations in the buffer are selected for output. For nonword list recall, activation of buffered representations at the phonemic level will be used for recall. According to our approach, if the representations or processes involved in word perception and production are damaged, then short-term memory will be affected as well, with predictable consequences depending on the particular representation or process that is affected. For example, if semantic representations are damaged, then feedback from the semantic to the lexical level will be minimal in the knowledge structure, and consequently the strength of lexi- 7 cal–semantic representations in the buffer will be reduced. Consequently, the normal advantage of word over nonword list recall (Brener, 1940; Crowder, 1978; Hulme, Maughan, & Brown, 1991; see below for further discussion) will be reduced. We have also argued that it is possible for word perception and production to be preserved, but for the buffer to be affected such that patients might show overly rapid decay of representations at a particular level or greater than normal effects of interference from other items in the to-be-recalled list. EVIDENCE FOR MULTIPLE LEVELS OF REPRESENTATION IN SHORT-TERM MEMORY Phonological Representations Language-based models of STM suggest the importance of multiple levels of representation (i.e., phonological, lexical, semantic, syntactic). The contribution of phonological representations to verbal short-term memory is well documented, and many models of short-term memory have dealt primarily with accounting for phonological effects (e.g., Baddeley, 1986; Burgess & Hitch, 1996; Houghton, Hartley, & Glasspool, 1996). Effects of phonological similarity have been taken as evidence for the phonological nature of the short-term store (Conrad & Hull, 1964; Hintzman, 1965; Luce, Feustel, & Pisoni, 1983; Schweickert, Guentert, & Hersberger, 1990; Sperling & Speelman, 1970; Wickelgren, 1966) and word length effects have been taken as evidence for an articulatory rehearsal process (Baddeley, Thomson, & Buchanan, 1975; Mackworth, 1963; Schweickert & Boruff, 1986; Schweickert et al., 1990). Recently, others have argued that word length effects do not necessarily implicate rehearsal, but instead reflect the greater number of phonological segments in longer words (Brown & Hulme, 1995; Neath and Nairne, 1995; Service, 1998). An issue separate from whether phonological representations are maintained in STM is whether there are separate retention capacities for input and output phonological forms. As argued above, some models of language pro- 8 MARTIN, LESCH, AND BARTHA FIG. 4. Model of short-term memory incorporating separate input and output phonological buffers. As in Fig. 3b, interactions occur only in the long-term knowledge store. cessing assume such a separation. A typical procedure in standard short-term memory paradigms involves presenting a list of words auditorily and having the subject reproduce the list orally. Thus, both word perception and word production are involved. Thus, it is plausible that there are separate capacities for maintaining input and output forms. If a separation between input and output phonology exists, then our model in Fig. 3b would need to be revised as shown in Fig. 4 to include separate capacities for maintaining input and output forms. On the word processing side there is a direct connection between input and output forms (that is, that doesn’t go through lexical and semantic forms). The ability to repeat nonwords is evidence for the existence of this connection. Either through learning or possibly through some innate endowment, humans can take an input acoustic form and come up with the articulatory form needed to reproduce it. The connection in the opposite direction reflects the ability to activate the input form from an output form— without involving audible speech production. That is, one can imagine the sound of a word or nonword even when the word or nonword might be pronounced internally. Some have suggested that the recirculation between input and output forms constitutes inner rehearsal (see Howard & Franklin, 1990; Martin, Blossom-Stach, Yaffee, & Wetzel, 1995; Monsell, 1987). With regard to separable STM capacities for retaining input and output forms, there are neuropsychological data that bear on the issue. Howard and Franklin (1988, 1990) have argued for a model in which there are separate input and output phonological stores and a rehearsal process which circulates information between input and output forms (see Monsell, 1987, for a related proposal). Part of their evidence comes from a patient, MK, who showed good performance on matching span tasks and good speech production, but severely impaired single word and nonword repetition. (In a matching span task, the patient has to say whether two lists are the same or different. Since overt repetition is INDEPENDENCE OF INPUT not required, matching span is presumed to reflect the retention of input phonological representations.) They argued that MK had preserved input and output stores but a disruption in the processes which convert between input and output forms. Other evidence comes from Allport’s (1984) study which contrasted two brain-damaged patients, both of whom showed very reduced memory span on repetition tasks. The two patients differed, however, in their performance on a matching span task. One patient performed as poorly on the matching span task as on the list repetition tasks, whereas the other showed excellent performance on the matching span task, at least for three- and four-word lists. Allport argued that the two patients differed in that one had a disruption of an input phonological store, whereas the other had a preservation of the input phonological store, but a disruption of the output phonological store. Romani (1992) has presented more recent evidence of a case who appeared to have a preserved input phonological store and disrupted output phonological store as the patient performed very well on matching span and probe tasks for even nonword lists, but performed poorly on list repetition. Other patients provide evidence of a dissociation opposite to that presented by Romani (1992). Patient EA reported by Martin et al. (1994) and patient JB reported by Shallice and Butterworth (1977) did very poorly on matching span and memory probe tasks (which also do not require list output), thus implying a disruption of the input phonological store. However, their spontaneous output was normal as assessed by a variety of measures including speech rate, syntactic complexity, pausing, etc. Assuming that spontaneous speech production involves planning several phonological forms simultaneously, their preserved production suggests a preserved output phonological store. In evaluating these neuropsychological data, it is necessary to take care to distinguish whether the evidence strongly supports the assumption of separate input and output phonological codes and input and output stores or whether a model which assumes separate input and output pathways between a single phono- 9 logical representation and semantics could accommodate the data (see Shallice, 1988, for discussion). Thus, for example, if a patient has good spoken word comprehension but poor production, one would not need to postulate separate input and output phonological forms, as the difficulty might be in the output pathway for activating phonology from lexical and semantic representations. However, some of the cases discussed above present a challenge to the single phonological representation account. For example, patient EA (Martin & Breedin, 1992; Martin et al., 1994), who was argued to have an input store deficit, showed excellent comprehension of single words, and it would thus be difficult to argue that disruption of the input pathway from phonology to semantics could account for her severe deficit on input STM tasks. Similarly, the patient reported by Romani (1992), who was argued to have an output store deficit, was good at producing single words as names of pictures and in repeating single words, and thus disruption of the output pathway from semantics to phonology seems an unlikely account of his output store difficulties. One source of evidence that seemed to argue strongly for the separation between input and output phonology came from cases of deep dysphasia (see Howard & Franklin, 1988, for a review). These patients have difficulty repeating nonwords and make semantic errors in the repetition of single words (e.g., saying “mirror” in response to “reflection”). They also show effects of imageability on word repetition, with better success at repeating high imageability words. The patients’ semantic errors suggest that phonological perception proceeded accurately— otherwise, why would they access a semantically related word? If input and output phonological forms were the same, one would then expect these patients to be able to produce the phonological form that they had perceived. Their production of a semantically related word, rather than the correct word, suggests that the input form cannot be used for production and that they had some type of difficulty in retrieving the output form (because of either degraded semantic representations or output phonological representations or impaired links between 10 MARTIN, LESCH, AND BARTHA them). This pattern of symptoms could not easily be accounted for in terms of separate pathways from semantics to phonology on the input and output sides, but one phonological representation. Even if output links from semantics to phonology were damaged, the patient should still be able to produce the phonological form perceived on the input side if the input and output forms were the same. Even though the evidence from deep dysphasia may seem to provide compelling support for a separation between input and output phonology, N. Martin and Saffran (1992) have proposed an account of these symptoms using their interactive activation model, which is closely related to Dell’s (1986; Dell & O’Seaghdha, 1992) model of speech production. In order to account for repetition, the model is assumed to work in the opposite direction as well, that is, in perception as well as in production. Their approach does not assume a separation between input and output phonological forms in accounting for deep dysphasia. Instead, they assume that deep dysphasic patients suffer from a rapid loss of activation at the phonological, lexical, and semantic levels. Since the phonological representation derived from perception of the input decays very rapidly, it is not available at the moment of production and has to be reconstituted from semantics. Decay at the lexical and semantic levels results in semantic errors (and other error types) in repetition. 1 Recently, however, Dell, Schwartz, Martin, Saffran, and Gagnon (1997) encountered difficulties when they attempted to model both the word production and word repetition patterns of aphasic speakers with this model. They found that the parameters needed to account for patients’ accuracy and error patterns in production could not reproduce their repetition patterns. To model repetition more accurately, it was necessary to assume that perception was entirely ac1 Howard and Franklin’s patient MK made semantic errors in repetition and showed very poor nonword repetition; thus, he would fit the clinical designation of deep dysphasia. MK’s good performance on tasks tapping the retention of input phonological forms argues against N. Martin and Saffran’s (1992) account of deep dysphasia as a general account of all patients showing this symptom complex. curate for most patients. In order to capture this difference between perception and production in their model, there has to be some separation between input and output phonological processes. They leave as an open question the issue of exactly where this differentiation occurs. Lexical and Semantic Representations With regard to the involvement of lexical and semantic codes in short-term memory, findings from both normal and brain-damaged patients support this assumption. For example, studies of normal subjects have demonstrated that memory span is greater for words than nonwords (Brener, 1940; Crowder, 1978) even when controlling for pronunciation rate for the two types of materials (Hulme, Maughan, & Brown, 1991). Thus, there is a lexical contribution to span that appears to be independent of the functioning of the articulatory loop (but see Multhaup, Balota, & Cowan, 1996). Also, memory span is greater for high than low frequency words (Gregg, Freedman, & Smith, 1989; Roodenrys, Hulme, Alban, Ellis, & Brown, 1994; Tehan & Humphreys, 1988; Watkins, 1977), greater for words drawn from the same semantic category than for words drawn from disparate categories (Poirier & St. Aubin, 1995), and greater for high than for low imageability words (Bourassa & Besner, 1994). Findings from neuropsychological studies support the conclusion that not only are semantic and phonological information retained in STM, but the capacities for retaining the two types of information are separable. These studies have demonstrated that dissociations may be obtained between patients’ ability to retain phonological and semantic information. These dissociations have been documented by examining the effects of phonological and lexical/semantic variables on span and by examining serial position effects and error patterns. For example, Martin et al. (1994) reported that patient EA failed to show normal effects of phonological similarity and word length on memory span, but showed a normal advantage in memory span for words over nonwords and performed better on a category probe task than on a rhyme probe task. Patient AB showed the reverse pattern of normal phonological effects, equivalent word INDEPENDENCE OF INPUT and nonword span, and better performance on a rhyme probe than category probe task. Another patient, ML, has recently been documented to show a pattern similar to that of AB (Martin & Lesch, 1996). Importantly, patients AB and ML perform at high levels on tasks that assess the integrity of semantic information (Martin & Lesch, 1996). Thus, it is the short-term retention of semantic information that is impaired and not semantic knowledge itself. Based on these data, Martin and colleagues (Martin & Lesch, 1996; Martin & Romani, 1994; Martin et al., 1994) propose that the capacities for the short-term retention of semantic and phonological information are separable. Additional neuropsychological evidence for the involvement of lexical and semantic codes comes from the work of Patterson and colleagues and of N. Martin and Saffran. Patterson, Graham, and Hodges (1994) and Knott, Patterson, and Hodges (in press) have demonstrated that patients with dementia that affects semantic representations show a larger word span for known words than for unknown words (that is, words for which they no longer know the meaning). Saffran and N. Martin (1990; Martin & Saffran, 1992, 1997) have analyzed the word processing and short-term memory deficits of patients with phonological vs. semantic processing deficits and found distinctive short-term memory patterns with regard to recency and primacy effects in serial recall and the effects of imageability and frequency at early vs. late serial positions. That is, patients with phonological processing deficits tend to show greater primacy than recency effects and greater effects of imageability at late serial positions, whereas patients with semantic processing deficits tend to show greater recency than primacy effects and large effects of imageability at early list positions. Thus, there is evidence from both normals and brain-damaged patients supporting the involvement of multiple linguistic codes in verbal short-term memory. GOALS OF THE CURRENT INVESTIGATION The present study investigated the relation between word perception and production and 11 short-term memory and the possible distinction between input and output phonology by examining the performance of MS, an anomic patient—that is, a brain-damaged individual with a severe and selective deficit in naming. According to the models shown in Figs. 1 and 2, a naming deficit could result from a breakdown at any point in the process going from semantics to articulation (including, for example, disrupted semantic representations or a disruption of connections between lexical and phonemic representations). For MS, we will present evidence that semantic and lexical levels are preserved and that his difficulty is in activating a phonological representation. According to the models shown in Figs. 3 and 4, a disruption of the connection between lexical and phonological representations in speech production should affect short-term memory, since the same representations and connections between representations are involved in feeding activation into the short-term memory buffer. Moreover, to the extent that the naming deficit is specific to certain items or types of items, then short-term memory for those items should also be impaired. The proposed distinction between input and output phonological capacities (see Fig. 4) is also relevant to the analysis of MS’s short-term memory performance. The contrast between his preserved comprehension and his very impaired naming suggests that input phonology, semantics, and the connections between them are preserved even though the connections between lexical representations and output phonology are disrupted. Thus, to the extent that input and output phonological representations are distinguished in short-term memory, one would predict that MS would perform poorly on tasks tapping the retention of output phonological codes, but might perform well on tasks tapping the retention of input phonological codes. PATIENT DESCRIPTION MS is a 30-year-old, right-handed male with 2 years of college education. He contracted herpes encephalitis in 1993 which resulted in an impairment of language abilities together with a sparing of most other cognitive abilities. An 12 MARTIN, LESCH, AND BARTHA MRI scan and an EEG recording suggested left temporal damage. The testing reported here took place between 6 months and 3 years postonset. MS displays a pattern of surface dyslexia and dysgraphia on single word reading and writing tasks. That is, he reads and spells regularly spelled words (e.g., belt) much better than irregular words (e.g., sword) and tends to make regularization errors in reading and spelling (e.g., reading “yacht” as /yækt/ and spelling “pheasant” as “fezent”). On the word lists from the Psycholinguistic Assessments of Language Processing in Aphasia (PALPA) (Kay, Lesser, & Coltheart, 1992), MS obtained a mean of 93% correct (across two testing sessions) in reading regular words, but only 52% correct in reading irregular words. Because of his difficulties with reading and spelling, the current investigation probed his abilities with tasks that used auditory presentation and oral responses. Portions of these data were presented previously in Martin and Lesch (1996). WORD PRODUCTION AND COMPREHENSION The tests reported below examined MS’s single word production and comprehension. These tests were administered in order to explore the nature of MS’s naming difficulty. Anomia may have multiple causes. For example, a patient may have difficulty naming pictures because the semantic representations corresponding to the depicted objects have been damaged (Warrington, 1975; Howard & Orchard-Lisle, 1984) or because the phonological representations for certain words have been disrupted (see Ellis & Young, 1988) or because the patient has difficulty activating a phonological representation from an intact lexical–semantic representation (Kay & Ellis, 1987). The following tests were designed to provide a rigorous assessment of MS’s semantic knowledge in order to rule out a semantic impairment as the cause of his anomia. Word Production Naming. MS obtained a score of 10 on the 60-item Boston Naming Test (Kaplan, Goodglass, & Weintraub, 1983), indicating a severe impairment in naming ability (control mean 5 TABLE 1 Number Correct on the Philadelphia Naming Test as a Function of Frequency and Length Number of syllables Frequency 1 2 3 4 Low Medium High 14/48 19/26 19/26 10/37 3/9 5/5 4/16 2/4 n/a 0/3 n/a n/a 55.86, SD 5 2.86, Kaplan et al., 1983). MS was also tested on the Philadelphia Naming Test (Roach, Schwartz, Martin, Grewal, & Brecher, 1996), which consists of 175 items with names varying on number of syllables (one to four) and frequency (frequency ranged from 1 to 20 for low, from 21 to 66 for medium, and from 70 to 1771 for high frequency items; means 5 7.69, 38.69, and 278.84 for the low, medium, and high items, respectively, Francis & Kucera, 1982). MS performed poorly, obtaining only 76/174 (44%) correct (the picture “ambulance” was removed as the name appeared within the picture). Performance varied as a function of frequency, with high frequency items (77% correct; 24/31 correct) being named correctly much more often than low frequency items (27% correct; 28/104 correct), x 2 5 25.71, P , .005; however, there was no evidence for an effect of number of syllables (see Table 1). Ninety-five percent of MS’s errors consisted of circumlocutions (i.e., descriptions of the meaning and/or use of the item). For example, for cane: “This is something you use to walk with if you have trouble walking, if you have, you broke your leg or something, and you need something to help you walk.” This description clearly suggests that MS comprehends the concept “cane.” The preponderance of semantic descriptions in MS’s responses suggests that detailed semantic information is available for objects that he cannot name. It has been found that some anomic patients who are initially unable to name a picture are successful when provided with a phonemic cue (Funnell & Hodges, 1991; Howard & OrchardLisle, 1984; Myers Pease & Goodglass, 1978). INDEPENDENCE OF INPUT In a follow-up to the Philadelphia Naming Test, MS was asked to name just those pictures that he had not been able to name on that test (98 pictures). If unsuccessful, he was then given a phonemic cue (the first phoneme of the target word). On this retest, MS was unable to name 60 of the 98 pictures. When provided with a phonemic cue, he was then able to name 31/60 of those pictures. A beneficial effect of a phonemic cue on naming is consistent with the hypothesis that output phonological representations persist, but MS has difficulty activating those representations. In terms of the model in Figs. 3 and 4, the connections between lexical and phonological representations have been weakened but have not been totally disrupted. Access to syntactic features of nonnameable pictures. In a recent study, Vigliocco, Vinson, Martin, and Garrett (in press) examined MS’s ability to make count/mass judgments when in an anomic state, that is, when unable to retrieve the phonological form when trying to name a picture or produce a name to a definition. Count vs. mass is a syntactic feature of a lexical representation that determines various syntactic frames into which a word can be fit (e.g., “There is a _______“ and “There won’t be many ____” for count nouns vs. “There is _________” and “There won’t be much ________” for mass). Although the count vs. mass distinction relates to conceptual features of the objects to be named, there are some nouns for which the distinction is quite arbitrary (consider “artichoke” vs. “broccoli”). The objects chosen for this study were all selected such that the count/ mass distinction was nonobvious from the conceptual features of the picture or definition. When MS was unable to provide a name, he was asked to choose which syntactic contexts were appropriate for the word he was trying to retrieve. He was highly accurate in making these judgments (.80% correct on 91 trials), even on trials for which he was unable to provide any segmental or syllabic information about the word. His accuracy on these judgments was within the range of 10 control subjects who were provided the names and asked to make the same judgments about appropriate syntactic contexts (mean accuracy 5 85%). 13 MS’s good access to this syntactic feature would suggest that even when he cannot retrieve phonological information, he can access a lexical representation (irrespective of which theory of lexical representations is employed) and that his naming difficulty does not derive from weak connections between semantic and lexical representations. Speech Perception Auditory discrimination task. In order to assess MS’s speech perception abilities, an auditory discrimination task (provided by N. Martin & Saffran, personal communication) was administered. There were 80 pairs of nonwords and 80 pairs of words— half of which were “same” and half of which were “different.” On the “different” trials the word (e.g., funnel– tunnel) and nonword pairs (beck–feck) differed in one phoneme and the position of the difference was varied. As a relatively pure test of auditory discrimination (that is, one that minimizes a short-term memory component), MS was asked to judge whether a pair of words was the same or different when there was no delay between presentation of the two items. In this condition, MS obtained 99% correct. When a delay of 5 s was introduced between presentation of the two members of the pair, MS again obtained 99% correct. Finally, when there was a filled 5-s delay (when the patient and the examiner counted out loud), MS obtained 98% correct. Thus, MS demonstrates a good ability to perform auditory discrimination in both no-delay and delay (unfilled or filled) conditions. MS was also tested on an auditory lexical decision task which included 180 words (90 abstract and 90 concrete words that were matched in frequency) (from Kroll & Merves, 1986) and 180 nonwords which differed from the real words by either one or two phonemes (provided by N. Martin and Saffran, personal communication). MS scored 96% correct overall with little difference in performance between words (172/180) and nonwords (173/180). Five of eight of the word errors were to abstract words. In a second test (see N. Martin & Saffran, 1992) of 160 items (80 words; 80 nonwords) the words varied on imageability and 14 MARTIN, LESCH, AND BARTHA frequency and the nonwords differed from the words by one or two phonemes. MS again scored at a high level, obtaining 97% correct overall, with little difference in performance between the words (76/80 correct) and nonwords (79/80 correct). All four word errors were to low frequency–low imageability words. Peabody picture vocabulary test. MS was tested on the Peabody Picture Vocabulary Test (Dunn & Dunn, 1981), which involves hearing a spoken word and choosing from four picture alternatives the one that matches the word. MS performed in the low-normal range (standard score 5 86 relative to age-matched controls where m 5 100 and s 5 15). This level of performance clearly contrasts with his extremely poor performance on a standardized naming test (i.e., the Boston Naming Test; Kaplan et al., 1983). However, the PPVT was not specifically designed to include close semantic distractors among the nonmatching pictures. Thus, it might be possible to obtain a good score on this task despite having only partial semantic knowledge of many of the words. Thus, several additional experimental tasks were administered that tested semantic knowledge more closely. These were based on tests developed by Hillis and Caramazza (1995), who demonstrated that these tests revealed semantic deficits in a so-called optic aphasic patient where other more standard tests had not. Which is more closely related task. In this task, the subject sees a picture of one object and is asked to pick the object that is most closely related to it from a picture of a pair of objects (e.g., which is more closely related to a desk, a table, or a bureau?). In this task, both alternatives are related to the target object, but one is more closely related. This task was administered to eight control subjects and only items for which there was a high degree of consistency (greater than 75%) in responding were included in the test. MS obtained 19/22 (86%) correct. This level of performance corresponds to the mean for the control subjects (range 5 13 to 22 items correct). Single spoken word-to-single-picture matching. In this task, the subject sees a single pic- tured object and is asked, “Is this a ____?” For each word (e.g., “cat”), four trials are presented. The four trials included a correct picture (cat), a picture of a semantically related object (dog), a picture of an object with a phonologically similar name (hat), or an unrelated (semantically or phonologically) picture (nailclippers). The test was administered over four sessions, with each word occurring once per session. This test was not administered to control subjects as it was assumed these subjects would obtain 100% correct. MS obtained 205/216 (95%) correct overall, with all 11 errors occurring when words were paired with semantically related pictures (e.g., “thread” paired with a picture of yarn). MS’s 20% error rate (11/54) on the semantically related pictures might suggest that he has some semantic disruption for these items. We decided to further probe MS’s comprehension of these 11 objects by presenting the pictured object and asking four questions designed to determine whether MS understood the differences between the pictured object and the word that had been presented (e.g., for the picture yarn which had been presented with “thread,” one of the questions was: Do you knit with this?). One question was asked at a time and the 11 pictures were cycled through four times in order to ask four questions per picture. MS answered all of the questions correctly, suggesting that his errors on the word-to-picture matching task were not due to comprehension failures, but more likely to a low criterion for a match decision— when questions were focused so as to distinguish between the members of each pair, MS performed perfectly. Attribute questions for pictured objects. In this task, the subject is presented with a picture of an object from one of the following categories: animals, vehicles, clothing, and edible plants. There were 33 animals, 26 vehicles, 25 articles of clothing, and 20 edible plants. Five questions were asked about attributes of the pictured objects from each category. For animals: Does it have fur? Does it eat other animals? Is it found in water? Is it domestic? Is it dangerous? For vehicles: Does it require fuel? Is it primarily used for recreational purposes? Is it used on land? Is it primarily used to transport 15 INDEPENDENCE OF INPUT TABLE 2 Performance of MS and Control Subjects on Questions Probing Semantic Knowledge for Pictured Objects—Number of Items Correct Category MS Controls Mean (SD) Range Animals Vehicles Clothing Plants 134/139 109/111 103/105 83/90 131 (5.09) 120–136 105 (3.08) 98–109 100 (3.86) 93–105 88 (1.45) 85–90 people? Is it quiet? For clothing: Is it used in cold weather? Is it for men? Is it formal wear? Is it worn on the extremities? Is it an accessory? For edible plants: Is it green? Is it primarily eaten raw or cooked? Is it a fruit or a vegetable? Do you eat the skin? Can it be used in preparing a dessert? Presentation of the pictures was blocked by category and, on each presentation of a picture, only one question was asked. After completing one question for a given category, the category was changed and one question was asked about all the pictured objects in that category. This procedure continued until all five questions for each category had been asked. Testing occurred over several sessions. This task was also administered to controls such that, for each category, data were obtained from 16 subjects. Unlike MS, no individual control subject answered questions from all four categories. Therefore, comparison to MS will be made on a category-by-category basis. Before examining MS’s performance, the performance of controls was examined for consistency of responding. Items (questions for particular objects) for which there was less than 75% agreement were eliminated. Additionally, one question for the clothing category (is it worn on the extremities?) was removed because MS seemed unfamiliar with the concept of “extremity.” After the removal of these items, MS obtained 134/139 (96%) correct on the questions about animals, 109/111 (98%) correct for vehicles, 103/105 (98%) correct for clothing, and 83/90 (92%) correct for edible plants. For all the categories except for edible plants, MS’s performance was above the mean for the control subjects (see Table 2). However, MS’s performance for edible plants fell just outside of the range for the controls. 2 In order to compare comprehension and naming performance for the same set of items, MS was asked to name the pictures that had been used in this comprehension test. MS named 45/104 (43%) of these items. There was no indication that MS’s naming deficit is due to a semantic impairment: MS failed to name 61% (51/84) of the items for which he scored 100% on the comprehension task, whereas he failed to name only 35% (7/20) of the items for which he made an error on one of the comprehension tests. SUMMARY OF PERFORMANCE ON COMPREHENSION TASKS MS performed at, or above, the mean for the control subjects on several of the comprehension tasks. The exceptions were the questions probing knowledge about pictured edible plants and the semantically related trials for the picture–word matching test (in fact, controls were not tested on the picture–word matching test as it was assumed that their performance would be at 100%). On the edible plants questions, MS’s performance fell just outside the range of the 2 There are several instances reported in the literature of herpes encephalitis cases who have a selective disruption of semantic knowledge for living things (see Saffran & Schwartz, 1994), and it might be hypothesized that MS’s deficit for plants reflects a mild version of this pattern. However, these patients tend to show impairments for both animals and plants and there was no evidence that MS had an impairment for animals. 16 MARTIN, LESCH, AND BARTHA controls. With regard to the semantically related picture trials, further probing indicated that MS has a good ability to distinguish the semantic properties of pictures and words for the trials on which he had made errors. MS’s high level of performance on tasks designed to require detailed semantic knowledge (Hillis & Caramazza, 1995) argues strongly that his naming deficit is not the result of an impaired semantic system. Even though there may be some indication of a semantic deficit limited to the category edible plants, this potential deficit clearly cannot account for the pattern of results observed with MS. Additionally, when asked to name the pictures involved in some of the comprehension tasks, there appeared to be little relationship between his naming and comprehension. For those items for which he performed perfectly on the questions probing semantic knowledge, he named only 39% (33/84), which again argues that his naming deficit is not related to a semantic impairment. These results, along with the finding that a phonemic cue benefits naming performance, are consistent with the hypothesis that MS has intact semantic representations and that the connections between lexical–semantic representations and output phonological representations remain, but have been weakened. For normal subjects, we assume that the connections between lexical and phonological representations are stronger for high frequency words than for low frequency words (for discussions of word frequency effects in production see Dell, 1990, and Jescheniak & Levelt, 1994). To explain the large frequency effect in naming for MS, we would hypothesize that the connections between lexical and phonological representations have been damaged for words of all frequencies, but because of the weaker connection strengths for low frequency items, the disruption to naming is more evident for these items. representations or damaged phonological word forms. If this same ability to activate output phonology from semantics is involved in word list recall, then MS should be impaired on shortterm memory tasks as well. SHORT-TERM MEMORY Words vs. nonwords. One piece of evidence that semantic information supports recall comes from the observation that memory span is greater for word lists than for nonword lists (Brener, 1940; Crowder, 1978; Hulme et al., 1991; Multhaup et al., 1996). MS was thus MS’s performance on the naming tasks and comprehension tasks suggests that his anomia reflects an inability to activate phonological representations from lexical–semantic representations and is not a result of degraded semantic Digit Span and Digit Matching Span Our initial evaluation of MS included the forward digit span task from the WAIS-R (Wechsler, 1981). On this test MS repeated the lists perfectly up to the eight-item lists, at which point he missed 1 of 2 lists. On a subsequent test of digit span using a pointing response (with 20 lists at each list length), MS scored at a normal level, obtaining 100, 90, 85, and 80% correct for four-, five-, six-, and seven-item lists, respectively. He also performed well on a digit matching span task. In this task, the subject hears 2 lists containing the same digits and is asked to judge whether the order of the items is the same or different across the 2 lists. On the nonmatching trials, the second list reverses the order of two adjacent items. Position of the reversal was balanced across serial positions. There were 20 lists with 10 matching and 10 nonmatching trials. MS’s performance was excellent, as he obtained 95% correct on six-item lists (the mean level of performance for six control subjects was 93% correct; range, 85–100% correct). The digit span results suggested that MS has normal short-term memory and thus appeared to contradict the hypothesis of a close relation between word production processes and list recall. However, digits are high frequency words (the word frequencies for the digits 0 to 9 range from 81 to 3372 per million, with a mean of 729.33 and standard deviation of 1074.93; Francis & Kucera, 1982) and, as indicated in the discussion of the naming results, MS’s naming ability was much worse with low frequency words. Word List Repetition 17 INDEPENDENCE OF INPUT TABLE 3 Percentage of Lists Correct for Word and Nonword Lists Matched in Constituent Phonemes—Repeated Sampling from Same Pool List length MS Words Nonwords 2 3 4 5 100 100 100 100 60 80 20 20 List length 3 4 5 Control subjects—Mean level of performance (range) Words 98 90 52 (90–100) (80–100) (10–80) Nonwords 90 63 25 (90) (30–90) (0–60) tested on the recall of word and nonword lists. The words were of low frequency (,10 per million, Kucera & Francis, 1967) and the nonwords were formed by switching phonemes among the words. A standard span procedure was used in which list recall began with 10 two-item lists and list length was increased by increments of one until lists were five items in length. Items were drawn from the same pool for each presentation. Spoken recall was used. The results are shown in Table 3. MS did not show the standard pattern of better recall for word than for nonword lists—at no list length did MS show an advantage of word over nonword recall. Recall was actually slightly worse for the word lists than the nonword lists, suggesting that MS’s recall does not benefit from the semantic information provided by words. Six control subjects were tested at list lengths three through five. As can be seen in Table 3, MS’s recall of the nonword lists was within the normal range, while his word recall was below the range of controls for the four-item lists. Collapsing across list length, all six control subjects showed an advantage of word recall over nonword recall (mean advantage, 21%; SD, 11.43). For only one subject, at one list length, did nonword recall exceed word recall: At list length four, one subject recalled one more nonword list than word list. We also had MS recall word and nonword lists that did not repeatedly sample from the same pool (in order to make the task more comparable to the recall tasks reported below). Word lists consisted of low frequency words (,10 per million, Kucera & Francis, 1967), while the nonwords again were formed by rearranging the phonemes contained within the words. As can be seen in Table 4, we again obtained evidence that MS’s recall does not benefit from the semantic information provided by words (indeed, for four-item lists substantially more nonword lists were recalled than word lists). A comparison with seven control subjects indicates that MS performed at a high level in recalling nonwords. However, in recalling word lists, MS again scored below the range of control subjects on the four-item lists. Collapsing across list length, all seven control subjects showed an advantage of word recall over nonword recall (mean advantage, 30%; SD, 7.14). For only one subject, at one list length, did nonword recall exceed word recall: At list length five, one subject recalled one nonword list and no word lists. Words varied on frequency and imageability. MS was also tested on list repetition tasks provided by N. Martin and Saffran (see Saffran & Martin, 1990; Martin, Saffran, & Dell, 1996) in order to examine effects of imageability and TABLE 4 Percentage of Lists Correct for Word and Nonword Lists Matched in Constituent Phonemes—New Items on each List List length MS Words Nonwords 3 4 5 100 100 30 70 20 10 Control subjects—Mean level of performance (Range) Words 99 84 17 (90–100) (70–100) (0–40) Nonwords 80 27 1 (60–90) (10–40) 0–10) 18 MARTIN, LESCH, AND BARTHA TABLE 5 Percentage of lists correct as a function of frequency (HF, LF) and imageability (HI, LI) MS HF HI LI Mean LF HI LI Mean Overall mean Controls 3-word 4-word 4-word 5-word 95 100 98 80 73 77 97 96 97 71 65 68 70 65 67 83 60 7 34 55 95 89 92 94 53 41 47 58 frequency on list recall. As indicated previously, N. Martin and Saffran (1992, 1997; Martin et al., 1996; Saffran & Martin, 1990; see also R. Martin & Lesch, 1996) have obtained evidence suggesting an association between type of STM impairment (phonological, semantic, or mixed) and patterns of imageability and frequency effects on list recall. Half of the lists were composed of high imageability words and half of low imageability words. High imageability words had ratings greater than 4.97 (on a scale of 1–7), while low imageability words had ratings less than 4.97 (Paivio, Yuille, & Madigan, 1968). Within each level of imageability, half of the lists were composed of high frequency words and half of low frequency words. High frequency words had frequencies of greater than 40 per million, while low frequency words had frequencies of less than 30 per million (Kucera & Francis, 1967). MS was presented with 80 three-word lists and 60 fourword lists. Spoken recall was used. Overall, MS recalled 83% of three-word lists and 55% of four-word lists. The percentage of lists correct by frequency and imageability is shown in Table 5. MS showed substantially better recall for the high than low frequency lists for both list lengths (for list length three, 39/40 lists vs. 27/40: x 2 5 12.47, P , .005; for list length four, 23/30 vs. 10/30: x 2 5 11.38, P , .005). An effect of imageability was evident within the four-word low frequency lists where he showed much better recall of the high than low imageability lists (9/15 vs. 1/15: x 2 5 9.60, P , .005). In terms of items correct at each serial position, the pattern of recall was similar for both list lengths (see Fig. 5)—a reduced recency effect and an effect of frequency particularly at later list positions. This pattern is consistent with data that N. Martin and Saffran (1997) have obtained from patients with presumed phonological deficits. Table 6 presents a breakdown of the errors (collapsed over list length) that MS made for the different list types. These errors do not include order errors (i.e., reporting an item in the incorrect serial position). As can be seen from Table 6, a high percentage of MS’s errors shared a phonological relationship with the target word, indicating that MS retained phonological information about the words in the lists. Further, it is FIG. 5. Frequency and imageability effects as a function of serial position (Martin & Lesch, 1996). 19 INDEPENDENCE OF INPUT TABLE 6 Percentage of Error Types in List Recall as a Function of Frequency (HF, LF) and Imageability (HI, LI) Error types Patient MS HF HI LI LF HI LI Controls HF HI LI LF HI LI Sa SD P-W P-NW 0 0 20 0 0 33 40 33 0 10 32 5 11 22 0 0 0 0 ,1 0 0 0 (SD 1 P) U O Other N 0 0 0 17 40 17 0 0 5 6 11 37 37 5 0 0 11 17 0 5 19 41 29 18 0 0 3 0 4 5 55 70 11 7 21 17 ,1 1 ,1 ,1 0 2 70 77 8 3 a Note. S, semantically related word; SD, semantic description; P-W, phonologically related word; P-NW, phonologically related nonword; SD 1 P, semantic description combined with a phonologically related response; S 1 P, semantically and phonologically related response; U, unrelated; O, omission; Other, some other type of response. N, total number of errors for that list type. interesting to note that phonologically related nonword responses appeared somewhat more likely than phonologically related word responses. We will return to this point later. MS’s responses also quite often included semantic descriptions of the words within the lists. This type of response was particularly likely in the recall of low frequency, high imageability lists. For example, for the list lobster, castle, and bagpipe, he responded: “losser—the thing you eat, the place the kings go in,” and “it comes from the place where men wear the same things as women” (mimics use). As shown in Table 6, 32% of MS’s errors on the low frequency, high imageability lists were semantic descriptions of the items. An additional 37% of his errors consisted of a semantic description combined with a phonologically related response. On the low frequency, low imageability lists, 5% of MS’s error responses consisted of semantic descriptions, while an additional 10% were semantically related words. The occurrence of semantic descriptions in MS’s recall suggests that MS at times retained semantic information about a word that he could not produce correctly. The greater likelihood of these errors on high imageability items most likely occurred because of the richer semantic information in these items. Control subjects were tested on the recall of both four- and five-item lists varying on frequency and imageability in order to determine whether MS’s level and pattern of performance would differ from those for controls. The fouritem lists were those that MS had been asked to recall, while the five-item lists were constructed by rearranging words from the four-item lists. Five subjects participated in the recall of the four-item lists, while 36 subjects participated in the recall of the five-item lists. The recall performance of the control subjects demonstrated effects of both frequency and imageability: In the recall of five-item lists subjects recalled significantly more high frequency (68%) than low frequency lists (47%), t(33) 5 8.96, P , .001, and significantly more high imageability (62%) than low imageability lists (53%), t(33) 5 3.83, P , .001. Finally, the Frequency X Imageability interaction was marginally significant, F(33) 5 1.94, p 5 .06. The 20 MARTIN, LESCH, AND BARTHA results thus replicate previous studies demonstrating frequency and imageability effects in list recall (e.g., Hulme et al., 1991; Bourassa & Besner, 1994) and further provide some evidence that these factors interact in supporting retention (this pattern of results is similar to that obtained by Lesch & Martin, 1998). As is evident in Table 5, MS performed substantially worse than the controls. Control subjects recalled 94% of the four-item lists (range, 5 87–100%) compared to 55% of lists correct for MS. The mean performance of the controls on the five-item lists (mean, 58%; range, 7–95% correct) was similar to MS’s level of recall for the four-item lists (55% correct). Although both MS and the control subjects showed effects of frequency and imageability, there was some indication of greater effects of these variables for MS than the controls. These comparisons are somewhat difficult to make, given the different level of performance for MS and the controls. However, some comparisons can be made by evaluating the effects of frequency and imageability when MS and the controls are matched for performance on certain cells (necessarily at different list lengths). For example, MS’s level of performance on the high frequency threeword lists (98%) was similar to that of controls on the four-word high frequency lists (97%). However, MS showed a much greater frequency effect on the three-word lists (31%) than did the controls on the four-word lists (3%). Also, the level of performance for MS on the high frequency four-word lists (77%) was fairly similar to that of the controls on the high frequency five-word lists (68% correct), but again MS showed a much larger frequency effect on the four-word lists (43%) than did the controls on the five-word lists (21%). It should be noted, though, that on the four-word lists, the larger frequency effect for MS was due primarily to his very poor performance on the low frequency, low imageability lists. For the low frequency four-item lists, MS showed a much larger effect of imageability (53%) than did the controls for the low frequency five-word lists (12%) even though MS and the controls were approximately matched in their level of recall for the low frequency, high imageability items. In order to explore the types of errors made by control subjects, mean error rates were calculated as a function of frequency, imageability, and error type. Subjects who accurately recalled all the lists in any frequency–imageability condition were excluded. The mean error rates are presented in Table 6. The error distributions appear quite different for MS and for the control subjects. Whereas MS provided a large percentage of semantic descriptions, control subjects never provided semantic descriptions of the items to be recalled and only very rarely produced semantically–related responses. Additionally, control subjects very rarely made phonologically related nonword responses, while this type of response was quite common in MS’s recall. The predominant error types for the controls were omissions and the substitution of phonologically related words. Thus, not only does MS’s level and pattern of performance differ from that of control subjects, the types of errors also differ (even when overall level of recall is approximately matched). List recall—Names of pictures named/not named and words with and without comprehension errors. MS performed at a high level on a variety of tasks that require the access of detailed semantic information, suggesting that his poor performance on list recall is not the result of insufficient semantic support due to disrupted semantic representations. In order to provide further evidence on this point, MS was tested on recall of lists of words corresponding to the names of pictures that he could or could not name and words for which he made or did not make comprehension errors. Given MS’s generally high level of performance on the semantic tasks, it is difficult to claim that his semantic knowledge for items with errors was actually disrupted relative to controls, since his level of performance was similar to that of controls on most tests. That is, even though MS made an error on, for example, one attribute of an object in the attribute questions task, his performance could not be said to differ from controls since they also made such errors at a similar rate— though perhaps not on the same items. However, if one takes a conservative approach and hypothesizes that MS does in fact have some 21 INDEPENDENCE OF INPUT degree of semantic deficit for the items on which he made errors, then recall should be worse for lists of items for which MS demonstrated some comprehension difficulty (see Warrington, 1975; McCarthy & Warrington, 1987; Patterson et al., 1994). 3 On the other hand, if difficulty in phonological retrieval underlies his naming deficit, and if list recall involves the same phonological retrieval processes involved in naming, then list recall should be worse for items he could not name than for items he could name. Items that MS could/could not name were taken from the Philadelphia Naming Test. Items that MS could/could not comprehend were taken primarily from the comprehension tasks reported above. Items for which there was the strongest evidence of comprehension difficulty (items that were responded to incorrectly in more than one task) were selected first. MS was presented with 10 four-item lists of the following types: (a) items that MS could name, (b) items that MS could not name, (c) items for which MS made errors on the comprehension tests, and (d) items for which MS made no errors on these tests. The named/not named lists were approximately matched in terms of frequency and number of syllables. The comprehended/not comprehended lists were also matched in terms of number of syllables, but as there were relatively few items for which MS demonstrated comprehension difficulty, it was difficult to match lists in terms of frequency. All lists were presented auditorily and spoken recall was used. This task was administered twice, 3 Warrington (1975; McCarthy & Warrington, 1987) first employed the known/unknown technique to study patients with characteristics similar to the patients of Patterson et al. (1994) and failed to observe a significant advantage for known compared to unknown items. Patterson et al. point to the different methods used to select known/unknown items as one possible source of the discrepant findings. They further suggest that the near ceiling levels of performance by Warrington’s (1975) patient on the unknown items suggests that, at the time of initial testing, the patient still maintained semantic knowledge for these items. At the time of a second testing, when a comparison of unknown words to nonwords was made, performance had dropped considerably for these items. However, no comparison was made for the known items. with the second testing occurring approximately 6 months after the first testing. As the pattern of performance was similar across the two administrations, we will report means collapsed over administration. MS was better able to recall lists composed of items that he could name (95% lists correct; 99% items correct) than lists of items that he could not name (55% lists correct; 81% items correct), for lists correct (19/20 vs. 11/20), x 2 5 8.53, P , .005, for items correct (79/80 vs. 65/80), x 2 5 13.61, P , .005. In contrast, there was no difference in the recall of lists composed of items for which he showed perfect comprehension (13/20 lists correct; 72/80 items correct) versus those for which he made any comprehension errors (13/20 lists correct; 71/80 items correct). MS’s pattern of performance on this recall task strongly argues that a semantic deficit is not the basis of his poor performance in list recall—MS’s level of recall appears to be unrelated to his accuracy in responding to the comprehension questions for particular items. This contrasts with the observation that MS’s recall was poorer for lists composed of items corresponding to pictures that he was unable to name in a naming task than for items that he had been able to name, again indicating a strong correspondence between his ability to retrieve phonological representations in word production and list recall. DISCUSSION To summarize, MS showed normal list recall for digits and nonwords, but impaired recall for words. Word recall was particularly impaired for low frequency words and within low frequency words, for low imageability words. MS’s normal recall of nonword lists indicates that he does not have difficulty in maintaining and reproducing phonological information per se. However, MS does not show the boost to recall from the lexical–semantic information available in words that is shown by normal subjects. Consistent with the suggestion of a reduced lexical influence on recall is the prevalence of phonologically related nonword responses in MS’s recall. The phonological relatedness of the responses suggests an ability to 22 MARTIN, LESCH, AND BARTHA retain phonological information. For normal subjects, feedback from the lexical to the phonological level should prevent the production of nonword responses, and few were observed in our control data. The few that were observed occurred for low frequency lists, suggesting that some of the subjects may not have been familiar with some of the items. (Note that MS made nonword responses to both low and high frequency items—see Table 6.) MS’s recall of word lists suggests that recall is characterized by the same difficulty in retrieving phonological representations from semantics that is characteristic of his naming. A large effect of frequency was evident in both his naming and list recall presumably due to the weaker connections between semantics and phonology for low frequency words. MS’s very good performance on digit span lists compared to word lists can be attributed to the high word frequency of digits. Further evidence of the concordance between MS’s word production and list recall was evident in the errors that MS made in list recall. That is, MS at times produced circumlocutions in list recall that were similar to his circumlocutions in naming. In these cases, MS recalled the meanings of the items contained within the list rather than the items themselves indicating that the words had been accurately perceived (indicating intact input phonological representations) and that appropriate semantic representations had been activated. These semantic descriptions were most likely to occur in the condition where retrieval of phonological forms would be assumed to be most difficult (low frequency words), but where semantic information should be most readily available (high imageability words), indicating that, while semantic information had been activated, it could not be used to retrieve the appropriate phonological form. A comparison of MS’s error types with those of controls indicated that control subjects never provided semantic descriptions of the items to be recalled. Other evidence of a correspondence between word production and list recall came from MS’s recall of lists corresponding to the names of pictures which he could or could not name. Better performance was obtained for words he produced as names than for those he could not produce as names. This result contrasted with equivalent performance on lists composed of words for which he did or did not make errors on the comprehension tests. MS’s naming and list recall responses diverged in that he produced many more phonological approximations (both word and nonword forms) in list recall than he had in naming. This difference can be attributed to the fact that phonological information is presented to MS in the list recall tasks, and, as indicated by his recall of nonwords, he has a good ability to hold onto phonological information. Thus, he can use this surviving phonological information to constrain his responses. In naming, phonological information is not provided, but has to be retrieved. The results of the word vs. nonword recall tasks and the task manipulating frequency and imageability of words might appear contradictory. Specifically, the failure to find an advantage for words over nonwords would seem to contradict the finding of an imageability effect for MS. 4 Our discussion of the word vs. nonword results focused on the low frequency of the words and MS’s poor ability to retrieve low frequency words. However, since words would be bound to be more imageable than nonwords (and the words we used in these tasks were fairly imageable), an advantage for words might be predicted. One possible explanation for the failure to find an advantage for words (and, in fact, the finding of a slight numerical disadvantage for words) is that with words, a semantic representation is activated which leads to the activation of incorrect but semantically related words on the output side. If these related words are of higher frequency than the target words, the phonological forms of the related words may become highly activated and interfere with the retrieval of the phonology of the target words. With nonwords, there would be no competition from words activated from semantics. According to this logic one would see both imageability and frequency effects for words, but the performance for nonwords would not 4 We thank an anonymous reviewer for this suggestion. 23 INDEPENDENCE OF INPUT necessarily be worse than that for any type of word. Up to this point, we have provided evidence that MS demonstrates difficulties in recall tasks that require verbal output (i.e., output phonological representations). Within a model that distinguishes between input and output phonology, the data suggest that MS has difficulty on the output side in retrieving phonological forms. If one further assumes that there are separate input and output phonological buffers, MS might be predicted to perform well on tasks that require only the retention of input phonological forms. STM for Input Phonology For the most part, these tasks did not require output of words from the memory lists, but rather a yes/no judgment about whether a probe word or list matched the preceding list. Previous evidence indicated that MS has a good ability to retain semantic information from word lists even when he cannot retrieve appropriate phonological forms corresponding to these semantic representations. Thus, it was necessary to ensure that these tasks tapped the retention of phonological information rather than semantic information. The first task, a rhyme probe task, required phonological information in order to make the rhyme/nonrhyme judgment. The next task required the retention of order information, which has been argued to rely on the retention of phonological information (e.g., Wickelgren, 1965). Rhyme probe task. In the rhyme probe task the subject judges whether a probed word rhymes with any item in a preceding list. Lists varied from 1 to 7 items in length and number of lists at each list length varied from 20 to 28. For each list length, half of the trials were rhymepresent and half rhyme-absent. On rhymepresent trials, each serial position was probed equally often. MS’s performance was similar to that of control subjects who were roughly matched with MS in terms of age and education level. MS’s estimated span (75% correct performance) was 6.4 items, while the mean for the control subjects was 7.08 (SD, 1.44) items. As MS’s performance on the repetition tasks TABLE 7 Percentage of Correct as a Function of List Length— Rhyme Probe Task (Low Frequency–Low Imageability Words) List length MS Controls Mean Range 4 5 6 94 95 100 89 (81–94) 86 (80–95) 70 (58–83) was more impaired for low frequency than for high frequency words, we constructed a new rhyme probe task that used only low frequency (,30 words per million; Kucera & Francis, 1967) and low imageability words (,497 on a scale of 100 to 700; Oxford Psycholinguistic Database, Quinlan, 1992). While a frequency value of 30 may not seem a particularly low cutoff for low frequency words, this is the same cutoff that was used in the lists for recall that varied on frequency and imageability and for which MS showed a large effect of frequency. List length varied from four to six items and number of lists at each list length varied from 16 to 24. As can be seen in Table 7, MS performed at a high level relative to six control subjects. In order to assess whether this level of performance would be stable across test sessions, MS was tested a second time on this task. He obtained 100, 85, and 83% correct for list lengths of four, five, and six, respectively—a level of performance which again compared favorably to that of control subjects (see Table 7). Order recognition task. In the order recognition task the subject hears an eight-item list of words followed by a pair of adjacent words from the list (with all serial positions being probed equally often). The pair of words either are in the same order as they occurred within the list or they are in the reverse order. The subject is asked to decide whether the word order within the pair is the same as it had been within the preceding list. Items were one, two, or three or more syllables in length and presentation was blocked by item length. There were 48 lists at 24 MARTIN, LESCH, AND BARTHA TABLE 8 can be seen in Table 9, MS performed at a high level on this difficult nonword probe task. Percentage Correct as a Function of Item Length—Order Recognition Task DISCUSSION OF PERFORMANCE ON STM TASKS TAPPING INPUT PHONOLOGY Number of syllables MS Controls 1 2 3 79 77 81 76 73 76 each list length and an equal number of same and different trials. As can be seen in Table 8, MS performed at least as well as control subjects on this task. We also constructed an order recognition task using only low frequency (,30 words per million, Kucera & Francis, 1967) and low imageability words (,497 on a scale from 100 to 700; Oxford Psycholinguistic Database, Quinlan, 1992). In this version of the task, subjects heard 28 lists of eight two-syllable words. MS performed at a high level, obtaining 89% (25/28) correct. Again, MS’s performance compared favorably to that of six control subjects (mean, 70%; range, 54 –79% correct). Indeed, he performed at a higher level than the control subjects. In a second administration, MS’s level of performance was equivalent to his performance on the initial testing (89% correct), indicating that he reliably performs well on this order recognition task. Nonword probe task. In the nonword probe task the subject hears a list of nonwords followed by a nonword probe. The subject must decide whether the probe item occurred in the preceding list. List length varied from three to five items and each serial position was probed equally often. Half of the probes occurred in the preceding list, while half did not. Of those probes that did not occur in the preceding list, half were phonologically similar (they shared an onset with one item and a body with another item— e.g., the probe “lirb” given the list items “jirb” and “lez”) and half were phonologically dissimilar. Number of lists at each list length varied from 20 to 24. The results for MS and for six control subjects are presented in Table 9. As MS demonstrates an impairment in STM tasks that require word production—MS recalled only 83% of the three word lists and 55% of the four word lists that were varied on frequency and imageability. Interestingly, MS at times reported the meanings of the words in the list rather than the words themselves, indicating that the words had been accurately perceived and the appropriate semantic representations activated. We suggested that MS’s deficit reflects a difficulty in retrieving output phonological representations from semantics. Consistent with this interpretation, MS’s pattern of performance is quite different on STM tasks that do not require verbal output. On all the tasks reported here, MS’s performance was comparable to that of control subjects. Our results are thus consistent with an interpretation in terms of a separation between input and output phonology and a separation between input and output phonological buffers. However, there is some indication that we may actually be underestimating the extent of MS’s impairment in the retention of output phonological codes since the control subjects did not tend to perform as well as MS on the input tasks. The differing patterns of performance exhibited by MS on input and output tasks is underscored by a comparison of MS with an additional control subject whom we tested on TABLE 9 Percentage Correct as a Function of List Length—Nonword Probe Task List length MS Controls Mean Range 3 4 5 6 96 96 75 88 95 (79–100) 90 (79–100) 93 (80–100) 86 (75–96) INDEPENDENCE OF INPUT both the order recognition task (with low frequency–low imageability words) as well as the recall of word lists varying on frequency and imageability: On list recall, MS only recalled 55% of four-word lists compared to 100% correct recall for the control subject. However, this control subject only obtained 75% correct on the order recognition task, while MS obtained 89% correct (no individual subject performed as well as MS on this task). Even though none of the controls performed as well as MS did on the order recognition task, there appeared to be little difficulty in performing a task requiring output phonological codes—a task for which MS only obtained 55% lists correct. We have suggested that the dissociations between performance on input and output phonological STM tasks can be interpreted as support for the notion that there are separate input and output phonological representations and separate buffers for retaining these representations. As discussed in the introduction, it is necessary to consider whether a model such as those shown in Fig. 3 with a single phonological representation could accommodate the findings. In such a model, MS’s disruption would be in the connections from semantics on the output side. However, this approach runs into difficulty in accounting for MS’s STM data. That is, if there is one phonological buffer associated with storing phonological forms derived from either input or output, it would be difficult to account for MS’s normal performance on input STM tasks and poor performance on output STM tasks. That is, if one assumed that a disruption in the connections from semantics to phonology was the source of MS’s poor performance on output STM tasks, poor performance on input STM tasks would be expected as well because of the absence of feedback from the semantic to the phonological level. This reasoning assumes that input tasks are affected by lexical–semantic factors. One source of evidence in this regard comes from a recent event-related potential (ERP) study (Ruchkin, Berndt, Johnson, Grafman, Ritter, & Canoune, 1998) that examined performance for words versus nonwords on a recognition probe task, which would be a task tapping input retention. These researchers found 25 differences in the topographical pattern of ERPs for words versus nonwords that were evident both during encoding and during a 6-s retention interval. SUMMARY AND CONCLUSIONS We have reported data from an anomic patient, MS, whose naming performance can be characterized as demonstrating greater difficulty in producing lower frequency words and retention of detailed semantic information about objects that cannot be named. Rigorous testing provided evidence of preserved semantic and lexical information about names that could not be produced and we concluded that MS’s naming deficit derived from weakened connections between lexical and phonological representations. According to models such as those shown in Figs. 3 and 4 that postulate a close connection between word processing and short-term memory, the weakened connections between lexical and phonological representations should have predictable consequences for STM performance. That is, MS should not show the benefit to recall that derives from the flow of activation from semantic and lexical representations to phonological representations on the output side, and the factors that influenced his ability to retrieve phonology in single word tasks should influence his STM performance. We found this to be the case: (a) MS’s performance did not show the advantage normally seen in word recall relative to nonword recall; (b) word frequency exerted a strong influence on his STM performance, with higher frequency items being more likely to be recalled than lower frequency items; (c) specific items that were unlikely to be named were less likely to be recalled in a shortterm memory task than were items that had been correctly named; and (d) MS produced circumlocutions in list recall as he did in naming tasks. The data from MS also provided evidence relevant to distinguishing between a model such as those in Fig. 3, with a single phonological representation underlying both input and output, and that in Fig. 4, with separate input and output phonological representations and input and output phonological buffers. In support of the sep- 26 MARTIN, LESCH, AND BARTHA arate buffers interpretation we observed that, while MS’s performance on short-term memory tasks suffered when verbal output was required, his performance was normal on short-term memory tasks that did not require verbal output. A model such as that in Fig. 3 would have difficulty accounting for these findings, unless it were assumed that somehow performance on input STM tasks were uninfluenced by feedback from the lexical and semantic levels. The current investigation thus provides further support for the notion that verbal STM involves the maintenance of the various levels of representation involved in word perception and production. These results are consistent with the claim that the short-term retention of verbal material depends on the activation of long-term memory representations (phonological, lexical, and semantic) for words and the maintenance of this activation in short-term memory. While our approach suggests that LTM makes its contribution during encoding and retention, an alternative view is that LTM representations exert an influence at the point of recall. 5 For example, Hulme et al. (1991) hypothesize that at recall lexical representations are automatically retrieved and are used to reinstate information in decayed memory traces— since nonwords lack these representations, pattern completion should be more successful for words than for nonwords. A similar account of 5 It should be noted that these relatively recent attempts to attribute various aspects of span performance to a LTM contribution differ from earlier accounts of span performance as deriving from recall from both short- and longterm stores (e.g., Waugh & Norman, 1965; Craik, 1971). In these recent accounts, what is meant by LTM is the use of “semantic” memory to aid recall—that is, long-term knowledge of lexical and semantic representations of words. In the earlier accounts what was meant by LTM was “episodic” memory. According to these earlier views, information about a specific list (i.e., what words were presented in what order at a particular point in time) was represented in both STM and LTM. At the time of recall, items could be recalled from either STM or LTM. Neuropsychological evidence argues against this earlier view in that amnesic patients with very impaired ability to learn new information (i.e., impaired episodic memory) but preserved knowledge of words (i.e., preserved semantic memory) show normal memory span performance (Baddeley & Warrington, 1970; Levin, Benton, & Grossman, 1982). the lexicality effect has been offered by Schweickert and colleagues (Schweickert, 1993; Schweickert, Ansel, & McDaniel, 1991), who term the reconstruction process “redintegration.” Roodenrys et al. (1994) have suggested that redintegration can also account for the frequency effect—phonological representations in long-term memory are more accessible for high frequency words than for low frequency words. Thus, according to a redintegration account, effects of lexicality and frequency are due to the relative retrievability of lexical phonological representations at the time of recall. However, an effect of imageability (e.g., Bourassa & Besner, 1994) is not easily attributed to redintegration as there is no obvious reason to suspect that it would be easier to reconstruct high than low imageability words from a degraded phonological trace. That is, lexical phonological information would seem to be as readily available for low as for high imageability words. Thus, while a redintegration approach encounters difficulty in accounting for semantic effects on STM, the language-based approach accounts for both phonological and semantic effects on STM by positing a close relation between the codes stored in LTM (phonological, lexical, and semantic) and those active in STM—the phonological, lexical, and semantic representations shown in the left side of Fig. 3 are the long-term memory representations for the phonological units in the language and for the semantic specifications of known lexical items. 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