Illiteracy and brain damage--1. Aphasia testing in culturally contrasted populations (control subjects)

One hundred neurologically healthy adults were tested for their pointing (choosing one of four or six line drawings as the match to an auditorily presented linguistic stimulus), naming (from line drawings), and repetition abilities. All subjects were unilingual adult right-handers. Fifty-seven subjects were totally unschooled illiterates and 43 were fluent readers. Statistically significant differences were found to exist between the scores of the illiterate and literate subpopulations across all tasks. With the focus being placed on these cultural differences, the discussion bears on: (a) the interaction between linguistic and iconographic factors in certain types of naming and pointing tasks currently used in clinical and research aphasiology, (b) some of the linguistic parameters which are apparently at stake in repetition behavior, and (c) the circumstances in which aphasiological research dealing with groups of patients cannot yield reliable data without reference to neurologically healthy controls. It is argued that, when testing brain-damaged patients of different cultural backgrounds, one runs the risk of over- or underestimating the frequency of aphasia if one does not refer to norms which explicitly take educational level into account.