Syndromes in developmental dysphasia and adult aphasia

We have attempted to draw some parallels between syndromes of adult acquired aphasia and of childhood developmental dysphasia. There appear to be two syndromes that are almost exact duplicates in the adults and the children: (a) pure word deafness and verbal auditory agnosia, and (b) aphemia and verbal dyspraxia. Two other syndromes seem to have rather close but not exact counterparts: Broca's aphasia and the phonologic-syntactic deficit syndrome, and transcortical sensory aphasia and the semantic-pragmatic deficit syndrome. There are two dysphasic syndromes, the phonologic production deficit syndrome and the lexical-syntactic deficit syndrome, that do not seem to have close adult counterparts. Neither of these dysphasic syndromes has been defined in adequate linguistic detail, and it is possible that their description may have to be modified when more data become available. Whether these comparisons between dysphasias and aphasias have heuristic value for guiding external validation studies of the clinically defined dysphasic syndromes of preschool children remains to be determined. Our purpose was to formulate hypotheses as to which cerebral systems are likely to be dysfunctional in children with clinically defined dysphasic syndromes. We recognize that the disorders of language acquisition and those of overlearned adult language have fundamental differences, and that plasticity of the child's developing brain introduces further complexities. Nevertheless, it seems reasonable to think that there are constants in brain organization that span all ages. Looking for language deficits common to aphasic adults (whose lesions can usually be delineated with contemporary neuroimaging techniques) and to dysphasic children (in whom there are rarely any neurologic clues) may be a fruitful way to begin to define the cerebral correlates of the children's deficits.