Title:
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Aphasia and literacy : the application of practices associated with literacy teaching to the assessment of reading and writing disorders in adult aphasia.
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This study investigates the relevance of contemporary
theories of literacy and associated practices for the
assessment of functional reading and writing in
acquired aphasia. `Ideological' and `autonomous' models
of literacy are described. The ideological model
represents reading and writing as a set of activities
intrinsically connected with social behaviour. The
autonomous model represents literacy as a set of
discrete cognitive and linguistic skills which can
operate regardless of context. An analysis of
currently-used aphasia assessments, and the traditions
from which they spring, suggests that they operate a
predominantly autonomous model of literacy. Theoretical
analysis is reinforced by three studies of people with
and without aphasia. The first study demonstrates the
diversity of everyday literacy practice of 50
non-aphasic people. The second study is a qualitative
investigation of the literacy practices of twenty
people with mild-moderate aphasia. Again, a diversity
of psychosocial factors is found to affect literacy
practice. These concern the roles both lost and taken
on by the aphasic respondents, and the ways in which
they cope with their condition. In the final study of
the reading and writing difficulties of three aphasic
people, a direct comparison is made of autonomous and
ideological approaches to aphasia assessment, using a
cognitive neuropsychological battery of tests, and an
investigative procedure developed along ethnographic
principles. These qualitative data suggest that the
ideological approach addresses functional use of
written language more adequately than the autonomous
approach. There is little predictive relationship
between the two approaches. The relevance of an
ideological approach is supported, and the qualitative
methodology associated with this model endorsed as a
means of investigating aphasia. While the contributions
of autonomous measures to the knowledge of impairment
are acknowledged, the shortcomings of prescriptive
approaches to functional assessment are also apparent.
Contemporary theories of disability contribute to a
re-evaluation of current approaches in the study of
aphasia. It is argued that the personal interpretation
of impairment must be addressed in functional
assessment. The study represents a development in the
theory of functional assessment of aphasia. It also
develops a methodology which has implications for
clinical practice.
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