Ошибки при эфферентной моторной и сенсорной аграфиях как проявление функциональных стратегий письменной деятельности
The research is devoted to the study of functional rearrangements in the structure of agraphia syndrome, depending on the content of the written task. Aim: To identify the variability of writing disorders in sensory and motor efferent agraphia in the conditions of performing different types of writing in terms of functional orientation. Materials and methods. The study involved 51 participants with post stroke aphasia and agraphia (29 people with with Wernicke aphasia). The severity of speech syndromes ranged from mild to moderate. All patients were right-handed. The native language for all participants was Russian. The study was carried out on the basis of inpatient departments of the Center for Speech Pathology and Neurorehabilitation in Moscow. Experimental methods included specially designed tasks that actualize the communicative, mnestic and regulatory functions of written speech. The productivity of writing when performing these tasks was compared with the assessment of the performance of diagnostic tasks traditionally used in clinical practice. Written errors were assessed at the level of individual graphemes, words and sentences. Statistical error analysis was carried out by intraindividual comparison of errors using nonparametric Chi-square tests and Wilcoxon’s test with subsequent correction for multiple comparisons using the Holm-Bonferroni method. Results. It was shown that in the group of patients with sensory agraphia, changes in the error structure were leading due to the increased load on the operation of auditory-speech analysis. In the group of patients with efferent motor dissociation agraphia identified when comparing different kinds of syntax errors. A common pattern for both groups was the use of compensatory strategies that optimize the writing process. Patients of both groups resorted to elliptical (incomplete, abbreviated) writing, used phrases of simple syntactic constructions, trying to reduce the number of written errors. The patients also resorted to a high variability of the communicative task, choosing the vocabulary that was most solidified in the past experience, which made it possible to avoid writing errors. Conclusion. Writing errors due to aphatic syndromes can be not only a manifestation of structural disorders of the component structure of speech function, but also a manifestation of the action of functional strategies of written communication.