JOURNAL OF CLINICAL AND EXPERIMENTAL NEUROPSYCHOLOGY 2011, 33 (10), 10991107

Compounds in different aphasia categories: A study on picture naming

Carlo Semenza1,2 , Serena De Pellegrin1,2 , Irene Battel2 , Martina Garzon2 , Francesca Meneghello2 , and Valentina Chiarelli3
Department of Neuroscience, University of Padua, Padua, Italy IRCCS Ospedale S. Camillo, Lido di Venezia, Venice, Italy 3 Department of Psychology, University of Trieste, Trieste, Italy
2 1

This study investigated the production of compounds in Italian-speaking patients affected by different aphasia categories (i.e., Brocas, Wernickes, and anomic aphasia) in a confrontation naming task. Questions of theoretical interest concerning the processing of compounds within the framework of the lemma theory as well as the role of morphological productivity in compound processing are addressed. Results indicate that all persons with aphasia retain knowledge of the morphological status of words, even when they fail to retrieve the corresponding phonological form (the compound effect). A difference was found among aphasia categories in the type of errors produced (omission vs. substitution) and in the position (rst or second) of these errors within the compound words. In Brocas aphasia, the rst component is omitted more frequently than the second one, but only in verbnoun compounds. Anomic and Wernickes aphasia, unlike in Brocas aphasia, seem to retain sensitivity to morphological productivity. Keywords: Compound words; Aphasia; Position effect; Lexical access; Productivity.

Compound words are an important domain of investigation since they provide researchers with a unique opportunity to understand the interplay between storage and computation in the mind, the manner in which morphological and semantic factors impact the nature of storage, and the manner in which the computational processes serve the demands of online language comprehension and production (Libben, 2006). In the past three decades, neuropsychological studies have been carried out with the specic aim of understanding how compounds are represented and processed in the brain. The main results of prior neuropsychological research (see Chiarelli, Menichelli, & Semenza, 2007; El Yagoubi et al., 2008; Semenza & Mondini, 2006, 2010; for updated reviews), mostly conducted on persons with aphasia, concern several aspects of compound processing. Several studies have shown that patients who fail to retrieve compound words nonetheless retain knowledge of the words morphological status (they know whether a word is a compound or a morphologically simple word),

knowledge of the compounds structure (e.g., whether the word is a nounnoun or a verbnoun compound), and knowledge of the word formation rules of their own language. For example, in picture-naming tasks people with aphasia substitute compound words for compound targets (Badecker, 2001; Blanken, 2000; Chiarelli et al., 2007; Hittmair-Delazer, Andree, Semenza, De Bleser, & Benke, 1994; Semenza, Butterworth, Panzeri, & Hittmair-Delazer, 1992; Semenza, Luzzatti, & Carabelli, 1997) but they seldom produce compound words or compound neologisms instead of simple word targets. This very reliable effect, called the compound effect (Semenza & Mondini, 2010), is reported even in languages, like Italian, where compounding is only moderately productive. Thus, for instance, Chiarelli et al. (2007) showed that, in a picture-naming task, aphasic patients substituted simple words with other simple words in 85% of the cases and substituted compound words with other compounds in 79%. The compound effect has been shown with both transparent and opaque compounds. In fact, Blanken (2000) found even more compound

Address correspondence to Valentina Chiarelli, Department of Psychology, University of Trieste, via S. Anastasio 12, 34100 Trieste, Italy (E-mail: valentina.chiarelli@gmail.com).

2011 Psychology Press, an imprint of the Taylor & Francis Group, an Informa business http://www.psypress.com/jcen http://dx.doi.org/10.1080/13803395.2011.603691

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errors when the target compound was opaque rather than when it was transparent. One common nding in retrieving compound words in people with aphasia is thus the production of compound neologisms. For example, in Hittmair-Delazer et al. (1994), errors were commonly observed like spindelgrammophon (a nonexistent compound word) instead of plattenspieler, record player. Compound neologisms must be the product of compositional processes. As argued by Badecker (2001), the lexicon should not contain entries that would permit neologisms to be retrieved: Some feature of the compound must initiate the compositional procedure evident in these errors. Polysyllabic monomorphemic words do not induce this error type. Thus the compound effect is not due to prosodic factors, but must be due to preserved representation of the morphological structure. Therefore, knowledge of the compound structure must be stored in the brain independently of the knowledge of the phonological form. Evidence has emerged in favor of decomposition in the processing even for opaque compounds (Badecker, 2001; Mondini, Luzzatti, Zonca, Pistarini, & Semenza, 2004; Semenza et al., 1997). Semantically based, rule-based, and lexically based gender assignment to compounds is shown to undergo independent processing (Luzzatti & De Bleser, 1996; Mondini, Jarema, Luzzatti, Burani, & Semenza, 2002; Mondini, Luzzatti, & Semenza, 1999). Finally, there is evidence for a prominent role of the headthat is, the component that determines the compounds grammatical categoryand the syntactic (e.g., number and gender) and semantic properties of the compound as a whole (El Yagoubi et al., 2008; Jarema, Perlak, & Semenza, 2010). One important variable that has emerged as having an additional and interacting effect with the structural properties of the compound is that of aphasia type. For example, the grammatical class of the compounds components that are differentially impaired in different linguistic pathologies interacts in the process of compound retrieval. The position of the components in the compound also plays an important role and interacts with classic aphasia type (Ahrens, 1977; Dressler & Denes, 1989; Stark & Stark, 1990). In a pioneering study, Ahrens (1977) compared three groups of German speakers with aphasia (Brocas, Wernickes, and Anomic) in a confrontation naming task. Targets were simple nouns and compounds of the noun noun and verbnoun types, the components of which had a high or a low word frequency. In this study, there were fewer errors for compounds with a high-frequency rst component, whereas the effect of high frequency of the second component was less evident. When only one part of the compound was successfully named, it was usually the rst onethat is, the one that in German species the meaning of the second, more general word. This effect, however, was not replicated in other group studies of German aphasics (Blanken, 2000; HittmairDelazer et al., 1994). Ahrens attributed this nding to the fact that the rst component of a compound has a more specic meaning and is also the stress-bearing

part. He also speculated that the grammatical unit of the compound noun is not very stable. The use of productive word-building rules would depend on the frequency of the compound, whereby frequent compounds would be lexicalized, and less frequent ones would be composed by rules. The patient groups behaved differently: Participants with Brocas aphasia (BA) often had trouble in connecting the two parts, while participants with Wernickes aphasia (WA) produced a large number of phonemic paraphasias. More interestingly, participants with anomic aphasia (AA) tried to build the whole compound, a strategy leading to compound paraphasias. Dressler and Denes (1989) investigated comprehension and identication of transparent and opaque compounds in Italian-speaking BA and WA. Participants were found to apply two basic strategies to identify and explain compounds: a morphological strategy, using one or both parts of a given compound, suitable only for transparent items, and a semantic strategy using synonyms of the whole compound or descriptions. Examples of the morphological strategy are saying, portalettere, instead of postino (postman), which literally translates to letter carrier. Examples of the semantic strategy are providing a synonym or a semantic description without a morphological connection to any part of the compound (e.g., employee of the post ofce). All participants performed better in dealing with transparent compounds, and BA were always superior to WA. BA applied the appropriate strategy more often, while WA tended to rely on the easier, but often inadequate, morphological strategy. More modern and theoretically motivated studies also occasionally showed how aphasia category interacts with the processing of compound. A study in Italian by Semenza et al. (1997) tested knowledge of the words morphological status for each of three aphasia subgroups. WA and, more clearly, a single AA, showed the overall group trendthat is, they tended to substitute a compound with a compound and a single word with a single word. BA, instead, gave more simple than compound responses on compound stimuli. This was largely due to the fact that they tended to omit the rst part of the compound; however, they never provided compound responses to a simple stimulus. Another, more theoretically interesting effect concerning the sensitivity of aphasia categories to the grammatical class of the components of compound words was also found in Semenza et al. (1997) and was replicated in Mondini et al. (2004). Unlike persons with other aphasia categories, BA, on the whole affected by a verb-relative-to-noun decit (the reverse condition, nouns worse than verbs, appears more frequently in AA), omit or replace the verb component of Italian verbnoun compounds that are grammatically nouns. Thus, for example, in compounds like [(aspira) V (polvere) N] N (where V = verb, N = noun), vacuum cleaner [literally, suck-dust], BA tended to omit or substitute the rst component more frequently than the second component; in contrast they omitted or substituted with equal frequency the components of compounds like [(ferro) N (via) N] N, railway [literally, iron-way]. This nding cannot

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be attributed to a simple effect of position because the patients did not show the same effect in compounds other than that of the verbnoun (VN) type (note that in Italian, the stress pattern of VN compounds is comparable to that of other compounds). This conclusion is also supported by the fact that no position effect was found with persons with Brocas aphasia in the German study by Hittmair-Delazer et al. (1994). The verb omission effect would only be possible if the locus of the decit, at least in BA, is at the level where the representation of compounds is decomposed into separate noun and verb forms. Such neuropsychological ndings thus provide some of the clearest pieces of evidence that compounds are parsed into their component parts in the course of lexical retrieval. This study investigates the production of compounds in Italian-speaking persons affected by different aphasia categoriesthat is, Brocas, Wernickes, and anomic, in a confrontation naming task. As mentioned above, interesting intercategory differences in the processing of compounds have been found in the past. However, in the most recent and linguistically complex studies (e.g., Chiarelli et al., 2007; Semenza et al., 1997), the small number of patients for each category or the limited number of items made conclusions cautionary. Single case studies with more items may focus on a more specic effect and otherwise yield too few errors to study other interesting contrasts. In this study, we tested a larger number of patients, thus allowing for comparisons among different syndromes. Information was collected on how the compound effect as well as the effects of position (rst vs. second component), type of compound (VN vs. other), and type of error (omission vs. substitution) interact with classic aphasia syndromes. The motivation of this study stems from questions of theoretical interest left open by previous studies. These questions concern, in particular, effects localizable within the framework of the lemma theory at the lemma level (Levelt, 1979; Levelt, Roelofs, & Meyer, 1999). In this model, spoken word production involves the retrieval of two different types of lexical representation: amodal representations (lemmas), specied for morphosyntactic semantic properties, and modality-specic word forms (lexemes), specied for phonological properties. In the aphasiological domain, where this distinction has never been dealt with in reference to classical aphasia categories, errors are thought to stem from problems at both levels. In particular, however, it has been suggested that persons with aphasia may have difculties in activating the phonological form (lexeme), while they seem to maintain information at the lemma level. The compound effect shows preservation of lemma-level morphosyntactic information (compound structure) while failing to retrieve the corresponding phonological form. One important question, therefore, concerns whether the compound effect is comparable among different aphasia categories. Do BA, who otherwise suffer from problems with the morphology of complex words (i.e., with inection and derivation), show the compound effect to the same degree as other aphasics? If this is the case, there would be evidence for the separability of the knowledge of the word

compound structure from other pieces of information within the domain of morphology. A further question concerns the inuence of morphological productivity. Morphological productivity refers to the likelihood of a word formation process (like derivation or compounding) to be used in coining new words in a given language. Compounding in general is a very productive word formation process in languages like English and German, but much less so in languages like Italian. Verbnoun compounds represent the result of the most productive compounding process in Italian. As has been shown, their verb component is sensitive to the agrammatism of BA. Does the higher productivity of this kind of compound as a whole imply different processing? Interaction with aphasia categories not due to grammatical factors may be due to different processing of more productive compounding (as in VN) with respect to less productive compounding (as in NN). Finally, this is the rst study to examine whether the visual complexity of the stimuli could account for the compound effect.

METHOD Participants The experimental data were collected from 9 BA, 23 WA, and 16 AA, while undergoing language rehabilitation at the Ospedale S. Camillo of Lido di Venezia, Italy, in the period 20002008. Classication into aphasia category was made in each case on the basis of the Italian version of the Aachen Aphasia Test (Luzzatti, Willmes, & De Bleser, 1996). Lesion sites were established on the basis of computed tomography (CT) scans, with the help of a radiologist. Table 1 reports demographic and lesion data for each patient.

Stimuli and procedure A picture-naming task was administered, consisting of 50 pictures that are consistently named with a twoword compound noun. These pictures were randomly intermixed with 50 pictures that are named only with simple nouns. This is the same material as that used in Semenza et al. (1997), with the addition of one item (see Appendix). Non-brain-injured participants perform at ceiling on this task. Compound types included 37 verb noun (VN) compounds, the most productive type of compound in Italian, and 13 other compounds (noun noun, nounadjective, adjectivenoun, adverbadverb), which were collapsed for the purpose of statistical analyses into a single group other. This was done because compounds that can be pictured in Italian are very limited in number, and their categories cannot be equally represented. This method, unfortunately, considerably reduces the amount of items that can be used in a picturenaming task in Italian and makes it hard to have a balanced set of stimuli for all possible research questions on compounds. However, picture naming is a better tool

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SEMENZA ET AL. TABLE 1 Demographic and lesion data for each participant Education (years) 13 5 13 5 18 13 12 13 5 8 13 5 8 12 5 13 5 5 13 5 13 10 18 8 5 5 13 3 11 8 13 8 3 13 13 8 13 5 8 18 11 18 18 8 5 13 8 18 Months post onset 13 5 14 11 112 61 10 8 60 15 4 2 8 7 11 20 5 3 12 8 88 13 9 7 3 13 15 22 3 3 8 5 6 2 3 5 14 4 2 3 3 2 14 23 2 4 22 17

Patient B.G. C.E. C.P. D.R.R. E.E.M. M.E. N.P. S.M. T.L. C.V. C.A. D.E.R. F.A. F.E. G.M.C. G.L. L.M. M.L. M.B.M. M.F. N.M. N.A. P.G. P.R. R.A.M. R.F. R.G. S.G. S.A. S.T.G. S.U. V.A. V.G. V.M. C.T. C.M. G.M. M.M. M.L. P.A.G. P.A. P.E.R. R.A.R. R.U. S.E. S.A.E. S.P.G. T.M.

Group Broca Broca Broca Broca Broca Broca Broca Broca Broca Wernicke Wernicke Wernicke Wernicke Wernicke Wernicke Wernicke Wernicke Wernicke Wernicke Wernicke Wernicke Wernicke Wernicke Wernicke Wernicke Wernicke Wernicke Wernicke Wernicke Wernicke Wernicke Wernicke Wernicke Wernicke Anomic Anomic Anomic Anomic Anomic Anomic Anomic Anomic Anomic Anomic Anomic Anomic Anomic Anomic

Age 45 74 53 61 50 40 60 43 60 20 50 75 59 73 78 25 31 73 54 59 35 58 82 42 73 66 22 61 60 63 27 60 59 83 67 20 51 77 53 40 87 84 66 67 61 26 21 51

Gender Male Female Male Male Male Female Male Male Male Male Male Female Male Female Female Male Female Male Female Female Female Male Female Female Female Female Male Male Female Male Male Male Male Female Male Male Male Female Male Male Female Male Female Male Female Female Male Male

Lesion site Multiple FTP FT FTP FP FTP and basal ganglia FP FP FP F Deep TP FT Deep T FT TPO FT Deep FT T Deep T T P Multiple FTP T T TP FTP Deep FT TP TP Deep T FP TPO FT T TP Deep P TP TP PO Deep P T P Deep P TP Deep P P FT FT T

Etiology Vascular Vascular Vascular Vascular Vascular Neoplastic Vascular Vascular Vascular Traumatic Traumatic Vascular Traumatic Vascular Vascular Traumatic Vascular Vascular Vascular Vascular Traumatic Vascular Vascular Vascular Vascular Vascular Traumatic Vascular Vascular Vascular Vascular Vascular Vascular Vascular Vascular Traumatic Vascular Vascular Vascular Traumatic Vascular Vascular Vascular Vascular Vascular Traumatic Traumatic Vascular

Note. F = frontal; T = temporal; P = parietal; O = occipital.

than naming on denition. Picture naming is the task that is used as the basis for all theoretical models of word production. Naming on denition, moreover, is harder to test. Errors on compounds were classied into the following categories: anomia (omissions); compound verbal paraphasias (real compound words that replace both

components of the target; e.g., passaverdura, food mill, instead of scolapasta, colander); compound neologisms (nonwords made of two real words that do not appear in the target; e.g., mettiverdura, literally, put vegetable, instead of scolapasta); single word paraphasias; left right inversions; omissions of the rst component; omission of the second component; substitutions of the

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rst component; substitutions of the second component; circumlocutions. Phonemic and phonetic paraphasias were not counted; however, errors phonologically distant from the target for more than three phonemes were discarded from the analysis. The classication of errors into each category was made by two independent judges without any instance of disagreement.

Familiarity analysis Thirty participants were asked to evaluate, on a 5-point rating scale, how frequently they used or heard each word and how familiar they were with the word (1 indicated very unfamiliar, and 5 indicated very familiar). Seven different categories were contrasted: VN compounds, other compounds, simple words, rst components of VN compounds (that is, always a verb), second components of VN compounds (that is, always a noun), rst components of other compounds, and second components of other compounds. Stimulus presentation was randomized for each participant. Participants recorded their responses on individual data sheets. A one-way analysis of variance (ANOVA) was run, and a Scheff post hoc test was applied. A signicant difference in terms of familiarity between the categories of words was found, F (6, 179) = 3.04, p < .01. However, the only difference was that between simple words and second component of VN compounds (p < .05), with the second component more familiar than simple words (3.59 and 2.68, respectively). No crucial difference was found between any two of the compound categories or those of their components.

Visual complexity analysis Previous investigations of the compound effect never dealt with the potential confound of visual complexity. Research in aphasia (e.g., Hallowell, Douglas, Wertz, & Kim, 2004) has shown that it is important to control for visual function. One possibility is that the pictures used to elicit compound words are visually more complex than the pictures used for single-word nouns, leading to verbally more complex answers. The arbitrary nature of compound naming makes this possibility somewhat unlikely, because pictures named with a compound in one language may in fact be named with a noncompound in another language (e.g., in our sample, portabagagli, trunk, or scala mobile, escalator). Yet it is important to make sure that the material used for the experiment does not contain a visual complexity bias. A procedure similar to that described by Snodgrass and Vanderwart (1980) to control for visual complexity was therefore used. Twenty-two control participants were instructed to rate the complexity of each picture on a 5-point scale, in which 1 indicated very simple, and 5 indicated very complex. Complexity was dened as the amount of detail or intricacy of the lines shown in the picture. The participants were instructed to evaluate the complexity of the drawing itself rather than the complexity of the real objects represented by the pictures. Two different random sequences of the 100 pictures were used. Each slide was presented for a period of approximately 4 s. Subjects recorded their responses on individual data sheets. Results indicated that there was no difference in terms of visual complexity between pictures named by a simple nouns and those named by a compound nouns in both analysis by words, t(49) = 0.38, p > .1, and analysis by subjects, t(21) = 0.70, p > .1.

RESULTS On simple words, the number of errors was 1,297. These errors were classied according to the following criteria: anomia (omissions), 368 (28.4%); single word paraphasias, 585 (45.1%); circumlocutions, 344 (26.5%). Table 2 reports the distribution of the main error categories (for compound words) in the three aphasic groups (Broca, Wernicke, and anomic). A total of 1,386 errors were detected on compounds. The rst statistical analysis, performed on raw data, was aimed at getting information about the knowledge of the compound status of target words, irrespective of the knowledge of their phonological form. In fact, as suggested above, in persons with aphasia, awareness of the morphological structure of the target may be preserved, in contrast with the inability to retrieve the correct phonological form. In this analysis, a comparison between the morphological (simple vs. compound) structure of the target and the morphological structure of

TABLE 2 Error distribution in the three aphasia categories Type of error Anomia (omission) Compound verbal paraphasias Compound neologisms Single word paraphasias Leftright inversions Omissions of the rst component Omissions of the second component Substitutions of the rst component Substitutions of the second component Circumlocutions Broca 90 14 11 64 0 30 5 12 10 26 Wernicke 149 65 46 149 2 24 19 26 41 190 Anomic 104 35 28 84 0 11 7 26 33 85 Total 343 114 85 297 2 65 31 64 84 301

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the errors was performed. An above-chance proportion of errors that nonetheless respected the morphological structure of the target was found in the whole group of participants with aphasia, 2 (1) = 439.21, p < .001. Thus, overall, persons with aphasia tended to substitute compounds with compounds (including compound neologisms, compound paraphasias, and substitutions of one of the components) and simple words with simple words, and, most importantly, they never replaced a simple word with a compound word. Data broken into the three categories of participants with aphasia showed that this effect held for WA, 2 (1) = 134.54, p < .001; AA, 2 (1) = 102.18, p < .001; and BA, 2 (1) = 202.49, p < .001. The data were analyzed with a mixed-design ANOVA with subjects as the random factor and the factors compound type (VN vs. other), error type (omission vs. substitution), position (rst position vs. second position in the compound word), and aphasic group (BA, WA, and AA). There was a signicant main effect of compound type, F (1, 45) = 82.22, p < .001, revealing that, on average, people with aphasia produced more errors in VN compounds than in other compounds. The interaction between error type and aphasic group was also signicant, F (2, 45) = 3.99, p < .05, showing that, while BA and WA tended to omit and substitute the components of the compound with the same frequency, F (1, 45) = 1.62, p > .1, ns, F (1, 45) = 2.16, p > .1, ns, respectively, AA made more substitutions than omissions, F (1, 45) = 9.07, p < .01. There was also a signicant interaction between position and aphasic group, F (2, 45) = 5.61, p < .01. Post hoc analysis showed that only BA made more errors on the rst than on the second component of compounds, F (1, 45) = 11.10, p < .01. This nding was better explored by the triple interaction between compound type, position, and aphasic group, F (2, 45) = 4.10, p < .05. Post hoc analysis demonstrated that BA produced more errors on the rst than on the second component only in the case of VN compounds, F (1, 45) = 9.99, p < .01, but not in the case of other compounds, F (1, 45) = 2.61, p > .1, ns. No signicant difference emerged for WA and AA. Interestingly, BA tended to omit and/or substitute the rst component of VN compounds more frequently than the secondthat is, the verb component, while they did not behave in the same way with other compounds. Moreover, a signicant interaction between compound type, error type, and aphasic group was found, F (1, 45) = 9.07, p < .01. Post hoc analysis revealed that only BA produced more omissions in VN compounds than in other compounds, F (1, 45) = 15.80, p < .001. Another interesting effect revealed by post hoc analysis was that only AA made signicantly more substitutions than omissions, but only in VN compounds, F (1, 45) = 10.94, p < .01, and not in other compounds, F (1, 45) = 0.08, p > .1, ns. This effect was never found in previous investigations on compounds. A mixed-design ANOVA by items with the factor compound type (two levels: VN vs. other), error type (two levels: omission vs. substitution), position (two levels: rst position vs. second position in the compound word), and aphasic group (three levels: BA, WA, and AA) was also performed. A signicant main effect of compound

type was found, F (1, 48) = 6.25, p < .05, showing that VN compounds were more prone than other compounds to induce errors in participants with aphasia. Moreover, a signicant interaction between compound type, error type, and aphasic group was found, F (2, 96) = 3.42, p < .05. Post hoc analysis revealed that WA and AA produced more substitutions than omissions, but only in VN compounds, F (1, 48) = 6.63, p < .05; F (1, 48) = 13.40, p < .01, respectively. Thus, the results obtained with by-items analysis resembles greatly those obtained with by-subjects analysis.

DISCUSSION The main goal of the present study was to investigate the processing and the production of compound words in different aphasia categories. In fact, in the most recent and linguistically complex studies, the limited number of patients for each category or the limited number of items did not allow many rm conclusions and interesting inferences about intercategorical differences. A number of remarkable effects emerged in the present investigation that could not possibly be highlighted in single case studies and were not observed in previous group studies. These effects can be interpreted in the light of the lemma theory (Levelt, 1979; Levelt et al., 1999), providing evidence of processes happening for compounds at the lemma level. The rst issue we addressed was the presence of a compound effect. This effect (Chiarelli et al., 2007; Semenza et al., 1997) refers to the fact that persons with aphasia tend to retain the knowledge that the target has a compound structure while being unable to access the full phonological form. In the present study, the compound effect was conrmed for all main aphasia categories. In word substitutions, patients tended to replace compounds with compounds and simple words with simple words. Nothing in each picture could suggest whether the corresponding name was a compound or not. This fact, more or less tacitly taken for granted in previous investigations, is now clearly demonstrated for the rst time. An analysis of visual complexity, never performed before, was carried out on experimental items showing no bias between pictures representing compound words and simple words. Not all patients with brain injury show the compound effect so clearly: Chiarelli et al. (2007) showed how patients with Alzheimer dementia substituted simple words with other simple words in most of the cases, but compounds with other compounds in only about half of the times. Anomia in aphasia and Alzheimers disease may, however, stem from partially different decits. In aphasia, the compound effect probably arises from a problem in activating the phonological form of a word, while in Alzheimers disease, most naming failures may result from decits at an earlier lexical processing stage. Within the framework provided by the lemma theory, the compound effect is better conceived as resulting from a decit in activating the target phonological form (i.e., lexeme) from an at least partially preserved lemma (i.e.,

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the representation stage containing information about the morphological status of the target word). The effect is thus taken as evidence of retained knowledge of the compound status of the target even when the correct phonological form cannot be retrieved. Within this framework, the main retrieval decit for all aphasia categories considered here is in the activation of the lexical word form, while information about lexical morphology may still be intact. Generally, in BA the compound effect is less evident than in other aphasia categories, but only because BA omit one of the words components more often than do other categories. However, like other individuals with aphasia, BA never produce compound responses to simple noun stimuli. The preservation of knowledge of the compound status even in patients, like BA, presumably affected by agrammatism, suggests how various aspects of morphosyntactic knowledge and processing may dissociate or, at least, may be differentially sensitive to brain injury. It would have been difcult to come to this conclusion from a corpus of errors collected in a single case study, at least in a language, like Italian, where picturable items with a compound name are limited in number. Instead, loosely homogeneous as their individual members may be, the contrast of different categories of aphasia allows us to see this effect. Secondly, in the present investigation, we found a difference between aphasic groups in the type of errors produced. This nding may indicate different dealing with the dimension of morphological productivity. In particular, AA and, to a lesser extent, WA (as shown by the item analysis) produced more single component substitutions than omissions, while no such difference was found in BA. This effect of the anomic group in the type of errors produced is observed for the rst time. Previous research comparing omissions and substitutions never considered AA as a group. AA seem more revealing than patients with BA about what happens at the level of the retrieval of the phonological form. While the compound effect just reveals knowledge of the compound structure of the word, single component substitutions are more informative than other types of errors about the compositional process at the word form retrieval level. Compound neologisms and paraphasias may be produced, in fact, by just respecting knowledge of the compound status. Moreover, as Semenza et al. (1997) argued, in languages like German, morphological rules concerning compounds are so simple that they may be produced idiosyncratically. Unlike compound neologisms and paraphasias, single component substitutions could reect failure in searching for the two components independently from one another. Consistently with Delazer and Semenzas (1998) hypothesis (their patient, M.B., was affected by anomia), AA failure with compounds therefore consists, more clearly than in other patients (where the position effect and the grammatical class play an important role), in retrieving two phonological forms with one lexical entry. Importantly, though, the prevalence of substitutions over omissions in AA (and in WA) regards specically VN compounds. However, unlike in BA, this effect does not concern exclusively the verb component of VN compounds: In AA and WA,

instead, substitutions in VN compounds concern the verb and the noun components equally. This nding may be interpreted in consideration of the status of VN compounds in Italian, where VN compounding is the most productive compounding process. AA (and to a lesser extent WA) may be prompter than BA in using productive processes in the attempt to compensate for their name retrieval failure. All people with aphasia may retain lemma information about the compound structure but no access to the phonological form. However, AA and WA at this stage may benet, unlike BA, from further information about productive processes. In speakers of a given language, the most productive processes would be stored at the lemma level as ready-to-use information to help retrieval. This would entail an important distinction between, on the one side, information about the grammatical structure of a word and, on the other side, information about productivitythat is, the likelihood a word formation process is used in producing new words in a particular language. Another nding of this study concerns the position effect. In fact, a different position effect was found among the three aphasia categories: While BA omitted or substituted the rst component about three times as much as the second component, such a difference between components was not found in both WA and AA. This effect was due to difculty of BA with the rst component of verbnoun compounds. In contrast, BA drop or substitute with equal frequency the components of nounnoun compounds. Articulation difculties, whatever their effect, are thus not a sufcient explanation for the problems of BA with the rst component. This nding conrms earlier results obtained in Semenza et al. (1997) and replicated in Mondini et al. (2004). Indeed BA tend to omit more verbs than nouns in picture naming and in their spontaneous speech output (Semenza, 1999). As argued in the introduction, there would be no reason for the effect on verbnoun compounds if at some point in processing the two components were not separate. Thus, consistent with previous literature, this last nding provides a very strong indication that compound words are parsed into their grammatical components in the course of lexical retrieval. In conclusion, on the whole, this study conrms and extends ndings obtained in previous aphasiological research. In particular, the compound effect has been found for all categories of aphasia, including anomic aphasia. It is suggested that morphological productivity is more preserved in anomic aphasia and, to a lesser degree, in Wernickes aphasia than in Brocas aphasia. In the lack of better imaging, it is hard to tell how these results are related to the location of the lesions and to their severity. Observed lesions were, however, mostly consistent with what is commonly believed about each aphasia category, BA being affected by more anterior lesions than both WA and AA (in this last category, lesions were, as expected, marginally more heterogeneous than in the other categories). Aphasia category is shown to interact signicantly with the position of the components and their grammatical class. The position effect is, however, ultimately shown to depend entirely

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SEMENZA ET AL. compounds and potential impact of headedness effect: An ERP study. Cognitive Neuropsychology, 25, 559581. Hallowell, B., Douglas, N., Wertz, R., & Kim, S. (2004). Control and description of visual function in research on aphasia and related disorders. Aphasiology, 18, 611623. Hittmair-Delazer, M., Andree, B., Semenza, C., De Bleser, R., & Benke, T. (1994). Naming by German compounds. Journal of Neurolinguistics, 8, 2741. Jarema, G., Perlak, D., & Semenza, C. (2010). The processing of compounds in bilingual aphasia: A multiple-case study. Aphasiology, 24, 126140. Levelt, W. J. M. (1979). The origins of language and language awareness. In M. Von Cranach, K. Foppa, W. Lepenies, & D. Ploog (Eds.), Human ethology. Cambridge, UK: Cambridge University Press. Levelt, W. J. M., Roelofs, A., & Meyer, A. (1999). A theory of lexical access in speech production. Behavioral and Brain Science, 22, 138. Libben, G. (2006). Why study compound processing? An overview of the issues. In G. Libben & G. Jarema (Eds.), The representation and processing of compound words. Oxford, UK: Oxford University Press. Luzzatti, C., & De Bleser, R. (1996). Morphological processing in Italian agrammatic speakers: Eight experiments in lexical morphology. Brain and Language, 54, 2674. Luzzatti, C., Willmes, K., & De Bleser, R. (1996). Aachener Aphasia Test (AAT): Versione italiana [Aachen Aphasia Test (AAT): Italian version] (2nd ed.). Florence, Italy: Organizzazioni Speciali. Mondini, S., Jarema, G., Luzzatti, C., Burani, C., & Semenza, C. (2002). Why is Red Cross different from Yellow Cross? A neuropsychological study on nounadjective agreement within Italian compounds. Brain and Language, 81, 621634. Mondini, S., Luzzatti, C., & Semenza, C. (1999). Grammatical gender in an Italian agrammatic patient. Brain and Language, 69, 278281. Mondini, S., Luzzatti, C., Zonca, G., Pistarini, C., & Semenza, C. (2004). The mental representation of verbnoun compounds in Italian: Evidence from a multiple single-case study in aphasia. Brain and Language, 90, 470477. Semenza, C. (1999). Lexical semantic disorders in aphasia. In G. Denes & L. Pizzamiglio (Eds.), Handbook of neuropsychology (pp. 215244). London, UK: Lawrence Erlbaum Associates. Semenza, C., Butterworth, B., Panzeri, M., & Hittmair-Delazer, M. (1992). Derivational rules in aphasia. Berkeley, CA: Berkeley Linguistic Society. Semenza, C., Luzzatti, C., & Carabelli, S. (1997). Morphological representation of a noun: A study on Italian aphasic patients. Journal of Neurolinguistics, 10(1), 3343. Semenza, C., & Mondini, S. (2006). Neuropsychology of compound words. In G. Libben & G. Jarema (Eds.), Compound processing (pp. 7195). Oxford, UK: Oxford University Press. Semenza, C., & Mondini, S. (2010). Compound words in neuropsychology. Linguistiche Berichte, 17, 331348. Snodgrass, J. G., & Vanderwart, M. (1980). A standardized set of 260 pictures: Norms for name agreement, image agreement, familiarity, and visual complexity. Journal of Experimental Psychology: Human Learning and Memory, 6, 174215. Stark, J., & Stark, H. K. (1990). On the processing of compound nouns by a Wernickes aphasic. Grazer Linguistische Studien, 35, 95113.

upon the grammatical class of the compounds component. Verb components were relatively more sensitive to anterior lesions (leading to Brocas aphasia), as expected from the literature (see Crepaldi, Berlingeri, Paulesu, & Luzzatti, 2011, for a review). A nal comment concerns future directions and, in particular, clinical implications of this study. Other types of compounds may be studied. For instance, in Italian, another compounding process is preposition noun. Compounds belonging to this category (e.g., fuorisede, out-of-town, or fuorimoda, out-of-fashion) are less productive than VN. However, like in the case of VN, their rst component is expected to be more sensitive to agrammatism. In order to further study the issue of productivity, research on languages, where compounding is more productive than in Italian, may be conducted. The Aachen Aphasia Test, in fact, originally developed in German, specically assesses naming of compound words. Different categories of compounds are not contrasted, however. But, as this study shows, different aphasia categories deal very differently and in a very different way with various types of complex words such as compounds.
Original manuscript received 21 March 2011 Revised manuscript accepted 21 June 2011 First published online 7 October 2011

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APPENDIX
List of compound stimuli Compound stimuli accendigas apribottiglie apriscatole aspirapolvere attaccapanni batticarne battipanni cacciavite cavatappi colapasta contagocce corrimano giradischi girarrosto girasole grattacielo lavastoviglie lustrascarpe mangiafuoco paracadute parafanghi portabagagli portacenere portachiavi portafoglio portamatite portaombrelli portauovo reggiseno salvadanaio salvagente schiaccianoci spaventapasseri spazzacamino spremilimoni tergicristallo tostapane arcobaleno astronauta funivia mappamondo motoscafo ragnatela seggiovia francobollo mezzaluna monopattino cassaforte scalamobile pianoforte Type VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN VN Nn nN nN nN nN nN nN AN AN AN NA NA AdvAdv English translation gas lighter bottle opener can opener vacuum cleaner clothes stand meat pounder carpet beater screwdriver corkscrew pasta strainer dropper handrail record player spit sunower skyscraper dishwasher shoeshine boy re-eater parachute mudguard trunk ashtray key ring/key case wallet pencil case umbrella stand eggcup bra moneybox life jacket nutcracker scarecrow chimneysweep lemon squeezer windscreen wiper toaster rainbow astronaut cablecar globe motorboat spiders web chairlift stamp mincing knife scooter safe escalator piano Literal translation lightverb gas openbottles opencans suck updust hangclothes beatverb meat beatverb cloths driveverb screw extractverb corks strainverb pasta count verb drops run verb hand turn verb records turn verb roastnoun turnverb sun scrape verb sky wash verb dishes shine verb shoes eat verb re avoid verb fall protectmud carryluggage carryash carrykeys carrynote carrypencils carryumbrellas carryeggs support verb breast savemoney savepeople crush verb nuts scare verb sparrows sweep verb chimney squeeze verb lemons wipeglass toast verb bread archlightning starsailor cablesway mapworld motionboat spiderweb chairway freeseal halfmoon singleskate boxstrong stairmobile softlyloudly

Note. VN = verbnoun; Nn = left-headed nounnoun; nN = right-headed nounnoun; AN = adjectivenoun; NA = noun adjective; AdvAdv = adverbadverb.

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