Journal of Russian and East European Psychology, vol. 41, nos.

3–4,
May–June/July–August 2003, pp. 75–95.
© 2003 M.E. Sharpe, Inc. All rights reserved.
ISSN 1061–0405/2003 $9.50 + 0.00.

T.V. AKHUTINA

Is Agrammatism an Anomaly?

The problem

Kolk, van Grunsven, and Keyser (1985) and Kolk and Hofstede
(1987) answer “No” to the question posed in the title of this ar-
ticle. Let us consider instances when normal subjects use “tele-
graphic style.” The authors mentioned above point to dialogue
markers, talking to foreigners and children as such cases. How-
ever, the offered list seems incomplete and may be enlarged; in
doing so, it is important to define the structure and function of
agrammatical utterances in normal language users. A Russian
author has an advantage in solving this because in the Russian
scientific tradition the problem has been approached from both
the linguistic (Potebnia, 1888; Iakubinsky, 1923; Zemskaia, 1973;
Zemskaia, Kitaigorodskaia, and Shir’aev, 1981) and psychologi-
cal (Vygotsky, 1934) perspectives.
The first to be included in the above list is inner speech. A
Western reader would most probably object here, arguing the im-
possibility of dealing with something inaccessible in carrying out
an objective analysis. However, Vygotsky suggested two ways of
performing such an analysis.

Adapted for republication here with permission from Grazer Linguistische

Studien, 1991, vol. 35, pp. 65–81.
The author wishes to express her gratitude to Lise Menn for her help in re-
viewing the present article.
75
76 JOURNAL OF RUSSIAN AND EAST EUROPEAN PSYCHOLOGY

Vygotsky distinguished five functionally different aspects that

comprise a unitary process in the transition from thought to utter-
ance: motive–thought–inner speech–semantic plane–external
speech. To analyze the central link in this chain—inner speech
being the main interface in transition from thought to word—
Vygotsky first studied the ontogenesis of this phenomenon, and
second, he compared functionally different forms of speech: dia-
logue, written, and inner speech. This second method will be ana-
lyzed in detail.
According to Vygotsky, dialogue is the initial form of speech
and occupies the intermediate position between the extremes of
written and inner speech forms. Dialogue is contextual, thus al-
lowing the speaker to omit the psychological subject and express
only the psychological predicate. Written speech requires recon-
struction of the context to write, that is, both the psychological
subject and psychological predicate have to be expressed.
The conditions of dialogue that resulted in expressions of only
predicates (shared familiarity of the subject, similar apperceptions
of the participants) are the most essential characteristics also of
inner speech. That is why, according to Vygotsky, the syntax of
inner speech is supposed to be purely predicative (i.e.,
agrammatic). Vygotsky’s ontogenetic studies analyzing egocen-
tric speech support this argument.
Following W.Humboldt, Vygotsky believes that functional char-
acteristics of speech forms determine its formal features, that is,
each functionally different speech form possesses specific seman-
tics in vocabulary and specific syntax. The two methods of carry-
ing out research on inner speech provided the opportunity to define
not only its syntax characteristics but also its vocabulary—inner
speech does not have constant linguistic meaning but subjective
sense. Loaded with contextual meanings and associations, the
word becomes a carrier of a unique subjective sense that is poten-
tially unlimited.
Unlike inner speech, the semantic plane is mediated, according
to Vygotsky, not by subjective senses but by objective (conven-
tional) meanings. Its syntax is characterized by “live” meaningful
 MAY–JUNE/JULY–AUGUST 2003 77

grammar categories that differentiate it from the syntax of exter-

nal speech with its “frozen” categories. Following G. Paul and
K. Fossler, Vygotsky refers to these categories as psychological
subject and predicate. Unlike categories with the same names in
inner speech, here they both have to be expressed due to more
detailed presentation on the semantic plane. Moreover, the psy-
chological subject may correlate not only with the knowledge of
the speaker but also with that of the listener. Taking into account
the similarity of apperception of the listener, the speaker can con-
struct the utterance either following the logic of subjective impor-
tance or the logic convenient for the listener—“known-new” (for
the listener).
The list of meaningful “counterparts” for grammar categories
of semantic syntax, according to Vygotsky, was to be supplemented.
Further studies, both ontogenetic and functional-linguistic, sup-
ported Vygotsky’s concept of syntaxes behind external syntax. In
modern studies, inner speech syntax approximates the concepts
of “topic-comment,” “figure-ground,” or functional perspective
of the sentence; the list of live counterparts for the subject is
extended by the category of role grammar—Agent (Ag)
(Fillmore, 1968; Danes, 1964; Firbas, 1964; Li and Thompson,
1976; Bowerman, 1973; Greenfield and Smith, 1976; Bates,
1976).
Now I will try to summarize the psychological and linguistic
ideas about the structures and functions of internal syntaxes from
the Vygotskian perspective. Inner speech syntax (in other terms,
communicative or pragmatic syntax) is related to its origin with
orientation reaction (Bates, 1976) and reflects a shift of attentional
focus. The operational ground for this syntax is the recursive rep-
etition of a predicative act. The psychological subject is a field of
attention, and the psychological predicate is a focus of attention.
Because attention can be focused on whatever is subjectively im-
portant or new to the listener as well as important for the speaker,
this syntax mechanism can be used in different strategies of text
and sentence construction (i.e., speaker’s grammar and listener’s
grammar).
78 JOURNAL OF RUSSIAN AND EAST EUROPEAN PSYCHOLOGY

Cases in which the output of this syntax is brought to the surface

without any further processing include the following: one-word
sentences and their chains observed in phylo- and ontogenesis of
language; exclamation in stressful situations (“Fire!”); cues in
dialogue such as “Me–Rostov University” (cf. in folklore “Mon-
day–washday”); appearance of the topical part of the utterance in
languages with a preceding topic (Li, 1976) and in conversational
constructions in other languages (cf. in Russian “Bookstore–I’ll
get off ”; Zemskaia, 1973); consituational sign language of the
deaf or of the hearing working in a noisy environment (Fried-
man, 1976; Sobolevsky, 1986); utterances in pidgin languages
(“Building–high place–wall part–time . . .”; Bickerton, 1983;
1984); utterances produced in altered states of consciousness on
further stages of dissolution (“Normal . . . normal . . . head”;
Spivak, 1986).
Another class of agrammatical utterances is found in children’s
utterances, like “Mummy book read”; in nonsituational sign lan-
guage of the deaf and the hearing working in noisy environments
(Leontiev, 1967; Sobolevsky, 1986); utterances in Creole lan-
guages (of the second generation using a mixed language;
Bickerton, 1983; 1984 ); utterances produced in altered states of
consciousness in the middle stages of dissolution (Question: “How
is your head?” Answer: “Head normal”; Spivak, 1986).
The common feature in all these cases is the fact that they fol-
low the rules of word (sign) order dependent on semantic roles.
These rules may vary, however; in the given examples they were
the following: Ag precedes verb (V) and object (Obj); attribute
follows the defined; Obj. precedes V. The last two rules do not
correspond to conventional Russian word order, but still they are
found in the speech of Russian children and workers in noisy
environments. It is essential that word order rules work in the
process of comprehension of syntactic constructions—the first
noun in the sentence may be perceived as Ag independently of
syntactic construction under the conditions of noise or altered
state of consciousness (Stern, 1980; Spivak, 1986). A similar phe-
 MAY–JUNE/JULY–AUGUST 2003 79

nomenon was found in four-year-old children, including those

who speak languages that have relatively free word order, for ex-
ample, Russian, German, Hungarian, and Japanese, where the er-
rors cannot easily be attributed to overgeneralization of word order
rules (Slobin, 1982; Pléh, 1981; Hakuta, 1982; Akhutina, 1989).
Following Vygotsky’s logic, one can suggest that in the se-
mantic plane communicative syntax works in parallel with the
syntax of semantic roles: the result of the first (syntax) being the
“hierarchy of saliency,” while the second fixes the roles of par-
ticipants, that is, the “hierarchy of cases” (cf. Fillmore, 1977).
The structures of semantic syntax are multipositional frames with
role-fixed slots.
Thus, in accordance with Vygotsky’s concept, speech gen-
eration involves: (1) communicative syntax, (2) semantic syn-
tax, and (3) external syntax. The appearance of agrammatism in
normal speech results from “turning off” the external syntax.
This understanding of syntactic organization results in certain
suggestions about aphasia, which are presented as the hypoth-
eses of this study. The research will verify the suggested con-
cepts of syntax mechanisms.

Research hypotheses

l. In cases of anterior agrammatism (agrammatism in the syn-

drome of efferent motor aphasia), the mechanism of external
(surface) syntax is disordered, and in more severe cases it is
also accompanied by disorders of semantic syntax, which re-
sults in constructing utterances according to rules of intact forms
of syntax.
2. Anterior agrammatism is characterized by parallelism in dys-
functions of constructing and comprehending syntactic constructions.
3. Disorders of syntactic operations may be partially compen-
sated by “background” (Bernshtein, 1947; 1967) motor level, and
vice versa, they may increase when the operations of text pro-
gramming and word choice become more complex.
80 JOURNAL OF RUSSIAN AND EAST EUROPEAN PSYCHOLOGY

Method and Subjects

The study included:
1. A neuropsychological syndrome analysis of higher mental
function disorders (A.R. Luria’s method);1
2. a longitudinal study of expressive speech; and
3. grammar tests.
The study involved eight patients with anterior agrammatism,
which is a part of the syndrome of efferent verbal and nonverbal
disorders. The syndrome was sometimes complicated by afferent
verbal and nonverbal disorders or problems in text planning (dy-
namic aphasia). For more detail on patient status as well as a com-
parison of this group with control groups having other forms of
aphasia, see Akhutina (1989).

Results
The longitudinal study of speech in eight patients with anterior
agrammatism lasted from two to thirteen years. In addition, the
analysis included patients with the same syndrome examined by
A.R. Luria (one subject) and M.K. Shokor-Trotskaia (four subjects).
Because agrammatism is found in the dialogue of normal sub-
jects, the study included only freshly composed monologue
speech—stories based on a picture or several pictures (represent-
ing one story); reproduced and familiar or frequently repeated
texts (the story of the beginning of the disease, retelling) were
excluded.
The following classification of grammar structures was based
on the suggested hypotheses (* denotes substitution, 0.—omis-
sion, In.—inclusion; and specification of the error category is given
in parentheses):
1. Unitary nominations (N): “Boy . . . mother . . . well, brother . . .
well . . . bike”;
2. a row of names combined by intonation (NN): “Radio—
weather—rain,” “Vegetation—fir tree, silver fir”;
3. sentences of the type NNV: “Son, daughter . . . star (* case) . . .
 MAY–JUNE/JULY–AUGUST 2003 81

New year tree (case) good . . . decorated (* number)”;

4. sentences of the type NV, NAt: “Cat to lie (* verb form),”
“boy dirty”;
5. sentences of the type NVN (Ag V Obj): “Cat plays cubes (0.
preposition)”; “Doll sits on the floor”;
6. other structures.
The longitudinal study showed that half of the patients (Tsv,
Roz, K, Nas) at the beginning of the research constructed texts
predominantly of pure nominations (the first level of agramma-
tism); it was followed by a period characterized by prevalent use of
the structures N, NNV, and NVN, where Ag regularly occupied the
preceding position (second level); after this there was a period char-
acterized by greater variability of structures (structures like NVN
and other constitute more than half of all structures) (third level).
In two patients, Zav and L, the second level of agrammatism
transferred into the third. In one patient, Abl, the second level
was observed over the seven years she participated in the study.
Another patient, N, had the third level of agrammatism. A.R.
Luria’s and M.K. Shokhor-Trotskaia’s patients were found to
have first (four subjects) and second (one subject) levels of
agrammatism. The typical distribution of syntactic structures are
presented in Table 1. Below are the texts of the patients with the
first level of agrammatism:
Boy . . . mother . . . boy got a bad mark . . . well . . . brother . . . well bike
. . . and sister is writing . . . well . . . well that’s all. (ROOM DESCRIP-
TION:) Good . . . well, table and that’s all ... chair and cupboard, well
and that’s all. (Tsv 3-72)
Children and grandson . . . grandfather . . . and ball . . . and chap.
Grandfather! Ball! Ball! Magazine, no, not magazine, a book . . . Pio-
neer . . . bench . . . here . . . Grandfa . . . saw . . . children . . . ball . . .
beautiful . . . beautiful - bench . . . ball . . . sun. (Dik)
Grandfather gives the ball. Boy book bench. Two children—boy, girl.
Little—girl skirt, boy pants. Grandfather beard. Moscow (* case) street
(* word order). Floor house. Children—children ball. Children went
to . . . to . . . no . . . boy and girl. Sun . . . bench. Tree—two trees . . .
house . . . urn . . . forest no (* word order). The children were going.
 82

Table 1

Types of Syntactic Structures in Monologues of Patients with Anterior Agrammatism (%)

First level Second level Third level

Tsa V Dik Sh Tsv K Roz P-s L Ab Zav Tsv Tsv L K K Nas N

Tsa V Dik Sh 3.72 76 75 P-s 67 73 75 5.72 76 68 78 80 76 65

N 77 51 51 24 55 37 16 16 18 16 20 5 14 10 14 9 11 8
NN,
NNN — 23 18 33 3 8 14 7 7 3 3 2 2 2 — — 1 2
NNV
(SOV) — 1 3 7 — 1 1 11 4 2 4 5 1 1 3 1 3 6
NV, Nat 5 10 11 17 10 16 32 34 29 33 40 28 30 36 24 30 13 25
NVN
(SVO) — — 3 7 3 28 27 25 35 37 20 56 45 46 38 33 50 39
Other 18 15 14 12 29 9 10 7 7 9 13 4 8 5 21 27 21 20

Grammar
structures 38 224 240 120 31 85 71 73 150 96 70 88 106 129 106 70 70 88
Mean
length of
JOURNAL OF RUSSIAN AND EAST EUROPEAN PSYCHOLOGY

syntagmas 1.0 1.7 1.4 2.0 1.6 1.7 1.8 1.8 2.2 2.8 2.6 2.9 3.1 3.0 3.0 3.1 3.0 3.4
 MAY–JUNE/JULY–AUGUST 2003 83

Ball fell, no thread (* case) . . . Pioneer—pioneer ball tree. Boy got

fall branch (O. preposition, * case). Pioneer ball: Take. Children—
very much thank you. (Sh)
Aside from some randomly grammatical fragments, the utter-
ances of these patients are constructed according to the rules of
communicative syntax. In one-word phrases the psychological
subject (topic) is implied and in a series of names the verbalized
comment becomes the topic of the following predication. Thus,
recursive repetition of a predicative act, that is, detection of the
area of attention (topic) and pointing to its focus (comment), con-
stitutes the simplest syntactic mechanism, which is characteristic
for the first level of agrammatism.
The texts of the patients with the second level of agramma-
tism are:
Supper. Granny pours . . . cup. Bread . . . no . . . mother bread . . . no . . .
cuts bread. An egg is . . . table (O. preposition, * case) . . . no . . . on the
table. (K 77)
Husband and wife wate (WATERED) . . . garden . . . Husband and
wife rested (* number). Husband slept hammock (O. preposition, *
case) wife sat (* gender)—no knitts (* root form) . . . knit (* root form,
number). Visitors came (* number) came (* stem form). Visitors to have-
good-time (* stem form) vodka. They dance . . . Visitors leaves (* num-
ber). Husband and wife . . . I don’t know. (Tsv 4-72)
Children . . . play house (0. preposition). Children . . . new house (0.
verb) . . . Dog room (0. preposition, * case) runs (* word order). Dog
house (* case) end . . . break (* verb aspect, tense, number) . . . Chil-
dren cry . . . Children dog . . . scold (* word order). (P-s)
Note the fragment of the first text: “Bread . . . no . . . mother
bread . . . no . . . cuts bread.” Such self-corrections are typical of
patients with the second level of agrammatism. In this case the
patient starts with the subjectively salient element of the context
“bread,” but then corrects herself and puts “mother” in the first
position according to the rules of semantic syntax, “Frig - door
apart”; and after that remembers the necessity to nominate the
action.
Appearance of the rule associated with objective characteris-
84 JOURNAL OF RUSSIAN AND EAST EUROPEAN PSYCHOLOGY

tics of the situation differentiates this type of grammar from the

preceding one. The majority of sentences are constructed in ac-
cordance with the rule “First noun—Ag.” On the basis of this rule
the contrast pairs are constructed: “I went neighbors, neighbors
went I” (L 67).
Among various nonregular exceptions to this rule, only one
structure is found more regularly, topic-first, as in:
Husband: it’s bad (“husband decided that I was bad”). (Ab 72)
New Year tree—kids come . . . play. (P-s)

Frig—door apart, Trolleybus—passengers (* case) many. (L 67)

The phenomenon of placing the topic in the first position (cf.

similar structure in Russian conversational style, for example,
“Bookstore—I’ll get off ”) may be connected with the fact that
the speaker begins to construct the utterance on the basis of
communicative syntax thus demonstrating the direction of at-
tention; then after fragmenting (breaking down) the scene and
pointing out the roles of its participants, the speaker constructs
the sentence case frame. These examples support the notion that
at the second level of agrammatism the mechanisms of two “in-
ner” syntaxes operate.
Moreover, the postposition of attributes found both in the given
group of patients and in normal conversational style (“Girl
younger is coming,” Ab 74) may be explained either by the hi-
erarchy of saliency or by the hierarchy of roles. The careful
reader might already have noted that the concepts of roles and
case frames suggested in this article are somewhat different from
the traditional ones (cf. Fillmore, 1968; 1977). The main differ-
ence is that in aphasics’ speech the structure is organized not by the
verb, but by a chief name which is counterposed by its attributes:
the name of an action or a feature or an object name in a broad
sense.
The essential characteristics in semantic syntax are logical-
grammatical features of words but not the formal-grammatical
 MAY–JUNE/JULY–AUGUST 2003 85

ones. The fact that the verb is used only as the name of action is
supported by substitutions of finite forms by the infinitive and
verbal nouns, and the diversity of grammatical forms for coor-
dinate predicates (“Maid room tidying up (N),” Roz 72; “Wa-
tered (V) cucumbers, tidying up (N) room, bed, brushed, dust . . .
to wash up,” L 67; “Husband slept hammock, wife sat—no knits,”
Tsv 72).
Though the regularly used rule is that of word order, the gram-
mar is much closer to a normal form than to a random one. This
can probably be explained by two reasons, which will be ana-
lyzed below. Here it should be noted that the same rule of using
Ag in the preceding position is found in the comprehension of
sentences.2
Comprehension was examined in three patients who demon-
strated the second level of agrammatism in their expressive speech.
In all of these cases it was found that patients make the fewest
number of errors in constructions with preceding Ag, that is, in
active voice with a direct order of words (AD) and in passive
voice with an inverted order of words (PI), while maximum errors
occurred in constructions with Ag in postpositions, that is, in ac-
tive voice with an inverted order of words (AI) and in passive
voice with a direct order of words (PD)—see Table 2.
Now I will consider the speech of patients with the third level
of agrammatism, which is characterized first by the regular use of
central rules of surface syntax such as opposition of subject and
grammar object, nominal subject, and verbal predicate. In the
course of improvement, the range of rules and the number of
different grammatical structures increase. These phenomena al-
low us to trace the hierarchy of grammatical complexity, for ex-
ample, among cases: the first opposition is nominative and
accusative cases, then the genitive and/or prepositional cases are
included, and later on dative and instrumental (Akhutina, 1975).
The system of declining personal pronouns is reconstructed long
after that of nouns (this is not characteristic in paragrammatism).
Even in residual agrammatism one can note the greater diffi-
 86

Table 2

Comprehension of Grammar Constructions (number of errors, as %)

Second level Third level

Roz Ab Ab Zav Zav Tsv TSV K Nas Buk

75 72 76 75 76 72 76 80 76 73
O O O O W O Mean O O O O W O O W O W O Mean

AD 7 7 7 7 7 21 8 0 0 7 7 14 0 7 0 0 0 0 3
Al 57 50 50 57 21 64 50 21 14 7 14 7 21 14 7 14 0 0 11
PP 86 71 64 64 50 71 68 43 36 29 14 0 21 14 0 14 21 21 19
PI 36 21 0 21 14 36 21 57 29 64 43 50 21 14 50 21 43 14 37

Note: Sentences were presented in oral (O) or written format (W).

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 MAY–JUNE/JULY–AUGUST 2003 87

Table 3

Distribution of Parts of Speech in Aphasics

Acoustic-
Anterior Dynamic mnestic
agrammatism aphasia aphasia

Agrammatism
level first second third first second third first

Noun + + +>0 + 0 – –
Verb – 0>+ +>0 + + +>0 0/+
Adverb –/0 –/0 –/0 – 0 0 +
Pronoun – – – 0 0 + +
Preposition – – – 0 0 0 0/–
Particle 0/+ 0/+ 0/+ 0 0 + +
Parenthetic
words 0 0 0>+ + + + +

Notes: + and – stand for significant increase and decrease, 0 for absence of alterations;
> shows the regular alteration of the given part of speech ratio in the course of im-
provement; / shows possible variations of the given part of speech ratio.

culty in processing grammatical meanings and forms in omis-

sions or substitutions of function words, interchange of grammar
forms, for example, aspectual-temporal verb forms, and deficiency
of syntactical constructions (Tsvetkova and Glozman, 1978).
Grammatical peculiarities of aphasics’ speech are also mani-
fested in the distribution of parts of speech. The speech of pa-
tients with the first level of agrammatism is characterized by the
predominance of nouns; in patients with the second level of
agrammatism, the number of verbs is increased; and in patients
with the third level of agrammatism, the ratio of nouns and verbs
approaches normal, although the number of pronouns and
prepositions remains small (Table 3).
Regular use of certain surface syntax rules is also found in
comprehension: the distribution of errors across constructions
tends to correspond to their grammar complexity from AD to PI
(see Table 2). Only in one case (Tsv) the number of errors in the
88 JOURNAL OF RUSSIAN AND EAST EUROPEAN PSYCHOLOGY

first examination was fewer in PI than in PD. One could con-

sider it occasional if it were not accompanied by a great in-
crease of errors in PI with a decrease of errors in other
constructions in later examinations. It seems reasonable to sug-
gest that this case reveals the transitory stage in the comprehen-
sion of the most complex construction, in which old and new
rules compete.
The following example illustrates the third level of agramma-
tism. It shows hypermarking of the object, which is the sign of
transition from the second level to the third level.
Mother and child to have-a-walk (* verb form). Boy goes into . . .
onto (* preposition) the pit. Then boy goes into the box (correct
zero ending) box (In. Instr. case ending) box (In. Prepos. case end-
ing). Boy sits on bench (* case) painted. Mother ran in (* preposi-
tion) boy (* case). Boy washed-himself-no to wash (* verb form) to
(In. preposition) boy. Mother washed (* gender) in (In. preposition)
boy (* case). (Tsv 4-72)
The last sentence is constructed according to the patient’s
own rules used during this period. Note that the patient changed
the previous normal (but not corresponding to this grammar) con-
struction, “The boy washed-himself.” The question is how he
managed to create such a construction. I will try to answer this
question in discussing the results.

Discussion

Analyses of monologues of patients with agrammatism as well as

their comprehension of syntactic constructions supports the first
hypothesis on three levels of syntax.
The data also support the second hypothesis on the central
organization of the syntactic mechanism, since the disorders of
construction and comprehension of grammar structures were
found to be parallel.
Though parallelism in the construction and verification of gram-
mar structures was not found, this does not contradict the issue of
 MAY–JUNE/JULY–AUGUST 2003 89

central organization of the syntactic mechanism, because cases

of discordance can be explained by the use of a compensatory
strategy that differs in different patients. The experimental data
are presented in Table 4.
In the first experiment (n = 55), the possible nonreversible con-
structions were presented together with highly impossible ones
(such as “Ivan builds a hut” and “Ivan is built by a hut”), that is,
in these constructions Ag and Obj were interchanged; in the sec-
ond variant (n = 76) either a case or the voice were changed. We
also presented pictures to prevent possible misunderstandings.
Compare the results of patient Ab and Tsv. Despite the fact that
Tsv demonstrated less sebver (third level agrammatism) than Ab
did (second level), he showed lower scores, making more than
twice as many mistakes as patient Ab. To interpret these results
we used data from special grammar tests and neuropsychological
assessment (see Table 5).
The data from the first three tests (construction and compre-
hension of sentences) is consistent with evidence from analysis
of monologues of these two patients: Tsv is better than Ab. From
the other side, patient Ab is better in repeating sentences be-
cause she has less severe motor verbal problems. The same ra-
tionale may also explain this patient’s better results in the
verification test.
In the verification test Ab was not always able to define the
error in the sentence she considered wrong. At the same time
her monologue differed from that of other patients in showing
greater variability in constructing habitual and new texts—in
the habitual texts she did not strictly follow the rule of preced-
ing Ag, so that the repertoire of grammar structures was wider.
This suggests that the patient uses ready-made stereotypes in
these texts. Similarly in the verification test, the patient uses a
holistic strategy based on auditory-motor stereotypes. This strat-
egy is much less acceptable for Tsv, who showed the worst re-
sults in this test, which corresponds to his speech having shown
the most severe efferent motor disorders.
 90
Table 4

Grammar Verification (number of errors, as %)

Roz Ab Ab Zav Zav Tsv Tsv K Has Buk

75 72 76 75 76 73 76 80 76 73

Experiment 1 — 13 — 16 — 31 18 — — 2
Experiment 2 20 23 13 25 20 — 26 16 9 3

Table 5

Performance of Grammar Tests by Patients Ab and Tsv (number of correct responses, as %)

Constructing
Severity of disorder sentences

Comprehension Grammar
of AI and PD verification, Sentence
agrammatism motor independent constrained sentences experiment 1 repetition
JOURNAL OF RUSSIAN AND EAST EUROPEAN PSYCHOLOGY

Ab 72 second mild 25 28 41 87 43
Tsv 73 third moderate 39 39 78 69 27
 MAY–JUNE/JULY–AUGUST 2003 91

This sort of correlation is readily explained by N.A. Bernshtein’s

(1947; 1967) theory of motor control: If one turns to the initial
point of the development of grammar function, it is quite reason-
able to suggest that, originally, kinetic motor patterns are the lead-
ing (superior) level in acquisition of grammar. The child acquires
a grammar pattern as a motor scheme, reproduces it, and even
transfers it into the new forms, that is, seems to perform the same
grammar operations as an adult does, but this grammar operation
is based on the different grammar meaning (which is complex),
that is, the other grammar mechanisms.
Later a higher, proper grammar level develops, while the level
of kinetic motor patterns reverts to the background (for more de-
tail see Akhutina, 1989; Akhutina, Velichkovsky, and Kempe
[1988]). The work of this background level is most clearly seen
in compensatory strategy. It explains the differences between the
regular grammar used by patients and the grammar constructions
that they reproduce. It can also explain the influence of “phono-
logical factors” (Goodglass, 1976) on patients’ grammar.
The second source of greater normality of patients’ texts may
be residual capacity of a proper grammar level. Their existence is
explained, if, after Mountcastle (1978), the work of brain ensemble
in processing one or another verbal operation is treated as a dis-
tributed system. Aphasiologists seldom observe a total impair-
ment of verbal functions, particularly in reference to the naming
function and speech perception; to a lesser degree this is also true
of motor programming and grammar.
Finally, changes in grammar that are dependent on task com-
plexity should be noticed. We compared the stories created by
patients on the basis of pictures, “Family,” “Bad mark again,”
and a landscape, where the complexity of text programming and
the choice of words increases from the first to the third picture.
Seventeen sets of three stories were evaluated; they were taped
on the same day for each patient. The syntagma length (period
between pauses) constitutes 2.7, 2.4, and 2.0 words (see Table 1,
where the relation between the type of syntactic structure and
syntagma length is clearly seen). The level of agrammatism limits
92 JOURNAL OF RUSSIAN AND EAST EUROPEAN PSYCHOLOGY

the ceiling performance in active (but not reproductive) construc-

tion of texts; cognitive or emotional problems result in grammar
simplification (cf. syntagma length of 1.9, 1.4, and 1.1 in Roz 75
with the second level of agrammatism and that of 3.4, 2.3, and
1.7 in Tsv 76 with the third level). Thus cognitive constituents
only worsen the grammar problems without changing their mecha-
nism in essence.

Conclusion

Many of the above-described agrammatic pehnomena in normal

subjects and patients are familiar to specialists. I have tried to
arrange them into a system, based on Vygotsky’s concept of ver-
bal thinking, which suggests three levels of syntax. I have not
exhausted all the arguments for this concept, particularly its cor-
respondence to the data obtained in studies of errors and hesita-
tion pauses. It is not a mere coincidence that Garrett’s (1982)
model based on such data includes the message, functional, and
positional levels that in essence are close to Vygotsky’s levels of
inner speech, semantic plane, and external speech. The aim of
this study was to show that research on agrammatism can be used
to support and develop Vygostky’s concept.
While we share certain common points with Western research-
ers, we also disagree in some ways, primarily in our different inter-
pretations of similar experimental data. For example, we believe
that agrammatism in aphasics does not result from a strategy choice.
Similarly, we do not think that cognitive aspects, attention, and so
forth decisively influence grammar disorders. After A.R. Luria, we
also insist on syndrome analysis of agrammatic phenomena. Our
answer to the question posed in the title should be: agrammatism is
normal in normal subjects’ speech and it is an anomaly in pathology.

Notes

1. Following A.R. Luria, neuropsychological syndromes incorporate the

 MAY–JUNE/JULY–AUGUST 2003 93

disorders of sensory-motor and verbal operations, which are close in their

origin and localization and have the same principle of functioning, includ-
ing, for example, serial organization in the case of efferent nonverbal and
verbal (articulatory and syntactic) disorders. That is why Luria insisted on
“syndrome analyses” of disorders of higher cortical functions. A similar idea
of doing neurolinguistic analysis in the context of general assessment of
cognitive functions was postulated in Caramazza and Berndt (1985).
2. The patients were presented a sentence (n = 56), and the task was to choose
one of two pictures (reversible situations); for more details, see Akhutina (1983;
1989).

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