Towards a unitary account of access dysphasia: a single case study.

We report the case of a patient, H.E.C., with a profound verbal comprehension impairment. His comprehension impairment involved both common names (animal and inanimate items) and proper names. Within the proper name category, his comprehension of country and famous peoples' names was better than his comprehension of common forenames. By using matching to sample techniques, H.E.C.'s impairment was found to be affected by presentation rate and by semantic relatedness, but not by word frequency. An analysis of his responses showed marked inconsistency and serial position effects (i.e. a decrement of performance on subsequent presentations of the same items). H.E.C.'s comprehension deficit was interpreted in terms of an "access" impairment within the word-meaning system. A unitary account of this impairment in terms of a deficit that delays the return, following activation, of the set of representations underlying a word, to a "ready state" is proposed.