The interaction of lexical and non-lexical processing mechanisms: evidence from anomia

Patient SF presented with a selective deficit in naming, in the presence of normal auditory, visual and pictorial input processing, and of normal comprehension. The naming disorder was independent of input modality, and resulted in the inability to respond to low-frequency items. The analysis of the patient's performance in the repeated administration of the same set of pictures for oral naming and for written naming demonstrated that both tasks were disrupted to a similar extent - high consistency values were observed both across and within modality. Thus, the profile of the naming disorder observed in this patient was consistent with damage to phonological and orthographic output lexicons. SF's performance in reading and writing was apparently at odds with this account, as he was able to read aloud words with lexically-assigned stress, and to write to dictation words whose spelling is also determined lexically. The co-occurrence of the inability to activate output lexical representations in both oral and written picture naming, in the context of normal ability to activate the same representations reading and in writing is consistent with the notion that phonological and orthographic output lexicons are distinct, but interact with nonlexical conversion mechanisms.