The functional basis of speech automatisms (recurring utterances)

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Abstract
Speech automatisms (or recurring utterances) are stereotyped and repetitive productions especially seen in more severely handicapped aphasic patients. First this paper summarizes important observations on the occurrence and phenomenology of that symptom. It then addresses the issue of syndrome categorization of these patients. The main part of this review deals with attempts to account for this sterotyped output pattern. Theories assuming a non-propositional mode of automatism production can elucidate the very first occurrence of some lexical automatisms. However, this approach cannot explain their repetitive and stereotyped character. Other accounts are founded on detailed single case studies within the framework of language processing models. Based on these studies it is argued that speech automatisms are triggered by modality-specific and subphonemic mechanisms. It is proposed that a subphonemic buffer system is involved in automatism generation. This system can be dysfunctional by direct impairment or by lack of activation through higher levels of language control.