Abstract: Objective To evaluate the damaged level of auditory processing and diagnose the type of language impairment in an auditory agnosia patient using Psycholinguistic Assessment in Chinese Aphasia (PACA), and predict the outcome of the language function. Methods A patient with a bilateral damage involving the temporal lobe could physically hear the sounds, but was unable to recognize or differentiate between the sounds. Speech and language evaluations were taken with PACA 4 weeks, 8 weeks and 3 months after the onset of disease. Results At 4 weeks, the correct rates were 2.5% and 95.0% in spoken word-picture matching and written word-picture matching (P<0.001), and were 5.6% and 80.6% in spoken semantic knowledge and written semantic knowledge (P<0.001). The scores of auditory input processing function score were low, including phoneme discrimination, spoken word matching with minimal differences, environmental sounds identification. The correct rates were 67.5% in oral picture naming, 0 in word repetition, 70.0% in word reading, 0 in dictation, 100.0% in directly copy writing. At 8 weeks and 3 months, there was complete recovery in written word- picture matching (both 100%) and written semantic knowledge (97.2%, 100%), and improvement in oral picture naming (87.5%, 90%), word repetition (87.5%, 97.5%), picture name writing (77.5%, 87.5%) and copy writing (both 100%) (P<0.05). But no change was found in auditory input processing function examinations, spoken word-picture matching (5.0%, 7.5%), spoken semantic knowledge (2.8%, 5.6%), word repetition (0, 3.3%) and dictation (both 0). Conclusion The patient was diagnosed as auditory agnosia with the inability to distinguish sounds. PACA can well identify the impaired level of auditory comprehension disorder and the outcome of language function recovery for aphasics.

Key words: auditory agnosia, auditory comprehension, aphasia, psycholinguistic assessment, pure word deafness, cortical deafness