© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permission@oup.com. doi:10.1093/arclin/acaa072 Advance Access publication 00 Month 0000 Archives of Clinical Neuropsychology 00 (2020) 1–10 Acalculia in Aphasia Rafael Gonzalez 1 , Macarena Rojas 1 , Mónica Rosselli 2 , Alfredo Ardila 3,4, * 1 Departamento de Neurología y Neurocirugía, Hospital Clínico de la Universidad de Chile, Santiago, Chile 2 Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Davie, FL, USA 3 Institute of Linguistics and Intercultural Communication, I.M. Sechenov First Moscow State Medical University, Moscow, Russia 4 Psychology Doctoral Program, Albizu University, Miami, FL, USA *Corresponding author at: 12230 NW 8th Street, Miami, FL 33182, USA.E-mail address: ardilaalfredo@gmail.com (A. Ardila). Received 22 April 2020; revised 15 July 2020; Accepted 15 August 2020 Abstract Background: Patients with aphasia can present a type of acalculia referred to as aphasic acalculia. Aims: To investigate the correlation and to test regression models for one- and two-digit calculation skills using verbal and nonverbal predictors. Methods and Procedures: We selected an aphasia sample of 119 men and 81 women with a mean age of 57.37 years (SD = 15.56) and an average level of education of 13.52 years (SD = 4.08). Spanish versions of the Western Aphasia Battery and Boston Diagnostic Aphasia Examination, plus a Written Calculation test, were individually administered. The calculation section of the Western Aphasia Battery and the Written Calculation tests were used to pinpoint calculation difficulties. Outcomes and Results: Calculation difficulties were more severe in Global and Mixed non-fluent aphasia; they were very similar in Broca, Conduction, and Amnesic Aphasia. All correlations between the two calculation subtests and the other subtests of the Western Aphasia Battery were statistically significant. Calculation subtests correlated negatively with age and positively with schooling. Sex and time post-onset did not show any correlation with the calculation scores. Education, Reading, Block Design, and Raven’s Colored Progressive Matrices were significant predictors of Western Aphasia Battery Calculation. Writing was the only significant predictor of the Written Calculation scores. Conclusions: Nonverbal abilities were predictors of calculation tests, whereas agraphia defects were predictors of the Written Calculation test. Therefore, calculation abilities can be regarded both as written language-dependent and verbal language-independent. Keywords: Acalculia; Aphasia; Western Aphasia Battery; Spanish Introduction Numerical knowledge can be regarded as a multifactor ability, involving at least language, spatial abilities, executive functions, and somatic knowledge (Ardila & Rosselli, 2002). Consequently, it is not surprising that aphasic patients frequently present mathematical difficulties that can go from simple counting deficits to complex arithmetical problem solution (Ardila & Rosselli, 1990a, 1990b, 2002, 2019; Basso, Burgio, & Caporali, 2000; Rosselli & Ardila, 1989, 2020). This disorder has been usually termed “aphasic acalculia” (Ardila & Rosselli, 2002). As an illustration of these difficulties, De Luccia and Ortiz (2016) compared to non-brain damage participants, the numerical and computational abilities of 32 patients with aphasia resulting from a single vascular lesion of the left hemisphere. Aphasic patients presented errors in simple count (i.e., 1, 2, 3 ... ), in performing automatic series (to count adding or subtracting three, or ten) and in both forward (i.e., 3, 6, 9, 12 ... ) and backward (e.g., 50, 40, 30, 20 ... ) counting. In addition, the aphasics showed difficulties in naming and writing to dictation arithmetic signs Downloaded from https://academic.oup.com/acn/advance-article/doi/10.1093/arclin/acaa072/5911715 by Florida International University user on 26 September 2020