Chapter 1
Introduction
1 Background of the Study
In this chapter, it explains about the reason why choose this topic in background of the study, the problems of the study which are investigated, purposes of research in objectives of the study, expectation for some target readers in significance of the study, scope and limitation and operational definition of the key terms.
1.1 Background of the Study
In this world, there are several disease that could infect the human, some of them might be harm or harmless to several human, some of them are also lethal but some of them are not. There are so many example of the disease that would harm the body basically from the outside or inside the human body itself, a few example of the disease that invincible or from the inside the body usually attack the fatal organs or part of the human body, brain is one of the fatal organs that might be infected by some disease. One of the famous diseases that could attack human’s brain is Alzheimer’s. Alzheimer’s disease is kind of disorder that commonly happen for the old people because at that time the part of brain will broken and some of memory that held on that part will be damaged. A person with Alzheimer’s disease may have the following communication problems such as they may say a great deal but it may not convey any meaning, difficulty concentrating on tasks or conversation topics, remembering new or old information and events, understanding words, expressing thoughts and feelings. As Alzheimer’s disease progresses, communication becomes less verbal. People rely on body language and tone of voice to understand what others are saying and to express their own feelings, needs and wants.
As the communication is very important nowadays, everybody needs to communicate with each other for a purpose. Communication is a process how people exchange or share the information with each other, to have a good communication we have to think before we speak to others. In order to have a good communication we have to synchronize our mind and the ability to speaking, it is so natural that most of us do not even think about it when we are communicating, some of people will easily doing that kind of thing because they do not have a language disorders, people with Alzheimer’s disease are categorize is having a speech or language disorder. As the psycholinguistics feature that studies about language disorder, there are several kind of language disorder such as stutter, Dysarthria, Several mutism, Aphasia and Dementia. The dementia is one of the language disorder that caused by Alzheimer disease that makes people lose the ability to communicate to the other. A person with a language disorder has problems receiving, understanding and formulating what they read, what other people say, or even things they want to say , this difficulty can affect the way a person lives their life from day to day, whether it be at home, work, or school. (Turnbull, et al., 2004) This kind of language disorder could be happen naturally or by other factors.
In psycholinguistics feature that studies about language disorder, there are several kind of language disorder such as stutter, Dysarthria, Several mutism, Aphasia and Dementia. The dementia is one of the language disorder that caused by Alzheimer disease that makes people lose the ability to communicate to the other. Alzheimer’s disease is kind of disorder that commonly happen for the old people because at that time the part of brain will broken and some of memory that held on that part will be damaged. A person with Alzheimer’s disease may have the following communication problems such as may say a great deal but it may not convey any meaning, difficulty concentrating on tasks or conversation topics, remembering new or old information and events, understanding words, expressing thoughts and feelings. As Alzheimer’s disease progresses, communication becomes less verbal. People rely on body language and tone of voice to understand what others are saying and to express their own feelings, needs and wants.
The early Alzheimer’s disease in the Still Alice movie is one of the unique case that uncommonly happen to the Alzheimer’s disease but the Alzheimer’s disease that hit Alice is passed by generation make this Alzheimer’s disease will surely passed to her children and the next generation. The character Alice in this movie is a former Linguistic Lecture at Columbia University who finds she’s suffering from early-onset Alzheimer’s disease has diagnosed that she got Alzheimer in the early age. This movie is tell us about the life journey of Alice that fight against her Alzheimer’s disease, as the object of study in researching dementia, there are several example in this movie that show the language disorder specially in Alzheimer’s disease that cause dementia in psycholinguistic feature.
1.2 Statement of the Problem
1. What are the characteristic of Alzheimer’s brain in Still Alice movie?
2. How does Alice’s brain work in language process during her Alzheimer in Still Alice movie?
1.3 Objective of Study
1. To know more about the characteristic of Alzheimer’s brain in Still Alice movie.
2. To inspect Alice’s brain work in language process during her Alzheimer in Still Alice movie.
1.4 Significance of the Study
Analyzing the symptom of Alzheimer’s in the speaker there are some examples in the character of Alice. Several language disorders by Alzheimer’s have a contribution to change Alice life. This thesis tries to find the several language disorders by Alzheimer’s in the early age. Then, this thesis is also referring her characteristic of Alzheimer’s brain in Still Alice movie and how does Alice’s brain work in processing language during her Alzheimer in Still Alice movie.
This research is supposed to give deeper description about Alzheimer’s for the students and next Alzheimer’s researcher as the first reader. Besides, it can stimulate psycholinguistic or neurolinguistic lecturers to explain and give examples about language disorders. This research is not only useful for the students and lecturers but also for teachers which this research would be very useful not only in language subject but also in medical subject for further level of research.
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1.5 Scope and Limitation
This research topic is in psycholinguistic field and focuses on the characteristic of Alzheimer’s brain, and Alice’s brain work in language process during her Alzheimer in Still Alice movie. To get more understanding about this phenomenon, this research using a theory of Anne Brown Rodgers (2008) which explains that Alzheimer’s disease is an irreversible, progressive brain disease that slowly destroys memory and thinking skills, eventually even the ability to carry out the simplest tasks. In most people with Alzheimer’s disease, symptoms first appear after age 60. Alzheimer’s disease is caused by a disease that affects the brain. In the absence of disease, the human brain often can function well into the 10th decade of life. This research also using David F.Tang-Wai and Naida L. Graham (2006) which explains the relation between language and brain in Alzheimer’s patient to understand their language disorder of the brain function, in other words it tries to explore how the brain understands and produces language and communication.
This research is limited on the movie Still Alice, a 2014 American drama film written and directed by Richard Glatzer and Wash Westmoreland and based on Lisa Genova's 2007 bestselling novel of the same name. The data source is not natural but it is reliable because the movie is inspired from real life. Then, the data are limitedly taken from the main character (Alzheimer’s) only, namely Alice Howland.
1.6 Definition of Key Term
• Alzheimer’s disease is a degenerative brain disease and the most common cause of dementia. Dementia is also caused by other diseases and conditions. It is characterized by a decline in memory, language, problem-solving and other cognitive skills that affect a person’s ability to perform everyday activities. This decline occurs because nerve cells (neurons) in parts of the brain involved in cognitive function have been damaged and no longer function normally. In Alzheimer’s disease, neuronal damage eventually affects parts of the brain that enable a person to carry out basic bodily functions such as walking and swallowing. People in the final stages of the disease are bed-bound and require around-the-clock care. Alzheimer’s disease is ultimately fatal. (Alzheimer’s Association. 2015 Alzheimer’s Disease Facts and Figures. Alzheimer’s & Dementia 2015)
• Language and brain is a study to critical ancillary areas: memory, psycholinguistics and normal brain processes all of which interrelate with language and knowledge of the nature of memory, the nature of normal language processing and the brain correlates of normal cognitive functions of language, brain imaging and language disorders considered at all levels from the sound system to syntax, semantics, discourse and pragmatics. As well, neurological disorders that typically manifest language disturbances in addition to the primary disease, e.g., the various dementias, apraxia, agnosia and, of course, the schizophrenias. (Harry A. Whitaker, 2010)
• Language disorders difficulties in understanding a language or a communication with others, Language disorder may include difficulty in speaking, listening, and learning whether reading or writing; or a combination of all these areas and also language problems that result from two types of neurological disorders to which involved from many factor. (Clark cotton, 2007)
Chapter 2
Review of related literature:
This chapter describes the linguistics framework for the thesis and the theories, which related and used in this thesis. This chapter also gives other studies which can be reference toward this thesis.
2.1 Alzheimer’s
According to the Alzheimer’s association 2015, Alzheimer’s disease is a degenerative brain disease and the most common cause of dementia.1 or 2 Dementia is also caused by other diseases and conditions. It is characterized by a decline in memory, language, problem-solving and other cognitive skills that affect a person’s ability to perform everyday activities. This decline occurs because nerve cells (neurons) in parts of the brain involved in cognitive function have been damaged and no longer function normally. In Alzheimer’s disease, neuronal damage eventually affects parts of the brain that enable a person to carry out basic bodily functions such as walking and swallowing. People in the final stages of the disease are bed-bound and require around-the-clock care. Alzheimer’s disease is ultimately fatal (Alzheimer’s Association. 2015 Alzheimer’s disease Facts and Figures. Alzheimer’s & Dementia 2015). The research by California Workgroup on Guidelines for Alzheimer’s Disease in Management Alzheimer’s Disease (AD) in 2008 currently afflicts over 5.2 million Americans, including an estimated 200,000 patients under the age of 65. The number of those afflicted is increasing annually as the population continues to age. Following the aging of the baby boomers, prevalence will escalate rapidly and is expected to double by 2020. The burden on families and the health care system will be substantial as one out of every eight baby boomers develops this disease.
Causes of Alzheimer’s disease
The cause or causes of Alzheimer’s disease are not yet known. However, most experts agree that Alzheimer’s, liked other common chronic diseases, develops as a result of multiple factors rather than a single cause. These factors include a variety of brain changes that begin as many as 20 years before symptoms appear. Increasingly, the time between the initial brain changes of Alzheimer’s and the symptoms of advanced Alzheimer’s is considered by scientists to represent the “continuum” of Alzheimer’s. At the start of the continuum, the individual is able to function normally despite these brain changes. Further along the continuum, the brain can no longer compensate for the increased neuronal damage caused by brain changes, and the individual shows subtle decline in cognitive function. In some cases, physicians identify this point in the continuum as Mild Cognitive Impairment (MCI). Toward the end of the continuum, neuronal damage and death is so significant that the individual shows obvious cognitive decline, such as memory changes or confusion as to time or place. At this point, physicians following the 1984 criteria for Alzheimer’s would diagnose the individual as having Alzheimer’s disease. The new criteria and guidelines propose that the entire continuum, not just the symptomatic points on the continuum, represents Alzheimer’s. Researchers continue to explore why some individuals who have the brain changes associated with the earlier points of the continuum do not go on to develop the overt symptoms of the later points of the continuum. Among the brain changes believed to contribute to the development of Alzheimer’s are the accumulation of the protein beta-amyloid outside neurons in the brain and the accumulation of the protein tau inside neurons. A healthy adult brain has 100 billion neurons, each with long, branching extensions. These extensions enable individual neurons to form specialized connections with other neurons. At these connections, called synapses, information flows in tiny chemical pulses released by one neuron and detected by the receiving neuron. The brain contains 100 trillion synapses. They allow signals to travel rapidly and constantly through the brain’s circuits, creating the cellular basis of memories, thoughts, sensations, emotions, movements and skills. In Alzheimer’s disease, information transfer at synapses begins to fail, the number of synapses declines and neurons eventually die. The accumulation of beta-amyloid outside neurons is believed to interfere with the neuron-to-neuron communication of synapses and to contribute to cell death. Inside the neuron, abnormally high levels of tau form tangles that block the transport of nutrients and other essential molecules throughout the cell. This process is also believed to contribute to cell death. Brains from people with advanced Alzheimer’s show dramatic shrinkage from cell loss and widespread debris from dead and dying neurons. One known cause of Alzheimer’s is genetic mutation. A small percentage of Alzheimer’s disease cases, probably less than 1 percent, are caused by three known genetic mutations. These mutations involve the gene for the amyloid precursor protein and the genes for the presenilin 1 and presenilin 2 proteins. Inheriting any of these genetic mutations guarantees that an individual will develop Alzheimer’s disease. In such individuals, the disease tends to develop before age 65, sometimes in individuals as young as age 30 (Alzheimer’s Association, 2012 Alzheimer’s Disease Facts and Figures, Alzheimer’s & Dementia, Volume 8, Issue 2).
MCI is a condition in which an individual has mild but measurable changes in thinking abilities that are noticeable to the person affected and to family members and friends, but do not affect the individual’s ability to carry out everyday activities. People with MCI, especially MCI involving memory problems, are more likely to develop Alzheimer’s and other dementias than people without MCI. Revised criteria and guidelines for diagnosis of Alzheimer’s disease suggest that in some cases MCI is actually an early stage of Alzheimer’s or another dementia. However, MCI does not always lead to dementia. In some individuals, MCI reverts to normal cognition or remains stable. In other cases, such as when a medication causes cognitive impairment, MCI is mistakenly diagnosed. Therefore, it’s important that people experiencing cognitive impairment seek help as soon as possible for diagnosis and possible treatment. (Alzheimer’s Association. 2015 Alzheimer’s Disease Facts and Figures. Alzheimer’s & Dementia 2015)
2.2 Brain and language
Brain is one the important organ part of every creature specially a human, The brain consists of a vast amount of neurons and glial cells both of which constitute the basic operative units of the brain. During the period of the most rapid prenatal brain development, which occurs between 10 and 26 weeks after conception, the brain is estimated to grow at a rate of 250 000 neurons per minute. At birth, the brain contains the majority of the cells it will ever have, with estimates ranging from 15 to 32 billion. There are many function of the brain, one of the main function is to provide the language, the brain is also the place where is the language produced (Barbara Ischinger, 1999). Language is often mentioned as one of the functions of the brain, in addition to perception, action, feeling and thought and indicates possible areas involved but a topographic arrangement of areas is not sufficient (Helmut Schnelle, 2010). Though certain brain structures are biologically primed for language, the process of language acquisition needs the catalyst of experience. There are developmental sensitivities as language circuits are most receptive to particular experience-dependent modifications at certain stages of the individual’s development (Barbara Ischinger, 1999).
According to Harry A. Whitaker (2010) Language and brain is a study to critical ancillary areas: memory, psycholinguistics and normal brain processes all of which interrelate with language and knowledge of the nature of memory. the nature of normal language processing and the brain correlates of normal cognitive functions of language, brain imaging and language disorders considered at all levels from the sound system to syntax, semantics, discourse and pragmatics. As well, neurological disorders that typically manifest language disturbances in addition to the primary disease, e.g., the various dementias, apraxia, agnosia and, of course, the schizophrenias
2.3 Language Disorder
There are several cases that related to difficulties in understanding a language or a communication with others, this kind of condition called language disorder. Language disorder may include difficulty in speaking, listening, and learning whether reading or writing; or a combination of all these areas.
Language disorders, are presumed to have as their cause some form of damage to some specific site in the hemisphere where language is located. Such damage causes characteristic problems in spontaneous speech, as well as in the understanding of speech and writing. It is also caused by family factor passed by the generation. (Anne Brown Rodgers, 2008)
According to Clark cotton (2007) Brain injury or neurodegenerative disease often produces serious language disorders in adults. This section gives an overview of the language problems that result from two types of neurological disorders to which older adults are disproportionately subject: cerebrovascular accident (commonly called stroke), which may lead to aphasia and dementia of the Alzheimer’s type. It also briefly considers the implications of aging for adults with childhood language disorder.
Several areas that has not been well studied is the language performance in adulthood of people with developmental language disorders. Diagnosis and treatment of childhood language problem were much less available when contemporary adult were children, and many people who would now be recognized as having disordered language were not identified as such in childhood. In individuals with developmental language disorders difficult, but a consideration of this subgroup of older adults is important to developing a fuller understanding of language changes in aging.
2.4 Previous Studies
1. Patrick Corney (2008). He studied the Attention in Normal Aging and Alzheimer’s disease. There are three questions in this research, first, considered methodological differences between the divided attention tasks used by Baddeley et al., and the tasks used by researchers who have reported age-related differences. Second, examined attention in normal aging and Alzheimer’s disease young adults, older adults, and early-stage Alzheimer’s disease patients were compared on tasks of selective attention, focal attention, and divided attention, with each task administered at two levels of difficulty. Third, considered attentional tasks from a clinical perspective. Specifically, the attentional tasks utilized in Study 2 were examined with respect to their ability to correctly classify individuals with early stage Alzheimer’s disease and normal older adults. Findings showed that all attentional tasks successfully discriminated patients from cognitively healthy older adults, with one task of divided attention showing particularly impressive sensitivity and specificity.
2. Ronny Plontke (2003). The author analyzes and discussed important aspects of the connection between language and brain details of human language. It also show the relevance of the topic on some examples from the linguistically relevant films to examined how language phenomena can be explained by neural network behavior. There are three questions in this paper; first, the human brain functions as the basic groundwork for the following explanations, these explanations are based on Obler and Gjerlow (13-36) and on the more comprehensive descriptions in Calvin and Ojemann (15-90). Second, neural learning and consider the significant aspects for language, how the human brain is able to process and to store information, especially language relevant data like the meaning of words and grammatical rules. This topic is also exceedingly interesting for computer scientists and closely related to artificial intelligence topics. Then the third is to evaluate films dealing with the language
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Chapter 3
Research method
Research methodology is becoming the most important role in this study, this study research is using the descriptive qualitative method. This chapter, begin with describing and explaining the research.
3.1 Research Design
This study uses the descriptive qualitative method which more focuses on the phenomenon of the object. According to Marshall (2007), this kind of method is focused on the eventual or segment However, data collection also may include observations, and examination of records, reports, photographs, and documents. Data analysis of qualitative descriptive research, unlike other qualitative approaches, does not use a pre-existing set of rules that have been generated from the philosophical or epistemological stance of the discipline that created the specific qualitative research approach. Rather, qualitative descriptive research is purely data-derived in that codes are generated from the data in the course of the study. Collecting script data and analyze it the next level of the research. Like other qualitative research approaches, qualitative descriptive studies generally are characterized by simultaneous data collection and analysis.
3.2 Subject of the Study
The subject of this study is some movie that reflects the Alzheimer’s disease and dementia in the movie itself. “Still Alice”, the movie by Richard Glazer and Wash Westmoreland has the example to fulfill the research subject as the main subject. This study using the movie “Still Alice” to collect the data that needed.
The movie would contain the data and script that leading to analyze the Alzheimer disease that happen to Alice, and how that would affect the communication. The data for the first research question would be analyzed with Anne Brown Rodgers theory which explain about Alzheimer disease, and to analyze the second question is using David F.Tang-Wai and Naida L. Graham which related to psycholinguistics subject.
3.3 Source of the Data
The data is taken from the main character of the movie. Alice (Julianne Moore), who diagnosed got an early Alzheimer’s disease and her family is also the supporting object of this study. This research, analyze the Alzheimer’s symptoms in Alice daily life after she got the Alzheimer’s symptoms. In determining sample, the writer uses purposive sampling. Purposive sampling is a technique of taking sample based on certain purposes. The writer takes Alice utterances which contain language and speech disorder as the sample from the movie and script, then analyzed them based on the psycholinguistic form related to the theory.
3.4 Data Collection Technique
In the process of collecting data, the use of descriptive qualitative technique is very important to this kind of research. The goal of qualitative descriptive studies is a comprehensive summarization, in everyday terms, of specific events experienced by individuals or groups of individuals or even some moment or event from some movies can be categorized as this method of research. In order to analyze the psycholinguistic, especially in language disorders, this kind of method usually work for some sub subject, but not all the subject would be related to this kind of research. This method usually works to analyze the form of media observation like movie, TV show, Radio program, and reusing the previous study as the object of the study.
The researcher key instrument in this study uses the observation in the specific movie to collect the data. In the qualitative descriptive studies the researcher primary objective is to analyze the phenomenon of some moment or event in specific situation. After the data collected, the next problem is analyzing the data that been collected to the next step. Taking a good note will be increasing the understanding of the subject that will be analyzed.
In order to get a good data for the research, taking a screen capture of a segment of the movie that related to the research question would be necessary and very important role. In this research , the data was collected by inspecting the segment of the movie and taking a notes that related to the research question, and some screen shot will be taken as the prove of this research.
3.5 Data Analysis Technique
After the data has collected the next step is to analyze the data. The researcher using the descriptive qualitative method, Data collection of qualitative descriptive studies focuses on discovering the nature of the specific event sunder study. Thus, data collection involves minimal to moderate, structured, open-ended, individual or focus group interviews.
In summary, a qualitative descriptive approach needs to be the design of choice when a straight forward description of a phenomenon is desired. There are a number of researchers who believe and support the fact that ‘qualitative descriptive’ is a viable and acceptable label for a qualitative research design. While phenomenology, grounded theory, and ethnography also are descriptive qualitative approaches, by nature, they are not exclusively in the descriptive domain because they also tend to explain phenomena (Vickie A. Lambert: 225: 2012)
3.5.1 Describing
The descriptive research attempts to describe, explain and interpret conditions of the present i.e. “what is’. The purpose of a descriptive research is to examine a phenomenon that is occurring at a specific place(s) and time. A descriptive research is concerned with conditions, practices, structures, differences or relationships that exist, opinions held processes that are going on or trends that are evident. There are several steps that the researcher must do and aware of, the first step is describe the content or object that researcher pick, which mean in this step the researcher must explain the object setting that being analyzed to give detail description. Then the second thing is to explain the characteristic of some conversation to avoid the ambiguity meaning in some text. With those step the researcher can proceed to the next data analysis step.
3.5.2 Classifying
During the research this step is also important for the researcher. Usually during in this step, researcher makes the table for their data analysis for their related research. In this case researcher makes a table list of conversational analysis in the object in order to make the research easier and faster. Some researcher may need to analyze the same data more than one time, this kind of thing would really helpful for the researcher.
After the data has been collected from the movie, researcher uses that data to analyze the phenomenon in specific segment of the object. This also make researcher more focus on the research and keep it on the line of research. After this step researcher can proceed to the data combining and connecting the data.
3.5.3 Combine and connecting the data
After the previous step, this step is the most important. Describing and classifying is the only way to help the researcher get further step. The goal of this step is to keep the researcher focus on the object. By doing this aspect, the researcher will keep it on the topic and the main purpose of this analysis which is about Alzheimer’s disease language disorder. Combining the first data into the Chomsky theory that focus on mind and language and then using Jeff Hawkins to analyze the brain part that having a disorder of the Alzheimer’s disease. Combining the data after the previous step is necessary to make the data more details in every research subject.