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de Araújo CM, de Alcântara C, Alencar MA, da Gama NAS, Cruzeiro MM, França MC, Jaeger A, Camargos ST, Machado TH, de Souza LC. Language impairment in sporadic and familial (type 8) amyotrophic lateral sclerosis: A comparative study. Muscle Nerve 2024; 70:130-139. [PMID: 38738747 DOI: 10.1002/mus.28109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 04/20/2024] [Accepted: 04/24/2024] [Indexed: 05/14/2024]
Abstract
INTRODUCTION/AIMS Language is frequently affected in patients with sporadic amyotrophic lateral sclerosis (sALS), with reduced performance in naming, syntactic comprehension, grammatical expression, and orthographic processing. However, the language profile of patients with familial type 8 ALS (ALS8), linked to p.P56S VAPB mutation, remains unclear. We investigated language in patients with ALS8 by examining their auditory comprehension and verbal production. METHODS We included three groups of participants: (1) patients with sALS (n = 20), (2) patients with familial ALS8 (n = 22), and (3) healthy controls (n = 21). The groups were matched for age, sex, and education level. All participants underwent a comprehensive language battery, including the Boston Diagnostic Aphasia Examination, the reduced Token test, letter fluency, categorical fluency (animals), word definition from the Cambridge Semantic Memory Research Battery, and a narrative discourse analysis. Participants also were evaluated using Addenbrooke's Cognitive Exam-Revised Version, the Hospital Anxiety and Depression Scale, and the ALS Functional Rating Scale-Revised. RESULTS Compared to controls, sALS and ALS8 patients had impaired performance on oral (syntactic and phonological processing) comprehension and inappropriate discourse cohesion. sALS and ALS8 did not differ in any language measure. There was no correlation between language scores and functional and psychiatric scales. DISCUSSION ALS8 patients exhibit language deficits that are independent of motor features. These findings are consistent with the current evidence suggesting that ALS8 has prominent non-motor features.
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Affiliation(s)
- Caroline M de Araújo
- Postgraduate Program in Neuroscience, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Cássia de Alcântara
- Postgraduate Program in Neuroscience, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Natália A S da Gama
- Postgraduate Program in Neuroscience, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Marcelo M Cruzeiro
- Department of Internal Medicine, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | | | - Antônio Jaeger
- Department of Psychology, Faculty of Philosophy and Human Sciences, UFMG, Belo Horizonte, Brazil
| | - Sarah T Camargos
- Postgraduate Program in Neuroscience, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
- Department of Internal Medicine, School of Medicine, UFMG, Belo Horizonte, Brazil
| | - Thais H Machado
- Department of Speech-Language-Hearing Sciences, School of Medicine, UFMG, Belo Horizonte, Brazil
- Programa de Pós-graduação em Ciências Fonoaudiológicas, Departamento de Fonoaudiologia, School of Medicine, UFMG, Belo Horizonte, Brazil
| | - Leonardo Cruz de Souza
- Postgraduate Program in Neuroscience, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
- Department of Internal Medicine, School of Medicine, UFMG, Belo Horizonte, Brazil
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Park H, Obermeyer J, Paek EJ, Zurbrugg M. Verb Tense Production in People With Nonfluent Aphasia Across Different Discourse Elicitation Tasks. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1301-1316. [PMID: 38324346 DOI: 10.1044/2024_ajslp-23-00165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
PURPOSE Verb tense production is known to be impaired in people with nonfluent aphasia. Selective past tense impairment in this population has been reported, but results are inconsistent and lacking at the discourse level. In addition, language production can be affected by discourse elicitation tasks depending on the cognitive linguistic demands and instructions unique to each task. There is limited evidence regarding whether verb tense production in people with nonfluent aphasia is impacted by discourse task demands. Understanding this potential impact is important for clinicians and researchers who are interested in assessing and then identifying effective clinical goals for this population. Therefore, this study aimed to investigate the trends of verb tense production across various discourse elicitation tasks in people with nonfluent aphasia compared to people without aphasia. METHOD Language samples for 23 people with nonfluent aphasia and 27 people without aphasia were obtained for six discourse tasks from the AphasiaBank database. We calculated ratios of past tense, present tense, future tense, imperative, and unknown verb types to compare which tense was used most frequently within and across the tasks and groups. RESULTS AND CONCLUSIONS Our findings revealed evidence of verb tense production deficits and a selective past tense impairment in people with nonfluent aphasia. Discourse task effects were shown for people without aphasia but were scarce in people with nonfluent aphasia. This finding could be explained by an overall reduction of verb production and overreliance on present tense production in nonfluent aphasia. These results suggest the potential methodological implications of using different discourse tasks to evaluate verb tense production in people with nonfluent aphasia. Future studies need to evaluate discourse task effects on other aspects of verb production (e.g., moods) and specific task factors (e.g., presence or absence of visual stimulus). SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25146242.
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Affiliation(s)
- Hyejin Park
- Department of Communication Sciences and Disorders, The University of Mississippi, Oxford
| | - Jessica Obermeyer
- Department of Communication Sciences and Disorders, University of North Carolina at Greensboro
| | - Eun Jin Paek
- Department of Audiology and Speech Pathology, College of Health Professions, The University of Tennessee Health Science Center, Knoxville
| | - Madeline Zurbrugg
- Department of Communication Sciences and Disorders, The University of Mississippi, Oxford
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Carragher M, Mok Z, Steel G, Conroy P, Pettigrove K, Rose ML, Togher L. Towards efficient, ecological assessment of interaction: A scoping review of co-constructed communication. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:831-875. [PMID: 37864388 DOI: 10.1111/1460-6984.12957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 08/28/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND The complexity of communication presents challenges for clinical assessment, outcome measurement and intervention for people with acquired brain injury. For the purposes of assessment or treatment, this complexity is usually managed by isolating specific linguistic functions or speech acts from the interactional context. Separating linguistic functions from their interactional context can lead to discourse being viewed as a static entity comprised of discrete features, rather than as a dynamic process of co-constructing meaning. The ecological validity of discourse assessments which rely on the deconstruction of linguistic functions is unclear. Previous studies have reported assessment tasks that preserve some of the dialogic features of communication, but as yet, these tasks have not been identified as a distinct genre of assessment. We suggest the term 'co-constructed communication' to describe tasks which are specifically designed to capture the dynamic, jointly produced nature of communication within a replicable assessment task. AIMS To identify and summarize how co-constructed communication has been assessed with individuals with non-progressive acquired communication disability regarding task design, measures and psychometric robustness. METHODS A scoping review methodology was used to identity relevant studies. Systematic database searches were conducted on studies published before July 2021. Studies in the yield were assessed against eligibility criteria, with 37 studies identified as eligible for inclusion. MAIN CONTRIBUTION This is the first time that co-constructed communication has been defined as a genre of discourse assessment for stroke and traumatic brain injury populations. Co-constructed communication has been assessed for 144 individuals with aphasia and 111 with cognitive-communication disability. Five categories of co-constructed communication tasks were identified, ranging in complexity. Variability exists in how these assessment tasks are labelled and measured. Assessment measures require further psychometric profiling, specifically regarding test-retest reliability and validity. CONCLUSIONS Co-constructed communication is a discourse genre which offers researchers and clinicians a replicable method to assess language and communication in an experimentally rigorous way, within an ecologically valid context, bridging the gap between experimental and ecological assessment approaches. WHAT THIS PAPER ADDS What is already known on this subject Standardized assessments of language skills and monologue offer reliable, replicable ways to measure language. However, isolating language from an interactional context fundamentally changes the behaviour under study. This raises questions about the ecological validity of the measures we routinely use to determine diagnoses, guide treatment planning and measure the success of treatment. What this study adds to the existing knowledge This review highlights studies that conceptualize, and often quantify, interaction by combining experimental rigour and aspects of everyday dialogue. This is the first time this genre of discourse assessment has been identified. We propose the term 'co-constructed communication' to describe this genre and provide an operational definition for the term. What are the practical and clinical implications of this study? Co-constructed communication assessment tasks require refinement, particularly regarding aspects of psychometric robustness. In the future, these tasks offer pragmatic, meaningful ways to capture the effect and impact of aphasia and cognitive-communication disability within interaction.
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Affiliation(s)
- Marcella Carragher
- Centre for Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Victoria, Australia
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Zaneta Mok
- School of Allied Health, Faculty of Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
- Speech Pathology, Alfred Health, Melbourne, VIC, Australia
| | - Gillian Steel
- Centre for Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Victoria, Australia
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Paul Conroy
- School of Health Sciences, The University of Manchester, Manchester, UK
| | - Kathryn Pettigrove
- Centre for Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Victoria, Australia
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Miranda L Rose
- Centre for Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Victoria, Australia
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Leanne Togher
- Centre for Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Victoria, Australia
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Cordella C, Di Filippo L, Kolachalama VB, Kiran S. Connected Speech Fluency in Poststroke and Progressive Aphasia: A Scoping Review of Quantitative Approaches and Features. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-38. [PMID: 38652820 DOI: 10.1044/2024_ajslp-23-00208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
PURPOSE Speech fluency has important diagnostic implications for individuals with poststroke aphasia (PSA) as well as primary progressive aphasia (PPA), and quantitative assessment of connected speech has emerged as a widely used approach across both etiologies. The purpose of this review was to provide a clearer picture on the range, nature, and utility of individual quantitative speech/language measures and methods used to assess connected speech fluency in PSA and PPA, and to compare approaches across etiologies. METHOD We conducted a scoping review of literature published between 2012 and 2022 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. Forty-five studies were included in the review. Literature was charted and summarized by etiology and characteristics of included patient populations and method(s) used for derivation and analysis of speech/language features. For a subset of included articles, we also charted the individual quantitative speech/language features reported and the level of significance of reported results. RESULTS Results showed that similar methodological approaches have been used to quantify connected speech fluency in both PSA and PPA. Two hundred nine individual speech-language features were analyzed in total, with low levels of convergence across etiology on specific features but greater agreement on the most salient features. The most useful features for differentiating fluent from nonfluent aphasia in both PSA and PPA were features related to overall speech quantity, speech rate, or grammatical competence. CONCLUSIONS Data from this review demonstrate the feasibility and utility of quantitative approaches to index connected speech fluency in PSA and PPA. We identified emergent trends toward automated analysis methods and data-driven approaches, which offer promising avenues for clinical translation of quantitative approaches. There is a further need for improved consensus on which subset of individual features might be most clinically useful for assessment and monitoring of fluency. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25537237.
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Affiliation(s)
- Claire Cordella
- Department of Speech, Language and Hearing Sciences, Boston University, MA
| | - Lauren Di Filippo
- Department of Speech, Language and Hearing Sciences, Boston University, MA
| | - Vijaya B Kolachalama
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, MA
- Department of Computer Science and Faculty of Computing & Data Sciences, Boston University, MA
| | - Swathi Kiran
- Department of Speech, Language and Hearing Sciences, Boston University, MA
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Ozturk S, Özçalışkan Ş. Gesture's Role in the Communication of Adults With Different Types of Aphasia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-20. [PMID: 38625101 DOI: 10.1044/2024_ajslp-23-00046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
PURPOSE Adults with aphasia gesture more than adults without aphasia. However, less is known about the role of gesture in different discourse contexts for individuals with different types of aphasia. In this study, we asked whether patterns of speech and gesture production of individuals with aphasia vary by aphasia and discourse type and also differ from the speech and gestures produced by adults without aphasia. METHOD We compared the amount, diversity, and complexity of speech and gesture production in adults with anomic or Broca's aphasia and adults with no aphasia (n = 20/group) in their first- versus third-person narratives. RESULTS Adults with Broca's aphasia showed the lowest performance in their amount, diversity, and complexity of speech production, followed by adults with anomic aphasia and adults without aphasia. This pattern was reversed for gesture production. Speech and gesture production also varied by discourse context. Adults with either type of aphasia used a lower amount of and less diverse speech in third-person than in first-person narratives; this pattern was also reversed for gesture production. CONCLUSIONS Overall, our results provide evidence for a compensatory role of gesture in aphasia communication. Adults with Broca's aphasia, who showed the greatest speech production difficulties, also relied most on gesture, and this pattern was particularly pronounced in the third-person narrative context.
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Marcotte K, Roy A, Brisebois A, Jutras C, Leonard C, Rochon E, Brambati SM. Reliability of the picture description task of the Western Aphasia Battery - revised in Laurentian French persons without brain injury. Clin Neuropsychol 2024:1-29. [PMID: 38605497 DOI: 10.1080/13854046.2024.2340777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 04/04/2024] [Indexed: 04/13/2024]
Abstract
Objective: Limited normative data (including psychometric properties) are currently available on discourse tasks in non-dominant languages such as Laurentian (Quebec) French. The lack of linguistic and cultural adaptation has been identified as a barrier to discourse assessment. The main aim of this study is to document inter-rater and test-retest reliability properties of the picnic scene of the Western Aphasia Battery - Revised (WAB-R), including the cultural adaptation of an information content unit (ICU) list, and provide a normative reference for persons without brain injury (PWBI). Method: To do so, we also aimed to adapt an ICU checklist culturally and linguistically for Laurentian French speakers. Discourse samples were collected from 66 PWBI using the picture description task of the WAB-R. The ICU list was first adapted into Laurentian French. Then, ICUs and thematic units (TUs) were extracted manually, and microstructural variables were extracted using CLAN. Inter-rater reliability and test-retest reliability were determined. Results: Excellent inter-rater reliability was obtained for ICUs and TUs, as well as for all microstructural variables, except for mean length of utterance, which was found to be good. Conversely, test-retest reliability ranged from poor to moderate for all variables. Conclusion: The present study provides a validated ICU checklist for clinicians and researchers working with Laurentian French speakers when assessing discourse with the picnic scene of the WAB-R. It also addresses the gap in available psychometric data regarding inter-rater and test-retest reliability in PWBI.
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Affiliation(s)
- Karine Marcotte
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Alexandra Roy
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
| | - Amélie Brisebois
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Claudie Jutras
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Québec, Canada
- Département de psychologie, Faculté des arts et des sciences, Université de Montréal, Montréal, Québec, Canada
| | - Carol Leonard
- School of Rehabilitation Sciences, University of Ottawa, Ontario, Ottawa, Canada
- Department of Speech-Language Pathology, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Ontario, Canada
| | - Elizabeth Rochon
- Department of Speech-Language Pathology, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Ontario, Canada
- KITE Research Institute, Toronto Rehabilitation Institute, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Simona Maria Brambati
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Québec, Canada
- Département de psychologie, Faculté des arts et des sciences, Université de Montréal, Montréal, Québec, Canada
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
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Riccardi N, Nelakuditi S, den Ouden DB, Rorden C, Fridriksson J, Desai RH. Discourse- and lesion-based aphasia quotient estimation using machine learning. Neuroimage Clin 2024; 42:103602. [PMID: 38593534 PMCID: PMC11016805 DOI: 10.1016/j.nicl.2024.103602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 04/01/2024] [Accepted: 04/01/2024] [Indexed: 04/11/2024]
Abstract
Discourse is a fundamentally important aspect of communication, and discourse production provides a wealth of information about linguistic ability. Aphasia commonly affects, in multiple ways, the ability to produce discourse. Comprehensive aphasia assessments such as the Western Aphasia Battery-Revised (WAB-R) are time- and resource-intensive. We examined whether discourse measures can be used to estimate WAB-R Aphasia Quotient (AQ), and whether this can serve as an ecologically valid, less resource-intensive measure. We used features extracted from discourse tasks using three AphasiaBank prompts involving expositional (picture description), story narrative, and procedural discourse. These features were used to train a machine learning model to predict the WAB-R AQ. We also compared and supplemented the model with lesion location information from structural neuroimaging. We found that discourse-based models could estimate AQ well, and that they outperformed models based on lesion features. Addition of lesion features to the discourse features did not improve the performance of the discourse model substantially. Inspection of the most informative discourse features revealed that different prompt types taxed different aspects of language. These findings suggest that discourse can be used to estimate aphasia severity, and provide insight into the linguistic content elicited by different types of discourse prompts.
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Affiliation(s)
- Nicholas Riccardi
- Department of Communication Sciences and Disorders, University of South Carolina, United States.
| | | | - Dirk B den Ouden
- Department of Communication Sciences and Disorders, University of South Carolina, United States
| | - Chris Rorden
- Department of Psychology, University of South Carolina, United States
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, United States
| | - Rutvik H Desai
- Department of Psychology, University of South Carolina, United States
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Stark BC, Dalton SG. A scoping review of transcription-less practices for analysis of aphasic discourse and implications for future research. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024. [PMID: 38520735 DOI: 10.1111/1460-6984.13028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 03/08/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND It is important to capture a comprehensive language profile from speakers with aphasia. One way to do this is to evaluate spoken discourse, which is language beyond a single simple clause used for a specific purpose. While the historical trend in aphasiology has been to capture performance during isolated language tasks, such as confrontation naming, there is a demonstrated need and benefit to collecting language information from tasks that resemble everyday communication. As a result, there has been an increase in discourse analysis research over time. However, despite clinicians' and researchers' desire to analyse spoken discourse, they are faced with critical barriers that inhibit implementation. AIMS To use scoping review methodology to identify transcription-less tools developed to analyse discourse from individuals with aphasia. The review addressed the following question: 'What transcription-less tools and analysis procedures are available to assess discourse in people with aphasia?' and included several sub-questions to further characterise the type of discourse and tool being used, participants on whom the tool was used to rate discourse abilities, tool users (raters), and psychometric properties. METHODS The scoping review was conducted between the months of October 2022 and January 2023, concluding 30 January 2023, on PubMed/NCBI, Academic Search Complete and Linguistics and Language Behavior Abstracts. Major inclusion parameters included peer-reviewed papers written in English; that the tool was used to analyse discourse elicited by individuals with acquired aphasia; and that the tool was not a part of a standardised battery or assessment. Perceptual discourse analysis was defined as any analysis which primarily relied on listener impressions and did not numerically quantify specific language behaviours. 'Transcription-less' analysis was defined as any discourse analysis which did not require a written record of the discourse sample in order to be completed. A total of 396 abstracts were screened and 39 full articles were reviewed, yielding 21 papers that were included in the review. MAIN CONTRIBUTION An overview of the state of transcription-less tools for aphasic discourse analysis is provided, and next steps are identified to facilitate increased implementation of discourse analysis in clinical and research settings. CONCLUSION Transcription-less tools have many benefits for analysing multiple levels (e.g., linguistic, propositional, macrostructural, pragmatic) of discourse, but require more research to establish sound psychometric properties and to explore the implementation of these tools in clinical settings. WHAT THIS PAPER ADDS What is already known on this subject Individuals with aphasia prioritise treatment outcomes at the discourse level such as being able to engage in conversations with friends and family about important topics and participating in social and leisure activities. However, discourse is rarely used as a treatment outcome measure in clinical practice due to multiple barriers. When speech-language pathologists do assess discourse, they often make perceptual judgements without transcribing the discourse sample. Transcription-less analysis procedures may improve clinical implementation of discourse assessment, which would better match treatment outcome measurement to clients' desired outcomes. However, little is known about the current state of transcription-less discourse analysis, blocking progress. What this paper adds to existing knowledge This study provides an overview of currently available transcription-less discourse analysis procedures that are not part of published standardised aphasia assessments. Transcription-less measures are available to evaluate discourse at all levels (i.e., lexical, propositional, macro-structural/planning, and pragmatic) and most measures include items that assess discourse abilities across multiple levels. Additionally, there are transcription-less measures available for both structured (e.g., picture scene description) and spontaneous (e.g., conversation) discourse tasks. However, current transcription-less procedures are lacking psychometric data including information about validity and reliability. What are the potential or actual clinical implications of this work? Transcription-less analysis methods may provide an avenue for increased implementation of discourse measurement into clinical practice. Further research is needed to determine the clinical utility of transcription-less discourse analysis to better monitor clients' desired treatment outcomes.
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Affiliation(s)
- Brielle C Stark
- Department of Speech, Language and Hearing Sciences, Indiana University Bloomington, Bloomington, Indiana, USA
| | - Sarah Grace Dalton
- Department of Speech Pathology and Audiology, Marquette University, Milwaukee, Wisconsin, USA
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Deng BM, Gao J, Liang LS, Zhao JX, Lin F, Yin MY, Zheng HQ, Hu XQ. Discourse Task Type-Specific Linguistic Characteristics in Anomic Aphasia and Healthy Controls: Evidence From Mandarin-Chinese AphasiaBank. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:937-951. [PMID: 38266215 DOI: 10.1044/2023_ajslp-23-00078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
PURPOSE This study was designed to examine the hypothesis that discourse task types influence language performance in Mandarin Chinese-speaking people and to reveal the discourse task-specific linguistic properties of persons with anomic aphasia compared to neurotypical controls. METHOD Language samples from persons with aphasia (n = 31) and age- and education-matched controls (n = 31) across four discourse tasks (sequential-picture description, single-picture description, story narrative, and procedural discourse) were collected from Mandarin AphasiaBank. Task-specific distributions of parts of speech were analyzed using mosaic plots. The main effects of tasks in each group and the between-group differences within each task for several typical linguistic variables were evaluated, including the mean length of utterance, tokens, moving-average type-token ratio, words per minute, propositional density, noun-verb ratio, noun percentage, and verb percentage. RESULTS The results revealed an impact of discourse tasks on most language variables in both groups. In the healthy controls, story narratives yielded the highest total words and lowest verb percentage. In the aphasia group, procedural discourse elicited the fewest total words and densest expressions, whereas their single-picture descriptions had the highest noun-verb ratio. For all tasks, the aphasia group performed worse than the control group in the mean length of utterance, tokens, moving-average type-token ratio, and words per minute. For noun-verb ratio, noun percentage, and verb percentage, only one task (i.e., single-picture description) showed significant between-group differences. CONCLUSION The selection of discourse tasks should be addressed in assessments and interventions for Mandarin Chinese-speaking individuals with aphasia to obtain more accurate and feasible outcomes.
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Affiliation(s)
- Bao-Mei Deng
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jing Gao
- School of Rehabilitation Medicine, Nanjing Medical University, Jiangsu, China
- Sir Run Run Hospital, Nanjing Medical University, Jiangsu, China
| | - Li-Si Liang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jia-Xin Zhao
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Feng Lin
- School of Rehabilitation Medicine, Nanjing Medical University, Jiangsu, China
| | - Ming-Yu Yin
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Hai-Qing Zheng
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xi-Quan Hu
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
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Deng BM, Liang LS, Zhao JX, Zheng HQ, Hu XQ. Correct Information Unit Analysis in Different Discourse Tasks Among Persons With Anomic Aphasia Based on Mandarin AphasiaBank. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:800-813. [PMID: 38099824 DOI: 10.1044/2023_ajslp-23-00217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
PURPOSE This study aimed to explore how well persons with anomic aphasia communicate information during discourse regarding quantity, quality, and efficiency compared to neurotypical controls, to investigate the influence of discourse tasks on informativeness and efficiency and to examine impact factors like aphasia severity and cognitive ability. METHOD Language samples of four discourse tasks from 31 persons with anomic aphasia and 31 neurotypical controls were collected from Mandarin AphasiaBank. Correct information unit (CIU) analysis measures including the total number of CIUs, percentage of CIUs, CIUs per minute, and words per minute were calculated. Group differences and the effects of discourse tasks on informativeness and efficiency were investigated. Correlations of CIU analysis measures with aphasia severity and cognitive ability were examined. RESULTS Persons with anomic aphasia showed lower efficiency in conveying information than controls. They underperformed controls on all CIU analysis measures when executing story narrative tasks. Discourse tasks influenced the informativeness and efficiency of both groups. Neurotypical controls delivered the greatest quantity of information most efficiently when narrating stories. Persons with anomic aphasia exhibited reduced quantity of information during procedural discourse and displayed superior information quality in sequential-picture descriptions. Discourse information may be impacted by aphasia severity and cognitive ability, with varying effects depending on the task. CONCLUSIONS Persons with anomic aphasia are inefficient in communicating discourse messages and perform poorly on all measures in story narratives. When measuring discourse information, the effects of discourse tasks and factors like aphasia severity and cognitive ability should be considered.
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Affiliation(s)
- Bao-Mei Deng
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Li-Si Liang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jia-Xin Zhao
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hai-Qing Zheng
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xi-Quan Hu
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Malcorra BLC, García AO, Marcotte K, de Paz H, Schilling LP, da Silva Filho IG, Soder R, da Rosa Franco A, Loureiro F, Hübner LC. Exploring Spoken Discourse and Its Neural Correlates in Women With Alzheimer's Disease With Low Levels of Education and Socioeconomic Status. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:893-911. [PMID: 38157526 DOI: 10.1044/2023_ajslp-23-00137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
PURPOSE Early impairments in spoken discourse abilities have been identified in Alzheimer's disease (AD). However, the impact of AD on spoken discourse and the associated neuroanatomical correlates have mainly been studied in populations with higher levels of education, although preliminary evidence seems to indicate that socioeconomic status (SES) and level of education have an impact on spoken discourse. The purpose of this study was to analyze microstructural variables in spoken discourse in people with AD with low-to-middle SES and low level of education and to study their association with gray matter (GM) density. METHOD Nine women with AD and 10 matched (age, SES, and education) women without brain injury (WWBI) underwent a neuropsychological assessment, which included two spoken discourse tasks, and structural magnetic resonance imaging. Microstructural variables were extracted from the discourse samples using NILC-Metrix software. Brain density, measured by voxel-based morphometry, was compared between groups and then correlated with the differentiating microstructural variables. RESULTS The AD group produced a lower diversity of verbal time moods and fewer words and sentences than WWBI but a greater diversity of pronouns, prepositions, and lexical richness. At the neural level, the AD group presented a lower GM density bilaterally in the hippocampus, the inferior temporal gyrus, and the anterior cingulate gyrus. Number of words and sentences produced were associated with GM density in the left parahippocampal gyrus, whereas the diversity of verbal moods was associated with the basal ganglia and the anterior cingulate gyrus bilaterally. CONCLUSIONS The present findings are mainly consistent with previous studies conducted in groups with higher levels of SES and education, but they suggest that atrophy in the left inferior temporal gyrus could be critical in AD in populations with lower levels of SES and education. This research provides evidence on the importance of pursuing further studies including people with various SES and education levels. WHAT IS ALREADY KNOWN ON THIS SUBJECT Spoken discourse has been shown to be affected in Alzheimer disease, but most studies have been conducted on individuals with middle-to-high SES and high educational levels. WHAT THIS STUDY ADDS The study reports on microstructural measures of spoken discourse in groups of women in the early stage of AD and healthy women, with low-to-middle SES and lower levels of education. CLINICAL IMPLICATIONS OF THIS STUDY This study highlights the importance of taking into consideration the SES and education level in spoken discourse analysis and in investigating the neural correlates of AD. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24905046.
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Affiliation(s)
- Bárbara Luzia Covatti Malcorra
- Department of Linguistics, School of Humanities, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Alberto Osa García
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Québec, Canada
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Québec, Canada
| | - Karine Marcotte
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Québec, Canada
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Québec, Canada
| | - Hanna de Paz
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Québec, Canada
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Québec, Canada
| | - Lucas Porcello Schilling
- Graduate Course in Medicine and Healthy Sciences, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Graduate Course in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Brain Institute of Rio Grande do Sul (InsCer)Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Irênio Gomes da Silva Filho
- Graduate Course in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Ricardo Soder
- Graduate Course in Medicine and Healthy Sciences, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Brain Institute of Rio Grande do Sul (InsCer)Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Alexandre da Rosa Franco
- Center for Biomedical Imaging and Neuromodulation, The Nathan S. Kline for Psychiatric Research, Orangeburg, NY
- Center for the Developing Brain, Child Mind Institute, New York, NY
- Department of Psychiatry, NYU Grossman School of Medicine, New York
| | - Fernanda Loureiro
- Graduate Course in Biomedical Gerontology, School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Lilian Cristine Hübner
- Department of Linguistics, School of Humanities, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
- National Council for Scientific and Technological Development (CNPq), Brasília, DF, Brazil
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Hall Z, Elbourn E, Togher L, Carragher M. Co-constructed communication therapy for individuals with acquired brain injury: A systematic review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:496-518. [PMID: 36640114 DOI: 10.1111/1460-6984.12841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Meaningful, varied, joyful conversation is an important therapy target for adults with language or cognitive-communication disorders following acquired brain injury (ABI). However, the complexity of daily communication is often reduced to component parts within intervention programmes, with mixed evidence of generalization to everyday conversation. Interventions targeting co-construction of communication within a dyad offer a structured way in which to retain and treat elements of everyday conversation for individuals and their communication partner (CP). Such interventions exist but they are variably labelled, target different ABI populations and have not been synthesized. AIMS To identify the nature, scope and effects of intervention studies targeting co-constructed communication in adults with ABI. METHOD This systematic review was completed using PRISMA Guidelines. Six databases (MEDLINE, Embase, CINAHL, Scopus, LLBA, PsychInfo) were searched and 1210 studies were screened. Data were extracted and studies were rated for methodological quality and completeness of reporting. Outcome measures and effects of treatment were collated through descriptive synthesis. MAIN CONTRIBUTION This review highlights an emerging evidence base in relation to an intervention approach that targets everyday communication. Co-constructed communication interventions have been reported by 13 studies, from a total of 206 participants with post-stroke aphasia, traumatic brain injury and progressive language impairments. These interventions take a range of formats, including referential communication tasks, retell/recount therapies and communication training programmes. Methodological quality evaluation indicated mostly low-level study designs. Heterogeneity was identified in primary outcome measures, with 28 unique primary outcome measures reported across studies. Most studies demonstrated change in task-specific or broad communication outcome measures. CONCLUSIONS Co-constructed communication interventions may offer clinicians a systematic, protocolized, replicable way to target everyday communication for adults with ABI. More high-quality, experimental designs with complete reporting and psychometrically sound outcome measures are needed to strengthen the evidence base. WHAT THIS PAPER ADDS What is already known on this subject Everyday conversation is an important therapy target for adults with ABI, but there is mixed evidence of therapy gains generalizing to everyday life. Many interventions reduce conversation to component parts such as naming or sentence construction. A different approach is needed to capture the social, dyadic, interactive and multifaceted nature of conversation. We propose the term 'co-constructed communication interventions' as a therapy genre targeting semi-structured dialogue. These interventions retain elements of everyday conversation (such as multimodal communication and situating tasks within dyads), combined with experimental elements (where stimuli prompt interactions and responses can be scored against normative data). What this paper adds to existing knowledge This review proposes and describes a distinct genre of discourse intervention within the current evidence base with a novel operational definition of 'co-constructed communication'. What are the potential or actual clinical implications of this work? Co-constructed communication interventions directly target elements of everyday communication by situating the therapy goals within a dyadic, interactive, multimodal task. A range of intervention tasks have been identified, including collaborative storytelling and problem-solving. This review will be of interest to clinicians working with adults with ABI; co-constructed communication interventions may offer a useful, replicable way to target aspects of everyday communication. This synthesis of the current evidence base encourages clinicians' informed, evidence-based decisions around these interventions.
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Affiliation(s)
- Zali Hall
- The Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Elise Elbourn
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Leanne Togher
- The Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Marcella Carragher
- The Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
- Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
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Bontemps M, Servières-Bordes M, Moritz-Gasser S. Combining executive function training and anomia therapy in chronic post-stroke aphasia: A preliminary study of multidimensional effects. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-19. [PMID: 38356392 DOI: 10.1080/17549507.2023.2289351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
PURPOSE The influential relationship between executive functioning and aphasia rehabilitation outcomes has been addressed in a number of studies, but few have studied the effect of adding executive function training to linguistic therapies. The present study aimed to measure the effects of combining, within therapy sessions, executive function training and anomia therapy on naming and discourse abilities in people with chronic aphasia. METHOD A single-case experimental design with multiple baselines across participants was used. Four persons with chronic post-stroke aphasia received 12 sessions of a tailored treatment combining executive function training and semantic feature analysis (SFA) therapy. Naming accuracy of treated items was examined over the course of the treatment while control naming scores of untreated items and discourse measures were collected pre-treatment, immediately post-treatment, and 4 weeks post-treatment, in order to investigate the multidimensional effects of the treatment and their maintenance. RESULT Naming skills improved in all participants for treated and untreated items, were maintained over time, and were accompanied by improved discourse abilities. Visual and statistical analyses showed a significant treatment effect for naming skills in three out of the four participants. CONCLUSION A combination of executive function training and SFA treatment in people with chronic aphasia may improve both naming skills and discourse efficiency. Further studies are needed to substantiate these promising preliminary results.
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Affiliation(s)
- Mélanie Bontemps
- Department of Speech-Language Pathology, University of Montpellier, Montpellier, France
| | | | - Sylvie Moritz-Gasser
- Department of Speech-Language Pathology, University of Montpellier, Montpellier, France
- Departments of Neurology and Neurosurgery, University Hospital of Montpellier, Montpellier, France
- Institute of Functional Genomics INSERM U 1191, Montpellier, France
- Praxiling UMR 5267 CNRS, Montpellier, France
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Kim H, Obermeyer J, Wiley RW. Written discourse in diagnosis for acquired neurogenic communication disorders: current evidence and future directions. Front Hum Neurosci 2024; 17:1264582. [PMID: 38273880 PMCID: PMC10808624 DOI: 10.3389/fnhum.2023.1264582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 11/23/2023] [Indexed: 01/27/2024] Open
Abstract
Purpose We aimed to perform the first review of research focusing on written discourse performance in people with acquired neurogenic communication disorders. In studies from 2000 onward, we specifically sought to determine: (1) the differences between patient populations and control groups, (2) the differences between different patient populations, (3) longitudinal differences between patient populations, and (4) modality differences between spoken and written discourse performance. Methods We completed a thorough search on MEDLINE, Embase, Cochrane, APAPsycinfo, Web of Science, and Scopus databases. We identified studies that focus on written discourse performance in people with aphasia, primary progressive aphasia, mild cognitive impairment, and Alzheimer's disease. Results Nineteen studies were identified from the review of literature, some of which addressed more than one of our review questions. Fifteen studies included a comparison between clinical populations and controls. Six studies compared different characteristics of patient populations. Three studies reported changes over time in progressive disorders. Six studies targeted different modalities of discourse. Conclusion Differences in linguistic features by patient populations are not yet clear due to the limited number of studies and different measures and tasks used across the studies. Nevertheless, there is substantial evidence of numerous linguistic features in acquired neurogenic communication disorders that depart from those of healthy controls. Compared to the controls, people with aphasia tend to produce fewer words, and syntactically simpler utterances compared to the controls. People with Alzheimer's disease produce less information content, and this feature increases over time, as reported in longitudinal studies. Our review imparts additional information that written and spoken discourse provide unique insights into the cognitive and linguistic deficits experienced by people with aphasia, Alzheimer's disease, mild cognitive impairment and primary progressive aphasia and provide targets for treatment to improve written communication in these groups.
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Affiliation(s)
- Hana Kim
- Department of Communication Sciences and Disorders, University of South Florida, Tampa, FL, United States
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jessica Obermeyer
- Department of Communication Sciences and Disorders, University of North Carolina at Greensboro, Greensboro, NC, United States
| | - Robert W. Wiley
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, United States
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Kintz S, Kim H, Wright HH. A preliminary investigation on core lexicon analysis in dementia of the Alzheimer's type. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024. [PMID: 38165595 DOI: 10.1111/1460-6984.12999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 12/01/2023] [Indexed: 01/04/2024]
Abstract
BACKGROUND Core lexicon (CL) analysis is a time efficient and possibly reliable measure that captures discourse production abilities. For people with aphasia, CL scores have demonstrated correlations with aphasia severity, as well as other discourse and linguistic measures. It was also found to be clinician-friendly and clinically sensitive enough to capture longitudinal changes in aphasia. To our knowledge, CL has never been investigated in individuals with neurologically progressive disease. AIMS As a preliminary investigation, we sought to investigate (1) whether CL scores correlate with dementia severity, (2) whether CL scores correlate with measures of discourse quality, and (3) whether CL scores correlate with other measures of lexical/semantic access. METHODS & PROCEDURES Twelve participants with a cognitive impairment associated with dementia of the Alzheimer's type (DAT) completed several measures of language and cognitive ability, as well as provide a language sample from the wordless picture book, Picnic. RESULTS & CONCLUSION Results are informative, as they provide insight into characteristics of CL and provide support for potential use of CL in individuals with neurologically progressive disease. The results indicated that CL scores do correlate with dementia severity and several measures of language ability, indicating they may provide a useful measure of language abilities in DAT, but more research is needed. WHAT THIS PAPER ADDS What is already known on the subject Core lexicon (CL) analysis is an assessment measure of discourse ability, most closely related to informativeness or productivity, used in aphasiology that is easier to use and less time consuming than previous measures of informativeness, such as correct information units or type-token ratio (TTR). For people with aphasia, CL analysis correlates with aphasia severity, measures of informativeness, as well as other measures of discourse quality. It has also been shown to be faster and more reliable between scorers than other informativeness measures. What this study adds Core lexicon analysis is a new simple and online method for assessing the informativeness of a discourse sample without the need to record or transcribe the language sample. CL is receiving a lot of attention in aphasia, correlating with everything from aphasia severity to measures of productivity and lexical access, as well as measures of informativeness. Unfortunately, no one has investigated CL analysis in dementia. The study demonstrates the first evidence that CL analysis may be a useful measure for determining dementia severity and language quality in people with dementia. What are the clinical implications of this work? Core lexicon analysis may provide clinicians and researchers with an easy method for assessing the discourse of people with a cognitive impairment associated with dementia of the Alzheimer's type. This will improve initial assessment, as well as improve ongoing language assessment that may provide clues into their functional ability to communicate effectively.
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Affiliation(s)
- Stephen Kintz
- Department of Speech Language Pathology, University of Arkansas at Little Rock, Little Rock, Arkansas, USA
| | - Hana Kim
- Department of Communication Sciences & Disorders, University of South Florida, Tampa Bay, Florida, USA
| | - Heather Harris Wright
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, North Carolina, USA
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Meier EL, Sheppard SM, Sebastian R, Berube S, Goldberg EB, Shea J, Stein CM, Hillis AE. Resting state correlates of picture description informativeness in left vs. right hemisphere chronic stroke. Front Neurol 2023; 14:1288801. [PMID: 38145117 PMCID: PMC10744570 DOI: 10.3389/fneur.2023.1288801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/20/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction Despite a growing emphasis on discourse processing in clinical neuroscience, relatively little is known about the neurobiology of discourse production impairments. Individuals with a history of left or right hemisphere stroke can exhibit difficulty with communicating meaningful discourse content, which implies both cerebral hemispheres play a role in this skill. However, the extent to which successful production of discourse content relies on network connections within domain-specific vs. domain-general networks in either hemisphere is unknown. Methods In this study, 45 individuals with a history of either left or right hemisphere stroke completed resting state fMRI and the Cookie Theft picture description task. Results Participants did not differ in the total number of content units or the percentage of interpretative content units they produced. Stroke survivors with left hemisphere damage produced significantly fewer content units per second than individuals with right hemisphere stroke. Intrinsic connectivity of the left language network was significantly weaker in the left compared to the right hemisphere stroke group for specific connections. Greater efficiency of communication of picture scene content was associated with stronger left but weaker right frontotemporal connectivity of the language network in patients with a history of left hemisphere (but not right hemisphere) stroke. No significant relationships were found between picture description measures and connectivity of the dorsal attention, default mode, or salience networks or with connections between language and other network regions. Discussion These findings add to prior behavioral studies of picture description skills in stroke survivors and provide insight into the role of the language network vs. other intrinsic networks during discourse production.
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Affiliation(s)
- Erin L. Meier
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
| | - Shannon M. Sheppard
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
| | - Rajani Sebastian
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, United States
| | - Shauna Berube
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
| | - Emily B. Goldberg
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
| | - Jennifer Shea
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
| | - Colin M. Stein
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, United States
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, United States
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Ding J, Middleton EL, Mirman D. Impaired discourse content in aphasia is associated with frontal white matter damage. Brain Commun 2023; 5:fcad310. [PMID: 38025278 PMCID: PMC10664411 DOI: 10.1093/braincomms/fcad310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 09/04/2023] [Accepted: 11/09/2023] [Indexed: 12/01/2023] Open
Abstract
Aphasia is a common consequence of stroke with severe impacts on employability, social interactions and quality of life. Producing discourse-relevant information in a real-world setting is the most important aspect of recovery because it is critical to successful communication. This study sought to identify the lesion correlates of impaired production of relevant information in spoken discourse in a large, unselected sample of participants with post-stroke aphasia. Spoken discourse (n = 80) and structural brain scans (n = 66) from participants with aphasia following left hemisphere stroke were analysed. Each participant provided 10 samples of spoken discourse elicited in three different genres, and 'correct information unit' analysis was used to quantify the informativeness of speech samples. The lesion correlates were identified using multivariate lesion-symptom mapping, voxel-wise disconnection and tract-wise analyses. Amount and speed of relevant information were highly correlated across different genres and with total lesion size. The analyses of lesion correlates converged on the same pattern: impaired production of relevant information was associated with damage to anterior dorsal white matter pathways, specifically the arcuate fasciculus, frontal aslant tract and superior longitudinal fasciculus. Damage to these pathways may be a useful biomarker for impaired informative spoken discourse and informs development of neurorehabilitation strategies.
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Affiliation(s)
- Junhua Ding
- Department of Psychology, University of Edinburgh, Edinburgh EH8 9JZ, UK
| | | | - Daniel Mirman
- Department of Psychology, University of Edinburgh, Edinburgh EH8 9JZ, UK
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Jiang YE, Liao XY, Liu N. Applying core lexicon analysis in patients with anomic aphasia: Based on Mandarin AphasiaBank. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:1875-1886. [PMID: 36866943 DOI: 10.1111/1460-6984.12864] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Patients with anomic aphasia experience difficulties in narrative processing. General discourse measures are time consuming and require necessary skills. Core lexicon analysis has been proposed as an effort-saving approach but has not been developed in Mandarin discourse. AIMS This exploratory study was aimed (1) to apply core lexicon analysis in Mandarin patients with anomic aphasia at the discourse level and (2) to verify the problems with core words among people with anomic aphasia. METHODS & PROCEDURE The core nouns and verbs were extracted from narrative language samples from 88 healthy participants. The production of core words for 12 anomic aphasia and 12 age- and education-matched controls were then calculated and compared. The correlation between the percentages and the Aphasia Quotients of the revised Western Aphasia Battery was analyzed as well. OUTCOMES & RESULTS The core nouns and verbs were successfully extracted. Patients with anomic aphasia produced fewer core words than healthy people, and the percentages differed significantly in different tasks as well as word classes. There was no correlation between the core lexicon use and the severity of aphasia in patients with anomic aphasia. CONCLUSIONS & IMPLICATIONS Core lexicon analysis may potentially serve as a clinician-friendly manner of quantifying core words produced at the discourse level in Mandarin patients with anomic aphasia. WHAT THIS PAPER ADDS What is already known on the subject Discourse analyses in aphasia assessment and treatment have increasingly garnered attention. Core lexicon analysis based on English AphasiaBank has been reported in recent years. It is correlated with microlinguistic and macrolinguistic measures in aphasia narratives. Nevertheless, the application based on Mandarin AphasiaBank is still under development in healthy individuals and patients with anomic aphasia. What this paper adds to existing knowledge A Mandarin core lexicon set was developed for different tasks. The feasibility of core lexicon analysis to evaluate the corpus of patients with anomic aphasia was preliminarily discussed and the speech performance of patients and healthy people was then compared to provide a reference for the evaluation and treatment of clinical aphasia corpus. What are the potential or actual clinical implications of this work? The purpose of this exploratory study was to consider the potential use of core lexicon analysis to evaluate core word production in narrative discourse. Moreover, normative and aphasia data were provided for comparison to develop clinical use for Mandarin patients with anomic aphasia.
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Affiliation(s)
- Yu-Er Jiang
- Department of Rehabilitation, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Xiao-Yu Liao
- Department of Rehabilitation, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
| | - Na Liu
- Department of Rehabilitation, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, China
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Baker C, Bryant L, Power E. The effects of virtual reality immersion on the content and structure of the narrative discourse of healthy adults. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:2049-2061. [PMID: 37358346 DOI: 10.1111/1460-6984.12914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 05/23/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Narrative discourse is central to effective participation in conversations. When discourse is assessed in people with communication disability, structured tasks (e.g., picture descriptions) provide experimental control, while unstructured tasks (e.g., personal narratives) represent more natural communication. Immersive virtual reality (VR) technology may provide a solution by creating standardized experiences for narrative retell, therefore balancing ecological validity and experimental control in discourse assessment. Research is needed to understand how VR immersion affects narrative retell, first for adults with no communication disability, before application with adults with aphasia or related communication disability. AIMS To assess (1) the effects of VR immersion on the linguistic content and structure of narrative retells in a healthy adult population; and (2) whether VR immersion can influence the way a narrative is retold so that the speaker conveys their own experience, rather than the experience of the characters they are watching. METHODS & PROCEDURES In this pilot cohort study, 13 healthy adult participants with no reported communication disability watched an animated short film and a comparable immersive VR short film in a randomized order. Participants were asked to retell the events of the story after each condition in as much detail as possible. OUTCOMES & RESULTS Mean length of utterance (in morphemes) was significantly higher in the video condition compared with the VR condition. Significantly more first-person pronouns were used in the VR condition compared with the video condition. No other measures of linguistic content or structure were significantly different between the VR and video conditions. CONCLUSIONS & IMPLICATIONS Increased morpho-syntactic length and complexity in the video condition may suggest effects of elicitation stimulus on the narrative produced. The larger number of first-person pronouns in the VR condition may reflect that participants experienced a sense of presence in the virtual environment, and therefore were able to retell their communication experience rather than narrating the experiences of characters from an external perspective. Given the increasing need for more functional assessment of discourse in people with communication disability, further research is needed to validate these findings. WHAT THIS PAPER ADDS What is already known on this subject As an ecologically valid tool, discourse analysis is often used to assess daily communicative exchanges in adults with acquired communication disability. Clinicians and researchers using narrative discourse assessment must balance the experimental control and diagnostic reference sample capabilities of structured tasks with the ecological validity and real-life transferability of unstructured personal narratives. What this study adds to existing knowledge This study explores the use of immersive VR technologies to create standardized, replicable, immersive experiences as a foundation for narrative discourse assessment. It highlights how the 'sense of presence' in a virtual world can prompt healthy adult speakers to retell a narrative of a personal experience that can be replicated for many different participants. The results suggest that immersive VR narrative assessment for adults with communication disability may balance ecological validity with measurement reliability in discourse assessment. What are the potential or actual clinical observations of this work? Immersion in VR resulted in the production of narratives with morpho-syntactic features that aligned with typical narrative generation, rather than retell. Participants used more first-person pronouns, suggesting retelling of personal experience. Though further study is needed, these preliminary findings suggest clinicians can use immersive VR stimuli to generate structured story generations that balance experimental and diagnostic control with ecological validity in narrative discourse assessment for adults with communication disability.
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Affiliation(s)
- Clarisse Baker
- Faculty of Health, University of Technology Sydney Graduate School of Health, Sydney, NSW, Australia
| | - Lucy Bryant
- Faculty of Health, University of Technology Sydney Graduate School of Health, Sydney, NSW, Australia
| | - Emma Power
- Faculty of Health, University of Technology Sydney Graduate School of Health, Sydney, NSW, Australia
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20
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Schnur TT, Wang S. Differences in Connected Speech Outcomes Across Elicitation Methods. APHASIOLOGY 2023; 38:816-837. [PMID: 38798958 PMCID: PMC11114736 DOI: 10.1080/02687038.2023.2239509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/17/2023] [Indexed: 05/29/2024]
Abstract
Background Connected speech is often used to assess many aspects of an individual's language abilities after stroke. However, it is unknown the degree to which elicitation methods differ in generating structural and syntactic aspects of connected speech, two critical components of successful communication. Quantifying the degree to which elicitation methods differ in eliciting structurally, syntactically, and lexically complex connected speech at the earliest stage of stroke before reorganization and rehabilitation of function independent of clinical diagnosis of aphasia has not been examined to date. Addressing this gap has implications for early clinical intervention as well as empirical studies of connected speech production. Aims We compared two common elicitation methods, picture description and storytelling on lexical, structural, and syntactic measures of connected speech in speakers during the acute stage of left hemisphere stroke. Methods & Procedures We measured connected speech using an automated quantitative production analysis approach (Fromm et al., 2021) in 71 native-English speaking participants (27 female; 59 ± 13 years) within an average 3.9 days from left hemisphere stroke onset. We tested the degree of agreement and consistency between elicitation methods for lexical, structural, and syntactic measures of connected speech, as well as the degree of concordance in classifying deficits across individuals. Outcomes & Results Storytelling elicited significantly more words and more structurally complex, lexically diverse, and syntactically accurate speech in comparison to picture description. Elicitation methods differed in measuring outcomes across participants for the lexical and syntactic, but not structural complexity aspects of connected speech where storytelling classified more participants with impairments in comparison to picture description. Conclusions These differences suggest storytelling provides assessment of connected speech abilities more reflective of real-world abilities where its use is particularly critical for examining individual differences and providing diagnoses of acute stroke language deficits. As a result, using storytelling as a connected speech elicitation method more effectively captures a patient's language capabilities after stroke, consequently informing clinical diagnosis and treatment.
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Affiliation(s)
- Tatiana T. Schnur
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
- Department of Neuroscience, Baylor College of Medicine, Houston, Texas
| | - Sharon Wang
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
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21
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Wallace SJ, Worrall L, Rose TA, Alyahya RSW, Babbitt E, Beeke S, de Beer C, Bose A, Bowen A, Brady MC, Breitenstein C, Bruehl S, Bryant L, Cheng BBY, Cherney LR, Conroy P, Copland DA, Croteau C, Cruice M, Dipper L, Hilari K, Howe T, Kelly H, Kiran S, Laska A, Marshall J, Murray LL, Patterson J, Pearl G, Quinting J, Rochon E, Rose ML, Rubi‐Fessen I, Sage K, Simmons‐Mackie N, Visch‐Brink E, Volkmer A, Webster J, Whitworth A, Dorze GL. Measuring communication as a core outcome in aphasia trials: Results of the ROMA-2 international core outcome set development meeting. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:1017-1028. [PMID: 36583427 PMCID: PMC10946976 DOI: 10.1111/1460-6984.12840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Evidence-based recommendations for a core outcome set (COS; minimum set of outcomes) for aphasia treatment research have been developed (the Research Outcome Measurement in Aphasia-ROMA, COS). Five recommended core outcome constructs: communication, language, quality of life, emotional well-being and patient-reported satisfaction/impact of treatment, were identified through three international consensus studies. Constructs were paired with outcome measurement instruments (OMIs) during an international consensus meeting (ROMA-1). Before the current study (ROMA-2), agreement had not been reached on OMIs for the constructs of communication or patient-reported satisfaction/impact of treatment. AIM To establish consensus on a communication OMI for inclusion in the ROMA COS. METHODS & PROCEDURES Research methods were based on recommendations from the Core Outcome Measures in Effectiveness Trials (COMET) Initiative. Participants with expertise in design and conduct of aphasia trials, measurement instrument development/testing and/or communication outcome measurement were recruited through an open call. Before the consensus meeting, participants agreed on a definition of communication, identified appropriate OMIs, extracted their measurement properties and established criteria for their quality assessment. During the consensus meeting they short-listed OMIs and participants without conflicts of interest voted on the two most highly ranked instruments. Consensus was defined a priori as agreement by ≥ 70% of participants. OUTCOMES & RESULTS In total, 40 researchers from nine countries participated in ROMA-2 (including four facilitators and three-panel members who participated in pre-meeting activities only). A total of 20 OMIs were identified and evaluated. Eight short-listed communication measures were further evaluated for their measurement properties and ranked. Participants in the consensus meeting (n = 33) who did not have conflicts of interest (n = 29) voted on the top two ranked OMIs: The Scenario Test (TST) and the Communication Activities of Daily Living-3 (CADL-3). TST received 72% (n = 21) of 'yes' votes and the CADL-3 received 28% (n = 8) of 'yes' votes. CONCLUSIONS & IMPLICATIONS Consensus was achieved that TST was the preferred communication OMI for inclusion in the ROMA COS. It is currently available in the original Dutch version and has been adapted into English, German and Greek. Further consideration must be given to the best way to measure communication in people with mild aphasia. Development of a patient-reported measure for satisfaction with/impact of treatment and multilingual versions of all OMIs of the COS is still required. Implementation of the ROMA COS would improve research outcome measurement and the quality, relevance, transparency, replicability and efficiency of aphasia treatment research. WHAT THIS PAPER ADDS What is already known on this subject International consensus has been reached on five core constructs to be routinely measured in aphasia treatment studies. International consensus has also been established for OMIs for the three constructs of language, quality of life and emotional well-being. Before this study, OMIs for the constructs of communication and patient-reported satisfaction/impact of treatment were not established. What this paper adds to existing knowledge We gained international consensus on an OMI for the construct of communication. TST is recommended for inclusion in the ROMA COS for routine use in aphasia treatment research. What are the potential or actual clinical implications of this work? The ROMA COS recommends OMIs for a minimum set of outcomes for adults with post-stroke aphasia within phases I-IV aphasia treatment research. Although not intended for clinical use, clinicians may employ the instruments of the ROMA COS, considering the quality of their measurement properties. The systematic inclusion of a measure of communication, such as TST, in clinical practice could ultimately support the implementation of research evidence and best practices.
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Affiliation(s)
- Sarah J. Wallace
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQLDAustralia
- Queensland Aphasia Research CentreBrisbaneQLDAustralia
- Centre of Research Excellence in Aphasia Recovery and RehabilitationAustralia
| | - Linda Worrall
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQLDAustralia
- Queensland Aphasia Research CentreBrisbaneQLDAustralia
- Centre of Research Excellence in Aphasia Recovery and RehabilitationAustralia
| | - Tanya A. Rose
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQLDAustralia
- Queensland Aphasia Research CentreBrisbaneQLDAustralia
| | - Reem S. W. Alyahya
- Communication and Swallowing Disorders DepartmentKing Fahad Medical CityRiyadhSaudi Arabia
- School of Health and Psychological Sciences, CityUniversity of LondonLondonUK
| | - Edna Babbitt
- Department of Physical Medicine and Rehabilitation, Feinberg School of MedicineNorthwestern UniversityChicagoILUSA
| | - Suzanne Beeke
- Deparment of Psychology and Language SciencesUniversity College LondonLondonUK
| | - Carola de Beer
- Faculty of Linguistics and Literary Studies & Medical School OWLUniversity of BielefeldBielefeldGermany
| | - Arpita Bose
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | - Audrey Bowen
- Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science CentreNorthern Care Alliance & University of ManchesterManchesterUK
| | - Marian C. Brady
- Nursing, Midwifery and Allied Health Professionals Research UnitGlasgow Caledonian UniversityGlasgowUK
| | - Caterina Breitenstein
- Department of Neurology with Institute of Translational NeurologyUniversity of MünsterMünsterGermany
| | - Stefanie Bruehl
- St. Mauritius Rehabilitation Centre, Meerbusch, Germany
- Medical Faculty, Heinrich‐Heine University Duesseldorf, Duesseldorf, Germany
- Clinical and Cognitive NeurosciencesDepartment of Neurology, RWTH Aachen UniversityGermany
| | - Lucy Bryant
- University of Technology Sydney Graduate School of Health, Faculty of HealthSydneyNSWAustralia
| | - Bonnie B. Y. Cheng
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQLDAustralia
- Queensland Aphasia Research CentreBrisbaneQLDAustralia
- Centre of Research Excellence in Aphasia Recovery and RehabilitationAustralia
| | - Leora R. Cherney
- Department of Physical Medicine and Rehabilitation, Feinberg School of MedicineNorthwestern UniversityChicagoILUSA
| | - Paul Conroy
- Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science CentreNorthern Care Alliance & University of ManchesterManchesterUK
| | - David A. Copland
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQLDAustralia
- Queensland Aphasia Research CentreBrisbaneQLDAustralia
- Centre of Research Excellence in Aphasia Recovery and RehabilitationAustralia
| | - Claire Croteau
- School of Speech–Language Pathology and Audiology, Centre for Interdisciplinary Research in Rehabilitation of Greater MontrealFaculty of Medicine, Université de MontréalMontrealQCCanada
| | - Madeline Cruice
- School of Health and Psychological Sciences, CityUniversity of LondonLondonUK
| | - Lucy Dipper
- School of Health and Psychological Sciences, CityUniversity of LondonLondonUK
| | - Katerina Hilari
- School of Health and Psychological Sciences, CityUniversity of LondonLondonUK
| | - Tami Howe
- School of Audiology and Speech SciencesUniversity of British ColumbiaVancouverBCCanada
| | - Helen Kelly
- School of Clinical TherapiesUniversity College CorkCorkIreland
| | - Swathi Kiran
- Department of Speech, Language, and Hearing SciencesBoston UniversityBostonMAUSA
| | - Ann‐Charlotte Laska
- Department of Clinical SciencesKarolinska Institutet Danderyd HospitalStockholmSweden
| | - Jane Marshall
- School of Health and Psychological Sciences, CityUniversity of LondonLondonUK
| | - Laura L. Murray
- School of Communication Sciences and DisordersWestern UniversityLondonONCanada
| | - Janet Patterson
- Research ServiceVA Northern California Health Care SystemMartinezCAUSA
| | - Gill Pearl
- Speakeasy Specialist Aphasia CentreBuryUK
| | - Jana Quinting
- Speech Language Pathology, Department of Rehabilitation and Special Education, Faculty of Human SciencesUniversity of CologneCologneGermany
| | - Elizabeth Rochon
- Department of Speech–Language Pathology and Rehabilitation Sciences InstituteUniversity of TorontoToronto, ONCanada
| | - Miranda L. Rose
- Queensland Aphasia Research CentreBrisbaneQLDAustralia
- School of Allied Health, Human Services and SportLa Trobe UniversityBundooraVICAustralia
| | - Ilona Rubi‐Fessen
- Speech Language Pathology, Department of Rehabilitation and Special Education, Faculty of Human SciencesUniversity of CologneCologneGermany
- RehaNova Rehabilitation HospitalCologneGermany
| | - Karen Sage
- Faculty of Health and EducationManchester Metropolitan UniversityManchesterUK
| | - Nina Simmons‐Mackie
- Communication Sciences & DisordersSoutheastern Louisiana UniversityHammondLAUSA
| | - Evy Visch‐Brink
- Department of NeurologyErasmus UniversityRotterdamthe Netherlands
| | - Anna Volkmer
- Deparment of Psychology and Language SciencesUniversity College LondonLondonUK
| | - Janet Webster
- School of Education, Communication and Language SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Anne Whitworth
- School of Health SciencesCollege of Health and MedicineUniversity of TasmaniaHobartAustralia
| | - Guylaine Le Dorze
- School of Speech–Language Pathology and Audiology, Centre for Interdisciplinary Research in Rehabilitation of Greater MontrealFaculty of Medicine, Université de MontréalMontrealQCCanada
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22
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Stark BC, Alexander JM, Hittson A, Doub A, Igleheart M, Streander T, Jewell E. Test-Retest Reliability of Microlinguistic Information Derived From Spoken Discourse in Persons With Chronic Aphasia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-30. [PMID: 37335766 DOI: 10.1044/2023_jslhr-22-00266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
PURPOSE The purpose of this study was to characterize test-retest reliability of discourse measures across a battery of common tasks in individuals with aphasia and prospectively matched adults without brain damage. METHOD We collected spoken discourse during five monologue tasks at two timepoints (test and retest; within 2 weeks apart) in an aphasia group (n = 23) and a peer group with no brain damage (n = 24). We evaluated test-retest reliability for percentage of correct information units, correct information units per minute, mean length of utterance, verbs per utterance, noun/verb ratio, open/closed class word ratio, tokens, sample duration (seconds), propositional idea density, type-token ratio, and words per minute. We explored reliability's relationship with sample length and aphasia severity. RESULTS Rater reliability was excellent. Across tasks, both groups demonstrated discourse measures with poor, moderate, and good reliability, with the aphasia group having measures demonstrating excellent test-retest reliability. When evaluating measures within each task, test-retest reliability again ranged from poor to excellent for both groups. Across groups and task, measures that appeared most reliable appeared to reflect lexical, informativeness, or fluency information. Sample length and aphasia severity impacted reliability, and this differed across and by task. CONCLUSIONS We identified several discourse measures that were reliable across and within tasks. Test-retest statistics are intimately linked to the specific sample, emphasizing the importance of multiple baseline studies. Task itself should be considered an important variable, and it should not be assumed that discourse measures found to be reliable across several tasks (averaged) are likewise reliable for a single task. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23298032.
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Affiliation(s)
- Brielle C Stark
- Department of Speech, Language and Hearing Sciences, Indiana University Bloomington
| | - Julianne M Alexander
- Department of Speech, Language and Hearing Sciences, Indiana University Bloomington
| | - Anne Hittson
- Department of Speech, Language and Hearing Sciences, Indiana University Bloomington
| | - Ashleigh Doub
- Speech and Hearing Sciences, University of Illinois at Urbana-Champaign, Champaign
| | - Madison Igleheart
- Department of Speech, Language and Hearing Sciences, Indiana University Bloomington
| | - Taylor Streander
- Department of Speech, Language and Hearing Sciences, Indiana University Bloomington
| | - Emily Jewell
- Department of Speech, Language and Hearing Sciences, Indiana University Bloomington
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23
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Gallée J, Cartwright J, Volkmer A, Whitworth A, Hersh D. "Please Don't Assess Him to Destruction": The R.A.I.S.E. Assessment Framework for Primary Progressive Aphasia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:391-410. [PMID: 36763839 DOI: 10.1044/2022_ajslp-22-00122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
PURPOSE Speech-language pathologists (SLPs) assess people with primary progressive aphasia (PPA) through measurements of speech, language, communication, and well-being, with the aims of identifying challenges and strengths, monitoring change, and informing treatment directions and supports. The purpose of this clinical focus article is to highlight the necessity for person-centered assessment specific to PPA and to conceptualize a framework that acknowledges the multifaceted nature of assessment for this population. In this framework, the unique challenges posed by a diagnosis of PPA are addressed with the aim to provide practical guidance for clinicians and to support reflection on current practices. METHOD In clinical and research practice, assessment of people with PPA requires an ever-evolving approach that is centered on the client. In this clinical focus article, a discussion-based consensus process was used to synthesize authentic longitudinal experiences of people with PPA to explore assessment approaches, tools, and philosophies. RESULTS This analysis of person-centered assessment identifies seven essential components of assessment in PPA that set the foundation for the five steps of the R.A.I.S.E. Assessment framework. These components each contribute to a clear definition of assessment that reveals clients' competencies with a strengths-based focus; prioritizes the reciprocity of benefits; promotes dynamic assessment; and recognizes the complexity, evolution of assessment over time, and advocacy. CONCLUSIONS This clinical focus article takes a novel look at assessment in PPA by stepping away from assessment practices that focus on revealing deficits and decline and, instead, provides practical recommendations through the conceptualization of a PPA-specific assessment framework. The R.A.I.S.E. Assessment framework is grounded in principles of uplifting clients through person-centered assessment, keeps pace with best practice in PPA intervention, and contributes to a supportive experience for clients and families in the face of a progressive diagnosis over time.
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Affiliation(s)
- Jeanne Gallée
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
- Evergreen Speech & Hearing Clinic, Redmond, WA
| | - Jade Cartwright
- School of Health Sciences, University of Tasmania, Launceston, Australia
| | - Anna Volkmer
- Division of Psychology and Language Sciences, University College London, United Kingdom
| | - Anne Whitworth
- School of Health Sciences, University of Tasmania, Launceston, Australia
| | - Deborah Hersh
- Speech Pathology, School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Speech Pathology, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
- School of Allied Health Sciences and Practice, Adelaide University, South Australia, Australia
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24
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Tilton-Bolowsky VE, van der Stelt CM, DeMarco A, Laks A, Dobbins C, Snider SF, Turkeltaub PE, Vallila-Rohter S. Evaluating circumlocution in naming as a predictor of communicative informativeness and efficiency in discourse. APHASIOLOGY 2023; 38:237-260. [PMID: 38559315 PMCID: PMC10977788 DOI: 10.1080/02687038.2023.2183076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 02/16/2023] [Indexed: 04/04/2024]
Abstract
Background Discourse analyses yield quantitative measures of functional communication in aphasia. However, they are historically underutilized in clinical settings. Confrontation naming assessments are used widely clinically and have been used to estimate discourse-level production. Such work shows that naming accuracy explains moderately high proportions of variance in measures of discourse, but proportions of variance remain unexplained. We propose that the inclusion of circumlocution productions into predictive models will account for a significant amount more of the variance. Circumlocution productions at the naming-level, while they may not contain the target word, are similar to the content that contributes to discourse informativeness and efficiency. Thus, additionally measuring circumlocution may improve our ability to estimate discourse performance and functional communication. Aim This study aimed to test whether, after controlling for naming accuracy, the addition of a measure of circumlocution into predictive models of discourse-level informativeness and efficiency would account for a significant amount more of the variance in these discourse-level outcomes. Methods & Procedures Naming and discourse data from 43 people with poststroke aphasia were analyzed. Naming data were collected using 120 pictured items and discourse data were collected using two picture description prompts. Data scoring and coding yielded measures of naming accuracy, incorrect response type, communicative informativeness, and efficiency. We used robust hierarchical regression to evaluate study predictions. Outcomes & Results After controlling for naming accuracy, the inclusion of circumlocution into predictive models accounted for a significant amount more of the variance in both informativeness and efficiency. The subsequent inclusion of other response types, such as real word and nonword errors, did not account for a significant amount more of the variance in either outcome. Conclusions In addition to naming accuracy, the production of circumlocution during naming assessments may correspond with measures of informativeness and efficiency at the discourse-level. Reducing the burden of estimating patients' functional communication will increase our ability to estimate functional communication using tools that are easy to administer and interpret.
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Affiliation(s)
- Victoria E. Tilton-Bolowsky
- MGH Institute of Health Professions, Boston, MA, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Candace M. van der Stelt
- Georgetown University, Washington, D.C., USA
- Department of Neurology, Georgetown University Medical Center
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
- Research Division, MedStar National Rehabilitation Hospital
| | - Andrew DeMarco
- Center for Brain Plasticity and Recovery, Georgetown University Medical Center
- Department of Rehabilitation Medicine, Georgetown University
| | - Alycia Laks
- Georgetown University, Washington, D.C., USA
- Department of Neurology, Georgetown University Medical Center
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
| | | | - Sarah F. Snider
- Georgetown University, Washington, D.C., USA
- Department of Neurology, Georgetown University Medical Center
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
| | - Peter E. Turkeltaub
- Georgetown University, Washington, D.C., USA
- Center for Brain Plasticity and Recovery, Georgetown University Medical Center
- Department of Neurology, Georgetown University Medical Center
- Center for Aphasia Research and Rehabilitation, Georgetown University Medical Center
- Research Division, MedStar National Rehabilitation Hospital
- Department of Rehabilitation Medicine, Georgetown University
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25
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Brisebois A, Brambati SM, Rochon E, Leonard C, Marcotte K. The longitudinal trajectory of discourse from the hyperacute to the chronic phase in mild to moderate poststroke aphasia recovery: A case series study. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023. [PMID: 36705070 DOI: 10.1111/1460-6984.12844] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/23/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Discourse analysis has recently received much attention in the aphasia literature. Even if post-stroke language recovery occurs throughout the longitudinal continuum of recovery, very few studies have documented discourse changes from the hyperacute to the chronic phases of recovery. AIMS To document a multilevel analysis of discourse changes from the hyperacute phase to the chronic phase of post-stroke recovery using a series of single cases study designs. METHODS & PROCEDURES Four people with mild to moderate post-stroke aphasia underwent four assessments (hyperacute: 0-24 h; acute: 24-72 h; subacute: 7-14 days; and chronic: 6-12 months post-onset). Three discourse tasks were performed at each time point: a picture description, a personal narrative and a story retelling. Multilevel changes in terms of macro- and microstructural aspects were analysed. The results of each discourse task were combined for each time point. Individual effect sizes were computed to evaluate the relative strength of changes in an early and a late recovery time frame. OUTCOMES & RESULTS Macrostructural results revealed improvements throughout the recovery continuum in terms of coherence and thematic efficiency. Also, the microstructural results demonstrated linguistic output improvement for three out of four participants. Namely, lexical diversity and the number of correct information units/min showed a greater gain in the early compared with the late recovery phase. CONCLUSIONS & IMPLICATIONS This study highlights the importance of investigating all discourse processing levels as the longitudinal changes in discourse operate differently at each phase of recovery. Overall results support future longitudinal discourse investigation in people with post-stroke aphasia. WHAT THIS PAPER ADDS What is already known on the subject Multi-level discourse analysis allows for in-depth analysis of underlying discourse processes. To date, very little is known on the longitudinal discourse changes from aphasia onset through to the chronic stage of recovery. This study documents multi-level discourse features in four people with mild to moderate aphasia in the hyperacute, acute, subacute and chronic stage of post-stroke aphasia recovery. What this paper adds to existing knowledge The study found that most discourse variables demonstrated improvement throughout time. Macrostructural variables of coherence and thematic units improved throughout the continuum whereas microstructural variables demonstrated greater gains in the early compared to the late period of recovery. What are the potential or actual clinical implications of this work? This study suggests that multilevel discourse analysis will allow a better understanding of post-stroke aphasia recovery, although more research is needed to determine the clinical utility of these findings. Future research may wish to investigate longitudinal discourse recovery in a larger sample of people with aphasia with heterogenous aphasia profiles and severities.
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Affiliation(s)
- Amélie Brisebois
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Montreal, QC, Canada
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (Hôpital du Sacré-Cœur de Montréal), Montreal, QC, Canada
| | - Simona Maria Brambati
- Département de psychologie, Faculté des arts et des sciences, Université de Montréal, Montreal, QC, Canada
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, QC, Canada
| | - Elizabeth Rochon
- Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
| | - Carol Leonard
- Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Ottawa, ON, Canada
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Karine Marcotte
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Montreal, QC, Canada
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (Hôpital du Sacré-Cœur de Montréal), Montreal, QC, Canada
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26
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D'Aprano F, Malpas CB, Roberts S, Saling MM. Verbosity with retelling: Narrative discourse production in temporal lobe epilepsy. Epilepsy Res 2023; 189:107069. [PMID: 36603454 DOI: 10.1016/j.eplepsyres.2022.107069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/09/2022] [Accepted: 12/17/2022] [Indexed: 12/25/2022]
Abstract
To examine micro- and macrolinguistic underpinnings of circumstantiality in temporal lobe epilepsy (TLE), we examined the elicited narrative output of 15 individuals with TLE and 14 controls. To replicate and extend Field and colleagues' (2000) work, participants were asked to produce five immediately consecutive elicitations of an eight-frame cartoon "Cowboy Story" (Joanette et al., 1986). Following transcription and coding, detailed multi-level discourse analysis demonstrated a typical pattern of compression in controls. The narratives produced by individuals with TLE were less fluent, cohesive, and coherent across trials: producing fewer novel units and more repetitive and extraneous content. Significant group by trial interactions in sample length, spontaneous duration, and statements, were not explained by seizure burden, age, or lexical retrieval deficits. These findings suggest that they do not benefit from repeated engagement with a narrative in the same manner as controls. Disturbed social cognition and pragmatics in TLE might underpin communication inefficiencies.
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Affiliation(s)
- Fiore D'Aprano
- Melbourne School of Psychological Sciences, The University of Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Australia; Department of Neurology, Alfred Health, Australia.
| | - Charles B Malpas
- Melbourne School of Psychological Sciences, The University of Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Australia; Department of Neurology, Alfred Health, Australia; Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Australia.
| | - Stefanie Roberts
- Department of Neurology, The Royal Melbourne Hospital, Australia; Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Australia.
| | - Michael M Saling
- Melbourne School of Psychological Sciences, The University of Melbourne, Australia; Department of Clinical Neuropsychology, The Austin Hospital, Australia.
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27
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D'Aprano F, Malpas CB, Roberts S, Saling MM. Vague retellings of personal narratives in temporal lobe epilepsy. Seizure 2022; 107:177-185. [PMID: 36631304 DOI: 10.1016/j.seizure.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Aside from deficits identified in single-word level retrieval, individuals with temporal lobe epilepsy (TLE) exhibit clinical oddities, such as circumstantiality in their language production. Circumstantiality refers to the use of language which is pedantic, repetitive, and overly detailed. This becomes particularly evident when elicitation tasks impose minimal structure, or when impersonal narratives are retold over consecutive occasions. Personal reminiscence is highly specific and localised in time, placing unique demands on cognitive-linguistic systems. It is hypothesised that the nature of this elicitation paradigm will produce a unique psycholinguistic phenotype in those with TLE. Among controls there is a compression of output for impersonal narratives, meaning that they use fewer words over less time and are more fluent. The opposite effect is observed when personal narratives are retold. METHODS To investigate the micro- and macrolinguistic processes underpinning personal discourse production in TLE, we examined the elicited language output of 15 surgically naïve individuals with TLE and 14 healthy controls. Participants were asked to recall and re-tell an autobiographical memory on four immediately consecutive occasions, representing an alternative unstructured elicitation. Following transcription and coding of output, a detailed multi-level discourse analysis of output volume, fluency, cohesion, and coherence was conducted. RESULTS As anticipated, a distinctly different pattern emerged in TLE when compared with controls who did not compress their output volume across repetitions but instead produced greater novelty, and a more coherent and refined account over time. Individuals with TLE consistently told a less distinct story across repetitions, with disturbances in fluency, cohesion, and coherence. CONCLUSION This reflects a reduced capacity to produce a coherent mental representation, in all likelihood related to the neurolinguistic demands of recalling and retelling specific personal events.
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Affiliation(s)
- Fiore D'Aprano
- Melbourne School of Psychological Sciences, The University of Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Australia; Department of Neurology, Alfred Health, Australia.
| | - Charles B Malpas
- Melbourne School of Psychological Sciences, The University of Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Australia; Department of Neurology, Alfred Health, Australia; Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia.
| | - Stefanie Roberts
- Department of Neurology, The Royal Melbourne Hospital, Australia; Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia.
| | - Michael M Saling
- Melbourne School of Psychological Sciences, The University of Melbourne, Australia; Department of Clinical Neuropsychology, The Austin Hospital, Australia.
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Grammar in 'agrammatical' aphasia: What's intact? PLoS One 2022; 17:e0278676. [PMID: 36473005 PMCID: PMC9725141 DOI: 10.1371/journal.pone.0278676] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Aphasia following cerebro-vascular accidents has been a primary source of insight for models of language in the brain. However, deviant language patterns in aphasia may reflect processing limitations and cognitive impairment more than language impairment per se. AIMS We sought to obtain new evidence from spontaneous speech in Broca's aphasia (BA) for the intactness of grammatical knowledge, operationalized as the preservation of the basic hierarchical structure of syntactic projections. METHODS & PROCEDURES Speech obtained with the AphasiaBank protocol from 20 people with BA, which were independently rated as also being agrammatic, was analyzed and compared to 20 matched non-brain-damaged controls. We quantified (i) marking of Aspect, Tense, and Modality (A-T-M), which are located at specific (high) layers of the syntactic hierarchy and ordered in relation to one another ([M…[T…[A…]]]); (ii) hierarchies of clausal units ([C…[C]]); (iii) discourse markers embedding clauses, located at the highest layer of the hierarchy; and (iv) attachment of adjuncts at different heights of a given hierarchical syntactic structure. Supplementary evidence was obtained from a typology of errors and from pauses subcategorized according to their hierarchical syntactic position. OUTCOMES & RESULTS Groups did not quantitatively differ on rates of either Aspect or Modality but underproduced T and embedded clauses. Evidence for compensatory effects was seen in both of the latter two cases. While all adjunct types were underproduced in BA, and pauses overproduced, both showed the same relative proportions within both groups. Errors were largely restricted to omissions, of a kind that would also be expected in condensed neurotypical speech. CONCLUSIONS Overall, these patterns support the hypothesis of intactness of grammatical knowledge in BA clinically rated as agrammatic, questioning it as a disease model of language impairment.
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Marcotte K, Lachance A, Brisebois A, Mazzocca P, Désilets-Barnabé M, Desjardins N, Brambati SM. Validation of Videoconference Administration of Picture Description From the Western Aphasia Battery-Revised in Neurotypical Canadian French Speakers. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2825-2834. [PMID: 36332144 DOI: 10.1044/2022_ajslp-22-00084] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE During the COVID-19 pandemic, clinicians and researchers have increasingly used remote online assessments to pursue their activities, but mostly with tests not validated for videoconference administration. This study aims to validate the remote online administration of picture description in Canadian French neurotypical speakers and to explore the thematic unit (TU) checklist recently developed. METHOD Spoken discourse elicited through the picture description task of the Western Aphasia Battery-Revised (WAB-R) was collected from Canadian French neurotypical speakers from Québec aged between 50 and 79 years old. Forty-seven participants completed the task in person, and 49 participants completed the task by videoconference. Videos of each discourse sample were transcribed using CHAT conventions. Microstructural variables were extracted using the CLAN (Computerized Language ANalysis) program, whereas thematic informativeness was scored for each sample using TUs. Chi-square tests were conducted to compare both groups on each TU; t tests were also performed on the total score of TUs and microstructural variables. RESULTS Groups were matched on sex, age, and education variables. The t tests revealed no intergroup difference for the total TU score and for the microstructural variables (e.g., mean length of utterances and number of words per minute). Chi-square tests showed no significant intergroup difference for all 16 TUs. CONCLUSIONS These findings support remote online assessment of the picnic scene of the WAB-R picture description in Canadian French neurotypical speakers. These results also validate the 16 TUs most consistently produced. The use of videoconference could promote and improve the recruitment of participants who are usually less accessible, such as people using assistive mobility technologies. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21476961.
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Affiliation(s)
- Karine Marcotte
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Québec, Canada
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Québec, Canada
| | - Arianne Lachance
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Québec, Canada
| | - Amélie Brisebois
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Québec, Canada
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Québec, Canada
| | - Patrizia Mazzocca
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Québec, Canada
| | | | - Noémie Desjardins
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Québec, Canada
| | - Simona Maria Brambati
- Faculté de médecine, Université de Montréal, Québec, Canada
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Québec, Canada
- Département de psychologie, Faculté des arts et des sciences, Université de Montréal, Québec, Canada
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Azios JH, Archer B, Simmons-Mackie N, Raymer A, Carragher M, Shashikanth S, Gulick E. Conversation as an Outcome of Aphasia Treatment: A Systematic Scoping Review. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2920-2942. [PMID: 36356216 DOI: 10.1044/2022_ajslp-22-00011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE Conversation-focused speech-language pathology services are a top priority for people living with aphasia, but little is known about how researchers measure conversation as an outcome of treatment. This scoping review was undertaken to systematically review the evidence regarding the measurement of conversation in aphasia studies and to identify current practices and existing gaps. METHOD A systematic literature search was conducted for studies published between January 1995 and September 2019 in multiple electronic databases. Covidence software was used to manage search results, study selection, and data charting processes. Data were extracted from each study and then collated and organized to elucidate the breadth of approaches, tools, or procedures oriented to measuring conversation as an outcome and identify gaps in the existing literature. RESULTS The systematic search of the literature resulted in 1,244 studies. A total of 64 studies met inclusion criteria and were included in the review. The review summarizes the various tools and procedures used to measure conversation as an outcome of aphasia intervention, including variations in data collection and analysis procedures. The review also evaluates the quality of conversation measures in terms of psychometric properties and informal measures of validity. There was a total of 211 measures used across the 64 studies. CONCLUSIONS While there was no clear measure that was objectively superior, several measures show promise and warrant future exploration. Some of the orientations, conceptualizations, and procedures we have presented can be seen as options that might be included in a future conversation-focused core outcome set. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21514062.
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Affiliation(s)
- Jamie H Azios
- Department of Communicative Disorders, University of Louisiana at Lafayette
| | - Brent Archer
- Department of Communication Sciences and Disorders, Bowling Green State University, OH
| | - Nina Simmons-Mackie
- Department of Health & Human Sciences, Southeastern Louisiana University, Hammond
| | - Anastasia Raymer
- Department of Communication Disorders & Special Education, Old Dominion University, Norfolk, VA
| | - Marcella Carragher
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
- Centre for Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
| | - Shriya Shashikanth
- Department of Communicative Disorders, University of Louisiana at Lafayette
| | - Eleanor Gulick
- Department of Communication Sciences and Disorders, Bowling Green State University, OH
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Berube SK, Goldberg E, Sheppard SM, Durfee AZ, Ubellacker D, Walker A, Stein CM, Hillis AE. An Analysis of Right Hemisphere Stroke Discourse in the Modern Cookie Theft Picture. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2301-2312. [PMID: 36075208 PMCID: PMC9907448 DOI: 10.1044/2022_ajslp-21-00294] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 03/20/2022] [Accepted: 06/09/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Adults with right hemisphere damage demonstrate differences in connected speech compared to controls, but systematic, quantitative methods to capture these differences are lacking. The current study aimed to (a) investigate if measures using the Modern Cookie Theft picture description would identify discourse differences in acute right hemisphere stroke, and (b) examine if discourse differences were associated with documented cognitive impairment. METHOD Eighty-four participants completed the Modern Cookie Theft picture description within 5 days of right hemisphere stroke. Descriptions were analyzed for multiple microlinguistic characteristics. Medical charts were retrospectively reviewed for documented presence of cognitive impairment. RESULTS Individuals with acute right hemisphere stroke produced fewer content units, total syllables, and lower left-right content unit ratios compared to controls, indicating a paucity of informativeness. Presence of cognitive impairment was associated with fewer content units produced. CONCLUSIONS Multiple measures of microlinguistic discourse characteristics differentiated adults with right hemisphere stroke from controls, highlighting variations in both the quantity and quality of connected speech. Findings continue to underscore the contribution and correlation between cognitive skills and discourse performance. Future work is needed to assess the relationship between particular cognitive domains and discourse production as well as to investigate longitudinal changes to discourse production during stroke recovery. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.20778541.
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Affiliation(s)
- Shauna K. Berube
- Department of Physical Medicine and Rehabilitation, The Johns Hopkins Hospital, Baltimore, MD
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Emily Goldberg
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Shannon M. Sheppard
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Communication Sciences and Disorders, Chapman University, Irvine, CA
| | | | - Delaney Ubellacker
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Alexandra Walker
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Colin M. Stein
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Argye E. Hillis
- Department of Physical Medicine and Rehabilitation, The Johns Hopkins Hospital, Baltimore, MD
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD
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Minga J, Stockbridge MD, Durfee A, Johnson M. Clinical Guidelines for Eliciting Discourse Using the RHDBank Protocol. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:1949-1962. [PMID: 36044890 PMCID: PMC9907450 DOI: 10.1044/2022_ajslp-22-00097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/12/2022] [Accepted: 06/15/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Examining discourse after right hemisphere brain damage (RHD) can provide invaluable clinical data and insight into functional communication capabilities. Yet, clinicians preparing to enter the field may have limited experience eliciting and analyzing discourse for therapeutic purposes. The purpose of this work is to present a practical guide for the clinical use of the RHDBank protocol. METHOD Following a brief overview of the RHDBank protocol, elicitation guidelines and protocol administration considerations are offered. Measures that should be considered when analyzing RHDBank-elicited discourse are summarized. The RHDBank protocol is positioned as an accessible resource for discourse elicitation in the clinical setting, and examples for the clinical use of the protocol are provided. CONCLUSIONS Discourse production can be a key source of information regarding communication ability following RHD. The RHDBank provides a structured and scripted approach to the clinical elicitation of language and consideration of discourse production. Its immediate clinical utility will assist developing clinicians with the acquisition of a clinically relevant elicitation approach and more comprehensive view of the RHD communication impairments. Application of the protocol can aid in collective knowledge advancement that will promote a better understanding of RHD language production as a clinical entity with an array of possible characteristics.
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Affiliation(s)
- Jamila Minga
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC
| | - Melissa D. Stockbridge
- Department of Neurology, Cerebrovascular Division, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Alexandra Durfee
- Department of Neurology, Cerebrovascular Division, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Melissa Johnson
- Department of Communication Sciences and Disorders, Nazareth College, Rochester, NY
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Alduais A, Alduais A, Alfadda H, Allegretta S. Clinical Linguistics: Analysis of Mapping Knowledge Domains in Past, Present and Future. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1202. [PMID: 36010092 PMCID: PMC9406678 DOI: 10.3390/children9081202] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 06/15/2023]
Abstract
Across the world, many infants, children, adults, and elderly people are reported with many types of disorders and disabilities that damage, delay, or impede typical language development and/or use. Speech-language pathologists and other relevant clinicians are responsible for diagnosing, assessing, and rehabilitating these conditions. In nearly all types of disorders or disabilities that affect language, clinical linguistics plays a significant role in their study, diagnosis, and evaluation. This study provides a thorough analysis of the field of clinical linguistics. Data from Scopus, WOS, and Lens were used between 1981 and 2022. The documents included in the analysis were 1685, 1628, and 2677 articles published between 1981 and 2022 in clinical linguistics in Scopus, WOS, and Lens, respectively. For the purpose of assessing the development and impacts of the field of clinical linguistics, we used eight bibliometric and eight scientometric indicators. As part of the study, the results summarized the top contributors to clinical linguistics in terms of production size by year, country, university/research centre, journal, publisher, and author. The impact of the examined evidence on clinical linguistics was visualized and tabulated in the form of visual networks, citation counts, burst, cooccurrence, centrality, and sigma factors that are helpful in identifying the main influencers in clinical linguistics. A few examples of clinical linguistics patterns that are being explored extensively by researchers include cleft palate speech with model theories, visual feedback, motor speech disorders with instrumental analysis, acoustic analysis to understand conversational breakdown, nonlinear phonological theory, aphasic conversation in atypical interaction, and diagnostic markers in functional segments. There are also phonological disorders, William Syndrome, and the use of ultrasound, which may be considered potential clusters of clinical linguistics. A key contribution of this paper is highlighting the importance of clinical linguistics as well as its integration with linguistics, speech-language pathology, neurolinguistics, psycholinguistics, neuroscience, cognitive sciences, psychology, and psychometrics.
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Affiliation(s)
- Ahmed Alduais
- Department of Human Sciences (Psychology), University of Verona, 37129 Verona, Italy
| | - Abdullah Alduais
- English Language Institute, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Hind Alfadda
- Department of Curriculum and Instruction, King Saud University, Riyadh 11362, Saudi Arabia
| | - Silvia Allegretta
- Department of General Psychology, University of Padua, 35122 Padua, Italy
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Alyahya RSW, Conroy P, Halai AD, Ralph MAL. An efficient, accurate and clinically-applicable index of content word fluency in Aphasia. APHASIOLOGY 2022; 36:921-939. [PMID: 35919460 PMCID: PMC7613208 DOI: 10.1080/02687038.2021.1923946] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/16/2021] [Indexed: 05/31/2023]
Abstract
Background Despite the clinical importance of assessing the efficiency and accuracy of fluency in terms of content words production during connected speech, assessments based on discourse tasks are very time-consuming and thus not clinically feasible. Aims (1) Examine the relationship between single-word naming and word retrieval during discourse production. (2) Investigate the relationship between word retrieval and content word fluency derived from a simple versus naturalistic discourse tasks. (3) Develop and validate an efficient and accurate index of content word fluency that is clinically viable. Methods Two discourse tasks (simple picture description and naturalistic storytelling narrative) were collected from 46 participants with post-stroke aphasia, and 20 age/education matched neuro-typical controls. Each discourse sample was fully transcribed and quantitative analysis was applied to each sample to measure word retrieval and content word fluency. Three single-word naming tasks were also administered to each participant with aphasia. Results Correlational analyses between single-word naming and word retrieval in connected speech revealed weak/moderate relationships. Conversely, strong correlations were found between measures derived from simple picture description against naturalistic storytelling discourse tasks. Moreover, we derived a novel, transcription-less index of content word fluency from the discourse samples of an independent group (neuro-typical controls), and then we validated this index across two discourse tasks in the tested group (persons with aphasia). Correlation and regression analyses revealed extremely strong relationships between participants' (neuro-typical controls and persons with aphasia) scores on the novel index and measures of content word fluency derived from the formal transcription and quantitative analyses of discourse samples, indicating high accuracy and validity of the new index. Conclusions Simple picture description rather than picture naming provides a better estimate of word retrieval in naturalistic connected speech. The novel developed index is transcription-less and can be implemented online to provide an accurate and efficient measure of content word fluency. Thus, it is viable during clinical practice for assessment purposes, and possibly as an outcome measure to monitor therapy effectiveness, which can also be used in randomised clinical trials.
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Affiliation(s)
- Reem S. W. Alyahya
- Communication and Swallowing Disorders Department, King Fahad Medical City, Riyadh, Saudi Arabia
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Paul Conroy
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Ajay D. Halai
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
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Litovsky CP, Finley AM, Zuckerman B, Sayers M, Schoenhard JA, Kenett YN, Reilly J. Semantic flow and its relation to controlled semantic retrieval deficits in the narrative production of people with aphasia. Neuropsychologia 2022; 170:108235. [PMID: 35430236 PMCID: PMC9978996 DOI: 10.1016/j.neuropsychologia.2022.108235] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 11/29/2022]
Abstract
Aphasia has had a profound influence on our understanding of how language is instantiated within the human brain. Historically, aphasia has yielded an in vivo model for elucidating the effects of impaired lexical-semantic access on language comprehension and production. Aphasiology has focused intensively on single word dissociations. Yet, less is known about the integrity of combinatorial semantic processes required to construct well-formed narratives. Here we addressed the question of how controlled lexical-semantic retrieval deficits (a hallmark of aphasia) might compound over the course of longer narratives. We specifically examined word-by-word flow of taxonomic vs. thematic semantic distance in the storytelling narratives of individuals with chronic post-stroke aphasia (n = 259) relative to age-matched controls (n = 203). We first parsed raw transcribed narratives into content words and computed inter-word semantic distances for every running pair of words in each narrative (N = 232,490 word transitions). The narratives of people with aphasia showed significant reductions in taxonomic and thematic semantic distance relative to controls. Both distance metrics were strongly predictive of offline measures of semantic impairment and aphasia severity. Since individuals with aphasia often exhibit perseverative language output (i.e., repetitions), we performed additional analyses with repetitions excluded. When repetitions were excluded, group differences in semantic distances persisted and thematic distance was still predictive of semantic impairment, although some findings changed. These results demonstrate the cumulative impact of deficits in controlled word retrieval over the course of narrative production. We discuss the nature of semantic flow between words as a novel metric of characterizing discourse and elucidating the nature of lexical-semantic access impairment in aphasia at multiword levels.
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Affiliation(s)
- Celia P. Litovsky
- Eleanor M. Saffran Center for Cognitive Neuroscience, Temple University, Philadelphia, PA, USA,Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA, USA,Corresponding author. Eleanor M. Saffran Center for Cognitive Neuroscience, Temple University, Philadelphia, PA, USA. (C.P. Litovsky)
| | - Ann Marie Finley
- Eleanor M. Saffran Center for Cognitive Neuroscience, Temple University, Philadelphia, PA, USA,Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA, USA
| | - Bonnie Zuckerman
- Eleanor M. Saffran Center for Cognitive Neuroscience, Temple University, Philadelphia, PA, USA,Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA, USA
| | - Matthew Sayers
- Eleanor M. Saffran Center for Cognitive Neuroscience, Temple University, Philadelphia, PA, USA,Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA, USA
| | - Julie A. Schoenhard
- Eleanor M. Saffran Center for Cognitive Neuroscience, Temple University, Philadelphia, PA, USA,Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA, USA
| | - Yoed N. Kenett
- Faculty of Industrial Engineering & Management, Technion – Israel Institute of Technology, Haifa, Israel
| | - Jamie Reilly
- Eleanor M. Saffran Center for Cognitive Neuroscience, Temple University, Philadelphia, PA, USA,Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA, USA
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Schneider F, Marcotte K, Brisebois A, Townsend SAM, Smidarle AD, Soder RB, Marrone LCP, Hübner LC. Macrostructural Aspects in Oral Narratives in Brazilian Portuguese by Left and Right Hemisphere Stroke Patients With Low Education and Low Socioeconomic Status. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:1319-1337. [PMID: 35302896 DOI: 10.1044/2021_ajslp-21-00205] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Individuals with a stroke in either the left hemisphere (LH) or the right hemisphere (RH) often present macrostructural impairments in narrative abilities. Understanding the potential influence of low education and low socioeconomic status (SES) is critical to a more effective assessment of poststroke language. The first aim was to investigate macrostructural processing in low-education and low-SES individuals with stroke in the LH or RH or without brain damage. The second aim was to verify the relationships between macrolinguistic, neuropsychological, and sociodemographic variables. METHOD Forty-seven adults with LH (n = 15) or RH (n = 16) chronic ischemic stroke and 16 matched (age, education, and SES) healthy controls produced three oral picture-sequence narratives. The macrostructural aspects analyzed were cohesion, coherence, narrativity, macropropositions, and index of lexical informativeness and were compared among the three groups. Then, exploratory correlations were performed to assess associations between sociodemographic (such as SES), neuropsychological, and macrostructural variables. RESULTS Both the LH and the RH presented impairments in the local macrostructural aspect (cohesion), whereas the RH also presented impairments in more global aspects (global coherence and macropropositions). All five macrostructural variables correlated with each other, with higher correlations with narrativity. Naming was correlated with all macrostructural variables, as well as prestroke reading and writing habits (RWH), showing that higher naming accuracy and higher RWH are associated with better macrostructural skills. CONCLUSIONS The present results corroborate the role of the LH in more local processing and that of the RH in more global aspects of discourse. Moreover, this study highlights the importance of investigating discourse processing in healthy and clinical populations of understudied languages such as Brazilian Portuguese, with various levels of education, SES, and RWH.
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Affiliation(s)
- Fernanda Schneider
- Federal Institute of Education, Science and Technology of Rio Grande do Sul, Ibirubá, Brazil
- Linguistics Department, School of Humanities, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Karine Marcotte
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Québec, Canada
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Québec, Canada
| | - Amélie Brisebois
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Québec, Canada
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Québec, Canada
| | - Sabrine Amaral Martins Townsend
- Linguistics Department, School of Humanities, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- Postdoctoral Program in Linguistics, University of Santa Cruz do Sul, Rio Grande do Sul, Brazil
| | - Anderson Dick Smidarle
- Linguistics Department, School of Humanities, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ricardo Bernardi Soder
- Brain Institute of Rio Grande do Sul, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Lilian Cristine Hübner
- Linguistics Department, School of Humanities, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
- National Council for Scientific and Technological Development, Brasília, Distrito Federal, Brazil
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Salis C, DeDe G. Sentence Production in a Discourse Context in Latent Aphasia: A Real-Time Study. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:1284-1296. [PMID: 35363996 DOI: 10.1044/2022_ajslp-21-00232] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The purpose of this study was to improve our understanding as to which factors determine online, spoken sentence production abilities of adults with latent aphasia in a discourse context. METHOD Discourse samples of the story of Cinderella elicited from AphasiaBank were analyzed with speech analysis software. Participants comprised people with latent and anomic aphasia as well as neurotypical controls (10 per group). Durations of pauses (silent and filled) were analyzed according to (a) the location they occurred (between or within sentences), (b) the syntactic complexity of sentences (simple, complex), and (c) sentence length (number of words). Statistical comparisons were conducted using mixed-effect models. RESULTS The two clinical groups (latent and anomic) differed from controls in the duration of pauses, both between and within sentences. Syntactic complexity did not exert an effect on either of the two clinical groups as compared with controls. As compared with controls, both clinical groups paused more before long in comparison with short sentences. CONCLUSION Reduction in processing speed, which affects the ability to simultaneously maintain multiple linguistic and other cognitive demands associated with planning and monitoring of utterances, is a major factor that compromises sentence production in spoken discourse in latent aphasia. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19448726.
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Affiliation(s)
- Christos Salis
- Speech & Language Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Gayle DeDe
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA
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Matar SJ, Newton C, Sorinola IO, Pavlou M. Transcranial Direct-Current Stimulation as an Adjunct to Verb Network Strengthening Treatment in Post-stroke Chronic Aphasia: A Double-Blinded Randomized Feasibility Study. Front Neurol 2022; 13:722402. [PMID: 35309584 PMCID: PMC8924047 DOI: 10.3389/fneur.2022.722402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 01/24/2022] [Indexed: 11/24/2022] Open
Abstract
Background Difficulties in discourse production are common in post-stroke chronic aphasia. Previous studies have found that speech and language therapy combined with transcranial direct-current stimulation (tDCS) may improve language skills like naming and enhance aphasia treatment outcomes. However, very few studies have investigated the effect of tDCS when combined with interventions for improving higher level language skills such as the Verb Network Strengthening Treatment (VNeST). Aims This study aimed to determine the feasibility of anodal tDCS as an adjunct to VNeST to improve discourse production in post-stroke chronic aphasia. Methods Six people with post-stroke chronic aphasia took part in this double-blinded randomized feasibility study. Participants were randomly allocated to either the experimental group receiving a 6-week block of once weekly VNeST sessions combined with active tDCS over the left inferior frontal gyrus (LIFG) or a control group that received VNeST with sham stimulation. Feasibility outcomes included screening, eligibility, retention, and completion rates, and adverse events. Preliminary response to intervention was also examined using discourse production, functional communication, quality of life, psychological state, and cognition outcomes. Results Overall 19 individuals were screened and ten met the inclusion criteria. Six individuals provided consent and participated in the study giving a consent rate of 60%. Participant retention and completion rates were 100% and no adverse effects were reported. Exploratory analyses revealed promising changes (i.e., estimated large effect size) in discourse production measures across discourse language tasks and functional communication for the active tDCS group. Conclusions Our results support the feasibility of tDCS as an adjunct to VNeST. Preliminary findings provide motivation for future large-scale studies to better understand the potential of tDCS as a safe and economical tool for enhancing rehabilitation in chronic aphasia.
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Affiliation(s)
- Shereen J. Matar
- Centre for Human & Applied Physiological Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Caroline Newton
- Division of Psychology and Language Sciences, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Isaac O. Sorinola
- Department of Population Health Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Marousa Pavlou
- Centre for Human & Applied Physiological Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
- *Correspondence: Marousa Pavlou
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Mason C, Nickels L. Are single-word picture naming assessments a valid measure of word retrieval in connected speech? INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 24:97-109. [PMID: 34488498 DOI: 10.1080/17549507.2021.1966098] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose: Picture naming assessments are one of the most common methods of examining word retrieval in aphasia. However, currently, it is unclear whether these assessments are able to accurately predict word retrieval in "real-life" communication. This paper aims to explore the evidence in the current literature regarding the relationship between picture naming and word retrieval in connected speech in people with aphasia.Method: Literature was reviewed that examined the correlation between picture naming and word retrieval in connected speech. The literature search was limited to articles that were English language, participants with aphasia, and that were not therapy studies.Result: The existing studies showed mixed findings. However, comparison of study outcomes was complicated by inconsistency in the research methods used, including in word retrieval measures and connected speech elicitation.Conclusion: While there is some evidence of a relationship between picture naming and word retrieval in connected speech, correlation outcomes were mixed with possible influences from participant characteristics, assessment method and speech sample type. We therefore suggest that clinical decision-making would benefit from supplementing picture naming tests with an analysis of word retrieval in connected speech. Further research is required with a focus on natural conversation and the development of standard testing procedures for connected speech.
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Affiliation(s)
- Catherine Mason
- Department of Cognitive Science, Macquarie University, Sydney, Australia
| | - Lyndsey Nickels
- Department of Cognitive Science, Macquarie University, Sydney, Australia
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Richardson JD, Dalton SG. Assessment of language impairment and function. HANDBOOK OF CLINICAL NEUROLOGY 2022; 185:175-193. [PMID: 35078598 DOI: 10.1016/b978-0-12-823384-9.00009-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This chapter is written for the qualified neurologist or related professional working with persons who have had a stroke or other sudden brain injury. It is critical that the presence of aphasia is detected, no matter how mild the presentation, and to support that assertion, this chapter highlights the plight of persons with latent aphasia. At the individual level, the impact of aphasia is devastating, with overwhelming evidence that aphasia negatively impacts psychosocial outcomes. At the global level, sensitive detection and accurate diagnosis of aphasia are critical for accurate characterization and quantification of the global burden of aphasia. The word "LANGUAGE" is leveraged as an acronym to create a useful and memorable checklist to guide navigation of aphasia screening and assessment: it begins with the definition of language (L), followed by the definition and diagnostic criteria for aphasia (A). Then language abilities and characteristics to be considered in assessment are presented: naming (N); grammar and syntax (G); unintelligible words, jargon, and paraphasias (U); auditory comprehension and repetition (A); graphemic abilities-reading and writing (G); and everyday communication and discourse (E). Recommendations for improving procedural adherence are provided, and a list of potential brief assessment measures are introduced.
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Affiliation(s)
- Jessica D Richardson
- Department of Speech and Hearing Sciences, University of New Mexico, Albuquerque, NM, United States.
| | - Sarah Grace Dalton
- Department of Speech Pathology and Audiology, Marquette University, Milwaukee, WI, United States
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Hickin J, Cruice M, Dipper L. A Systematically Conducted Scoping Review of the Evidence and Fidelity of Treatments for Verb and Sentence Deficits in Aphasia: Sentence Treatments. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:431-462. [PMID: 34941377 DOI: 10.1044/2021_ajslp-21-00120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE This review article synthesizes and evaluates the evidence for sentence production treatments in aphasia, systematically charting impairment-based and functional communication outcomes. It reports (a) the level of evidence and fidelity of sentence treatments; (b) the impact of treatment on production of trained and untrained verbs and sentences, functional communication, and discourse; and (c) the potential active ingredients of treatment. METHOD The search included studies from January 1980 to June 2019. The level of evidence of each study was documented, as was fidelity in terms of treatment delivery, enactment, and receipt. Studies were also categorized according to treatment methods used. RESULTS Thirty-three studies were accepted into the review and predominantly constituted Level 4 evidence (e.g., case control studies and case series). Thirty studies (90%) described treatment in sufficient detail to allow replication, but dosage was poorly reported, and fidelity of treatment was rarely assessed. The most commonly reported treatment techniques were mapping (10 studies: 30%), predicate argument structure treatment (six studies: 18%), and verb network strengthening treatment (five studies: 15%). Production of trained sentences improved for 83% of participants, and improvements generalized to untrained sentences for 59% of participants. Functional communication was rarely assessed, but discourse production improved for 70% of participants. CONCLUSIONS The evidence for sentence treatments is predominantly generated from Level 4 studies. Treatments were effective for the majority of participants regarding trained sentence and discourse production. However, there is inconsistent use of statistical analysis to verify improvements, and diverse outcome measures are used, which makes interpretation of the evidence difficult. The quality of sentence treatment research would be improved by agreeing a core set of outcome measures and extended by ascertaining the views of participants on sentence treatments.
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Affiliation(s)
- Julie Hickin
- Division of Language and Communication Science, City, University of London, United Kingdom
| | - Madeline Cruice
- Division of Language and Communication Science, City, University of London, United Kingdom
| | - Lucy Dipper
- Division of Language and Communication Science, City, University of London, United Kingdom
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Boucher J, Brisebois A, Slegers A, Courson M, Désilets-Barnabé M, Chouinard AM, Gbeglo V, Marcotte K, Brambati SM. Picture Description of the Western Aphasia Battery Picnic Scene: Reference Data for the French Canadian Population. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:257-270. [PMID: 34735273 DOI: 10.1044/2021_ajslp-20-00388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE The main aim of this study is to provide French Canadian reference data for quantitative measures extracted from connected speech samples elicited by the Western Aphasia Battery-Revised picnic scene, a discourse task frequently used in clinical assessment of acquired language disorders. METHOD Our sample consisted of 62 healthy French Canadian adults divided in two age groups: a 50- to 69-year-old group and a 70- to 90-year-old group. RESULTS High interrater reliability scores were obtained for most of the variables. Most connected speech variables did not demonstrate an age effect. However, the 70- to 90-year-old group produced more repetitions than the 50- to 69-year-old group and displayed reduced communication efficiency (number of information content units per minute). CONCLUSION These findings contribute to building a reference data set to analyze descriptive discourse production in clinical settings.
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Affiliation(s)
- Johémie Boucher
- Département de psychologie, Faculté des arts et des sciences, Université de Montréal, Québec, Canada
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Québec, Canada
| | - Amélie Brisebois
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Québec, Canada
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (Hôpital du Sacré-Cœur de Montréal), Québec, Canada
| | - Antoine Slegers
- Département de psychologie, Faculté des arts et des sciences, Université de Montréal, Québec, Canada
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Québec, Canada
| | - Melody Courson
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Québec, Canada
| | - Marianne Désilets-Barnabé
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Québec, Canada
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (Hôpital du Sacré-Cœur de Montréal), Québec, Canada
| | - Anne-Marie Chouinard
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Québec, Canada
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (Hôpital du Sacré-Cœur de Montréal), Québec, Canada
| | - Véronika Gbeglo
- Département de psychologie, Faculté des arts et des sciences, Université de Montréal, Québec, Canada
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Québec, Canada
| | - Karine Marcotte
- École d'orthophonie et d'audiologie, Faculté de médecine, Université de Montréal, Québec, Canada
- Centre de recherche du Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (Hôpital du Sacré-Cœur de Montréal), Québec, Canada
| | - Simona Maria Brambati
- Département de psychologie, Faculté des arts et des sciences, Université de Montréal, Québec, Canada
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, Québec, Canada
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Understanding Syntax Structure of Language After a Head Injury. Brain Inform 2022. [DOI: 10.1007/978-3-031-15037-1_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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Hoover E, DeDe G, Maas E. A Randomized Controlled Trial of the Effects of Group Conversation Treatment on Monologic Discourse in Aphasia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4861-4875. [PMID: 34731574 PMCID: PMC10110355 DOI: 10.1044/2021_jslhr-21-00023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/15/2021] [Accepted: 07/28/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE Evidence has shown that group conversation treatment may improve communication and reduce social isolation for people with aphasia. However, little is known about the impact of conversation group treatment on measures of discourse. This project explored the impact of conversation treatment on measures of monologic discourse. METHOD In this randomized controlled trial, 48 participants with chronic aphasia were randomly assigned to dyadic, large group, or control conditions. Conversation group treatment was provided for 1 hr, twice per week, for 10 weeks. Discourse samples were collected and coded at pretreatment, posttreatment, and 6-week maintenance. There were three narrative tasks: (a) Comprehensive Aphasia Test (CAT) picture description, (b) Cat Rescue Picture, and (c) Cinderella retell. All narratives were coded using the percent correct information units (percent CIUs), the CAT standardized narrative analysis method, and the complete utterance (CU) method. RESULTS No significant changes were observed on percent CIU, which was the primary outcome measure. The treated groups demonstrated improvement on aspects of the CU method following treatment, whereas the control group did not. Significant changes were observed for other CIU measures and the CAT standardized narrative analysis in both the treated and control groups. CONCLUSIONS The results suggest that the CU measures were more sensitive to the effects of conversation treatment in monologic discourse compared to CIU and CAT measures. Changes were more common in absolute rather than relative values, suggesting that conversation treatment impacts the overall amount of language produced rather than efficiency of production.
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Affiliation(s)
- Elizabeth Hoover
- Department of Speech, Language & Hearing Sciences, Boston University, MA
| | - Gayle DeDe
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA
| | - Edwin Maas
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA
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Kranou-Economidou D, Kambanaros M. Transcranial Magnetic Stimulation and Working Memory Training to Address Language Impairments in Aphasia: A Case Study. Behav Neurol 2021; 2021:9164543. [PMID: 34868389 PMCID: PMC8639281 DOI: 10.1155/2021/9164543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/25/2021] [Accepted: 11/10/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Traditionally, people with aphasia (PWA) are treated with impairment-based language therapy to improve receptive and expressive language skills. In addition to language deficits, PWA are often affected by some level of working memory (WM) impairments. Both language and working memory impairments combined have a negative impact on PWA's quality of life. The aim of this study was to investigate whether the application of intermittent theta-burst stimulation (iTBS) combined with computerized WM training will result in near-ransfer effects (i.e., trained WM) and far-transfer effects (i.e., untrained language tasks) and have a positive effect on the quality of life of PWA. METHODS The participant was a 63-year-old Greek-Cypriot male who presented with mild receptive aphasia and short-term memory difficulties. Treatment was carried out using a multiple baseline (MB) design composed of a pretherapy or baseline testing phase, a therapy phase, and a posttherapy/follow-up phase. The treatment program involved iTBS application to the left dorsolateral prefrontal cortex (DLPFC), an area responsible for WM, for 10 consecutive sessions. The participant received a 3-minute iTBS application followed by 30-minute computer-assisted WM training. Outcome measures included a WM screening test, a standardized aphasia test, a nonverbal intelligence test, story-telling speech samples, a procedural discourse task, and a questionnaire addressing quality of life. These measures were performed three times before the treatment, immediately upon completion of the treatment, and once during follow-up testing at 3 months posttreatment. RESULTS We found a beneficial effect of iTBS and WM training on naming, reading, WM, reasoning, narrative, communication efficiency, and quality of life (QoL). Implications for Rehabilitation. Noninvasive brain stimulation combined with computerized WM training may be used in aphasia rehabilitation to improve WM and generalize to language improvement.
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Affiliation(s)
| | - Maria Kambanaros
- Department of Rehabilitation Sciences, Cyprus University of Technology, Limassol 3036, Cyprus
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Stark BC, Dutta M, Murray LL, Fromm D, Bryant L, Harmon TG, Ramage AE, Roberts AC. Spoken Discourse Assessment and Analysis in Aphasia: An International Survey of Current Practices. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4366-4389. [PMID: 34554878 PMCID: PMC9132151 DOI: 10.1044/2021_jslhr-20-00708] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Purpose Spoken discourse analysis is commonly employed in the assessment and treatment of people living with aphasia, yet there is no standardization in assessment, analysis, or reporting procedures, thereby precluding comparison/meta-analyses of data and hindering replication of findings. An important first step is to identify current practices in collecting and analyzing spoken discourse in aphasia. Thus, this study surveyed current practices, with the goal of working toward standardizing spoken discourse assessment first in research settings with subsequent implementation into clinical settings. Method A mixed-methods (quantitative and qualitative) survey was publicized to researchers and clinicians around the globe who have collected and/or analyzed spoken discourse data in aphasia. The survey data were collected between September and November 2019. Results Of the 201 individuals who consented to participate, 189 completed all mandatory questions in the survey (with fewer completing nonmandatory response questions). The majority of respondents reported barriers to utilizing discourse including transcription, coding, and analysis. The most common barrier was time (e.g., lack of time). Respondents also indicated that there was a lack of, and a need for, psychometric properties and normative data for spoken discourse use in the assessment and treatment of persons with aphasia. Quantitative and qualitative results are described in detail. Conclusions The current survey study evaluated spoken discourse methods in aphasia across research and clinical settings. Findings from this study will be used to guide development of process standardization in spoken discourse and for the creation of a psychometric and normative property database. Supplemental Material https://doi.org/10.23641/asha.166395100.
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Affiliation(s)
- Brielle C. Stark
- Department of Speech, Language and Hearing Sciences and Program in Neuroscience, Cognitive Science Program, Indiana University, Bloomington, IN
| | - Manaswita Dutta
- Department of Communication Disorders and Sciences, Rush University, Chicago, IL
| | - Laura L. Murray
- School of Communication Sciences and Disorders, Western University, London, CA
| | - Davida Fromm
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA
| | - Lucy Bryant
- Graduate School of Health, University of Technology Sydney, New South Wales, Australia
| | - Tyson G. Harmon
- Department of Communication Disorders, Brigham Young University, Provo, UT
| | - Amy E. Ramage
- Department of Communication Sciences and Disorders, University of New Hampshire, Durham
| | - Angela C. Roberts
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
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Alyahya RSW, Halai AD, Conroy P, Lambon Ralph MA. Content Word Production during Discourse in Aphasia: Deficits in Word Quantity, Not Lexical-Semantic Complexity. J Cogn Neurosci 2021; 33:2494-2511. [PMID: 34407196 DOI: 10.1162/jocn_a_01772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Although limited and reduced connected speech production is one, if not the most, prominent feature of aphasia, few studies have examined the properties of content words produced during discourse in aphasia, in comparison to the many investigations of single-word production. In this study, we used a distributional analysis approach to investigate the properties of content word production during discourse by 46 participants spanning a wide range of chronic poststroke aphasia and 20 neurotypical adults, using different stimuli that elicited three discourse genres (descriptive, narrative, and procedural). Initially, we inspected the discourse data with respect to the quantity of production, lexical-semantic diversity, and psycholinguistic features (frequency and imageability) of content words. Subsequently, we created a "lexical-semantic landscape," which is sensitive to subtle changes and allowed us to evaluate the pattern of changes in discourse production across groups. Relative to neurotypical adults, all persons with aphasia (both fluent and nonfluent) showed significant reduction in the quantity and diversity of production, but the lexical-semantic complexity of word production directly mirrored neurotypical performance. Specifically, persons with aphasia produced the same rate of nouns/verbs, and their discourse samples covered the full range of word frequency and imageability, albeit with reduced word quantity. These findings provide novel evidence that, unlike in other disorders (e.g., semantic dementia), discourse production in poststroke aphasia has relatively preserved lexical-semantic complexity but demonstrates significantly compromised quantity of content word production. Voxel-wise lesion-symptom mapping using both univariate and multivariate approaches revealed left frontal regions particularly the pars opercularis, insular cortex, and central and frontal opercular cortices supporting word retrieval during connected speech, irrespective of their word class or lexical-semantic complexity.
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Affiliation(s)
- Reem S W Alyahya
- University of Cambridge.,King Fahad Medical City, Riyadh, Saudi Arabia.,Alfaisal University, Riyadh, Saudi Arabia
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Fromm D, Greenhouse J, Pudil M, Shi Y, MacWhinney B. Enhancing the Classification of Aphasia: A Statistical Analysis Using Connected Speech. APHASIOLOGY 2021; 36:1492-1519. [PMID: 36457942 PMCID: PMC9708051 DOI: 10.1080/02687038.2021.1975636] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 08/30/2021] [Indexed: 05/31/2023]
Abstract
BACKGROUND Large shared databases and automated language analyses allow for the application of new data analysis techniques that can shed new light on the connected speech of people with aphasia (PWA). AIMS To identify coherent clusters of PWA based on language output using unsupervised statistical algorithms and to identify features that are most strongly associated with those clusters. METHODS & PROCEDURES Clustering and classification methods were applied to language production data from 168 PWA. Language samples were from a standard discourse protocol tapping four genres: free speech personal narratives, picture descriptions, Cinderella storytelling, procedural discourse. OUTCOMES & RESULTS Seven distinct clusters of PWA were identified by the K-means algorithm. Using the random forests algorithm, a classification tree was proposed and validated, showing 91% agreement with the cluster assignments. This representative tree used only two variables to divide the data into distinct groups: total words from free speech tasks and total closed class words from the Cinderella storytelling task. CONCLUSION Connected speech data can be used to distinguish PWA into coherent groups, providing insight into traditional aphasia classifications, factors that may guide discourse research and clinical work.
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Affiliation(s)
- Davida Fromm
- Department of Psychology, Carnegie Mellon University
| | - Joel Greenhouse
- Department of Statistics & Data Science, Carnegie Mellon University
| | - Mitchell Pudil
- Department of Statistics & Data Science, Carnegie Mellon University
| | - Yichun Shi
- Department of Statistics & Data Science, Carnegie Mellon University
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McCann CM, Plourde J, Moore C, Purdy SC. Linguistic analysis in public speaking: evidence from a Gavel Club for people with aphasia. CLINICAL LINGUISTICS & PHONETICS 2021; 35:793-808. [PMID: 33021121 DOI: 10.1080/02699206.2020.1830302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/22/2020] [Accepted: 09/26/2020] [Indexed: 06/11/2023]
Abstract
Public speaking has been described as one of the most daunting tasks one can engage in, even more so for people with aphasia (PWA). Gavel Clubs (affiliated with Toastmasters International) were established over 20 years ago for those who want to engage in public speaking but do not meet the eligibility criteria for Toastmasters membership. This study is the first of its kind to systematically evaluate changes in the speeches of PWA attending a weekly Gavel Club. The aims were to compare Table Topics (TT) and Prepared Speeches (PS) which are two different tasks regularly performed in a Gavel Club; to measure linguistic change over time in the two speech types; and to determine the feasibility of a discourse measure for analysing public speeches. Thirty-six speeches (four each from nine PWA) were audio-recorded, transcribed and analysed using the Linguistic Communication Measure (LCM). The nine participants represented a wide range of aphasia severity. Analysis revealed that engaging in weekly speaking activities in the GC was associated with an improvement in conveying content and in grammaticality through an increase in total number of words and number of correct words produced. The LCM is a comprehensive analysis tool but proved to be challenging in its speed and utility when measuring linguistic change in public speeches of PWA. Regular GC participation appears to facilitate improved language abilities, but we have yet to find the best tool to demonstrate this.
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Affiliation(s)
- Clare M McCann
- School of Psychology (Speech Science), University of Auckland, Auckland, New Zealand
| | - Julie Plourde
- School of Psychology (Speech Science), University of Auckland, Auckland, New Zealand
| | - Celia Moore
- School of Psychology (Speech Science), University of Auckland, Auckland, New Zealand
| | - Suzanne C Purdy
- School of Psychology, University of Auckland, Auckland, New Zealand
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Fromm D, Katta S, Paccione M, Hecht S, Greenhouse J, MacWhinney B, Schnur TT. A Comparison of Manual Versus Automated Quantitative Production Analysis of Connected Speech. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:1271-1282. [PMID: 33784197 PMCID: PMC8608208 DOI: 10.1044/2020_jslhr-20-00561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/19/2020] [Accepted: 12/14/2020] [Indexed: 05/08/2023]
Abstract
Purpose Analysis of connected speech in the field of adult neurogenic communication disorders is essential for research and clinical purposes, yet time and expertise are often cited as limiting factors. The purpose of this project was to create and evaluate an automated program to score and compute the measures from the Quantitative Production Analysis (QPA), an objective and systematic approach for measuring morphological and structural features of connected speech. Method The QPA was used to analyze transcripts of Cinderella stories from 109 individuals with acute-subacute left hemisphere stroke. Regression slopes and residuals were used to compare the results of manual scoring and automated scoring using the newly developed C-QPA command in CLAN, a set of programs for automatic analysis of language samples. Results The C-QPA command produced two spreadsheet outputs: an analysis spreadsheet with scores for each utterance in the language sample, and a summary spreadsheet with 18 score totals from the analysis spreadsheet and an additional 15 measures derived from those totals. Linear regression analysis revealed that 32 of the 33 measures had good agreement; auxiliary complexity index was the one score that did not have good agreement. Conclusions The C-QPA command can be used to perform automated analyses of language transcripts, saving time and training and providing reliable and valid quantification of connected speech. Transcribing in CHAT, the CLAN editor, also streamlined the process of transcript preparation for QPA and allowed for precise linking of media files to language transcripts for temporal analyses.
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Affiliation(s)
- Davida Fromm
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA
| | - Saketh Katta
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX
| | - Mason Paccione
- Department of Statistics & Data Science, Carnegie Mellon University, Pittsburgh, PA
| | - Sophia Hecht
- Department of Statistics & Data Science, Carnegie Mellon University, Pittsburgh, PA
| | - Joel Greenhouse
- Department of Statistics & Data Science, Carnegie Mellon University, Pittsburgh, PA
| | - Brian MacWhinney
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA
| | - Tatiana T. Schnur
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX
- Department of Neuroscience, Baylor College of Medicine, Houston, TX
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