American Journal of Speech-Language Pathology最新文献

Background: Understanding the impact that poststroke aphasia has on dual-task performance across multiple domains of function may inform the development of effective interventions. The purpose of this scoping review is to identify (a) the main theoretical frameworks used to explain dual-task performance deficits in individuals with poststroke aphasia; (b) the domains of function measured and the assessments used; (c) interventions aimed to improve dual-task performance; and, finally, (d) gaps that exist in the current body of literature regarding dual-task in persons with aphasia.

Method: A search of Linguistics and Language Behavior Abstracts, PsycINFO, Communication & Mass Media Complete, PubMed, CINAHL Plus, ScienceDirect, and the Cochrane Library was undertaken to identify publications on the topic. Articles were included in the review if they (a) were written in English, (b) included individuals with chronic poststroke aphasia, (c) included measures of dual-task performance, and/or (d) consisted of a theoretical narrative with a focus on dual task in persons with aphasia.

Results: Following the full-text screening, a total of 17 studies were in included for synthesis. Fourteen articles focused on dual-task experimental studies; one study consisted of a dual-task intervention; and two papers proposed a theory, framework, or schema to explain dual-task performance.

Conclusion: Gaps were identified in the literature, as well as differences in the methodology employed across studies, highlighting the need for consistency across experimental tasks and further examination across domains.

Purpose: Handwriting and typing have different cognitive and motor demands; however, questions remain as to whether performance in people with aphasia varies based on modality. This study compares written discourse production across handwritten and onscreen typed modalities for a large sample of people with aphasia. We also aimed to explore potential variables that predict the number of written words generated by participants and determine if modality differences emerge when these variables are included as predictors.

Method: Writing samples, via handwriting and onscreen typing, elicited in a picture description task were collected from 52 participants with chronic aphasia and coded for number of words. Generalized linear mixed-effects models were used to model the data. Aphasia type, severity of aphasia, writing severity, and use of nondominant hand for writing or onscreen typing were included as predictor variables.

Results: There were no significant differences between the number of words generated in the typed modality versus handwritten modality for the sample. Of the predictor variables examined, Western Aphasia Battery-Revised writing scores significantly predicted the number of words produced (p < .001). However, the interaction of writing severity with modality was not significant.

Conclusions: This preliminary study suggests that there was no effect of modality on one measure of written production, number of words. Future research is needed to evaluate if there are meaningful differences between modalities when additional measures, such as writing informativeness, are considered.

Supplemental material: https://doi.org/10.23641/asha.26506144.

Purpose: Unison production is a common aphasia treatment technique in which the clinician and the person with aphasia (PWA) produce phrases aloud together. It can be implemented using a typical "conversational," syntax-influenced prosodic timing structure, or with a "metrical," beat-based timing structure, but to date no study has directly compared these two approaches. This study compared the effects of metrical versus conversational prosodic timing during unison production on the (a) accuracy of participants' spoken output and (b) timing alignment of participants' productions with the stimuli.

Method: PWAs and controls listened to conversationally timed and metrically timed sentences and repeated them in unison with audio recordings. Productions were transcribed and scored in two ways: (a) Accuracy was calculated as the percentage of correctly produced syllables, and (b) timing alignment was determined by extracting the voice onset moment of identical target syllables in the unison stimuli and participant productions in both conditions and comparing the corresponding time points.

Results: Metrical timing yielded a greater number of accurate syllables in both groups, with larger effect in PWAs than in controls. Both groups exhibited more anticipatory, less variable timing when speaking along with metrical stimuli, though evidence of such prediction was also present in the conversational condition.

Conclusions: Results suggest that unison production works via entrainment-a process that utilizes prediction to guide synchronous production of spoken output. Metrically regular stimuli may facilitate this process as they are more rhythmically predictable. Future work will examine key behavioral variables that predict benefit from unison production and metrical timing.

Purpose: This study acoustically characterized the oral reading prosody of persons with aphasia (PWA) and neurotypical controls for a connected text and aimed to determine which prosodic features were most associated with performance on a reading comprehension task.

Method: Six PWA and six neurotypical, age- and education-matched controls participated in this preliminary study. Participants read Paragraph 3 of the Gray Oral Reading Tests-Fifth Edition aloud and subsequently answered five comprehension questions. A total of 11 measures related to phrasing, intonation, and expressivity were extracted using Praat for each participant in order for comparisons to be made across participant groups and associations examined with reading comprehension scores.

Results: The Mann-Whitney U test suggested a significant difference between PWA and control participants for intersentential pause durations, pausal intrusion frequency, and duration of pausal-pausal syllables. Although statistically nonsignificant, intersentential pause duration, pausal intrusion frequency, pausal intrusion duration, duration of prepausal syllables, and intensity amplitude following a syntactic juncture were all moderately correlated (all rs > .58) with comprehension of Paragraph 3 of the Gray Oral Reading Tests-Fifth Edition in PWA. All measures were weakly correlated with comprehension for the control participants.

Conclusions: PWA demonstrated statistically significant longer durations for intersentential pauses and prepausal syllables, and a greater number of pausal intrusions. Interestingly, three of the five measures moderately correlated to comprehension were those that were statistically different between the two participant groups. As such, preliminary findings of this study warrant further investigation in a larger sample of PWA.

Purpose: The aim of this study was to explore the subjective experiences of people with aphasia when communicating in the presence of various types of background noise. We hypothesized that (a) people with aphasia would report greater perceived effort and stress than controls when talking in noise, (b) perceived effort and stress would be greater in noise than silence, and (c) people with aphasia would describe more negative reactions to communicating in noise than controls.

Method: Eleven people with aphasia and 11 age- and gender-matched controls retold stories in a baseline silent condition and five background noise conditions (pink noise, cocktail party, monologue, one-sided phone call, and conversation) and rated their perceived effort and stress after each story. Participants then described their experience in a semistructured interview. Perceived effort and stress ratings were analyzed statistically using quantitative methods. Interview data were analyzed qualitatively.

Results: Quantitative findings showed that people with aphasia reported significantly greater perceived effort and stress than controls. Across groups, phone call, conversation, and monologue conditions were perceived as either more effortful or stressful than the silent baseline condition. Although both participant groups discussed cognitive and emotional challenges and strategies related to talking in noise, qualitative findings showed distinct difficulties for people with aphasia. Specifically, unlike controls, participants with aphasia mentioned difficulty ignoring background noise, decreased processing speed, fatigue, negative emotional reactions, deliberately focusing, slowing down/taking breaks, and consciously regulating their emotions.

Conclusions: Although aphasia therapy often occurs in quiet clinic environments, everyday communication does not. The increased perceived difficulty that people with aphasia have for coping with background noise should be acknowledged, and training should be designed to prepare people with aphasia to communicate in noisy environments.

Supplemental material: https://doi.org/10.23641/asha.27893445.

Purpose: This study had three objectives: (a) to verify if Grodzinsky et al.'s (1993) findings of worse comprehension of personal than reflexive pronouns can be replicated in a larger meta-analysis of individual participant data, (b) to examine if the heterogeneity found in the patterns of pronoun comprehension in agrammatism can be attributed to task effects, and (c) to evaluate the risk of bias in the reviewed studies.

Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic literature search was performed to identify studies examining the personal-reflexive pronoun dissociation in agrammatic comprehension. Seven studies met the search criteria and were included in the meta-analysis. For each participant, individual accuracy scores for the comprehension of personal and reflexive pronouns were extracted in addition to information on the study methods. Individual accuracy data were analyzed using the Fisher's exact test and the binomial test. The risk of bias in the studies was assessed using an adapted version of the Newcastle-Ottawa Quality Assessment Scale.

Results: The meta-analysis had three main findings: (a) The majority of the persons with agrammatic aphasia (89%) had no dissociation between the comprehension of personal and reflexive pronouns; (b) 8% revealed a pattern consistent with a neuropsychological dissociation, faring worse on the comprehension of personal than reflexive pronouns; and (c) 2% performed worse on reflexive than personal pronouns. The type of the task used affected pronoun comprehension accuracy and accounted for the heterogeneity in the patterns of pronoun comprehension attested across the different participants.

Conclusions: Taken together, the meta-analysis did not support a dissociation between personal and reflexive pronoun comprehension in agrammatic comprehension. When confirmed, the dissociation was driven by task effects. The clinical implications of these findings were discussed together with implications to minimize the risk of bias in future examinations of the topic.

Purpose: Writing can be completed by hand or by typing. Increasingly, functional and social activities are completed in the virtual domain, which often requires discourse level writing. Yet, there is a shortage of research on discourse writing in aphasia. The purpose of this study was to provide preliminary reference data for a sequential picture description task in writing by hand and typing for people with aphasia. Additionally, we examined individual modality differences when comparing handwritten and typed discourse.

Method: Fifteen people with mild-moderate aphasia participated in this study. They completed a sequential picture description task in handwriting and in typing. Discourse samples were coded for Correct Information Units (CIUs) and Complete Utterances. Measures of productivity were also evaluated (e.g., Total Words, Total Utterances). Participants completed a computer use questionnaire regarding their current and premorbid typing and computer use.

Results: Preliminary reference data are reported. No significant differences were found at the group level for the measures evaluated. At the individual level, there was evidence of a modality effect for seven participants who demonstrated differences in the proportion of CIUs.

Conclusions: Although preliminary, these findings suggest that, at the group level, the handwritten and typed discourse produced by people with mild-moderate aphasia is similar. However, at the individual level, there is potential for modality differences. Consistent patterns of premorbid computer use, difficulty ratings, and individual differences in writing modes were not identified for the participants who demonstrated a modality effect. However, there was preliminary evidence that poststroke handedness may contribute to modality differences exhibited by some participants, which should be explored in future research. Additionally, these reference data are preliminary and further research is required from a more heterogeneous group of people with aphasia and to better establish assessment practices for discourse writing.

Purpose: Acquired reading deficits, or alexia, affect a significant proportion of individuals with aphasia. We sought to improve treatment for alexia by targeting specific cognitive information-processing components critical to reading (i.e., phonology or semantics).

Method: To target either phonological or semantic processing, we administered two anomia treatments, phonomotor treatment (PMT) and semantic feature analysis, modified to include a focus on reading throughout the therapy. Chronic left-hemisphere stroke survivors (N = 5) completed one or two 60-hr treatment rounds. Based on predictions from a computational reading model, three participants received the treatment recommended for their specific reading challenges (e.g., PMT for phonological deficits), while two participants had the nonrecommended treatment first, followed by the recommended model-matched treatment. Changes in reading aloud accuracy and response times (RTs) from before to after treatment were examined as a function of matching treatment to the deficit profile, type of treatment, therapy round, and word characteristics.

Results: Participants' reading aloud accuracy improved after treatment relative to baseline with higher accuracy for high-frequency words and shorter words. After the first treatment round, participants' accuracy and RT improved, irrespective of whether treatment was matched to the deficit profile. Furthermore, participants who completed the second treatment round continued achieving accuracy gains. Following treatment, participants demonstrated enhanced reading efficiency and generalized improvements on the selected sections of the Woodcock Reading Mastery Test.

Conclusions: While larger studies are needed to test for the effects of matching treatment type to the deficit profile, we conclude that treatments targeting specific information-processing components can effectively improve reading. Doubling the treatment dose offers small but significant gains.

Supplemental material: https://doi.org/10.23641/asha.26517319.

Purpose: This study explored the acceptability and impact of relationship-centered communication partner training (RC-CPT) in couples impacted by aphasia. In particular, couples considered whether discussing their relationship roles and responsibilities was important and relevant to the changes they desire. Preliminary quasi-experimental data regarding perceived communication confidence and the marriage relationship were also obtained.

Method: Three couples participated in RC-CPT across two sessions. Surveys were used to measure communication confidence and the marital relationship before and after participation in RC-CPT. The quantitative findings were analyzed using descriptive statistics. Couples also participated in a semistructured interview about the acceptability of RC-CPT during a third session. The interviews were transcribed and analyzed using reflexive codebook analysis.

Results: Quantitative data indicated that participants generally maintained or improved self-rated accessibility, responsiveness, engagement, conflict resolution, and communication within their marriage after participating in RC-CPT. Additionally, individuals with aphasia demonstrated enhanced communication confidence scores. Qualitative analysis revealed three themes: (a) Impact on Communication, (b) Impact on Relationship, and (c) Impact on Psychosocial Well-Being. Feedback from participants regarding future development was also included.

Conclusions: The convergence of quantitative and qualitative data supports the conclusion that couples experienced positive changes in their communication, relationship, and psychosocial well-being during the intervention, suggesting that RC-CPT has the potential to positively impact both communicative and psychosocial effects of aphasia on couples. Moreover, this study highlights the promise of RC-CPT as a relationship-centered counseling tool, warranting further exploratory and experimental research.

Supplemental material: https://doi.org/10.23641/asha.25937383.

Purpose: The purpose of this viewpoint was to advocate for increased study of semantic memory ability in traumatic brain injury (TBI).

Method: We review modern conceptualizations of semantic memory and its neural correlates and discuss how common neuroanatomical and cognitive deficits in TBI place this population at an increased risk for semantic disruption. Building on discussions at the 2024 International Cognitive-Communication Disorders Conference, we offer possible explanations for how these disruptions may have been overlooked by our field and offer examples of how semantic memory has been studied in other populations as well as how this work may apply to TBI research.

Result: Semantic memory is critical for academic, vocational, and interpersonal outcomes. Yet, little is known about semantic memory in TBI beyond naming ability. By examining only surface forms of semantic memory, we may be missing a deeper disruption in semantic structure.

Conclusion: More in-depth examination of semantic memory promises to uncover underlying mechanisms of cognitive-communication disorders and new opportunities to develop more sensitive clinical measures of semantic memory impairment.