Lucy Dipper

The Boston Naming Test in Greek: Normative data and the effects of age and education on naming

Background: The Boston Naming Test (BNT) is widely used as a clinical assessment of language and cognitive deficits. It has been adapted and translated for use in other languages and cultures. Aims: This study translated and adapted the test for use in Greece. Normative data were collected on the test for healthy Greek speakers of different ages and educational backgrounds. Methods and Procedures: Participants in four different age ranges and with three levels of educational achievement were tested. They were screened for cognitive decline using a Greek version of the mini mental state examination. Outcomes and Results: Strong effects of age and education were found on naming. The former replicates previous results. Results on the latter have been less consistent and their occurrence here reflects the greater inequality in educational opportunity that has existed in Greece until comparatively recent times. Significant interactions between age, education, and gender are interpreted as reflecting changing social and gender roles in Greek society. A reordering of items reflecting their difficulty for this Greek sample is presented for clinical use. Conclusions: This study provides norms for a Greek version of the BNT. These highlight the effects of age and education on naming. Scores for many older and less‐educated participants might be taken to indicate pathology despite their lack of neurological or cognitive problems. This illustrates the need for norms that reflect local circumstances and the need to update norms as social and educational changes occur.

The impact of impaired semantic knowledge on spontaneous iconic gesture production

Background: Previous research has found that people with aphasia produce more spontaneous iconic gesture than control participants, especially during word-finding difficulties. There is some evidence that impaired semantic knowledge impacts on the diversity of gestural handshapes, as well as the frequency of gesture production. However, no previous research has explored how impaired semantic knowledge impacts on the frequency and type of iconic gestures produced during fluent speech compared with those produced during word-finding difficulties. Aims: To explore the impact of impaired semantic knowledge on the frequency and type of iconic gestures produced during fluent speech and those produced during word-finding difficulties. Methods & Procedures: A group of 29 participants with aphasia and 29 control participants were video recorded describing a cartoon they had just watched. All iconic gestures were tagged and coded as either “manner”, “path only”, “shape outline” or “other”. These gestures were then separated into either those occurring during fluent speech or those occurring during a word-finding difficulty. The relationships between semantic knowledge and gesture frequency and form were then investigated in the two different conditions. Outcomes & Results: As expected, the participants with aphasia produced a higher frequency of iconic gestures than the control participants, but when the iconic gestures produced during word-finding difficulties were removed from the analysis, the frequency of iconic gesture was not significantly different between the groups. While there was not a significant relationship between the frequency of iconic gestures produced during fluent speech and semantic knowledge, there was a significant positive correlation between semantic knowledge and the proportion of word-finding difficulties that contained gesture. There was also a significant positive correlation between the speakers’ semantic knowledge and the proportion of gestures that were produced during fluent speech that were classified as “manner”. Finally while not significant, there was a positive trend between semantic knowledge of objects and the production of “shape outline” gestures during word-finding difficulties for objects. Conclusions: The results indicate that impaired semantic knowledge in aphasia impacts on both the iconic gestures produced during fluent speech and those produced during word-finding difficulties but in different ways. These results shed new light on the relationship between impaired language and iconic co-speech gesture production and also suggest that analysis of iconic gesture may be a useful addition to clinical assessment.

Thinking for speaking and thinking for listening: the interaction of thought and language in typical and non-fluent comprehension and production

In this paper, we reconsider some of the processes that distinguish production and comprehension. In particular, we discuss the specific forms of thinking involved in each: “thinking for speaking” and “thinking for listening” (Black & Chiat, 2000; Slobin, 1996). We argue that thinking for speaking (or for any form of language output) crucially involves schematisation or “paring down” of conceptual information (Dipper, 1999), a process partly driven by the language system itself. Thinking for listening, on the other hand, involves an “enrichment” of skeletal conceptual information derived from the linguistic input, using pragmatic principles. Production and comprehension involve distinct forms of interaction between thought and language, and should not be characterised as a simple reversal of the same processes. This approach allows us to account for different patterns of production and comprehension in non-fluent aphasia, and predict some of the factors the facilitate processing for people with these language impairments.

Language and iconic gesture use in procedural discourse by speakers with aphasia

Background: Conveying instructions is an everyday use of language, and gestures are likely to be a key feature of this. Although co-speech iconic gestures are tightly integrated with language, and people with aphasia (PWA) produce procedural discourses impaired at a linguistic level, no previous studies have investigated how PWA use co-speech iconic gestures in these contexts. Aims: This study investigated how PWA communicated meaning using gesture and language in procedural discourses, compared with neurologically healthy people (NHP). We aimed to identify the relative relationship of gesture and speech, in the context of impaired language, both overall and in individual events. Methods & Procedures: Twenty-nine PWA and 29 NHP produced two procedural discourses. The structure and semantic content of language of the whole discourses were analysed through predicate argument structure and spatial motor terms, and gestures were analysed for frequency and semantic form. Gesture and language were analysed in two key events, to determine the relative information presented in each modality. Outcomes & Results: PWA and NHP used similar frequencies and forms of gestures, although PWA used syntactically simpler language and fewer spatial words. This meant, overall, relatively more information was present in PWA gesture. This finding was also reflected in the key events, where PWA used gestures conveying rich semantic information alongside semantically impoverished language more often than NHP. Conclusions: PWA gestures, containing semantic information omitted from the concurrent speech, may help listeners with meaning when language is impaired. This finding indicates gesture should be included in clinical assessments of meaning-making.

Event Processing through naming: Investigating event focus in two people with aphasia

Some people with aphasia may have trouble with verbs because of fundamental difficulties in processing situations in a way that maps readily onto language. This paper describes a novel assessment, the Order of Naming Test, that explores the conceptual processing of events through the order in which people name the entities involved. The performance of non-brain damaged control participants is described. The responses of two people with non-fluent aphasia are then discussed. Both ‘Helen’ and ‘Ron’ showed significant difficulty with verbs and sentences. Ron also had trouble on a range of tasks tapping aspects of event processing, despite intact non-verbal cognition. While Helens performance on the Order of Naming Test was very similar to the controls, Rons differed in a number of respects, suggesting that he was less focused on the main participant entities. However, certain aspects of his response pointed at covert event processing abilities that might be fruitfully exploited in therapy.

The language–gesture connection: Evidence from aphasia

Abstract A significant body of evidence from cross-linguistic and developmental studies converges to suggest that co-speech iconic gesture mirrors language. This paper aims to identify whether gesture reflects impaired spoken language in a similar way. Twenty-nine people with aphasia (PWA) and 29 neurologically healthy control participants (NHPs) produced a narrative discourse, retelling the story of a cartoon video. Gesture and language were analysed in terms of semantic content and structure for two key motion events. The aphasic data showed an influence on gesture from lexical choices but no corresponding clausal influence. Both the groups produced gesture that matched the semantics of the spoken language and gesture that did not, although there was one particular gesture–language mismatch (semantically “light” verbs paired with semantically richer gesture) that typified the PWA narratives. These results indicate that gesture is both closely related to spoken language impairment and compensatory.

To the sentence and beyond: a single case therapy report for mild aphasia

Background: Mild aphasia has received limited attention in the research literature, with few published treatment studies despite significant disruption of communication reported by affected individuals. This includes difficulty understanding and producing grammatically complex language, and consequent discourse and/or conversational difficulties. The limited research may be due to a lack of clarity regarding the deficits underlying the disorder, with linguistic and/or cognitive impairments implicated, as well as limited research and treatment resources being targeted at those with more severe deficits. Aims: This single case study investigated the effectiveness of a multifaceted treatment approach designed to improve the complex sentence and discourse production of a young woman with mild aphasia. Methods & Procedures: The participant, BM, was a 22-year-old female with mild aphasia following a left-sided embolic cerebro-vascular accident approximately 2 years prior to the study. She participated in 16 sessions of impairment-based treatment on a weekly basis. The study used a multiple baseline design across time and behaviours. Due to the lack of published assessments suitable for mild aphasia, the study included informal outcome measures comprising linguistic analysis of Cinderella narratives, as well as the picture description tasks of the Comprehensive Aphasia Test. Outcomes & Results: BM’s picture description demonstrated modest improvements in spoken language production immediately post-treatment. Her Cinderella narrative gave further indications of improvements in complex sentence production. Analysis of her functional language output at the end of treatment indicated that improvement was most evident in written narrative production using voice recognition software. Conclusions: This study provides some preliminary evidence that impairment-based treatment for mild aphasia can improve complex sentence and discourse production. Given the multicomponent nature of treatment, it is not possible to identify what aspects of treatment were (most) effective. However, the study highlights the potential effectiveness of impairment-based treatments for high-level language deficits, and of multimedia technology both as therapy software and in the form of assistive technologies. The development of assessments suitable for mild aphasia and potential future directions for research are discussed.

Iconic gesture in normal language and word searching conditions: A case of conduction aphasia

Abstract Although there is a substantive body of research about the language used by individuals with aphasia, relatively little is known about their spontaneous iconic gesture. A single case study of LT, an individual with conduction aphasia indicated qualitative differences between the spontaneous iconic gestures produced alongside fluent speech and in tip of the tongue states. The current study examined the iconic gestures produced by another individual with conduction aphasia, WT, and a group of 11 control participants. Comparisons were made between iconic gestures produced alongside normal language and those produced alongside word-searching behaviour. Participants recounted the Tweety and Sylvester cartoon Canary Row. All gesture produced was analysed qualitatively and quantitatively. WT produced more iconic gestures than controls accompanying word searching behaviour, whereas he produced a similar frequency of iconic gestures to control participants alongside normal language. The iconic gestures produced in the two language contexts also differed qualitatively. Frequency of iconic gesture production was not affected by limb apraxia. This study suggests that there are differences between iconic gestures that are produced alongside normal language and those produced alongside word-searching behaviour. Theoretical and clinical implications of these findings are discussed.

Use of Spatial Communication in Aphasia

BACKGROUND Spatial communication consists of both verbal spatial language and gesture. There has been minimal research investigating the use of spatial communication, and even less focussing on people with aphasia. AIMS The aims of this exploratory study were to describe the frequency and variability of spatial language and gesture use by three participants with aphasia in comparison to nine control participants. This included: 1) frequency of gestures; 2) types of gesture; 3) number of spatial descriptions described by gestures but no language; and 4) frequency and variety of locative prepositional, verb, and noun phrases. METHODS & PROCEDURES Each participant was videoed undertaking 11 spatial communication tasks: four description tasks, and seven tasks involving directing the researcher in the placement of objects or pictures. Gestures and language produced were transcribed and analysed. OUTCOMES & RESULTS Participants with aphasia used significantly more gesture. Participants with aphasia also used more gesture without spoken phrases when spatial vocabulary was unavailable. Finally, there were differences between the participants with regards to the types of gesture that they used when they were unable to access language. CONCLUSION & IMPLICATIONS The results suggest that the analysis of gesture produced by people with aphasia may provide insight into their underlying language impairment. As this was an exploratory study, with just three participants with aphasia, further research is needed.

The effect of social media promotion on academic article uptake

Important emerging measures of academic impact are article download and citation rates. Yet little is known about the influences on these and ways in which academics might manage this approach to dissemination. Three groups of papers by academics in a center for speech‐language‐science (available through a university repository) were compared. The first group of target papers were blogged, and the blogs were systematically tweeted. The second group of connected control papers were nonblogged papers that we carefully matched for author, topic, and year of publication. The third group were papers by different staff members on a variety of topics—Unrelated Control Papers. The results suggest an effect of social media on download rate, which was limited not just to Target Papers but also generalized to Connected Control Papers. Unrelated Control Papers showed no increase over the same amount of time (main effect of time, F(1,27) = 55.6, p < .001); Significant Group×Time Interaction, F(2,27) = 7.9, p = .002). The effect on citation rates was less clear but followed the same trend. The only predictor of the 2015 citation rate was downloads after blogging (r = 0.450, p = .012). These preliminary results suggest that promotion of academic articles via social media may enhance download and citation rate and that this has implications for impact strategies.