Marianne Lind

Semi-spontaneous oral text production: Measurements in clinical practice

Functionally relevant assessment of the language production of speakers with aphasia should include assessment of connected speech production. Despite the ecological validity of everyday conversations, more controlled and monological types of texts may be easier to obtain and analyse in clinical practice. This article discusses some simple measurements for the analysis of semi-spontaneous oral text production by speakers with aphasia. Specifically, the measurements are related to the production of verbs and nouns, and the realization of different sentence types. The proposed measurements should be clinically relevant, easily applicable, and linguistically meaningful. The measurements have been applied to oral descriptions of the ‘Cookie Theft’ picture by eight monolingual Norwegian speakers, four with an anomic type of aphasia and four without any type of language impairment. Despite individual differences in both the clinical and the non-clinical group, most of the measurements seem to distinguish between speakers with and without aphasia.

Spoken language production as outcome measurement following constraint induced language therapy

Background: Spoken language production reflects a more natural communication aspect of language than most standardised aphasia tests. Several methods for text analysis have been developed; however, clinical application in speech-language therapy has so far been limited. Further exploration of the generalisation effect of specific impairment-based treatment forms to spontaneous speech and everyday communication is warranted. Aims: The present study explores the relevance of spoken language production for measurement of aphasia treatment outcome with constraint induced language therapy (CILT). The study investigates if improvement on standardised tests generalises to spoken language production with a focus on vocabulary and content. Methods & Procedures: Analyses are based on the pre- and post-intervention transcriptions of dialogical interviews with three speakers with aphasia participating in a clinical CILT treatment study in early aphasia rehabilitation. The analyses include quantitative measurements of the speech production (number of words, number of utterances, and mean length of utterance), of the lexical production of nouns and verbs (proportion, variation, frequency, and specificity), and of the content (proportion of informative utterances and meta-communicative utterances). In addition, the analyses include a qualitative evaluation of the content. Outcomes & Results: Results indicate an overall increase in noun production for all three cases post-CILT with individual differences in improvement of noun diversity and specificity. There is a slight decrease in the amount of verbs produced post-intervention, but more specific verbs are produced after the treatment. Content evaluation and the quantitative measures of content demonstrate increased informativeness on the individual level. Conclusions: The applied measures provide a helpful structure for interpreting outcome changes in the use of nouns and verbs. Analysis of spoken language production supports a generalisation effect of increased word production to a more demanding speech context (connected speech production).

Imageability of Norwegian nouns, verbs and adjectives in a cross-linguistic perspective.

In this article, we present a study of imageability ratings for a set of 1599 Norwegian words (896 nouns, 483 verbs and 220 adjectives) from a web-based survey. To a large extent, the results are in accordance with previous studies of other languages: high imageability scores in general, higher imageability scores for nouns than for verbs, and an inverse relation between frequency and imageability. A more surprising finding is the low imageability of low-frequency verbs. Also, imageability ratings increase systematically and significantly with informant age, reminding us that conceptual learning continues and changes throughout life. This has consequences for our expectations of different linguistic skills in a life span perspective. These findings have an obvious clinical relevance both for choice of items in test construction, for evaluation of performance in clinical groups and for development of therapy material.

Norwegian Words: A lexical database for clinicians and researchers

Abstract All words have properties linked to form, meaning and usage patterns which influence how easily they are accessed from the mental lexicon in language production, perception and comprehension. Examples of such properties are imageability, phonological and morphological complexity, word class, argument structure, frequency of use and age of acquisition. Due to linguistic and cultural variation the properties and the values associated with them differ across languages. Hence, for research as well as clinical purposes, language specific information on lexical properties is needed. To meet this need, an electronically searchable lexical database with more than 1600 Norwegian words coded for more than 12 different properties has been established. This article presents the content and structure of the database as well as the search options available in the interface. Finally, it briefly describes some of the ways in which the database can be used in research, clinical practice and teaching.

Semantic feature analysis targeting verbs in a quadrilingual speaker with aphasia

Background: Semantic feature analysis (SFA) is a treatment approach aimed at enhancing lexical retrieval by improving access to the semantic network in speakers with aphasia. Although there are promising results on trained items, previous studies exploring the impact of SFA on verb production in monolingual speakers have shown mixed results for generalisation to untrained items and discourse. There are few published studies investigating SFA and action naming in multilingual speakers. Aims: The study explores the impact of SFA on trained and untrained verbs, semantics and syntax, and narrative production in the trained and untrained languages of a multilingual speaker (Japanese–English–German–Norwegian) with moderate non-fluent aphasia. Treatment was conducted in a late-acquired language (Norwegian). Methods & Procedures: SFA was provided during an intensive schedule of about 22 hr of therapy, with approximately 10 hr per week over two and a half weeks. The treatment focused on the production of verbs in sentence contexts. Outcomes & Results: Outcome measures include the Bilingual Aphasia Test, an action-naming test, and production of semi-spontaneous narratives. Outcomes in the treated language: Overall, the participant responded positively to the SFA treatment. The trained verbs improved significantly, but no transfer was observed to untrained verbs. There were no changes in the formal testing of semantics or syntax, but improvements were noted in narrative production. Cross-linguistic outcomes: Transfer to verbs in untreated German was evident. There were significant increases in the semantics and syntax in both English and German. The participant showed an improvement in discourse in English and German, although not in Japanese. Conclusions: SFA treatment in a late-acquired language can lead to gains in the treated language and transfer to both stronger and weaker languages, with different patterns for the various languages. This indicates that SFA may be a promising method for treating multilingual speakers with aphasia. The authors further advocate the use of narratives as an assessment tool. In addition to enhancing the ecological validity of the findings, the narratives provided information not obtainable from the other assessment tools for within- and cross-linguistic therapy gains for the participant.

Prosodic contextualization of minimal responses to yes/no-questions in aphasic talk-in-interaction: A descriptive single-case study of a Norwegian aphasic speaker

The article explores aspects of the role of prosody as a contextualization cue in aphasic conversation through auditory and acoustic analysis of an aphasic speakers use of pitch variation in responses to closed yes/no-requests. The results reveal two prosodic realizations of ‘yes’ and ‘no’ contextualizing different kinds of responses: a flat realization with no prolongation and minimal pauses, signalling decisiveness, and a realization with movement in pitch, prolongation and preceding pauses, signalling indecisiveness. The analysis also shows how the aphasic uses a particular realization manipulatively for interactional purposes. The study illustrates the vital role that seemingly unimportant details play in the co-constructive process of creating meaning in interaction. The results indicate an area of competence that seems undisturbed in this speaker.

Cross-linguistic transfer effects of verb-production therapy in two cases of multilingual aphasia

ABSTRACT Background: Verb retrieval is challenging for monolingual and multilingual speakers with aphasia. Previous research on bilingual aphasia shows equivocal results of cross-linguistic transfer and inhibition. Aims: This study explores the impact of verb-production treatment in the treated and untreated languages of two bilingual speakers with aphasia. The main goals were to explore treatment effects, possible cross-linguistic transfer effects and to investigate possible inhibition of the untreated languages. Methods & Procedures: The participants were one trilingual speaker (Portuguese-Ronga-Norwegian) with nonfluent aphasia and one bilingual speaker (English-Norwegian) with fluent aphasia. They received two types of treatment: communication-based therapy and Semantic Feature Analysis. Treatment was conducted in Norwegian, a late-acquired language for both speakers. Treatment effects were measured in action naming tasks and narrative tasks in the treated language as well as the untreated languages. Outcomes & Results: Overall, the participants responded positively to the verb production treatments. This was demonstrated at the lexical level and also in discourse production, especially in the treated, but also in the untreated languages. No inhibition of the untreated languages was found. Conclusions: The data provide evidence for positive effects of verb-retrieval treatment provided in sentence contexts in a late-learned weaker language of multilingual speakers with aphasia. The treatments did not lead to an unwanted inhibition of the untreated language, which is an important finding for clinicians as well as for researchers. The results provide evidence for a shared conceptual network of the languages in bilingual speakers, supporting current models of bilingual language processing.

Compound Nouns in Spoken Language Production by Speakers with Aphasia Compared to Neurologically Healthy Speakers: An Exploratory Study.

Compounds are words that are made up of at least two other words (lexemes), featuring lexical and syntactic characteristics and thus particularly interesting for the study of language processing. Most studies of compounds and language processing have been based on data from experimental single word production and comprehension tasks. To enhance the ecological validity of morphological processing research, data from other contexts, such as discourse production, need to be considered. This study investigates the production of nominal compounds in semi-spontaneous spoken texts by a group of speakers with fluent types of aphasia compared to a group of neurologically healthy speakers. The speakers with aphasia produce significantly fewer nominal compound types in their texts than the non-aphasic speakers, and the compounds they produce exhibit fewer different types of semantic relations than the compounds produced by the non-aphasic speakers. The results are discussed in relation to theories of language processing.

Lexical access in a bilingual speaker with dementia: changes over time

ABSTRACT In this article, we explore the naming skills of a bilingual English-Norwegian speaker diagnosed with Primary Progressive Aphasia, in each of his languages across three different speech contexts: confrontation naming, semi-spontaneous narrative (picture description), and conversation, and at two points in time: 12 and 30 months post diagnosis, respectively. The results are discussed in light of two main theories of lexical retrieval in healthy, elderly speakers: the Transmission Deficit Hypothesis and the Inhibitory Deficit Theory. Our data show that, consistent with the participant’s premorbid use of and proficiency in the two languages, his performance in his L2 is lower than in his L1, but this difference diminishes as the disease progresses. This is the case across the three speech contexts; however, the difference is smaller in the narrative task, where his performance is very low in both languages already at the first measurement point. Despite his word finding problems, he is able to take active part in conversation, particularly in his L1 and more so at the first measurement point. In addition to the task effect, we find effects of word class, frequency, and cognateness on his naming skills. His performance seems to support the Transmission Deficit Hypothesis. By combining different tools and methods of analysis, we get a more comprehensive picture of the impact of the dementia on the speaker’s languages from an intra-individual as well as an inter-individual perspective, which may be useful in research as well as in clinical practice.

Imageability ratings across languages

Imageability is a psycholinguistic variable that indicates how well a word gives rise to a mental image or sensory experience. Imageability ratings are used extensively in psycholinguistic, neuropsychological, and aphasiological studies. However, little formal knowledge exists about whether and how these ratings are associated between and within languages. Fifteen imageability databases were cross-correlated using nonparametric statistics. Some of these corresponded to unpublished data collected within a European research network—the Collaboration of Aphasia Trialists (COST IS1208). All but four of the correlations were significant. The average strength of the correlations (rho = .68) and the variance explained (R2 = 46%) were moderate. This implies that factors other than imageability may explain 54% of the results. Imageability ratings often correlate across languages. Different possibly interacting factors may explain the moderate strength and variance explained in the correlations: (1) linguistic and cultural factors; (2) intrinsic differences between the databases; (3) range effects; (4) small numbers of words in each database, equivalent words, and participants; and (5) mean age of the participants. The results suggest that imageability ratings may be used cross-linguistically. However, further understanding of the factors explaining the variance in the correlations will be needed before research and practical recommendations can be made.