Harmon Tyson G, Jacks Adam, Haley Katarina L
Department of Communication Disorders, Brigham Young University, Provo, UT.
Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of North Carolina at Chapel Hill.
Am J Speech Lang Pathol. 2019 Jul 15;28(2S):905-914. doi: 10.1044/2018_AJSLP-MSC18-18-0107.
Purpose Slowed speech and interruptions to the flow of connected speech are common in aphasia. These features are also observed during dual-task performance for neurotypical adults. The purposes of this study were to determine (a) whether indices of fluency related to cognitive-linguistic versus motor processing would differ between speakers with aphasia plus apraxia of speech (AOS) and speakers with aphasia only and (b) whether cognitive load reduces fluency in speakers with aphasia with and without AOS. Method Fourteen speakers with aphasia (7 with AOS) and 7 neurotypical controls retold short stories alone (single task) and while simultaneously distinguishing between a high and a low tone (dual task). Their narrative samples were analyzed for speech fluency according to sample duration, speech rate, pause/fill time, and repetitions per syllable. Results As expected, both speaker groups with aphasia spoke slower and with more pauses than the neurotypical controls. The speakers with AOS produced more repetitions and longer samples than controls, but they did not differ on these measures from the speakers with aphasia without AOS. Relative to the single-task condition, the dual-task condition increased the duration of pauses and fillers for all groups but reduced speaking rate only for the control group. Sample duration and frequency of repetitions did not change in response to cognitive load. Conclusions Speech output in aphasia becomes less fluent when speakers have to engage in simultaneous tasks, as is typical in everyday conversation. Although AOS may lead to more sound and syllable repetitions than normal, speaking tasks other than narrative discourse might better capture this specific type of disfluency. Future research is needed to confirm and expand these preliminary findings. Supplemental Material https://doi.org/10.23641/asha.8847845.
言语迟缓以及连贯言语流的中断在失语症中很常见。在神经典型成年人的双任务表现中也观察到了这些特征。本研究的目的是确定:(a)患有失语症加言语失用症(AOS)的说话者与仅患有失语症的说话者在与认知 - 语言处理与运动处理相关的流畅性指标上是否存在差异;(b)认知负荷是否会降低患有或不患有AOS的失语症患者的流畅性。方法:14名失语症患者(7名患有AOS)和7名神经典型对照组独自复述短篇故事(单任务),同时区分高音和低音(双任务)。根据样本时长、语速、停顿/填充时间以及每音节重复次数对他们的叙述样本进行言语流畅性分析。结果:正如预期的那样,两组失语症患者说话都比神经典型对照组慢且停顿更多。患有AOS的患者比对照组产生更多的重复且样本更长,但在这些指标上与没有AOS的失语症患者没有差异。相对于单任务条件,双任务条件增加了所有组的停顿和填充时长,但仅降低了对照组的语速。样本时长和重复频率并未因认知负荷而改变。结论:当说话者必须同时进行任务时,失语症患者的言语输出流畅性会降低,这在日常对话中很常见。尽管AOS可能导致比正常情况更多的语音和音节重复,但除叙述性话语之外的说话任务可能能更好地捕捉这种特定类型的不流畅性。需要进一步的研究来证实和扩展这些初步发现。补充材料https://doi.org/10.23641/asha.8847845