Dipper Lucy, Marshall Jane, Boyle Mary, Hersh Deborah, Botting Nicola, Cruice Madeline
Division of Language and Communication Science, School of Health Sciences, University of London, London EC1V 0HB, UK.
Department of Communication Sciences and Disorders, Montclair State University, Montclair, NJ 07043, USA.
Brain Sci. 2021 Feb 2;11(2):183. doi: 10.3390/brainsci11020183.
Discourse (a unit of language longer than a single sentence) is fundamental to everyday communication. People with aphasia (a language impairment occurring most frequently after stroke, or other brain damage) have communication difficulties which lead to less complete, less coherent, and less complex discourse. Although there are multiple reviews of discourse assessment and an emerging evidence base for discourse intervention, there is no unified theoretical framework to underpin this research. Instead, disparate theories are recruited to explain different aspects of discourse impairment, or symptoms are reported without a hypothesis about the cause. What is needed is a theoretical framework that would clarify the specific linguistic skills that create completeness, coherence, and complexity (i.e., richness) in discourse, and illuminate both the processes involved in discourse production and the reasons for breakdown. This paper reports a review and synthesis of the theoretical literature relevant to spoken discourse in aphasia discourse, and we propose a novel theoretical framework which unites these disparate sources. This framework is currently being tested as the foundation for Linguistic Underpinnings of Narrative in Aphasia (LUNA) treatment research. In this paper, we outline the novel framework and exemplify how it might be used to guide clinical practice and research. Future collaborative research is needed to develop this framework into a processing model for spoken discourse.
语篇（一个比单个句子更长的语言单位）是日常交流的基础。失语症患者（一种最常发生在中风或其他脑损伤后的语言障碍）存在交流困难，这导致他们的语篇不那么完整、连贯和复杂。尽管有多项关于语篇评估的综述以及语篇干预的新兴证据基础，但尚无统一的理论框架来支撑这项研究。相反，人们采用不同的理论来解释语篇损伤的不同方面，或者在没有关于病因假设的情况下报告症状。我们需要一个理论框架，它能够阐明在语篇中创造完整性、连贯性和复杂性（即丰富性）的具体语言技能，并揭示语篇生成过程以及出现障碍的原因。本文报告了对失语症语篇中与口语语篇相关的理论文献的综述和综合，我们提出了一个新颖的理论框架，将这些不同的来源统一起来。这个框架目前正在作为失语症叙事语言基础（LUNA）治疗研究的基础进行测试。在本文中，我们概述了这个新颖的框架，并举例说明它如何用于指导临床实践和研究。未来需要开展合作研究，将这个框架发展成一个口语语篇的处理模型。
