Department of Hearing and Speech, University of Kansas Medical Center, Kansas City.
Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY.
J Speech Lang Hear Res. 2021 Nov 8;64(11):4344-4365. doi: 10.1044/2021_JSLHR-20-00641. Epub 2021 Oct 7.
Purpose This study evaluated interrater reliability (IRR) and test-retest stability (TRTS) of seven linguistic measures (percent correct information units, relevance, subject-verb-[object], complete utterance, grammaticality, referential cohesion, global coherence), and communicative success in unstructured conversation and in a story narrative monologue (SNM) in persons with aphasia (PWAs) and matched participants without aphasia (M-PWoAs). Furthermore, the relationship of language in unstructured conversation and SNM was investigated for these measures. Methods Twenty PWAs and 20 M-PWoAs participated in two unstructured conversations on different days with different speech-language pathologists trained as social conversation partners. An 8- to 12-min segment of each conversation was analyzed. Additionally, a wordless picture book was used to elicit an SNM sample at each visit. Correlational analyses were conducted to address the primary research questions. Normative range and minimal detectable change data were also calculated for the measures in both conditions. Results IRR and TRTS were moderate to good for parametric measures and moderate to excellent for nonparametric measures for both groups, except for TRTS for referential cohesion for the PWAs in conversation. Furthermore, in PWAs, a strong correlation was demonstrated for three of eight measures across conditions. Moderate or weaker correlations were demonstrated for three of eight measures, and correlations for two of eight measures were not significant. An ancillary finding was no significant differences occurred for sample-to-sample variability between the two conditions for any measure. Conclusions This study replicates previous research demonstrating the feasibility to reliably measure language in unstructured conversation in PWAs. Furthermore, this study provides preliminary evidence that language production varies for some measures between unstructured conversation and SNM, contributing to a literature base that demonstrates language variation between different types of monologue. Thus, these findings suggest that inclusion of the specific types of discourse of interest to the PWA may be important for comprehensive assessment of aphasia. Supplemental Material https://doi.org/10.23641/asha.16569360.
本研究评估了 7 种语言测量指标(正确信息单位百分比、相关性、主谓宾-宾格、完整话语、语法、指代衔接、整体连贯性)在失语症患者(PWAs)和匹配的非失语症对照组(M-PWoAs)中的组内信度(IRR)和重测稳定性(TRTS),以及在非结构化对话和故事叙述独白(SNM)中的交际成功率。此外,还研究了这些指标在非结构化对话和 SNM 中的语言关系。
20 名 PWAs 和 20 名 M-PWoAs 在不同的日子与经过培训的言语语言病理学家作为社交对话伙伴进行了两次非结构化对话。每次对话分析 8-12 分钟的片段。此外,在每次就诊时还使用无词图画书来引出 SNM 样本。进行相关分析以解决主要研究问题。还计算了两种情况下所有测量指标的正常范围和最小可检测变化数据。
对于参数测量指标,两组的 IRR 和 TRTS 为中等至良好,对于非参数测量指标,IRR 和 TRTS 为中等至优秀,除了 PWAs 在对话中的 TRTS 参考衔接指标。此外,在 PWAs 中,有三个指标在两种情况下具有很强的相关性。有三个指标显示出中等或较弱的相关性,而另外两个指标的相关性不显著。一个附带发现是,在任何指标上,两种情况下的样本间变异性都没有显著差异。
本研究复制了先前的研究,证明了在 PWAs 中可靠地测量非结构化对话中的语言是可行的。此外,本研究提供了初步证据,表明语言生成在某些指标上在非结构化对话和 SNM 之间存在差异,这为文献基础做出了贡献,证明了不同类型的独白之间的语言差异。因此,这些发现表明,纳入对 PWA 感兴趣的特定类型的话语可能对全面评估失语症很重要。