Tilton-Bolowsky Victoria E, van der Stelt Candace M, DeMarco Andrew, Laks Alycia, Dobbins Cassandra, Snider Sarah F, Turkeltaub Peter E, Vallila-Rohter Sofia
MGH Institute of Health Professions, Boston, MA, USA.
Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Aphasiology. 2024;38(2):237-260. doi: 10.1080/02687038.2023.2183076. Epub 2023 Mar 2.
Discourse analyses yield quantitative measures of functional communication in aphasia. However, they are historically underutilized in clinical settings. Confrontation naming assessments are used widely clinically and have been used to estimate discourse-level production. Such work shows that naming accuracy explains moderately high proportions of variance in measures of discourse, but proportions of variance remain unexplained. We propose that the inclusion of circumlocution productions into predictive models will account for a significant amount more of the variance. Circumlocution productions at the naming-level, while they may not contain the target word, are similar to the content that contributes to discourse informativeness and efficiency. Thus, additionally measuring circumlocution may improve our ability to estimate discourse performance and functional communication.
This study aimed to test whether, after controlling for naming accuracy, the addition of a measure of circumlocution into predictive models of discourse-level informativeness and efficiency would account for a significant amount more of the variance in these discourse-level outcomes.
METHODS & PROCEDURES: Naming and discourse data from 43 people with poststroke aphasia were analyzed. Naming data were collected using 120 pictured items and discourse data were collected using two picture description prompts. Data scoring and coding yielded measures of naming accuracy, incorrect response type, communicative informativeness, and efficiency. We used robust hierarchical regression to evaluate study predictions.
OUTCOMES & RESULTS: After controlling for naming accuracy, the inclusion of circumlocution into predictive models accounted for a significant amount more of the variance in both informativeness and efficiency. The subsequent inclusion of other response types, such as real word and nonword errors, did not account for a significant amount more of the variance in either outcome.
In addition to naming accuracy, the production of circumlocution during naming assessments may correspond with measures of informativeness and efficiency at the discourse-level. Reducing the burden of estimating patients' functional communication will increase our ability to estimate functional communication using tools that are easy to administer and interpret.
话语分析可得出失语症患者功能交流的量化指标。然而,从历史角度来看,它们在临床环境中的应用并不充分。对答命名评估在临床上被广泛使用,并已被用于估计话语层面的表达能力。此类研究表明,命名准确性在一定程度上能解释话语指标中较高比例的方差,但仍有部分方差无法得到解释。我们认为,将迂回表达纳入预测模型将能解释更多的方差。命名层面的迂回表达虽可能不包含目标词,但与有助于话语信息性和效率的内容相似。因此,额外测量迂回表达可能会提高我们估计话语表现和功能交流的能力。
本研究旨在检验,在控制命名准确性之后,将迂回表达指标添加到话语层面信息性和效率的预测模型中,是否能解释这些话语层面结果中更多的方差。
分析了43名中风后失语症患者的命名和话语数据。使用120个图片项目收集命名数据,使用两个图片描述提示收集话语数据。数据评分和编码得出命名准确性、错误反应类型、交流信息性和效率的指标。我们使用稳健分层回归来评估研究预测。
在控制命名准确性之后,将迂回表达纳入预测模型在信息性和效率方面都解释了更多的方差。随后纳入其他反应类型,如实词和非词错误,在这两个结果中都没有解释更多的方差。
除了命名准确性之外,命名评估期间的迂回表达可能与话语层面的信息性和效率指标相关。减轻估计患者功能交流的负担将提高我们使用易于实施和解释的工具来估计功能交流的能力。