A multi-level approach to the analysis of narrative language in aphasia

Background: Several studies have shown that traditional standardised aphasia tests may not be sensitive enough to adequately assess linguistic deficits and recovery patterns in persons with aphasia. As a result, both functional and structural methods for the analysis of connected language samples from people with aphasia have been devised (see Armstrong, 2000; Prins & Bastiaanse, 2004). Aims: The present article focuses on our attempt to provide a comprehensive, multi-level procedure for both structural and functional analysis of narrative discourse produced by speakers with brain damage. Accordingly, we will describe a method for analysis of connected language samples elicited on single picture and cartoon story description tasks. This method has proven sensitive in the assessment of language deficits in many neurogenic populations. Methods & Procedures: A comprehensive description of the language production system, a thorough discussion of the different approaches to discourse analysis in persons with aphasia, and the procedure for the analysis of narrative discourse are detailed. The characteristics of the eliciting stimuli, the procedures for their administration and the transcription of the language samples are carefully explained. The analysis focuses on four main aspects of linguistic processing: productivity, lexical and grammatical processing, narrative organisation, and informativeness. To further illustrate the analytic procedure, two case reports and an appendix with the analysis of a narrative sample are provided. Outcomes & Results: We will provide direct evidence of the usefulness of the multi-level procedure for discourse analysis for assessing changes in discourse performance of two persons with fluent aphasia, with different aetiologies, that were not captured by traditional standardised aphasia tests. Conclusions: The method of analysis presented in this paper has strong grounds in linguistic and psychological theories of linguistic structure and functioning. It also has the advantage of being both quantitative and functional as it captures selective aspects of linguistic processing, and can provide relevant information about the person's communicative and informative skills.

[1]  L. Turkstra,et al.  The effect of elicitation task on discourse coherence and cohesion in adolescents with brain injury. , 1999, Journal of communication disorders.

[2]  S. Matteson,et al.  “Let me tell you the point”: How speakers with aphasia assign prominence to information in narratives , 2010 .

[3]  Roelien Bastiaanse,et al.  Spontaneous speech in aphasia: A correlational study , 1989, Brain and Language.

[4]  E. Zurif,et al.  The effects of focal brain damage on pragmatic expression. , 1983, Canadian journal of psychology.

[5]  W. Levelt,et al.  The spatial and temporal signatures of word production components , 2004, Cognition.

[6]  Lewis P. Shapiro,et al.  TrainingWh-Question Production in Agrammatic Aphasia: Analysis of Argument and Adjunct Movement , 1996, Brain and Language.

[7]  R. Brookshire,et al.  A system for quantifying the informativeness and efficiency of the connected speech of adults with aphasia. , 1993, Journal of speech and hearing research.

[8]  P. Pasqualetti,et al.  Patterns of language improvement in adults with non‐chronic non‐fluent aphasia after specific therapies , 2007 .

[9]  G. Ramsberger,et al.  Treatment of agrammatism in long-term Broca's aphasia. , 1986, The British journal of disorders of communication.

[10]  B. Jacobs.  Social Validity of Changes in Informativeness and Efficiency of Aphasic Discourse Following Linguistic Specific Treatment (LST) , 2001, Brain and Language.

[11]  W. Huber,et al.  Agrammatism: Deficit or compensation? Consequences for aphasia therapy , 2000 .

[12]  J. A. Christiansen.  Coherence Violations and Propositional Usage in the Narratives of Fluent Aphasics , 1995, Brain and Language.

[13]  R. Duffy,et al.  Impairments of discourse abilities and executive functions in traumatically brain-injured adults. , 1997, Brain injury.

[14]  Walter Kintsch,et al.  Toward a model of text comprehension and production. , 1978 .

[15]  R. Bracewell,et al.  The Cognitive Representation and Processing of Discourse: Function and Dysfunction , 1990 .

[16]  R. Jakobson.  On Aphasic Disorders from a Linguistic Angle , 1985 .

[17]  Myrna F. Schwartz,et al.  The quantitative analysis of agrammatic production: Procedure and data , 1989, Brain and Language.

[18]  A. J. North,et al.  Production of narrative discourse in aphasia , 1983, Brain and Language.

[19]  Philip N. Johnson-Laird,et al.  Mental Models in Cognitive Science , 1980, Cogn. Sci..

[20]  Willem J. M. Levelt,et al.  A theory of lexical access in speech production , 1999, Behavioral and Brain Sciences.

[21]  H. Goodglass.  Boston diagnostic aphasia examination , 2013 .

[22]  S. Carlomagno,et al.  Expressive language recovery or improved communicative skills: Effects of p.a.c.e. therapy on aphasics' referential communication and story retelling , 1991 .

[23]  P. Doyle,et al.  The Communicative Informativeness and Efficiency of Connected Discourse by Adults With Aphasia Under Structured and Conversational Sampling Conditions , 1995 .

[24]  W. Kintsch.  Text comprehension, memory, and learning. , 1994, The American psychologist.

[25]  C. Snow,et al.  Spontaneous speech of aphasic patients: A psycholinguistic analysis , 1975, Brain and Language.

[26]  Chiara Gagliardi,et al.  Narrative language in Williams Syndrome and its neuropsychological correlates , 2010, Journal of Neurolinguistics.

[27]  Michael Halliday,et al.  Cohesion in English , 1976 .

[28]  Guila Glosser,et al.  Patterns of discourse production among neurological patients with fluent language disorders , 1991, Brain and Language.

[29]  N. Bresolin,et al.  Evaluation of narrative abilities in patients suffering from Duchenne Muscular Dystrophy , 2007, Brain and Language.

[30]  R. Berndt,et al.  Quantitative Analysis of Aphasic Sentence Production: Further Development and New Data , 2000, Brain and Language.

[31]  M. Wilcox,et al.  Adult Aphasia Rehabilitation: Applied Pragmatics , 1985 .

[32]  M. Oelschlaeger,et al.  Application of the correct information unit analysis to the naturally occurring conversation of a person with aphasia. , 1999, Journal of speech, language, and hearing research : JSLHR.

[33]  Sergio Carlomagno,et al.  Age-related Differences in the Production of Textual Descriptions , 2005, Journal of psycholinguistic research.

[34]  S. Sherratt.  Multi‐level discourse analysis: A feasible approach , 2007 .

[35]  W. Levelt,et al.  Speaking: From Intention to Articulation , 1990 .

[36]  M. Garrett.  Levels of processing in sentence production , 1980 .

[37]  Carlo Caltagirone,et al.  The language of schizophrenia: An analysis of micro and macrolinguistic abilities and their neuropsychological correlates , 2008, Schizophrenia Research.

[38]  B. Brown,et al.  A comparison of the speech of adult aphasic subjects in spontaneous and structured interactions. , 1982, The British journal of disorders of communication.

[39]  A. J. North,et al.  Production of narrative and procedural discourse in aphasia , 1981, Brain and Language.

[40]  Noam Chomsky,et al.  The Minimalist Program , 1992 .

[41]  E. Armstrong,et al.  Aphasic discourse analysis: The story so far , 2000 .

[42]  C. Shewan.  The Shewan Spontaneous Language Analysis (SSLA) system for aphasic adults: description, reliability, and validity. , 1988, Journal of communication disorders.

[43]  Willem J. M. Levelt,et al.  The neural correlates of language production , 2000 .

[44]  L. Murray,et al.  Functional measures of naming in aphasia: Word retrieval in confrontation naming versus connected speech , 2003 .

[45]  F. Fabbro,et al.  Assessment of linguistic abilities in Italian children with Specific Language Impairment , 2008, Neuropsychologia.

[46]  C. Snow,et al.  Recovery from aphasia: Spontaneous speech versus language comprehension , 1978, Brain and Language.

[47]  M. Grossman,et al.  Language: Structure, Processing, and Disorders , 1993 .

[48]  G. L. Dorze,et al.  An analysis of the word-finding difficulties and of the content of the content of the discourse of recent and chronic aphasic speakers , 1997 .

[49]  Walter Huber,et al.  Linguistic and nonlinguistic processing of narratives in aphasia , 1982, Brain and Language.

[50]  C. Caltagirone,et al.  The role played by the right hemisphere in the organization of complex textual structures , 2005, Brain and Language.

[51]  K. Ross.  Comparison of impairment and disability measures for assessing severity of, and improvement in, aphasia , 1999 .

[52]  D. Caplan,et al.  Language: Structure, Processing, and Disorders , 1994 .

[53]  Ruth B. Fink,et al.  Mapping therapy: A treatment programme for agrammatism , 1994 .

[54]  K. Yorkston,et al.  An analysis of connected speech samples of aphasic and normal speakers. , 1980, The Journal of speech and hearing disorders.

[55]  L. Obler,et al.  Left and right hemispheric contributions to discourse coherence and cohesion. , 1996, The International journal of neuroscience.

[56]  T. O'Neil-Pirozzi,et al.  Referential Cohesion and Logical Coherence of Narration after Right Hemisphere Stroke , 1997, Brain and Language.

[57]  R. Brookshire,et al.  Speech sample size and test-retest stability of connected speech measures for adults with aphasia. , 1994, Journal of speech and hearing research.

[58]  R. Bastiaanse,et al.  Analysing the spontaneous speech of aphasic speakers , 2004 .

[59]  Gillian Cawthra.  Patterns of Language , 1989 .

[60]  Siobhan Chapman.  Logic and Conversation , 2005 .

[61]  N. helm-estabrooks,et al.  Response of an agrammatic patient to a syntax stimulation program for aphasia. , 1981, The Journal of speech and hearing disorders.