A Large-Scale Comparison of Main Concept Production Between Persons With Aphasia and Persons Without Brain Injury

Abstract

Purpose The purposes of this study are to provide clinicians and researchers with introductory psychometric data for the main concept analysis (MCA), a measure of discourse informativeness, and specifically, to provide descriptive and comparative statistical information about the performance of a large sample of persons not brain injured (PNBIs) and persons with aphasia (PWAs) on AphasiaBank discourse tasks. Method Transcripts of 5 semi-spontaneous discourse tasks were retrieved from the AphasiaBank database and scored according to detailed checklists and scoring procedures. Transcripts from 145 PNBIs and 238 PWAs were scored; descriptive statistics, median tests, and effect sizes are reported. Results PWAs demonstrated overall lower informativeness scores and more frequent production of statements that were inaccurate and/or incomplete. Differences between PNBIs and PWAs were observed for all main concept measures and stories. Comparisons of PNBIs and aphasia subtypes revealed significant differences for all groups, although the pattern of differences and strength of effect sizes varied by group and discourse task. Conclusions These results may improve the investigative and clinical utility of the MCA by providing descriptive and comparative information for PNBIs and PWAs for standardized discourse tasks that can be reliably scored. The results indicate that the MCA is sensitive to differences in discourse as a result of aphasia. Supplemental Material https://doi.org/10.23641/asha.7485647

Using AphasiaBank for Discourse Assessment

“…Dalton and Richardson showed that these MC checklists were sensitive to differences between PWAs and controls, and reported on other MCA research demonstrating reliability in the scoring and test-retest properties. 22 Hameister and Nickels reported that the PWAs produced fewer MCs than the controls and had greater variability in the order of MCs. 3 The MC checklists and information about MC scoring are available at AphasiaBank's Discourse Analysis link.…”

“…Special symbols are used to mark a subset of the MCs in each checklist, indicating those that were spoken by 50 and 66% of the respondents. These results have been used for evaluating the performance of large samples of controls (N ¼ 145) and PWAs (N ¼ 238) 22 as well as a small sample (N ¼ 17) of persons with primary progressive aphasia (see Dalton et al in this issue). Using a criterion of 60% or greater, Hameister and Nickels also created a list of MCs for the Cat Rescue task based on 50 control participants from the AphasiaBank database.…”

Moving Toward Non-transcription based Discourse Analysis in Stable and Progressive Aphasia

“…32 Additionally, a formula for converting codes into scores has been developed by Kong, 56 and modified by Richardson and Dalton. 6 MCA is sensitive to differences between clinical and control populations, 32,[56][57][58][59][60][61] and correlates with listeners' perceptions. 62 Additionally, while different measures have been used (e.g., tau, absolute agreement), all investigations reporting reliability show adequate inter-and intra-rater reliability.…”

“…32 Normative control data, normative PWA data, comparisons between controls and all PWAs, and comparisons of aphasia subtypes to controls have been reported using these checklists. 6,57,64 Although MCA may not have been originally developed with non-transcription based analysis in mind, these tools may allow clinicians to reliably use it in this manner.…”

“…We examined differences in CoreLex scores, CoreLex efficiency (CoreLex/min), and AC main concepts efficiency (AC/min) for the five semispontaneous AphasiaBank discourse tasks reported by Dalton and Richardson. 57 Transcripts with phonetic error coding from 133 healthy controls (60 males, 73 females) and 206 persons with stable aphasia (112 males, 94 females) were retrieved from the AphasiaBank database (see Table 1). Included in the PWA sample were 25 individuals not aphasic by WAB (NABW) with persistent communication difficulties despite scoring above the WAB cut-off.…”