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

Abstract

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

Narrative Discourse Impairments in Persian-Speaking Persons with Traumatic Brain Injury: A Pilot Study

“…They can be fillers, repetitions, or revisions [34]. Phonological errors include phonological and phonetic paraphasias and neologisms [9]. A ratio of verbal errors was then calculated by dividing the total number of verbal errors by the total number of C-units in each discourse sample.…”

“…However, language is a highly complex cognitive function that rests on the interplay between different levels of processing. An interesting approach to solving the problem of narrative processing after TBI might rely on the possibility of performing narrative analysis that takes into account aspects of discourse at different levels [9]. For example, Marini et al [13] compared the narrative discourse of 14 non-aphasic speakers with severe TBI and 14 neurologically intact individuals.…”

“…In contrast to the microlinguistic dimension, which is responsible for intra-sentential functions, the macrolinguistic dimension is responsible for inter-sentential functions. Importantly, the levels of language are deeply interconnected [9]. Recently, growing attention has been devoted to the development of reliable procedures for the analysis of discourse skills in persons with communicative disorders such as those with TBI [10,11,12,13,14,15].…”

Evaluating Personal Stroke Narratives from Bilingual Greek-English Immigrants with Aphasia

“…Research studies reporting on this phenomenon are referenced in three recent reviews addressing discourse production in aphasia: one on describing the linguistic level of analysis [8], the second highlighting current theoretical and methodological challenges [9] and the third reporting on the quality of discourse information measures used in aphasia work [10]. On the whole, at the microstructure level, impaired narrative abilities have been linked to word level deficits [11], difficulties with verb semantics [12] and/or breakdown of sentence structure related to complex verb argument deficits [13]. In contrast, at the macrostructure level, PWA tend to produce coherent narratives regardless of word and surface structure deficits [1, 14].…”

“…Furthermore, significant correlations were observed between naming of nouns and the number of nouns produced in discourse, but not for noun type-token ratios nor between verb naming and number or diversity of verbs. For these reasons, it seems that picture naming of nouns and verbs is not always strongly predictive of discourse performance, and that discourse sampling may actually provide a more accurate measure of word retrieval deficits [11, 32, 33]. In relation to verb semantic complexity (e.g., instrumentality), recent evidence [12] confirms previous evidence from the monolingual aphasia literature [34] and findings reported earlier by Kambanaros and colleagues [29, 31, 32] for bilingual speakers, that PWA have no significant difficulty using semantically heavy verbs (e.g., fishing, building) when describing pictures or producing personal narratives.…”