Conceptual, methodological, and clinical considerations for a core outcome set for discourse

Intl J Lang & Comm Disor

Kintz

Zelnosky

et al. 2018

Background Discourse analysis procedures are time consuming and impractical in a clinical setting. Critical to clinicians are simple and informative discourse measures that require minimal time and labour to complete. Many studies, however, have overlooked difficulties that clinicians face. We recently developed core lexicon lists for nouns, verbs, adjectives and adverbs for two narrative discourse tasks with healthy control groups. Core lexicon lists consist of important lexical items required to produce coherently meaningful discourse in response to discourse tasks. Measuring core lexicon is useful for quantifying word retrieval impairments at the discourse level in clinical populations. Aims To apply an age‐based core lexicon list for nouns, verbs, adjectives and adverbs for the wordless picture books Good Dog Carl (1985) and Picnic (1984) and to determine how well the lists measured linguistic impairments in persons with aphasia (PWA). Materials & Methods Lemma forms were extracted from 470 control participants who were divided into seven age groups. Twenty‐five core lexicons were identified for four word classes (nouns, verbs, adjectives and adverbs) among the seven age groups. The nouns, verbs, adjectives and adverbs for each PWA (N = 11) were then compared with the core lexicon for their respective age group. Per cent agreement was computed by comparing the number of total items within each list to the number of items that PWA produced. A Spearman's correlation coefficient was computed between the WAB‐R AQ and the per cent agreement for each word type for PWA. Outcomes & Results The percentage of agreement for each word type among the age cohorts ranged between 56% and 96%. Of the four word types, core verbs significantly correlated with the WAB AQs for both discourse tasks. A post‐hoc analysis found significant differences between fluent and non‐fluent aphasia for core verbs. Conclusions & Implications Core lexicon analysis appears to be a practical way to capture impairments in word retrieval at the discourse level. Core verbs may be a better indicator to understand holistic language performances for PWA. Use of the core lexicon checklist can serve as an option to reconcile ecological validity with clinical usability.

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Measuring word retrieval in narrative discourse: core lexicon in aphasia

Intl J Lang & Comm Disor

Kintz

Zelnosky

et al. 2018

“…The second issue concerns discourse elicitation techniques. 6,[9][10][11] Researchers suggested selecting discourse elicitation techniques that best represent communicative exchanges or best fit with specific outcome measures while realizing the limited time in clinical settings; however, how well these tasks predict real-world communication is not well known. A third point concerns the time and training for completing discourse analysis.…”

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confidence: 99%

“…A fifth point relevant to clinical use of discourse analysis involves the lack of normative data to provide clinical guidance for interpreting results of the analyses. 8,9,21 Without normative data, clinicians are unable to interpret patients' performance, or further assess their linguistic changes following treatment.…”

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confidence: 99%

A Tutorial on Core Lexicon: Development, Use, and Application

Wright

2019

Semin Speech Lang

Evidence suggests that discourse-level assessment in aphasia should be implemented within clinical settings. However, existing discourse measures that are time and labor intensive in process prevent speech-language pathologists from applying such measures to their clinical practices. This article provides an overview of a lexicon-based analysis (core lexicon measure) that recently was developed and investigated for clinical usability. A new approach to core lexicon measures provides a simple scoring method with short instructions, which may be practical and time efficient for assessment and management of persons with aphasia. The article concludes with suggestions for clinical application and implementation.

Concurrent Validity and Reliability of the Core Lexicon Measure as a Measure of Word Retrieval Ability in Aphasia Narratives

Am J Speech Lang Pathol

Wright

2020

Purpose General agreement exists in the literature that clinicians struggle with quantifying discourse-level performance in clinical settings. Core lexicon analysis has gained recent attention as an alternative tool that may address difficulties that clinicians face. Although previous studies have demonstrated that core lexicon measures are an efficient means of assessing discourse in persons with aphasia (PWAs), the psychometric properties of core lexicon measures have yet to be investigated. The purpose of this study was (a) to examine the concurrent validity by using microlinguistic and macrolinguistic measures and (b) to demonstrate interrater reliability without transcription by raters with minimal training. Method Eleven language samples collected from PWAs were used in this study. Concurrent validity was assessed by correlating performance on the core lexicon measure with microlinguistic and macrolinguistic measures. For interrater reliability, 4 raters used the core lexicon checklists to score audio-recorded discourse samples from 10 PWAs. Results The core lexicon measures significantly correlated with microlinguistic and macrolinguistic measures. Acceptable interrater reliability was obtained among the 4 raters. Conclusions Core lexicon analysis is potentially useful for measuring word retrieval impairments at the discourse level. It may also be a feasible solution because it reduces the amount of preparatory work for discourse assessment.