Discourse Characteristics in Aphasia Beyond the Western Aphasia Battery Cutoff

Fromm, Davida; Forbes, Margaret; Holland, Audrey L.; Dalton, Sarah Grace; Richardson, Jessica D.; MacWhinney, Brian

doi:10.1044/2016_ajslp-16-0071

Cited by 97 publications

(51 citation statements)

References 25 publications

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“…Recent evidence suggests individuals with WAB‐R AQ > 93.8 (no aphasia) frequently present with subtle discourse deficits regardless of their normal WAB‐R AQ (Fromm et al . ).…”

Section: Methodsmentioning

confidence: 97%

Gender differences in aphasia outcomes: evidence from the AphasiaBank

Sharma

Briley

Wright

et al. 2019

Intl J Lang & Comm Disor

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Background: Stroke is one of the leading causes of death in the United States. Aphasia is a language impairment which results as a consequence of stroke. Gender differences are reported in underlying mechanisms of stroke, however, gender differences in aphasia type and severity remain unclear. Aims: To examine gender differences in aphasia impairment based on data from AphasiaBank, a research repository of data obtained from studies of aphasia. Methods & Procedures:The data were collected from AphasiaBank for 294 persons with aphasia (PWA) (172 men, 122 women). Baseline comparisons by gender groups were completed using independent samples t-tests and Pearson Chi square statistics. Univariate comparisons of the total Western Aphasia Battery-Revised (WAB-R) -AQ and -R subtests' scores were compared between the two groups using independent samples t-tests. Multivariate comparisons were completed by using multivariate analysis of variance (MANOVA). Outcomes & Results: Gender differences were observed in the severity of aphasia with men exhibiting more severe aphasia than women. Analyses of WAB-R indicated greater impairment among men based on AQ and greater impairment was observed in individual subtest performance. Men exhibited statistically significantly lower WAB-R AQs than women (67.4 versus 75.6). Lower WAB-R AQs were derived from lower scores among men on individual subtests; information content, fluency, repetition, sentence completion, responsive speech and tests of comprehension (yes/no, auditory word recognition and sequential commands). Conclusions & Implications:This study offers evidence of gender differences in aphasia severity, global communication impairment and lower scores on individual subtests used to derive the WAB-R AQ. The limitations of the study with suggestions for future directions are presented.

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“…Recent evidence suggests individuals with WAB‐R AQ > 93.8 (no aphasia) frequently present with subtle discourse deficits regardless of their normal WAB‐R AQ (Fromm et al . ).…”

Section: Methodsmentioning

confidence: 97%

Gender differences in aphasia outcomes: evidence from the AphasiaBank

Sharma

Briley

Wright

et al. 2019

Intl J Lang & Comm Disor

View full text Add to dashboard Cite

show abstract

“…For example, a patient may report language difficulties suggesting presence of aphasia, but scores are at or above the diagnostic cutoff on the WAB-R. Fromm et al recently shed light on the importance of capturing subtle language deficits in these patients, indicating that standardized test batteries are not sensitive to subtle linguistic deficits that can affect discourse-level language production. 67 Returning back to Dalton and Richardson's study, 54 omnibus median test demonstrated that core lexicon measures differed the control group from all aphasia subtypes, including those who have had a stroke but are not aphasic by WAB (NABW; N ¼ 25). The core lexicon measure also differed between the NABW and persons with anomic (p ¼ 0.002), conduction (p < 0.001), and Wernicke's aphasia (p < 0.001) groups.…”

Section: Considerations For Assessmentmentioning

confidence: 96%

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

Kim

Wright

2019

Semin Speech Lang

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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.

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“…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.…”

Section: Main Concept Analysismentioning

confidence: 99%

“…Crucially, AC efficiency and CoreLex scores are sensitive enough to detect differences between healthy controls and those who score above the cut-off for a diagnosis of aphasia, consistent with Fromm and colleagues. 58 Combined with previous research reporting changes in similar informativeness measures in response to treatment, [81][82][83][84][85] and their relationship to measures of quality of life, 62,81 these results suggest that MCA, CoreLex, and derived efficiency scores are informative discourse measures with standardized administration and accompanying normative data 6,32,40,56,57,[59][60][61]64,65 that may be appropriate for use as primary clinical outcomes as defined by Brady et al 2 Primary Progressive Aphasia This is the first study to examine discourse informativeness, typicality, and efficiency in adults with PPA. Individuals with PPA produce discourse that is less informative and efficient, with fewer typical lexical items than healthy controls.…”

Section: Stable Aphasiamentioning

confidence: 99%

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

2019

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Measurement of communication ability at the discourse level holds promise for predicting how well persons with stable (e.g., stroke-induced), or progressive aphasia navigate everyday communicative interactions. However, barriers to the clinical utilization of discourse measures have persisted. Recent advancements in the standardization of elicitation protocols and the existence of large databases for development of normative references have begun to address some of these barriers. Still, time remains a consistently reported barrier by clinicians. Non-transcription based discourse measurement would reduce the time required for discourse analysis, making clinical utilization a reality. The purpose of this article is to present evidence regarding discourse measures (main concept analysis, core lexicon, and derived efficiency scores) that are well suited to non-transcription based analysis. Combined with previous research, our results suggest that these measures are sensitive to changes following stroke or neurodegenerative disease. Given the evidence, further research specifically assessing the reliability of these measures in clinical implementation is warranted.

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Discourse Characteristics in Aphasia Beyond the Western Aphasia Battery Cutoff

Abstract: Individuals with aphasia who score above the WAB-R Aphasia Quotient cutoff demonstrate discourse impairments that warrant both treatment and special attention in the research literature.

Cited by 97 publications

References 25 publications

Gender differences in aphasia outcomes: evidence from the AphasiaBank

Gender differences in aphasia outcomes: evidence from the AphasiaBank

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

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

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