Spoken Discourse Assessment and Analysis in Aphasia: An International Survey of Current Practices

Abstract

Purpose Spoken discourse analysis is commonly employed in the assessment and treatment of people living with aphasia, yet there is no standardization in assessment, analysis, or reporting procedures, thereby precluding comparison/meta-analyses of data and hindering replication of findings. An important first step is to identify current practices in collecting and analyzing spoken discourse in aphasia. Thus, this study surveyed current practices, with the goal of working toward standardizing spoken discourse assessment first in research settings with subsequent implementation into clinical settings. Method A mixed-methods (quantitative and qualitative) survey was publicized to researchers and clinicians around the globe who have collected and/or analyzed spoken discourse data in aphasia. The survey data were collected between September and November 2019. Results Of the 201 individuals who consented to participate, 189 completed all mandatory questions in the survey (with fewer completing nonmandatory response questions). The majority of respondents reported barriers to utilizing discourse including transcription, coding, and analysis. The most common barrier was time (e.g., lack of time). Respondents also indicated that there was a lack of, and a need for, psychometric properties and normative data for spoken discourse use in the assessment and treatment of persons with aphasia. Quantitative and qualitative results are described in detail. Conclusions The current survey study evaluated spoken discourse methods in aphasia across research and clinical settings. Findings from this study will be used to guide development of process standardization in spoken discourse and for the creation of a psychometric and normative property database. Supplemental Material https://doi.org/10.23641/asha.166395100

Detecting post-stroke aphasia using EEG-based neural envelope tracking of natural speech

“…Standardized aphasia tests use isolated sounds, phonemes, words or short sentences, questioning the ecological validity of such tasks (Hamilton and Huth, 2018). Consequently, research reports a discrepancy between common test outcomes and everyday life speech assessments (Lesser and Algar, 1995; Kim et al, 2022; Stark et al, 2021; Wallace and Kimelman, 2013), and cognitive problems can bias the test result (Fonseca et al, 2019; Rohde et al, 2018). While there exist behavioral natural speech assessments (Armstrong, 2000), they are only limitedly applied in practice due to the high workload (time-intensive) and a lack of knowledge of natural speech analyses (Bryant et al, 2019; Stark et al, 2021).…”

“…Consequently, research reports a discrepancy between common test outcomes and everyday life speech assessments (Lesser and Algar, 1995; Kim et al, 2022; Stark et al, 2021; Wallace and Kimelman, 2013), and cognitive problems can bias the test result (Fonseca et al, 2019; Rohde et al, 2018). While there exist behavioral natural speech assessments (Armstrong, 2000), they are only limitedly applied in practice due to the high workload (time-intensive) and a lack of knowledge of natural speech analyses (Bryant et al, 2019; Stark et al, 2021). Novel automatic speech recognition and natural language processing techniques (Dalton et al, 2022; Jamal et al, 2017; Le et al, 2018) may provide a solution in the future.…”

“…Consequently, there is a discrepancy between clinical assessment and a patient's natural speech abilities in everyday life (Lesser and Algar, 1995;Kim et al, 2022;Stark et al, 2021;Wallace and Kimelman, 2013).…”

“…This contrasts with natural speech processing where language components interact, and higher-level context integration takes place (Hamilton and Huth, 2018; Kandylaki and Bornkessel-Schlesewsky, 2019). Consequently, there is a discrepancy between clinical assessment and a patient’s natural speech abilities in everyday life (Lesser and Algar, 1995; Kim et al, 2022; Stark et al, 2021; Wallace and Kimelman, 2013).…”

Digital Assessment of Acquired Alexia and Agraphia: On the Relevance of Written Discourse

“…The analysis of spontaneous speech or oral discourse is a frequent and important component of aphasia diagnostics (cf. Stark et al, 2021). The Aachen Aphasia Test (AAT, Huber et al, 1983) assesses spontaneous speech based on a semi-standardized interview using six 6level scales (communication, articulation, automated speech, semantics, phonology, syntax).…”