The actual and potential use of gestures for communication in aphasia

Abstract

Background: Two main conflicting positions exist concerning the relationship of gesture and speech. The first claims that gesture and speech constitute a single bimodal production process that leads to an impairment of both communication channels in the case of aphasia. The second accounts for two independent but tightly coordinated processes with a trade-off relationship of gesture and speech. According to the latter assumption, speakers who have aphasia should be able to compensate for their verbal deficiencies through gesture. Studies provide evidence for both accounts. Furthermore, non-verbal capacities like semantic processing or manual praxis have been shown to influence the gestural performance of speakers who have aphasia. Aims: The first aim of the current study was to clarify the relationship between gesture and speech production in aphasia by exploring how much information speakers with aphasia conveyed by gesture versus speech in narrations. The second aim was to evaluate if these speakers make use of their full communicative potential through gesture. We compared gesture use in a verbal narration with gesture use in a silent condition, where participants were not allowed to speak. Furthermore, the influence of language and non-verbal cognitive capacities on gesture was examined. Methods & Procedures:Sixteen participants with varying degrees of aphasia severity retold short video clips in a verbal and a silent condition. In the latter, participants were asked to retell the stories by exclusively using gestures. Subsequently, healthy speakers judged the comprehensibility of gestures and of the spoken expression in the verbal narration in a forced-choice recognition task. Comprehensibility scores were compared between conditions and influencing linguistic and non-verbal factors were evaluated. Outcomes & Results: In the verbal condition, two participants conveyed more information through gesture than through spoken expression. Furthermore, half of the participants could augment gestural comprehensibility in the silent condition. Communicative efficiency of gesture was predicted by the pantomime-to-command test.

Communicative effectiveness of pantomime gesture in people with aphasia

“…In the first of these studies by Hogrefe et al . (), 24 participants with aphasia were required to retell short film clips under two conditions. In the first, ‘verbal’ condition, participants were instructed to retell the story using speech.…”

“…In both studies (Hogrefe et al . , Mol et al . ), the metric used for scoring gesture informativeness was a forced choice: Was this the sweater scenario or the accident scenario, or which of the set of six videos was being narrated.…”

Co-verbal gestures among speakers with aphasia: Influence of aphasia severity, linguistic and semantic skills, and hemiplegia on gesture employment in oral discourse

“…Concerning the employment of gestures among individuals with aphasia, Hogrefe, Ziegler, Weidinger, and Goldenberg (2012) have also recently reported that speakers with severe aphasia tended to employ gestures more as a strategy to convey messages using an alternative means of communication. A follow-up study by Hogrefe, Ziegler, Wiesmayer, Weidinger, and Goldenberg (2013) revealed that some speakers with aphasia used gestures spontaneously to compensate for their limited verbal output and, more interestingly, these co-verbal gestures conveyed more information than the corresponding spoken expression. Parallel to Le May’s (1988) findings of significantly more kinetographs used by speakers with aphasia, Herrmann, Reichle, Lucius-Hoene, Wallesch, and Johannsen-Horbach (1988) reported that speakers with aphasia gestured significantly more frequently and for a significantly longer period of time than their normal conversational partners.…”

SPELTA: An expert system to generate therapy plans for speech and language disorders

“…More recently, Palmer et al (2012) argued that the advances in artificial intelligence and audiovisual signal processing make it possible to automate certain SLT tasks and thus deliver more intensive and efficient therapy out of the clinics, while making better use of the therapists' time. The state-of-the-art in this area includes web-based developments (Ooi, Raja, Sung, Fung, & Koh, 2012), mobile applications (Bunnell & Beidel, 2013) and various types of robots (Choe, Jung, Baird, & Grupen, 2013;Kose, Akalin, & Uluer, 2014), featuring components of voice-based and gesture-based interaction (Hogrefe, Ziegler, Wiesmayer, Weidinger, & Goldenberg, 2013;Sekine & Rose, 2013), avatars in the role of 'virtual therapists' (Abad et al, 2013;Teodoro, Martin, Keshner, Shi, & Rudnicky, 2013), etc. Expert systems have been used in this area, for example, to adapt parameters of the user interfaces, in order to make them more amenable and engaging (Kostoulas et al, 2012).…”