Effects of cognitive and social demands on linguistic production for people with moderate, mild, or no aphasia

Abstract

ABSTRACT Background Most everyday communication occurs in situations where cognitive and social demands are present. These types of situations may compound language deficits for people with aphasia (PWA). An understanding of the language interference that may occur from cognitive and social demands is an important precursor for assessment and intervention that addresses everyday communication situations. Aims To determine how cognitively and socially demanding conditions affect micro- and macrolinguistic production for people with moderate, mild, or no aphasia during narrative discourse and to compare effects among groups. Method Thirty participants with mild (n = 9), moderate (n = 9), or no (n = 12) aphasia completed story-retell tasks in three separate conditions: baseline, unresponsive partner, and dual-task. The stories and conditions were pseudorandomly presented for each participant. A secondary analysis investigated lexical, morphosyntactic, and macrolinguistic production. Results As expected, when compared with baseline, the dual-task condition interfered more with language production than the unresponsive partner condition for all participant groups. Interference on distinct aspects of language production for each participant group, however, was not anticipated. This interference was characterized by significant dual-task costs on (a) macrolinguistic production for participants with moderate aphasia, (b) word productivity and lexical diversity for participants with mild aphasia, and (c) lexical-phonological errors for participants with no aphasia. When compared with baseline, the unresponsive partner led to numerical interference on the same measure and group combinations as the dual-task, but these changes were not statistically significant. Conclusions Cognitive and social demands have different effects on language depending on the presence and severity of aphasia with cognitive demands impacting discourse-level structures for participants with moderate aphasia, lexical-level structures for participants with mild aphasia, and lexical-phonological errors for participants with no aphasia. Future research should identify how these demands could be integrated with assessment and treatment for PWA to help improve everyday communication participation.