Exploring the use of co-speech hand gestures as treatment outcome measures for aphasia

Abstract

ABSTRACT Background Research on aphasia treatments that directly target conversation skills have been on the rise in the recent past. Despite the ubiquitous nature of gestures in everyday conversations and their possible compensatory and/or supportive functions for adults with aphasia, the conversational treatment outcome measures continue to rely on spoken language alone. Aims We aimed to explore the feasibility of using co-speech hand gestures as a treatment outcome measure in Clyde, an individual with chronic and severe Wernicke’s aphasia. Methods & Procedures Using a multiple-probe single-case experimental research, we examined data from one participant with aphasia (Clyde) who was a part of a larger study involving 3 people with aphasia (Devanga, 2020). 10-minute conversations between Clyde and clinician, and Clyde and his spouse, were completed during 3 baseline probes, 3 treatment probes and 3 maintenance probes. Clyde also completed a 15-session Collaborative Referencing Intervention (CRI; Devanga etal., 2021) with the clinician. The 18 conversation samples were videorecorded, transcribed, and analysed. Outcomes & Results The outcomes analysed included overall gesture frequency and type (i.e., referential vs. non-referential) across sessions (baseline – treatment – maintenance) and partner familiarity (clinician – spouse). We also compared the gesture outcomes with the spoken language measure, CIUconv (Correct Information Units). Overall gesture frequency was higher with the clinician than the spouse, and the frequency of referential gestures were higher than the non-referential gestures with both partners. With the onset of treatment, we found that overall gesture frequency decreased and #CIUconv increased with the clinician, however there were minimal variations across phases with the spouse. Additionally, with the onset of treatment, referential gestures decreased, and non-referential gestures increased with both partners. Conclusions Findings from this exploratory study provide preliminary support to using co-speech hand gestures as treatment outcome measures for aphasia. Clinical implications including comparisons of gestural outcomes with spoken language outcomes and their implementation are discussed. Further research on differences in gesture use among aphasia types and severities and patterns of change in gesture use with aphasia treatment is warranted.