Theoretical and methodological challenges to define a cross-linguistic discourse core outcome set of measures for aphasia

People with aphasia (PWA) typically exhibit deficits in spoken discourse. Discourse analysis is the gold standard approach to assess language deficits beyond sentence level. However, the available discourse assessment tools are biased towards English and European languages and Western culture. Additionally, there is a lack of consensus on which discourse measures to use and limited evidence of the psychometric properties of published discourse measurements. (1) To develop a standardized, norm-referenced, culturally and linguistically appropriate Arabic Discourse Assessment Tool (ADAT); and (2) to examine the psychometric properties of content and construct validity and interrater reliability of different discourse measures elicited using three discourse genres (descriptive, narrative and procedural) in neurotypical control adults and matched PWA. Discourse samples were collected using three novel discourse stimuli that are sensitive to the Arabic language and culture from 70 neurotypical control adults and a matched group of 50 PWA. Transcription agreement was assessed. A standard approach was used to evaluate construct validity and interrater reliability for 16 discourse measures that assess fluency, language productivity, information content, lexical-semantics, lexical diversity, grammatical category, grammatical structure and syntactic complexity. Strong measures were identified based on their psychometric properties, and normative data were established on these measures. Discourse performance of PWA was then examined using the newly developed tool (ADAT). Transcription agreement was extremely high for all discourse stimuli in both groups. Eight discourse measures were proven to have consistently very high construct validity and consistently very good to excellent reliability across the three stimuli in both neurotypical control and aphasia groups: lexical information units, content information units, words per minute, discourse duration, number of different words, number of complete sentences and proportion of open and closed class words. Norms were established on these measures, and cut-off scores of impairments were determined. Other measures showed low construct validity and variable or poor reliability across the two groups. The newly developed, standardized, and norm-referenced tool(ADAT) consist of three discourse stimuli and eight high-quality discourse measures that assess multiple aspects of spoken discourse and were able to differentiate PWA from neurotypical adults consistently. ADAT also includes normative data and cut-off impairment scores. The tool has great potential to enhance clinical practice and research with Arabic speakers. Evidence was provided that not all discourse measures are of high quality, as some are vulnerable to differences between raters, discourse stimuli and groups. Clinicians and researchers can use ADAT for accurate aphasia assessments, better management plans and to monitor therapy effectiveness. ADAT can be further validated in other clinical populations with language impairments. What is already known on the subject Discourse analysis is the gold standard approach to assess language deficits beyond sentence level. However, existing discourse assessment tools are biased towards English and European languages and Western culture. Additionally, there is a lack of consensus on which discourse measures to use in aphasia, and limited evidence of the psychometric properties of published discourse measurements. What this paper adds to existing knowledge A novel, standardized, norm-referenced Arabic Discourse Assessment Tool (ADAT) was developed and validated in this study. ADAT was further validated among PWA. The study provides evidence that not all discourse measures are of high quality and thus should not be used with confidence. Specific measures are vulnerable to the type of stimuli, the rater and/or the tested group. On the other hand, eight discourse measures were identified to be reliable between different raters and across different stimuli for the two groups, and they were able to differentiate the discourse performance of PWA from neurotypical control adults. Normative data derived from neurotypical control adults were established on these strong measures, and the performance of PWA was classified as impaired based on these norms. What are the potential or actual clinical implications of this work? The present study provides a novel, standardized, norm-referenced, validated discourse assessment tool that is culturally and linguistically appropriate for use by Arabic speakers (ADAT). ADAT holds immense potential to enhance clinical practice and research with Arabic speakers. The study also identified strong discourse measures that can be used to assess language productivity, information content, lexical-semantics, lexical diversity, grammatical category, and syntactic complexity for accurate and comprehensive assessments. This will lead to better rehabilitation management by guiding the development of tailored client-centred interventions. ADAT can be utilized in clinical and research settings in PWA and has the potential to be further validated with other clinical populations.

Spoken discourse is integral to everyday communication; improving discourse outcomes is a primary goal for individuals with aphasia and their families. Consequently, the application of discourse analysis in aphasia assessment and treatment has gained increasing attention in both research and clinical settings. Despite its recognized value among researchers and clinicians, several barriers-such as limited time, inadequate training, and lack of resources-continue to impede the widespread use of discourse analysis into clinical practice. To facilitate its broader adoption, speech-language pathologists require access to comprehensive resources that include information on discourse tasks, outcome measures, psychometric properties, and practical examples of how to implement spoken discourse assessments effectively. The purpose of this tutorial is to equip clinicians with this knowledge, promoting the consistent and effective application of discourse analysis in clinical settings. This tutorial, developed by members of the FOQUSAphasia Writing Group-comprising both researchers and clinical practitioners-offers an overview of recommended spoken discourse collection and analysis procedures, outcome measures, and their psychometric properties, as well as factors to consider when planning to conduct discourse assessments. It includes a series of case studies (severe aphasia, latent or very mild aphasia, bilingual aphasia, and primary progressive aphasia) that illustrate the utility of discourse analysis for varied clinical contexts and shows how the choice of tasks and measures can reveal meaningful insights tailored to the individual being assessed. In addition, the tutorial provides practical recommendations and considerations for incorporating discourse analysis into clinical aphasia services, along with suggestions for future research. Spoken discourse production can be an important indicator of communication ability in individuals with aphasia. This tutorial is intended to support clinicians by providing evidence-based, practical ways for integrating discourse analysis into aphasia assessment and treatment. Our collation of information and case studies should encourage clinicians to apply spoken discourse-based approaches, ultimately improving outcomes for individuals with aphasia. https://doi.org/10.23641/asha.29287505.

Aphasia Assessment in Chinese Speakers

جنگ سرد از پایان جنگ جهانی دوم در سال 1945 م آغاز شد و تا فروپاشی اتحاد جماهیر شوروی در اوایل دهه نود ادامه داشت. در مورد ایران نیز بحران آذربایجان رابطه ایران و آمریکا را وارد مرحله تازه‌ای کرد، به‌گونه‌ای که اهمیت استراتژیک ایران به‌ عنوان بخشی از کشورهای «حلقه شمالی» برای ایالات متحده به اثبات رسید. از شهریور 1320 تا مرداد 1332 چهار گفتمان اصلی در ایران وجود داشت: پادشاهی، مارکسیستی، اسلامی، و ملیت‌گرایی. در این دوره مطبوعات از آزادی فراوانی برخوردار بودند و رمان پاورقی فارسی نیز پر رونق بود. در این مقاله، براساس رویکرد تحلیل‌گفتمانی لاکلائو و موفه، رمانی از هفته‌نامه تهران مصور، با عنوان من جاسوس شوروی در ایران بودم بررسی شده‌است. نتایج این بررسی نشان می‌دهد گفتمان مفصل‌بندی ‌شده در این رمان با گفتمان پادشاهی همسانی کامل دارد. روایت راوی آشکارا به بعدهای گفتمان شوروی یعنی رفاه و عدالت و آزادی حمله می‌کند و این سه را در جریان روایت چونان دال‌های شناوری در نظر می‌گیرد تا در گفتمان خود مفصل‌بندی کند. بعد دیگر این گفتمان، یعنی انترناسیونالیسم، که در تضاد آشکار با ناسیونالیسم راوی است، نیز در این رمان کاملا انکار می‌شود. درنتیجه این رمان در قالب شرایط جنگ سرد و تأثیر آن بر ایران آن سال‌ها قابل‌تحلیل است.

Social media is being employed to build support for social, economic, and political justice (Selander et al. 2016; Vaast et al. 2014) in movements such as occupy Wall Street, violence against women's movement and global sustainability movement. These movements have used social media in ways that goes beyond simple communications. As social media allows people to produce and share user generated content, they enable a certain set of affordances of these technologies (Bharati et al 2015; Bharati et al 2014). The social media affordances, available to both collective and individual actors, translate into capabilities afforded to social movements (Tufecki 2014). Research on connective action has examined the effects of digital action repertoires on interaction and engagement such as in the Tea Party and Occupy movements (Agarwal et al. 2014; Selander et al. 2016). Social media can also facilitate mobilization of movement and participation by new volunteers and oftentimes provides a transnational character by diffusing actions beyond the virtual (Van Laer and Van Aelst 2010). Conversation, an essential part of social movements, shapes “social life by altering individual and collective understandings, by creating and transforming social ties, by generating cultural materials that are then available for subsequent social interchange, and by establishing, obliterating, or shifting commitments on the part of participants&x201D; (Tilly 2002, p. 122). In a personal interaction that involves repeated organized interactions between individuals, typically, leads to shared values and trust. The role of social media technologies in furthering this conversation has to be studied and its' influence on social movement ascertained. A few scholars have started to investigate social media affordances and capabilities, especially focused on discourse, during contentious collective action. Still the research has been limited to studying mechanisms of participation, development of a sense of collective identity, creation of community, and framing of political discourse (Farrell 2012; Garrett 2006). Social media data on social movements can involve impersonal “like&x201D; and “share&x201D; to more engaged conversations. Twitter, Instagram, Facebook, and YouTube offer a wide communicative and discourse reach in networks with text, image, audio, and video data. This social media based big data, consisting mostly of unstructured data, comes in the form of social media posts, digital pictures and videos. The symposium will discuss how formal organizational structures and practices might be integrated with social media capabilities to reinforce and enhance social movement organizations as leaders in social change movements. It will explore the characteristics of social media discourse and assess the dynamics of social movements and, subsequent, impact on real-world protests. The symposium will also demonstrate how discourse analysis can be applied visually in order to understand communication patterns. The panel symposium will focus on theoretical and methodological challenges of social media analytics, big data and social movements. Panelists will engage the audience in an interactive discussion on: 1) Theoretical challenges: a. How and why are social movement recruitment and engagement mechanisms being impacted as a result of social media? b. How do we advance theory on social media and social movements when we are overwhelmed with social media based big data? c. What approach should we undertake if big data analysis contradicts most theories on social media and social movements? d. How do we address the issue of generalizability of social media and social movement research when data collection was limited to one social media platform, albeit involving big data? 2) Methodological challenges: a. What methodological approaches have worked in the analysis of social media, big data and social movements? b. How can discourse analysis be applied visually in order to understand communication patterns evident in social media-based big data? c. How can we employ social media analytics to investigate image and video data? d. What combinations of qualitative and quantitative methodologies be employed for big data and social media analytics in the context of social movements? e. What are the limitations of quantitative data analysis techniques, such as structural equation modeling, because of an extremely large sample size? f. What are the limitations of qualitative data analysis techniques as they become extremely labor intensive and, maybe even, impractical because of big data?

A comprehensive aphasia assessment is necessary to diagnose the type and severity of aphasia differentially and guide appropriate interventions. One component of an aphasia assessment is the picture description task (PDT), designed to probe spontaneous speech fluency and information content. Most aphasia assessments use black-and-white line drawings (LD) to elicit spontaneous language samples from people with aphasia (PWA). However, recent studies reported two visuographic variables: (1) colour (over black and white) and (2) photograph (over LD), that tended to encourage easier and faster comprehension and increased overall naturalistic language production from neurologically healthy individuals as well as PWA. Additionally, a suitable stimulus for a PDT should always be culturally relevant to the target population. Therefore, we suggest that a new PDT must include a culturally appropriate colour photograph (CP). To investigate if a culturally appropriate CP elicits longer and more complex utterances than a culturally appropriate black-and-white LD from neurologically healthy native Bangla speakers. A total of 30 participants (mean age = 36.03 years) were recruited based on self-reports of no known impairments in cognition, language, vision and hearing. All were of middle socioeconomic status with at least 12 years of formal education. A culturally appropriate CP was selected showing multiple characters performing various functions. Later, an artist prepared the black-and-white LD of that CP. The elicited language samples using these two pictures were transcribed and coded following preset transcription and coding guidelines. The transcribed samples were further analysed using the Bangla adaptation of Systematic Analysis of Language Transcripts (SALT) software. To identify the differences in language production between these two picture types, investigators used four measurement variables: mean length of utterances (MLU), complexity index (CI), total number of words (TNW) and words per minute (WPM). Of the four measures, only MLU showed a statistically significant difference between the CP and the black-and-white LD. CI demonstrated a strong correlation with MLU for the CP, which indicates that the participants who produced higher MLU for the CP also produced a higher CI for the CP. There were no significant differences between the two picture types for CI, TNW and WPM. This study found that the grammatical complexity, as measured by MLU, of spontaneous language production of neurologically healthy adults was higher when a CP was used in a PDT. A CP may also be beneficial for PWA to produce complex language samples. What this paper adds What is already known on the subject There are studies on neurologically healthy individuals as well as on PWA that identified the impact of using different visuographic variables (colour and photograph) separately, which enhanced the picture comprehension and improved performances on associated language production tasks. To our knowledge, no studies have identified the combined impact of these two visuographic variables on spontaneous language production. Therefore, this initial study on neurologically healthy Bangla adults reports the impact of using a CP as a stimulus item for a PDT task to elicit spontaneous language samples. What this paper adds to existing knowledge This study reports that using a culturally appropriate CP for a PDT enhances the grammatical complexity of spontaneous language production of neurologically healthy adults. To our knowledge, this is the first study in Bangla that used the MLU as a measurement variable to analyse adults' spontaneous language production. What are the potential or actual clinical implications of this work? The development of future aphasia assessments should consider incorporating CPs as stimuli for PDTs, which may guide speech-language pathologists to provide accurate diagnoses for aphasia and related language disorders.

Cameron, L., & Maslen, R. (Eds.). (2010). Analysis: Research Practice in Applied Linguistics, Social Sciences and the Humanities. London: Equinox. 306 pages. 978-1845534479 This book is a thorough summary of the project named Metaphor Analysis: Theoretical and Methodological Challenges in using Discourse Data, which was supported by the UK National Centre for Research Methods. There is also a parallel website from the Open University introducing the main intention, theoretical background, as well as some empirical studies discussed in the book. As is stated in the preface, the crucial point made in this book is that metaphor can be regarded not only as a research object but also a research (vii). The latter one has been explained in detail in the book, which is named by researchers as discourse (vii). Some studies have been done by applying this method to analyse spoken data. This book is a thorough summary of the project named Metaphor Analysis: Theoretical and Methodological Challenges in using Discourse Data, which was supported by the UK National Centre for Research Methods. There is also a parallel website from the Open University introducing the main intention, theoretical background, as well as some empirical studies discussed in the book. As is stated in the preface, the crucial point made in this book is that metaphor can be regarded not only as a research object but also a research (vii). The latter one has been explained in detail in the book, which is named by researchers as discourse (vii). Some studies have been done by applying this method to analyse spoken data. This book contains four sections and one concluding part. There are 15 chapters altogether distributing unevenly into the five sections. Section 1 and Section 2 deal with the motivation and theoretical approaches on metaphor analysis. Section 1 provides an overarching view on metaphor analysis, explains the powerfulness of metaphor being used as a tool to do discourse analysis with an empirical study done by Cameron who put forward the discourse dynamics approach to metaphor (cf. Cameron, 2003, 2007a; Cameron et al., 2009) which has been depicted in details in Section 2 Chapter 5. Meanwhile, some studies have been chosen to illustrate how metaphor analysis can be implemented in practice, comments on these studies are also provided with the purpose of providing some reference for the readers of the book to carry out their own research. Section 1 contains two chapters. Chapter 1 was contributed by Lynne Cameron, and Chapter 2 was co-written by Zazie Todd and Graham Low. Chapter 1 was written to argue that metaphor is crucial in human communication, understanding and conveying feelings. Therefore, metaphor-led discourse analysis has great potentiality and feasibility in doing discourse analysis. Cameron uses Burke's (1945) quotation to simply define metaphor. On the one hand, she points out the core of metaphor: using two different concepts to express one in terms of the other for better understanding. On the other hand, she puts forward the multidimensional nature of metaphor. In other words, a more adequate understanding on the phenomenon of metaphor needs to involve linguistic, embodied, cognitive, affective, socio-cultural, dynamic (p.1) considerations. To explain the linguistic aspect of metaphor in this book, Cameron first gives the working definitions of 'discourse' and 'discourse events'. Discourse is termed as the interactions (p.1) which involve the use of language, discourse events relate to the specific instances (p.1) of social interaction. in discourse is the key concept used in the book both as a tool and as an object. The use of 'linguistic metaphors' captures metaphors that are found in language use(p.2), which is different from the notion of 'conceptual metaphor' in conceptual metaphor theory. …

Identifying meaningful absences in discourse presents numerous theoretical and methodological challenges, some of which are addressed in this chapter. Section 8.1 focuses on how different types of discourse studies, namely Critical Discourse Analysis and French Discourse Analysis, approach absence. Among the numerous types of absence that researchers from these fields distinguish, this study concentrates on what does not need to be said because it is shared knowledge, on the one hand, and on what cannot be said because it would be socially unacceptable or make a text incoherent, on the other. In this perspective, the challenge for the analyst is not to find out what the speaker’s intentions nor the recipient’s expectations are, but to create the conditions in which he or she will be able to identify discursively relevant silences. Section 8.2 concentrates on analytical procedures for the detection of absences. Methodological tools developed by French Discourse Analysis are reviewed and completed by procedures capable of detecting absences that are not ‘signalled’ in discourse by any kind of specific ‘absence markers’. In a mapping, different analytical procedures are linked to various levels of ‘presences’ and ‘absences’ in discourse, which are in turn linked to different levels of consensus or disagreement on representations. This section also shows how analysing what is said and not said by means of the mapping helps to understand on-going social change. Finally, the methodology is illustrated by excerpts from studies on data sets in French, German and English from parenting guidebooks, intercultural parenting books and history textbooks.

1. Preface (by Thelin, Nils B.) 2. List of Contributors 3. Introduction: Verbal in Discourse$$On the State of the Art (by Thelin, Nils B.) 4. 1. Developmental properties of aspect and tense 5. On the Concept of Time: Prolegomena to A Theory of and Tense in Narrative Discourse (by Thelin, Nils B.) 6. The Functional Evolution of Aspects in Russian (by Holden, Kyril T.) 7. Discourse Functions of Tense-Aspect in French: Dynamic Synchrony (by Waugh, Linda R.) 8. 2. Ideo-pragmatic and conceptual-semantic correlates of aspect and the perspectival organisation of discourse 9. Notes on the Metaphysics of Russian (by Gasparov, Boris) 10. Verbal Aspect, Discourse Saliency, and the So-Called Perfect of Result in Modern Russian (by Chvany, Catherine V.) 11. Discourse Analysis of Aorist and Imperfect in Bulgarian and French (by Descles, Jean-Pierre) 12. Narrative Context and Russian (by Fielder, Grace E.) 13. Temporal and Semantic Factors Affecting Russian Choice in Questions (by Chaput, Patricia R.) 14. Russian in Questions: Information and Invariance in Discourse (by Merrill, Peter T.) 15. 3. Aspect, case and discourse 16. The Aspectual Case of Predicative Nouns in Lithuanian Texts (by Timberlake, Alan) 17. On Finnish Aspect in Discourse (by Tommola, Hannu) 18. 4. in Russian literacy discourse 19. in Textual Deep Structure: On the Message Theme of Puskin's The Bronze Horseman (by Holk, Andre G.F. van) 20. Narrative Description or Descriptive Narration: Problems of Aspectualityt in Cechov (by Alberg Jensen, Peter) 21. Index of proper names 22. Index of Languages 23. Index of Topics

The following article seeks to be a theoretical and methodological contribution for those who are faced with the task of realizing discourse analysis. In this sense, this text is especially directed to students who intend to perform this task in their thesis. In order to achieve this theoretical and methodological challenge, all along the article, it will be answering two questions: Why doing discourse analysis? and How is discourse analysis performed? As we may observe, the first question is of an explicative nature and the second has a methodological character.

[In this paper we present a new methodological approach for the analysis of public discourses aiming at the semi-automated identification of arguments by combining methods from discourse analysis with methods from Natural Language Processing. Discourses evolve over long periods of time and, consequently, form a broad database. Up to now, the analysis of discourses is hitherto performed primarily by hand, i.e., only small corpora or discourse fragments can be analyzed. Inevitably, this leads to lengthy and expensive annotation. Thus, there is a growing interest to overcome these methodological challenges by the use of computer-based methods and tools for the semi-automated analysis. However, there are only few approaches known that focus on the analysis of discourses and the (semi-)automated identification of arguments therein (e.g. Reed at al., 2008; Liakata et al., 2012; Ashley and Walker, 2013). Particularly, approaches that can be explicitly used for the analysis of German-language discourses exist only in initial stages. Therefore, we suggest a fine-grained semi-automated approach based on multi-level annotation that focuses on linguistic means as indicators of arguments. The aim is to identify regularities, respectively, indicators in the linguistic surface of the discourse (e.g. recurring lexical and typographical characteristics), which indicate the occurrence of certain arguments (e.g. premise). In this paper, we focus on the identification of indicators of argumentconclusion relationship: conclusive connectors or conclusiva, that are typically adverbs such as hence, consequently, therefore, thus, because (Govier, 2013; see example below): Die Campusbahn werde den Individualverkehr verdrangen, weil die Stadt eng bebaut sei. Schon in den 1970er Jahren sei deshalb das Aus fur die Strasenbahn besiegelt worden. [The campus train will displace the individual traffic because the city is densely built. Therefore, the end for the tram was sealed in the 1970s.] As an application example, a small corpus consisting of 21 newspaper articles is analyzed. The corpus belongs to the interdisciplinary project Future Mobility (FuMob), which is funded by the Excellent Initiative of the German federal and state governments. The methodological approach consists of three steps, which are performed iteratively: (1) manual discourselinguistic argumentation analysis, (2) semiautomatic Text Mining (PoS-tagging and linguistic multi-level annotation), and (3) data merge. (1) Discourse-linguistic argumentation analysis: First, the data is manually analyzed. Objectives of the analysis are (i) identifying discourserelevant arguments, (ii) forming argument classes, and (iii) determining the significance of an argument in the discourse (Niehr 2004). To determine the significance of an argument the use by various discourse participants is analyzed and quantified. The argument-use can be categorized as argumentative, positively cited, negatively cited or neutrally cited. In addition, to identify arguments and their use in public discourse, the analysis also aims to detect and characterize discourse participants who use similar arguments.

Aphasia assessment is crucial in diagnosing aphasia, determining the extent of language impairment, and identifying factors that may support or restrict aphasia recovery to design an appropriate plan of care for people with aphasia. Speech-language therapists (SLTs) play a major role in conducting aphasia assessments. Little is known about the practices of SLTs in assessing aphasia in low-resource regions. The present study aims to identify aphasia assessment practices among Malaysian SLTs and related challenges, as well as strategies for improving aphasia assessments from SLTs’ perspectives. A total of 32 SLT participants who have been practicing in Malaysia completed an online survey to gather their background information, data pertaining to practices and challenges in conducting aphasia assessments, and suggestions for improving aphasia assessments. Descriptive analyses were conducted for all numerical data. Suggestions for improving aphasia assessment practices were analysed qualitatively using the thematic content analysis approach. SLT practices in aphasia assessment were found to be consistent in certain aspects, but not all. Two major challenges were identified: (a) linguistic barriers between clinicians and clients/caregivers, and (b) a lack of standardized assessment tools for aphasia evaluations. Participants suggested “Internal Strategies” and “External Strategies” for improving aphasia assessment practices. Keywords:aphasia; clinical practices; Malaysia; speech-language therapists

This article analyses the role of Pan American Airways (Pan Am) in the shaping of the ‘Space Age’.The study arises out of our interest in the role of the organization in the development of discourse (Foucault 1979).While much has been written on discourse (Phillips and Hardy 2002) there have been few applied studies, and they tend to focus on the reproduction of discourse (e.g.New Public Management) within organizations (Thomas and Davies 2004) rather than on the role of organizations in the production of discourses. Pan Am was studied because of its role in the development of the US space program; its prominence as a major international company; and the availability of an extensive archive of company materials. Using critical hermeneutics (Prasad and Mir 2002), discourse analysis (Phillips and Hardy 2002), and archaeo-genealogical historiography (Rowlinson 2004), we examined the implications for organizational management and the study of organizational and management history.We conclude that the study of organizations as sites of discourse production is a fruitful area for further research; drawing attention to the implications for change by revealing the importance not only of the ‘localized’ aspects of discourse but also the discursive character of analyses of ‘the past’.

ABSTRACTBackground: Discourse analysis allows the examination of functional and ecological language impairment in post-stroke aphasia. Given its complexity, various methods of analysis have been developed to measure the multiple components of discourse. Clinical assessment usually includes discourse analysis, but how clinicians should assess recovery of discourse, particularly in acute care settings, is still a matter of debate.Aims: This study aimed to measure improvements in discourse production in early post-stroke aphasia recovery.Methods & Procedure: Twenty-three persons with aphasia following a first left middle cerebral artery stroke were recruited in the stroke unit of Hôpital du Sacré-Coeur de Montréal (May 2015-July 2018). Patients treated with thrombolysis (n = 10) and untreated patients underwent two aphasia assessments (0 to 72 hours, 7 to 14 days post-onset). Discourse assessment consisted of the picture description task from the Western Aphasia Battery. Changes in microlinguistic and thematic informativeness measures between the two assessment periods were analyzed.Outcomes & Results: In-depth microlinguistic analyses showed no significant difference between the initial and follow-up assessments. Conversely, some thematic informativeness variables improved significantly during the same time period. Patients treated with thrombolysis produced more thematic units than untreated patients at both assessments, but the change between the two groups was not significant.Conclusions & Implications: This study suggests that thematic informativeness variables are sensitive to language improvement in early post-stroke aphasia recovery whereas no microlinguistic variables improved significantly in the same period. In contrast to previous evidence, the difference between patients treated with thrombolysis and untreated patients was not evident over time. The results suggest that thematic informativeness constitutes an interesting path to explore as a routine clinical assessment in acute-care settings because it is time-efficient, simple to conduct and reliable in assessing early changes in the discourse production of individuals with aphasia in the acute post-stroke phase.

Although various hop tests have been proposed as performance-based outcome measures following anterior cruciate ligament (ACL) reconstruction, limited reports of their measurement properties exist. The purpose of this study was to investigate the reliability and longitudinal validity of data obtained from hop tests during rehabilitation after ACL reconstruction. Forty-two patients, 15 to 45 years of age, who had undergone ACL reconstruction participated in the study. The study design was prospective and observational with repeated measures. The subjects performed a series of 4 hop tests on 3 separate occasions within the 16th week following surgery and on a fourth occasion 6 weeks later. The tests were a single hop for distance, a 6-m timed hop, a triple hop for distance, and crossover hops for distance. Performance on the ACL-reconstructed limb was expressed as a percentage of the performance on the nonoperative limb, termed the "limb symmetry index." Subjects also completed the Lower Extremity Functional Scale and a global rating of change questionnaire. Intraclass correlation coefficients for limb symmetry index values ranged from .82 to .93. Standard errors of measurement were 3.04% to 5.59%. Minimal detectable changes, at the 90% confidence level, were 7.05% to 12.96%. Changes in hop test scores on the operative limb were statistically greater than changes on the nonoperative limb. Pearson correlations (r) between change in hop performances and self-reported measures ranged from .26 to .58. The results show that the described series of hop tests provide a reliable and valid performance-based outcome measure for patients undergoing rehabilitation following ACL reconstruction. These findings support the use and facilitate the interpretation of hop tests for research and clinical practice.