Clinical Linguistics Research Articles

Language resources for clinical linguistics: introduction to the special issue

Language resources for clinical linguistics: introduction to the special issue

Preface to the special issue “Typical and atypical speech development in Greek”

ABSTRACT This special issue of Clinical Linguistics and Phonetics presents a selection of papers, four in total, from the first thematic workshop entitled “Phonetic/phonological aspects of typical and atypical speech development with emphasis on Greek” which took place during the 25th International Symposium on Theoretical and Applied Linguistics held at Aristotle University in Thessaloniki in May 2022. It also includes one additional contribution within the thematic scope of the volume that was submitted to the journal independently of the workshop. Papers examine data from different clinical populations, including a clinical case study, as well as data or theoretical background from typical groups. They address aspects of speech production in childhood, adolescence and early adulthood. They thus reflect the aim of the workshop which was to provide a forum to researchers for the exchange of findings covering different populations (typical and clinical), age groups, genders, and various aspects of production. The ultimate goal was the formation of a working group that would bring together researchers with a special interest in phonetics and phonology, explore factors that influence speech acquisition and development in typical and atypical populations, convene and discuss present and future directions in speech acquisition and development with emphasis on the Greek language.

Acoustic Analysis of Fricatives /s/ and /ʃ/ and Affricate /ʧ/ in Persian-Speaking Cochlear-Implanted Children and Normal-Hearing Peers

Background and Aim: Hearing-impaired individuals have difficulty comprehending and producing speech sounds. Cochlear implantation is used to augment hearing. The present study aims to compare the production of fricatives /s/ and /ʃ/ and affricate /ʧ/ by Persian- speaking Cochlear-Implanted (CI) and Normal-Hearing (NH) children Methods: Fifteen Persian-speaking NH children and 15 Persian-speaking CI children, matched for age, gender, and general health conditions, were included in the study. The stimuli included two voiceless Persian fricatives /s/ and /ʃ/ and one voiceless Persian affricate /ʧ/ along with the open front vowel /æ/ in three Consonant-Vowel (CV), Consonant-Vowel- Consonant (CVC), and Vowel-Consonant (VC) contexts (/sæ/, /æsæ/, /æs/, /ʃæ/, /æʃæ/, /æʃ/,/ʧæ/, /æʧæ/, /æʧ/). After recording all utterances, Praat software was used to measure the friction duration, rise time, and spectral peak of the consonants Results: The CI children could not distinguish between /ʃ/ and /ʧ/ and produced affricate /ʧ/ as an allophone of /ʃ/ (p=0.01). Moreover, distinguishing between two fricatives /s/ and /ʃ/ was difficult for both groups. While NH children slightly treated these two sounds differently, the CI group produced fricative /s/ as an allophone of /ʃ/ (p=0.02). The rise time of /ʃ/ was longer in the NH children, except for /ʧæ/, where the CI children had a longer rise time. Conclusion: The speech of CI children is different in producing /s/, /ʃ/, and /ʧ/ from their NH peers. The results can help speech therapists, clinical linguists, and application designers focus on speech sounds that are challenging for CI children to produce. Keywords: Cochlear implant; speech production; fricatives; affricate

Clinical and Linguistic Aspects for Development of the Geriatric Anxiety Scale

In modern clinical practice, there are many conditions and diseases that cannot be detected by diagnostic testing alone due to their poorly understood pathogenesis. This is particularly true for somatoform, stress-related, and anxiety-depressive disorders: they are primarily diagnosed based on the patient’s narrative and the input of their family members, which thus highlights the interdisciplinary nature of the above-stated problem and defines an area ripe for further research in clinical linguistics. This article provides a brief analysis of the psychometric tools commonly used in the diagnostic screening for anxiety and depressive disorders among patients of various profiles. The obtained results show that most screening methods lack any nosological specificity or validity for geriatric practice. A new variant of the geriatric anxiety scale (GAS) was developed with the clinical and linguistic profiles of elderly patients taken into account.

Use of non-invasive transcutaneous auricular vagus nerve stimulation: neurodevelopmental and sensory follow-up.

To assess the impact of non-invasive transcutaneous auricular vagal nerve stimulation (taVNS) paired with oral feeding on long-term neurodevelopmental and sensory outcomes. We tested 21 of 35 children who as infants were gastrostomy tube (G-tube) candidates and participated in the novel, open-label trial of taVNS paired with oral feeding. To evaluate possible effects on development at 18-months after infant taVNS, we performed the Bayley-III (n = 10) and Sensory Profile (SP-2, n = 12) assessments before the COVID pandemic, and Cognitive Adaptive Test (CAT), Clinical Linguistics and Auditory Milestone (CLAMS), Ages and Stages Questionnaire (ASQ), and Peabody Developmental Motor Scales-2 gross motor tests as possible during and after the pandemic. We compared outcomes for infants who attained full oral feeds during taVNS ('responders') or received G-tubes ('non-responders'). At a mean of 19-months, taVNS 'responders' showed significantly better general sensory processing on the SP-2 than 'non-responders'. There were no differences in other test scores, which were similar to published outcomes for infants who required G-tubes. This is the first report of neurodevelopmental follow-up in infants who received taVNS-paired feeding. They had similar developmental outcomes as historical control infants failing oral feeds who received G-tubes. Our data suggests that infants who attained full oral feeds had better sensory processing.

Does splitting make sentence easier?

In this study, we focus on sentence splitting, a subfield of text simplification, motivated largely by an unproven idea that if you divide a sentence in pieces, it should become easier to understand. Our primary goal in this study is to find out whether this is true. In particular, we ask, does it matter whether we break a sentence into two, three, or more? We report on our findings based on Amazon Mechanical Turk. More specifically, we introduce a Bayesian modeling framework to further investigate to what degree a particular way of splitting the complex sentence affects readability, along with a number of other parameters adopted from diverse perspectives, including clinical linguistics, and cognitive linguistics. The Bayesian modeling experiment provides clear evidence that bisecting the sentence leads to enhanced readability to a degree greater than when we create simplification with more splits.

Syntactic complexity of spoken language in the diagnosis of schizophrenia: A probabilistic Bayes network model.

In the clinical linguistics of schizophrenia, syntactic complexity has received much attention. In this study, we address whether syntactic complexity deteriorates within the six months following the first episode of psychosis in those who develop a diagnosis of schizophrenia. We collected data from a cohort of twenty-six first-episode psychosis and 12 healthy control subjects using the Thought and Language Index interview in response to three pictures from the Thematic Apperception Test at first assessment and after six months (the time of consensus diagnosis). An automated labeling (part-of-speech tagging) for specific syntactic elements calculated large and granular syntactic complexity indices with a focus on clause complexity as a particular case from this spoken language data. Probabilistic reasoning leveraging the conditional independence properties of Bayes networks revealed that consensus diagnosis of schizophrenia predicted a decrease in nominal subjects per clause among individuals with first episode psychosis. From the entire sample, we estimate a 95.4% probability that a 50% decrease in mean nominal subjects per clause after six months is explained by the presence of first episode psychosis. Among those with psychosis, a 30% decrease in this clause-complexity index after six months of experiencing the first episode predicted with 95% probability a consensus diagnosis of schizophrenia, representing a conditional relationship between a longitudinal decrease in syntactic complexity and a diagnosis of schizophrenia. We conclude that an early drift towards linguistic disorganization/impoverishment of clause complexity-at the granular level of nominal subject per clause-is a distinctive feature of schizophrenia that decreases longitudinally, thus differentiating schizophrenia from other psychotic illnesses with shared phenomenology.

A tutorial on discourse analysis in healthy and pathological ageing.

Age is a key factor when dealing with language and speech disorders, as it entails a progressive loss of neuroplasticity even in healthy individuals. Apart from this, ageing also affects our word-retrieval abilities, and thus, our discursive skills, particularly in people suffering from neurodegenerative diseases. Therefore, descriptions and/or measures of communicative performance always need to be interpreted through the lens of variation across the lifespan. This paper's main objective is to create a general tutorial for researchers willing to start delving into discourse analysis, both in healthy and pathological ageing. An eight-step tutorial on discourse analysis in the elderly is presented. Each of these steps starts with general recommendations and progresses to more specific topics that may be relevant when conducting this type of research. All of the steps have been extrapolated from an extensive literature review on discourse analysis. This work presents an easy-to-follow, step-by-step tutorial on discourse analysis in the elderly. It is aimed at clinical researchers who are taking their first steps in discourse analysis.It may also be useful for those who are already familiar with the methodology but may be interested in reading a general overview on the topic. Moreover, it offers new insights into the following topics: types of research questions, advantages and disadvantages of the different research methodologies and ethical considerations for data production in clinical linguistics. Discourse analysis in the elderly is a highly complex issue that may require researching from different approaches and disciplines. This implies following a well-planned and thorough process, which we have detailed through the following eight steps: (i) reviewing literature; (ii) formulating the research question; (iii) designing the study; (iv) producing data; (v) selecting technological tools for data treatment; (vi) transcribing the corpus; (vii) annotating the corpus and (viii) analysing and interpreting the results. What is already known on the subject Approaches in discourse analysis in elderly adults, and particularly, in people suffering from dementia have already been analysed by previous researchers and categorised into three main trends: the quantitative-experimental approach, the qualitative-naturalistic approach and an in-between path, the quantitative-naturalistic approach. Also, several handbooks on general discourse analysis have presented comprehensive revisions on potential resources and methodologies that can be applied to researching discourse in elderly populations. What this paper adds to existing knowledge This paper takes these three main approaches and analyses how the most recent research on language in ageing and dementia fits into them. Furthermore, it reviews the advantages and disadvantages each of them may bring for beginners in the field of discourse analysis. Moreover, it adds some studies that may fit into a fourth approach: the qualitative-experimental. This article also presents information about several of the main steps when analysing data from the pragmatic perspective: the formulation of the research question, data production and the transcription/annotation process. What are the potential or actual clinical implications of this work? This work has been devised for linguists who may want to read a systematization of the steps for analysing discourse in elderly populations. It may also be of interest to specialists from different fields such as speech therapy, psychology, gerontology or neurology who desire to start applying methods from discourse analysis in their work and aim to have a comprehensive scope of the main research trends within the field of clinical pragmatics.

The gradual coevolution of syntactic combinatorics and categorization under the effects of human self-domestication: a proposal

The gradual emergence of syntax has been claimed to be engaged in a feedback loop with Human Self-Domestication (HSD), both processes resulting from, and contributing to, enhanced connectivity in selected cortico-striatal networks, which is the mechanism for attenuating reactive aggression, the hallmark of HSD, but also the mechanism of cross-modality, relevant for syntax. Here, we aim to bridge the gap between these brain changes and further changes facilitated by the gradual complexification of grammars. We propose that increased cross-modality would have enabled and supported, more specifically, a feedback loop between categorization abilities relevant for vocabulary building and the gradual emergence of syntactic structure, including Merge. In brief, an enhanced categorization ability not only brings about more distinct categories, but also a critical number of tokens in each category necessary for Merge to take off in a systematic and productive fashion; in turn, the benefits of expressive capabilities brought about by productive Merge encourage more items to be categorized, and more categories to be formed, thus further potentiating categorization abilities, and with it, syntax again. We support our hypothesis with evidence from the domains of language development and animal communication, but also from biology, neuroscience, paleoanthropology, and clinical linguistics.

Development of a normative baseline for speech stability in lingual articulation

In typical speech production, speakers usually use the same articulatory gesture for a particular speech sound in a particular context (such as a /k/ sound after an /i/ vowel). However, since people are not machines, there is inherent variation in how precisely a speech gesture is repeated. Previous research on consistency of tongue articulation has found individual variation in articulatory consistency in tongue posture that may also provide insight into communication disorders, such as stuttering (Frisch et al., 2016, Clinical Linguistics and Phonetics). This presentation will report on pilot data for the development a normative measure for speech stability to establish how much variation is typical for different age groups and whether the complexity of speech materials influences the articulatory measure of speech stability. Included in the pilot methodology are (1) a wide variety of lingual consonants, (2) variation in vowel context, and (3) evaluation of a perceptual proxy measure for speech stability that could be practically used in a clinical environment.

Discourse Diversity Database (3D) for Clinical Linguistics Research: Design, Development, and Analysis

RESUMO O Discourse Diversity Database (3D) é um corpus desenvolvido para a pesquisa em linguística clínica. Ele consiste de amostras de fala oral de três gêneros diferentes: narrativas induzidas por imagens, histórias pessoais e instruções baseadas em imagens. As subdivisões do 3D incluem gravações de falantes de russo de três grupos independentes: pessoas com tumores cerebrais antes e depois da remoção do tumor, pessoas com esquizofrenia e indivíduos neurologicamente saudáveis. O presente artigo é dedicado à descrição do procedimento de coleta de dados, do esquema de anotação e das características específicas de cada subdivisão do corpus.

Discourse Diversity Database (3D) para pesquisa em linguística clínica: projeto, construção e análise

ABSTRACT Discourse Diversity Database (3D) is a corpus designed for clinical linguistics research. It consists of oral speech samples of three different genres: picture-elicited narratives, personal stories, and picture-based instructions. The sub-sections of 3D include recordings by Russian speakers from three independent groups: people with brain tumors before and after tumor removal, people with schizophrenia, and neurologically healthy individuals. This article is devoted to the description of the data collection, the annotation scheme, and the specific characteristics of each sub-section of the corpus.

Становление клинической лингвистики: основные направления исследований когнитивно-речевых нарушений

Cognitive linguistics, psychophysiology, cardiology, and pathological psycholinguistics have common theory and methodology. Clinical linguistics is a new area of research within cognitive science. The authors reviewed domestic and foreign studies of communicative disorders published in 1981–2022. The review focused on the cardiology, neurology, and pathological psycholinguistics of speech abnormalities, which demonstrated similar terminology and methods. The authors identified three research directions: 1) disorders associated with the period of intrauterine, intranatal, or early postpartum development; 2) age-related disorders; 3) disorders caused by a prior disease or brain injury. The language and communication profile of patients with cognitive impairments was different, but all aspects of language and communication fell into the field of psychophysiology, cardiology, and pathological psycholinguistics, thus remaining within an interdisciplinary paradigm. The review highlighted some terminological inconsistency of studies focused on the analysis of language and speech in cognitive linguistics. The authors proved that clinical linguistics is a separate branch of cognitive research that bridges a certain gap between theory and practice. They defined the main objectives of clinical linguistics as the coordination of the conceptual and terminological research apparatus, unification of methodology, and development of unified principles for language and communication research.

Investigação em Bilinguismo. Caminhos percorridos e perspetivas futuras

This article presents a brief discussion of the key questions which were in the focus of interest in research on bilingualism in the last five decades, particularly in the field of bilingual language acquisition. We highlight how the initially negative view of bilingualism has changed based on scientific evidence. The overview starts with a discussion of some of the paths already taken in research on bilingualism, with a focus on the major findings concerning bilingual language development and the consequences of these findings for current views of bilingualism. The discussion moves, then, to the current research questions in this field, discussing the different methodologies used, as well as specific advances in the area of clinical linguistics. We conclude with a discussion on the topics that we believe still need further investigation, namely the nature of the interactions between the language systems of bilingual speakers and the role of the age of onset of bilingualism.

Clinical Linguistics: Analysis of Mapping Knowledge Domains in Past, Present and Future.

Across the world, many infants, children, adults, and elderly people are reported with many types of disorders and disabilities that damage, delay, or impede typical language development and/or use. Speech–language pathologists and other relevant clinicians are responsible for diagnosing, assessing, and rehabilitating these conditions. In nearly all types of disorders or disabilities that affect language, clinical linguistics plays a significant role in their study, diagnosis, and evaluation. This study provides a thorough analysis of the field of clinical linguistics. Data from Scopus, WOS, and Lens were used between 1981 and 2022. The documents included in the analysis were 1685, 1628, and 2677 articles published between 1981 and 2022 in clinical linguistics in Scopus, WOS, and Lens, respectively. For the purpose of assessing the development and impacts of the field of clinical linguistics, we used eight bibliometric and eight scientometric indicators. As part of the study, the results summarized the top contributors to clinical linguistics in terms of production size by year, country, university/research centre, journal, publisher, and author. The impact of the examined evidence on clinical linguistics was visualized and tabulated in the form of visual networks, citation counts, burst, cooccurrence, centrality, and sigma factors that are helpful in identifying the main influencers in clinical linguistics. A few examples of clinical linguistics patterns that are being explored extensively by researchers include cleft palate speech with model theories, visual feedback, motor speech disorders with instrumental analysis, acoustic analysis to understand conversational breakdown, nonlinear phonological theory, aphasic conversation in atypical interaction, and diagnostic markers in functional segments. There are also phonological disorders, William Syndrome, and the use of ultrasound, which may be considered potential clusters of clinical linguistics. A key contribution of this paper is highlighting the importance of clinical linguistics as well as its integration with linguistics, speech–language pathology, neurolinguistics, psycholinguistics, neuroscience, cognitive sciences, psychology, and psychometrics.

Is Collaborative Open Science Possible With Speech Data in Psychiatric Disorders?

Provision of mental health care is almost entirely built on a singular medium—naturally occurring spoken language conversations. However, datasets of spoken language from patients experiencing mental health issues are surprisingly difficult to obtain. In this commentary, we discuss some of the reasons behind this, and highlight successful approaches adopted in other areas of clinical linguistics and pose some ways forward, especially for the study of psychosis. Across disciplines, researchers are rapidly adopting Open Science principles for data sharing. This movement encourages researchers, clinicians, and institutions to provide fully open access to research data, programs, and publications. For example, the National Institutes of Health’s Strategic Plan for Data Science requires that newly funded research projects share data in accord with the FAIR principles1 for open access and that they include in their budget requests for the resources necessary to complete open access. Although many disciplines, funding agencies, researchers, journals, libraries, and institutions have adopted this new model, the movement has also encountered significant resistance, particularly for open sharing of spoken language data, including spoken language data from clinical populations (SLDCP). We can identify at least 6 barriers to open sharing of SLDCP.2 Some of these barriers come from the interpretation of regulations by various institutions, while others pertain to the prevailing public perception regarding SLDCP. Here we consider each of these barriers and the ways in which systems, such as TalkBank3 or Databrary4 manage to overcome them. With emerging collaborative efforts to study language in psychosis (eg, https://discourseinpsychosis.org/), we anticipate the commentary here to eventually inform “speech bank” infrastructures for psychiatric disorders.

Pragmatic impairment and COVID-19

Abstract The COVID-19 pandemic is the greatest global health threat in over 100 years. Its impact is seen in large numbers of premature deaths and the loss of economic stability for many millions of people. A significant number of people who contract the SARS-CoV-2 virus – the virus that causes COVID disease – experience symptoms many months after their acute illness. So-called Long COVID is now a recognized condition, with many affected individuals unable to return to work and engage in other daily activities. Among the complex symptoms of this condition is “brain fog”, a constellation of cognitive-linguistic problems that manifest as forgetfulness, word-finding difficulty, a lack of attention and concentration, and problems engaging in conversation. In this paper, I examine two women who had moderate COVID-19 infection during the first wave of the pandemic in Belgium and the UK. Both participants reported cognitive-linguistic difficulties several months after first becoming unwell. The UK participant is a native English speaker while the participant in Belgium speaks English as a second language. Case studies are used to examine their pre-morbid functioning and lifestyle, the onset and course of their COVID illness, and its impact on their language skills. It is argued that Long COVID has the potential to disrupt pragmatic and discourse skills even as structural language skills are intact. As such, this condition requires further systematic study by clinical linguists and speech-language pathologists.

Optimality of syntactic dependency distances.

It is often stated that human languages, as other biological systems, are shaped by cost-cutting pressures but, to what extent? Attempts to quantify the degree of optimality of languages by means of an optimality score have been scarce and focused mostly on English. Here we recast the problem of the optimality of the word order of a sentence as an optimization problem on a spatial network where the vertices are words, arcs indicate syntactic dependencies, and the space is defined by the linear order of the words in the sentence. We introduce a score to quantify the cognitive pressure to reduce the distance between linked words in a sentence. The analysis of sentences from 93 languages representing 19 linguistic families reveals that half of languages are optimized to a 70% or more. The score indicates that distances are not significantly reduced in a few languages and confirms two theoretical predictions: that longer sentences are more optimized and that distances are more likely to be longer than expected by chance in short sentences. We present a hierarchical ranking of languages by their degree of optimization. The score has implications for various fields of language research (dependency linguistics, typology, historical linguistics, clinical linguistics, and cognitive science). Finally, the principles behind the design of the score have implications for network science.

La interfaz sintaxis-semántica y la lingüística clínica: el algoritmo de enlace de la Gramática del Papel y la Referencia en pacientes con Alzhéimer

"Clinical linguistics analyzes and describes communication and language impairment in patients, a field in which aphasia and phonetic features have been widely studied. In this paper, I propound a syntax-semantics analysis by means of the linking algorithm shown in Role and Reference Grammar (Van Valin and LaPolla 1997; Van Valin 2005), which will be applied to a sample of transcriptions from the corpus compiled by Peraita and Grasso (2010) with patients that suffer from Alzheimer’s disease. Thus, the aims of this paper are, first, to analyze the verb predicates from patients of the first stage of the disease in search of language deficits; and, second, to show how this grammar may improve the description of the language in these patients and its possible early diagnosis. The results manifest that patients use states as the default Aktionsart; they tend to express more simple sentences and clauses than subordinate, coordinate and cosubordinate elements; we also find that most arguments are realized as verbal morphemes; and that patients rely more on the discourse-pragmatic content to compensate their cognitive deficits."

The format of the text as an inclusive practice in modern society

The article discusses discursive treatment of the texts in the context of inclusive pragmatics of the modern society. The key problem the article is devoted to is the necessity to specify the requirements of creating texts for people with cognitive impairment. The goal of the study is to unify theoretical material of clinical linguistics, logopedics and neurology to understand how the recipients with Alzheimer’s disease (primarily on the stage of predementia and on the early stage of the disease) decode texts and to test to what extent the texts created by social institu tions for a wide range of social groups are comprehensible for people with cognitive decline. The empirical material of the article are informational and directive texts located on the in formation boards and stands of social institutions of Krasnoyarsk in 2021. Linguistic features that complicate the text comprehension are inter alia the use of low-frequency words, polyse mes, ambiguous phrases, reversible constructions, inversions. The patients with Alzheimer’s disease and other mental features have difficulties when reading. These difficulties are not taken into consideration when the texts are being created for social groups. The perspectives to provide accessibility of linguistic information for the mentioned group of recipients lie in discursive technology text transformation.