Discourse Macrostructure Research Articles

A feasibility randomised waitlist-controlled trial of a personalised multi-level language treatment for people with aphasia: The remote LUNA study.

Stroke survivors with aphasia want to improve their everyday talking (discourse). In current UK practice, 90% of speech and language therapists believe discourse assessment and treatment is part of their role but are hampered by barriers in resources, time and expertise. There is a clinical need for well-articulated discourse assessment and treatments. LUNA is a multi-level treatment targeting words, sentences and discourse macrostructure in personal stories that addresses this clinical need. This study aimed to assess the feasibility and acceptability of LUNA trial procedures in a randomised waitlist-controlled trial; and to evaluate preliminary efficacy. This paper reports a phase II, waitlist-controlled, proof-of-concept feasibility trial. Participants with chronic aphasia (n = 28) were recruited from the community and randomised to an Immediate (n = 14) or Delayed (n = 14) group. LUNA treatment was delivered twice weekly for 10 weeks via the videoconferencing technology, Zoom. Feasibility was assessed in terms of participant recruitment and retention, adherence, missing data, and treatment fidelity. Preliminary treatment efficacy was assessed in terms of between group differences in outcome measures relating to discourse, language, and psychosocial state. The remote LUNA trial was feasible: 85% of those eligible consented to the trial; trial retention was 86%; 87% of treatment sessions were delivered as scheduled, and 79% of participants completed 80%+ of the treatment programme; data was missing only for participants who withdrew; treatment fidelity was high at 92% adherence; and only one clinical outcome measure demonstrated ceiling effects. ANCOVA analysis of the clinical outcome measures revealed group differences with medium and large effect sizes, indicating, improvements in the production of words, sentences, discourse macrostructure, overall language functioning (WAB-R), and psychosocial state (VAMS) following LUNA treatment. For most outcomes measured, similar treatment benefits were suggested in a secondary, non-parametric analysis. Large-scale evaluation of the clinical efficacy and cost-effectiveness of LUNA is warranted and supported by these findings. Clinical trials registration: NCT05847023 (clinical trials.gov).

Swearing, discourse and function in conversational British English

In this paper we look at the role that macrostructures in discourse have to play in the study of swearing. While studied in isolation, such macrostructures have not yet been studied comprehensively and the range of macrostructures studied has been small. By contrast, work on microstructures is much better developed. In response to this, using spoken corpus data from the BNC2014, we take two approaches to studying discourse in this paper. In the first approach, we explore spoken data which has been annotated with a functional discourse coding scheme that shows, across the corpus, the distribution of a set of macrostructures, discourse units, that generally characterise conversation. Our goal is to see how swearing distributes according to discourse unit function and to account for any observations made. Following from that, we explore a single macrostructure of discourse - narrative, including its sub-elements - to see whether swearing interacts with this macrostructure and its component parts. We conclude by arguing that discourse is an important dimension along which the use of swearing may vary, that such variation is likely to relate to emotion, and that the different perspectives on macrostructure taken in the paper are complementary.

Cognitive-communication disorder following right hemisphere damage: Narrative production.

Cognitive-communication disorder (CCD) results from the association of language and cognition impairment that may follow right hemisphere (RH) damage and impair the quality of life of affected persons. We studied a set of 1,625 narratives produced by a cohort of 125 individuals (50 with a single right vascular lesion in the MCA territory and 75 cognitively healthy controls) using a task of picture-based discourse production. Discourse production was analyzed in its macro-and microlinguistic aspects to characterize better the linguistic mechanisms underlying RH patients' performance. The RH group produced more words and elocutions than controls, with a lower rate of informational content and a higher percentage of global coherence errors (all p-values <0.0001). Individuals with RH lesions showed formal lexical and syntactic aspects of discourse mostly preserved. Alterations in the macrostructure of discourse prevailed over microstructural alterations in our sample, according to most literature studies. The group of individuals with RH lesions produced narratives containing more words and utterances, with a lesser degree of lexical information and more global coherence errors.

Sanctifying Microstructure in the Qur’anic Discourse: A Contextual Study

This research is an analytical analysis of Surat Al-Baqarah Verse No. 214, with an explanation of its situational context. This study aims to demonstrate the aspects of contextual analysis and its continuous horizons that are provided not only by the macro-structure of discourse, which is represented by default rules and semantics of rhetorical terms, but also by the micro-structure of discourse, which is represented by default rules and semantics of rhetorical terms. We recognize the perspectives, distinctions, and elements that are employed in lighting the discourse to impair the speaker's goals in order to achieve the eloquence of persuasion, communication, and comprehension through the micro-structure of discourse.

NEUROPSYCHOLOGICAL EVALUATION OF NARRATIVE DISCOURSE PATTERNS IN INDIVIDUALS WITH EARLY STAGE VASCULAR DEMENTIA VS. PATIENTS WITH EARLY STAGE ALZHEIMER’S DISEASE

Individuals in the early stages of dementia may demonstrate language difficulties. The aim of the study was an evaluation of the differences in narrative discourse abilities across two types of dementia, i.e., Vascular Dementia (VaD) and Alzheimer’s Disease (AD) in comparison to the young and old elderly. The AD and VaD groups displayed a lower performance than the age-matched YE on tasks involving reasoning. The VaD partici- pants outperformed patients with AD in verbal memory and narrative discourse. Discourse macrostructure analyses showed that the VaD reproduced more propositions than did the AD participants, but that these were comparable to YE and OE. There were more conjunctions in narratives reproduced by the VaD participants as compared to other groups, although this tendency was only present in the story but not in fairy tale reproductions themselves. Individ- uals in the AD group had more difficulties than YE and OE individuals in figuring out the moral of fairy tales. Clinical and control groups reproduced the microstructure and superstructure of texts comparatively well. Discourse recall correlated with performance on verbal memory, attention/working memory, and reasoning. Differences in narrative discourse abilities were found. Alzheimer’s Disease (AD) patients scored lower in verbal memory than did Vascular Dementia (VaD) patients. Both groups however obtained lower results than the young and old elderly.

Analisis Materi Struktur Atom Pada Buku Teks Kimia Kelas X SMA/MA

Penelitian ini merupakan penelitian Kualitatif. Metode penelitian ini adalah metode penelitian deksriptif. Instrumen penelitian yang digunakan adalah tabel identifikasi label konsep dan jenis representasi, tabel identifikasi kesesuaian label konsep dengan silabus, model struktur makro wacana, dan tabel kriteria representasi kimia. Hasil penelitian menunjukkan bahwa label konsep yang terdapat pada buku A sebanyak 27 label konsep dan memiliki 50 jenis representasi yang terbagi dalam tipologi makroskopik, submikroskopik, simbolik. Label konsep yang terdapat pada buku B sebanyak 32 label konsep dengan 68 jenis representasi yang terbagi dalam tipologi makroskopik, submikroskopik, dan simbolik. Kesesuaian label konsep buku teks A dan buku teks B terhadap silabus kimia kuriukulum 2013 terdapat 31 label konsep yang sesuai dengan silabus kimia K-13. Struktur makro buku A mencapai level 7 dimensi elaborasi, dan buku B mencapai level 7 dimensi elaborasi. Kriteria representasi kimia konsep struktur atom pada buku A terdapat 21 representasi, dan pada buku B terdapat 26 representasi.

Analisis Materi Ajar Kimia SMA/MA Kelas X Pada Konsep Stoikiometri

Penelitian ini bertujuan untuk melakukan analisis materi ajar pada buku teks kimia SMA. Instrumen yang digunakan yaitu tabel identifikasi proposisi mikro-makro, model struktur makro wacana, dan tabel identifikasi proposisi yang berpotensi kesalahan konsep (miskonsepsi). Data yang diperoleh dianalisis secara deskriptif. Hasil penelitian menunjukkan Label konsep yang dianalisis secara keseluruhan berjumlah 46 label konsep, label konsep pada buku teks A dan buku teks B yang sesuai terhadap silabus kurikulum 2013 masing-masing berjumlah 34 dan 37. Label konsep yang hanya terdapat pada buku A berjumlah 9 dan semuanya sesuai terhadap silabus kurikulum 2013, dan label konsep yang hanya terdapat pada buku B, berjumlah 12 dan semuanya sesuai dengan Silabus Kurikulum 2013. Berdasarkan struktur makro wacana untuk topik stoikiometri pada buku teks A pembahasan konsep pada dimensi elaborasi mencapai level 5 dan dimensi progresi terdapat 4 konsep pada level 2 sebagai cakupan bahasan, pada buku teks B sajian materi pada dimensi elaborasi mencapai level 4, dan dimensi progresi pada level 2 terdapat 8 konsep.

Analisis Materi Ajar Kimia SMA/MA Kelas XI Pada Konsep Termokimia

Penelitian ini bertujuan untuk mendeskripsikan kesesuaian konsep termokimia pada materi ajar kimia SMA/MA Kelas XI terhadap kurikulum 2013 dan mendeskripsikan struktur makro wacana dan proposisi yang berpotensi kesalahan konsep. Instrumen yang digunakan yaitu tabel identifikasi label konsep dan proposisi mikro-makro, model struktur makro wacana, dan tabel identifikasi proposisi yang berpotensi kesalahan konsep. Data dianalisis secara deskriptif. Hasil penelitian menunjukkan bahwa label konsep yang sama terdapat pada buku teks A maupun buku teks B berjumlah 22 yang sesuai dengan kurikulum 2013. Label konsep yang sesuai dengan kurikulum 2013 pada buku teks A dan buku teks B masing-masing berjumlah 15 label konsep dan 13 label konsep. Struktur makro wacana pada buku teks A pembahasan konsep pada dimensi elaborasi mencapai level 5 dan dimensi progresi pada level 2 terdapat 6 konsep, sedangkan pada buku teks B pembahasan konsep pada dimensi elaborasi mencapai level 6 dan dimensi progresi pada level 2 terdapat 4 konsep.

Para el caso: análisis de una construcción versátil en sintaxis del discurso

En este trabajo analizamos el funcionamiento discursivo de la construcción española para el caso. Este elemento se muestra muy rentable en el desempeño de ciertas funciones en la macroestructura del discurso. Principalmente, es capaz de ofrecer un marco enunciativo de contenidos proposicionales. Pero también es capaz de expresar contenidos modales, como la actitud de indiferencia del hablante ante lo dicho, o de caracterizar algunas informaciones ofrecidas por el texto. Se tendrán en cuenta en el análisis las distintas variantes adoptadas por la construcción, ya que los varios usos de para el caso presentan diferentes grados de fijación. Los casos de mayor fijación muestran valores discursivos más específicos y, en algunos contextos, su comportamiento se acerca al de los operadores discursivos, categoría perteneciente a una gramática del texto.

Exploring the Viability of NARNIA with Cognitive-Communication Difficulties: A Pilot Study.

Everyday discourse is a common context for the difficulties experienced by people with acquired neurogenic communication disorders. While evidence is present for effective manualized interventions that directly improve the discourse skills in aphasia, this remains limited for people with cognitive-communication disorders. This proof of concept study used an in-depth case series approach to trial the NARNIA discourse intervention used successfully in aphasia to explore transferability of the protocol and effectiveness in people with cognitive-communication impairments. Four female participants with mild to moderate cognitive-communication difficulties (mean age: 52.8 years)-two following traumatic brain injury and two following vascular episodes-were recruited. Modifications were made to the protocol to accommodate the participant group. Cognitive-linguistic abilities, self-perceptions of communicative behavior and psychosocial recovery, and repeated discourse measures were assessed pre-, immediately post, and at 4 weeks following intervention, to measure treatment effectiveness. Significant gains were observed in quantity of output, informativeness, and efficiency of information across both everyday and narrative discourse genres for all participants. However, in contrast to previous studies, minimal change was observed in discourse macrostructure elements. Significant improvements were also observed in memory or working memory for two participants. This study provides preliminary evidence for the effectiveness of using an adapted protocol with people with cognitive-communication disorders, highlighting how adaptations may address the cognitive needs of this diverse clinical group.

Some observations on the dualistic nature of discourse processing

AbstractA range of studies on language use suggests that there is a general contrast between two kinds of discourse processing. Based on a review of these studies, which rest on a number of different methodological approaches and perspectives, the present paper argues that there is in fact converging evidence in support of the hypothesis that linguistic discourse has a dualistic structure. Central to this structure is a distinction between what tends to be referred to, respectively, as the microstructure and the macrostructure of discourse. Furthermore, it is argued that the distinction shows significant neurolinguistic correlations, and that these correlations concern the lateralization of the cerebral brain.

Temporal and Episodic Analyses of the Story of Cinderella in Latent Aphasia.

Purpose The purpose of this study was to improve our understanding of the language characteristics of people with latent aphasia using measures that examined temporal (i.e., real-time) and episodic organization of discourse production. Method Thirty AphasiaBank participants were included (10 people with latent aphasia, 10 people with anomic aphasia, and 10 neurotypical control participants). Speech material of Cinderella narratives was analyzed with Praat software. We devised a protocol that coded the presence and duration of all speech segments, dysfluencies such as silent and filled pauses, and other speech behaviors. Using these durations, we generated a range of temporal measures such as speech, articulation, and pure word rates. Narratives were also coded into episodes, which provided information about the discourse macrostructure abilities of the participants. Results The latent aphasia group differed from controls in number of words produced, silent pause duration, and speech rate, but not articulation rate or pure word rate. Episodic organization of the narratives was similar in these 2 groups. The latent and anomic aphasia groups were similar in most measures, apart from articulation rate, which was lower in the anomic group. The anomic aphasia group also omitted more episodes than the latent aphasia group. Conclusions The differences between latent aphasia and neurotypical controls can be attributed to a processing speed deficit. We propose that this deficit results in an impaired ability to process information from multiple cognitive domains simultaneously.

Analysis of macrolinguistic aspects of narratives from individuals with Alzheimer's disease, mild cognitive impairment, and no cognitive impairment

IntroductionThe depiction of features in discourse production promotes accurate diagnosis and helps to establish the therapeutic intervention in cognitive impairment and dementia. We aimed to identify alterations in the macrolinguistic aspects of discourse using a new computational tool. MethodsSixty individuals, aged 60 years and older, were distributed in three different groups: mild Alzheimer's disease (mAD), amnestic mild cognitive impairment, and healthy controls. A narrative created by individuals was analyzed through the Coh-Metrix-Dementia program, extracting the features of interest automatically. ResultsmAD showed worse overall performance compared to the other groups: less informative discourse, greater impairment in global coherence, greater modalization, and inferior narrative structure. It was not possible to discriminate between amnestic mild cognitive impairment and healthy controls. DiscussionOur results are in line with the literature, verifying a pathological change in the macrostructure of discourse in mAD.

Reviewing the quality of discourse information measures in aphasia.

Discourse is fundamental to everyday communication, and is an increasing focus of clinical assessment, intervention and research. Aphasia can affect the information a speaker communicates in discourse. Little is known about the psychometrics of the tools for measuring information in discourse, which means it is unclear whether these measures are of sufficient quality to be used as clinical outcome measures or diagnostic tools. To profile the measures used to describe information in aphasic discourse, and to assess the quality of these measures against standard psychometric criteria. A scoping review method was employed. Studies were identified using a systematic search of Scopus, Medline and Embase databases. Standard psychometric criteria were used to evaluate the measures' psychometric properties. The current review summarizes and collates the information measures used to describe aphasic discourse, and evaluates their quality in terms of the psychometric properties of acceptability, reliability and validity. Seventy-six studies described 58 discourse information measures, with a mean of 2.28 measures used per study (SD = 1.29, range = 1-7). Measures were classified as 'functional' measures (n = 33), which focused on discourse macrostructure, and 'functional and structural' measures (n = 25), which focused on micro-linguistic and macro-structural approaches to discourse. There were no reports of the acceptability of data generated by the measures (distribution of scores, missing data). Test-retest reliability was reported for just 8/58 measures with 3/8 > 0.80. Intra-rater reliability was reported for 9/58 measures and in all cases percentage agreement was reported rather than reliability. Per cent agreement was also frequently reported for inter-rater reliability, with only 4/76 studies reporting reliability statistics for 12/58 measures; this was generally high (>.80 for 11/12 measures). The majority of measures related clearly to the discourse production model indicating content validity. A total of 36/58 measures were used to make 41 comparisons between participants with aphasia (PWA) and neurologically healthy participants (NHP), with 31/41 comparisons showing a difference between the groups. Four comparisons were made between discourse genres, with two measures showing a difference between genres, and two measures showing no difference. There is currently insufficient information available to justify the use of discourse information measures as sole diagnostic or outcome measurement tools. Yet the majority of measures are rooted in relevant theory, and there is emerging evidence regarding their psychometric properties. There is significant scope for further psychometric strengthening of discourse information measurement tools.

NARNIA: a new twist to an old tale. A pilot RCT to evaluate a multilevel approach to improving discourse in aphasia

Background: Developing effective interventions for people with aphasia, which both ameliorate impaired language and directly impact on real-life communication, is a key focus of aphasia research. While single-word and sentence-level models of language processing have informed effective interventions, there is limited evidence of intervention approaches that extend the principles from these models to discourse.Aims: This pilot randomised controlled trial (RCT) aimed to compare a novel multilevel intervention, a Novel Approach to Real-life communication: Narrative Intervention in Aphasia (NARNIA), with usual care (UC), with a view to assess the feasibility and acceptability of the approach and estimate effect sizes to design and power a definitive trial.Methods & Procedures: In a prospective, single-blind, RCT, 14 people with mild to moderate aphasia, between 2 and 165 months following stroke, were randomised to the two interventions. Both therapy conditions were delivered four times weekly over 5 weeks. The NARNIA intervention specifically combined word retrieval, sentence production, and discourse macrostructure across a range of everyday discourse (ED) genres. UC comprised any speech-language therapy routinely used in clinical practice, individually tailored to meet the assessed needs of the participant. The Curtin University Discourse Protocol (CUDP) was used to measure verb access, sentence production, and discourse structure.Outcomes & Results: Eight participants were assigned to the NARNIA intervention and six participants to UC. No significant differences were present in baseline prognostic factors between the two groups prior to intervention. Following intervention, orientation aspects of macrostructure were significantly greater in the NARNIA group on ED measures than in the UC group, with no other between-group differences found. Significant changes were, however, seen within groups across ED genres. The NARNIA group made significant gains across all language levels, while the UC made isolated gains in sentence production. Few changes were seen in narrative discourse for either group. While single-word processing was not significantly different between groups, significant within-group differences were seen. While both groups significantly improved in retrieving nouns in isolation, only the NARNIA group made significant improvement in verb processing. No change was seen in constrained sentence production for either group.Conclusions: These findings are highly promising in demonstrating the use of macrostructure to scaffold production of words and sentences and improve discourse organisation. The significantly greater within-group gains for the NARNIA participants will provide a platform to power a larger trial to evaluate the effectiveness of this integrated multilevel intervention for aphasia.

Analysis of prototypical narratives produced by aphasic individuals and cognitively healthy subjects.

Aphasia can globally or selectively affect comprehension and production of verbal and written language. Discourse analysis can aid language assessment and diagnosis.Objective[1] To explore narratives that produce a number of valid indicators for diagnosing aphasia in speakers of Brazilian Portuguese.[2] To analyze the macrostructural aspects of the discourse of normal individuals.[3] To analyze the macrostructural aspects of the discourse of aphasic individuals.MethodsThe macrostructural aspects of three narratives produced by aphasic individuals and cognitively healthy subjects were analyzed.ResultsA total of 30 volunteers were examined comprising 10 aphasic individuals (AG) and 20 healthy controls (CG). The CG included 5 males. The CG had a mean age of 38.9 years (SD=15.61) and mean schooling of 13 years (SD=2.67) whereas the AG had a mean age of 51.7 years (SD=17.3) and mean schooling of 9.1 years (SD=3.69). Participants were asked to narrate three fairy tales as a basis for analyzing the macrostructure of discourse. Comparison of the three narratives revealed no statistically significant difference in number of propositions produced by the groups. A significant negative correlation was found between age and number of propositions produced. Also, statistically significant differences were observed in the number of propositions produced by the individuals in the CG and the AG for the three tales.ConclusionIt was concluded that the three tales are applicable for discourse assessment, containing a similar number of propositions and differentiating aphasic individuals and cognitively healthy subjects based on analysis of the macrostructure of discourse.

Discourse treatment for word retrieval impairment in aphasia: The story so far

Background: Impairment-focused aphasia treatment has an ultimate goal of improving language production in connected speech and communication in daily life. Although impairment-based treatment has typically been carried out in words or sentences, investigations have begun to explore the efficacy of treatment during discourse production. Focusing treatment on an impaired linguistic process during discourse production is a complex and challenging endeavour. Aims: This paper aims to review investigations of discourse treatment for word retrieval impairment in aphasia in order to identify and discuss variables that emerge as being important considerations in clinical practice and continued research. Main Contribution: Seven investigations that applied treatments during structured discourse production to improve word retrieval in participants with aphasia were reviewed. Treatment methods used in the investigations included phonologic and orthographic cues, semantic feature analysis, contingency-based cueing hierarchies, and repeated conversational engagement. The discourse contexts used for treatment were structured conversations or structured narrative discourse. All investigations reported positive outcomes for improved word retrieval abilities. Although treated vocabulary items did not improve in all cases, improvements in general processes of word retrieval were reported. Focusing treatment on the linguistic process of word retrieval resulted in changes to discourse macrostructure, at least in terms of the informativeness of the discourse. When attitudes and perceptions of the participants with aphasia or of naïve judges were assessed, the outcomes were generally favourable. One investigation provided evidence that treatment in structured discourse was related to improved word retrieval in real-life conversations. Conclusions: There are several promising discourse treatment approaches for word retrieval impairments in aphasia. Systematic analysis of changes in the macrolinguistic processes of discourse, in real-life conversations, and in the attitudes and perceptions of participants with aphasia and others in future discourse treatment studies would enhance our insights about their efficacy.