Persons With Aphasia Research Articles

Oral Reading Prosody and Comprehension in Persons With Aphasia: A Preliminary Investigation.

This study acoustically characterized the oral reading prosody of persons with aphasia (PWA) and neurotypical controls for a connected text and aimed to determine which prosodic features were most associated with performance on a reading comprehension task. Six PWA and six neurotypical, age- and education-matched controls participated in this preliminary study. Participants read Paragraph 3 of the Gray Oral Reading Tests-Fifth Edition aloud and subsequently answered five comprehension questions. A total of 11 measures related to phrasing, intonation, and expressivity were extracted using Praat for each participant in order for comparisons to be made across participant groups and associations examined with reading comprehension scores. The Mann-Whitney U test suggested a significant difference between PWA and control participants for intersentential pause durations, pausal intrusion frequency, and duration of pausal-pausal syllables. Although statistically nonsignificant, intersentential pause duration, pausal intrusion frequency, pausal intrusion duration, duration of prepausal syllables, and intensity amplitude following a syntactic juncture were all moderately correlated (all rs > .58) with comprehension of Paragraph 3 of the Gray Oral Reading Tests-Fifth Edition in PWA. All measures were weakly correlated with comprehension for the control participants. PWA demonstrated statistically significant longer durations for intersentential pauses and prepausal syllables, and a greater number of pausal intrusions. Interestingly, three of the five measures moderately correlated to comprehension were those that were statistically different between the two participant groups. As such, preliminary findings of this study warrant further investigation in a larger sample of PWA.

Teasing apart time reference-related encoding and retrieval deficits in aphasia: evidence from Greek, Russian, Italian and English

ABSTRACT Background Persons with aphasia (PWAs) are often impaired in time reference/tense production. It has been suggested that this impairment is due to encoding or/and retrieval deficits. However, to the best of our knowledge, no experimental design that enables teasing apart selective encoding and retrieval deficits has been proposed thus far. Aims This study aims at disentangling time reference-related encoding deficits from time reference-related retrieval deficits in PWAs. Methods & procedures Two sentence completion tasks tapping production of time reference and subject-verb agreement (control condition) were administered to eight Greek-speaking PWAs, eight Russian-speaking PWAs, six Italian-speaking PWAs, seven English-speaking PWAs and four groups of language-, age- and education-matched healthy controls. Task 1 tapped encoding and retrieval processes to a similar extent. Task 2 predominantly tapped retrieval processes. Comparisons between each PWA and the corresponding control group, as well as within-participant comparisons were performed. Outcomes & results All four control groups performed at ceiling. Twenty-eight out of 29 PWAs were impaired in time reference in at least one of the two completion tasks, and all but three PWAs were impaired in production of subject-verb agreement in at least one of the two tasks. In all language groups, there were PWAs exhibiting between-task dissociations. A double dissociation emerged in the time reference condition, as some Greek-, Russian- and English-speaking PWAs performed better on Task 1 than on Task 2, whereas other Greek- and Italian-speaking PWAs performed worse on Task 1 than on Task 2. In the agreement condition, in each language group, there were PWAs performing better on Task 1 than on Task 2. However, none PWA exhibited the opposite pattern. Based on the results, we identified both PWAs with selective time reference-related encoding deficits and PWAs with selective time reference-related retrieval deficits. Conclusions The present experimental design provides a sound basis for teasing apart selective time reference-related encoding deficits and time reference-related retrieval deficits.

Eye movements of persons with aphasia during connected-text reading

ABSTRACT Background Eye movements reflect the cognitive-linguistic processing of neurotypical readers. Numerous reading related eye movement measures are associated with language processing, including first fixation duration, gaze duration, number of fixations, word skipping, and regressions. Eye movements have also been used to examine reading in neuro-atypical populations including persons with aphasia (PWA). Aims This study aimed to determine whether eye movement measures obtained from connected text reading differ among persons with varying types of aphasia and neurotypical individuals, as well as whether eye movement measures are associated with language processing severity and reading comprehension ability in PWA. Methods Twenty-four PWA and twenty-four age-matched control participants completed a connected text-reading eye-tracking task. The PWA also completed assessments to evaluate overall language processing severity and reading comprehension skills and to identify specific subtypes of aphasia. Results Persons with aphasia had shorter gaze duration, longer regression duration, and made more fixations than control participants, while no group differences emerged for first fixation duration or word skipping. Eye movement patterns did not differ among participants with anomic, Broca’s, or conduction/Wernicke’s. Language severity scores were a significant factor for gaze duration, while reading comprehension scores were not a significant factor for the eye movement measures examined. Conclusions The findings support previous eye tracking literature that indicate different eye movement patterns for persons with aphasia during text reading relative to neurotypical controls. The findings also highlight that the selection of eye movement measures examined, the stimuli used, and procedural considerations may impact the pattern of results. The results from this study can be used to further determine which eye movement measures may be most suited for studying language processing during reading in neuro-atypical individuals and determine whether persons with aphasia use different strategies for reading comprehension than neurotypical individuals.

The Relationship Between Executive Functioning and Narrative Language Abilities in Aphasia.

Although individuals with aphasia commonly exhibit challenges in executive functioning (EF) and spoken discourse, there is limited research exploring connections between these abilities within this specific population. Therefore, this study investigated the relationship between verbal and nonverbal EF and narrative productions in aphasia using a multilevel linguistic approach. Participants included 22 persons with aphasia (PWA) and 24 age- and education-matched, neurologically healthy controls (NHC). All participants completed assessments for EF and a story retelling task. Narrative samples were analyzed for microlinguistic (productivity, lexical and syntactic features, semantic content, word and sentence errors) and macrolinguistic (coherence, informational content, organization, and language use) characteristics. Correlational analyses were employed to explore the relationships among narrative variables. EF factors, extracted from principal component analysis, were used as predictive variables in hierarchical stepwise regression analyses to evaluate their role in predicting narrative performances of PWA and NHC. Relative to NHC, PWA exhibited impaired narrative performance affecting both microlinguistic and macrolinguistic levels. Breakdowns at the structural level (i.e., reduced productivity, syntax, lexical retrieval, and diversity) correlated with impaired story completeness, organization, and connectedness; this relationship was more prominent for PWA. Three EF factors representing (1) verbal EF, (2) verbal and nonverbal fluency, and (3) nonverbal EF were extracted. Factors 1 and 2 largely predicted narrative performance, whereas Factor 3 (i.e., nonverbal EF) contributed prominently to predicting macrolinguistic discourse performance in both groups although accounting for less variance in the data. Overall, lower EF scores, particularly verbal EF variables, predicted poor narrative performance in both groups. Our results indicate that both linguistic and extralinguistic cognitive abilities play a role in story retelling performances among PWA. Notably, both verbal and nonverbal EF skills were found to be correlated with narrative abilities. However, the extent of their contributions varied depending on the discourse levels assessed. These findings provide a significant contribution to our understanding of the cognitive factors associated with breakdowns in discourse among PWA and highlight the importance of comprehensive assessment of EF and discourse within this population. https://doi.org/10.23641/asha.26485627.

Vigilant Attention During Cognitive and Language Processing in Aphasia.

Persons with aphasia (PWA) experience differences in attention after stroke, potentially impacting cognitive/language performance. This secondary analysis investigated physiologically measured vigilant attention during linguistic and nonlinguistic processing in PWA and control participants. To evaluate performance and attention in a language task, seven PWA read sentences aloud (linguistic task) and were compared to a previous data set of 10 controls and 10 PWA. To evaluate performance and attention in a language-independent task, 11 controls and nine PWA completed the Bivalent Shape Task (nonlinguistic task). Continuous electroencephalogram (EEG) data were collected during each session. A previously validated EEG algorithm classified vigilant-attention state for each experiment trial into high, moderate, distracted, or no attention. Dependent measures were task accuracy and amount of time spent in each attention state (measured by the number of trials). PWA produced significantly more errors than controls on the linguistic task, but groups performed similarly on the nonlinguistic task. During the linguistic task, controls spent significantly more time than PWA in a moderate-attention state, but no statistically significant differences were found between groups for other attention states. For the nonlinguistic task, amount of time controls and PWA spent in each attention state was more evenly distributed. When directly comparing attention patterns between linguistic and nonlinguistic tasks, PWA showed significantly more time in a high-attention state during the linguistic task as compared to the nonlinguistic task; however, controls showed no significant differences between linguistic and nonlinguistic tasks. This study provides new evidence that PWA experience a heightened state of vigilant attention when language processing demands are higher (during a linguistic task) than when language demands are lower (during a nonlinguistic task). Collectively, results of this study suggest that when processing language, PWA may allocate more attentional resources than when completing other kinds of cognitive tasks.

Knowledge, Beliefs, and Experiences With Mental Health Services and Help-Seeking in People With Aphasia and Care Partners.

Supporting psychological well-being in persons with aphasia (PWA) can improve social and health outcomes; however, PWA and their care partners (CPs) are often not receiving mental health support. Previous research explores this from the perspective of health care professionals. The aim of this study was to examine knowledge, beliefs, and experiences related to mental health services directly from PWA and CPs. The study included 11 PWA and 11 CPs. Participants completed a guided survey (virtual) with opportunities for elaboration related to the knowledge, beliefs, and experiences of mental health. There was variability in personal preferences for referrals, types of coping strategies, and confidants for general thoughts and feelings and those specific to aphasia. PWA identified health care professionals as people to share thoughts and feelings, whereas CPs chose family and friends more often. Both CPs and PWA reported communication difficulty and finding a counselor as "sometimes" preventing access to services but cited fear and trust as "always" preventing access. Knowledge, beliefs, and experience with help-seeking and mental health services are personal and variable. Assessing barriers unique to living with aphasia, such as communication challenges and locating a suitable counselor, must also be considered within more complex and personal barriers of fear and trust that are consistently reported in the general public. Health professionals across the continuum of aphasia care need to understand the communication challenges of living with aphasia in tandem with understanding individual differences to personalize approaches to mental health services and help-seeking.

Design and development of a mixed reality application for aphasia rehabilitation: The ICMR-MiRAR project

BACKGROUND: Aphasia is an impaired ability to use language for communication after a brain damage. The primary means of intervention for aphasia – Speech-Language therapy (SLT) – usually involves didactic interaction between the Speech-Language therapist and the client, often without regard to the real-life environments in which the communication occurs. The provision of SLT in natural environments is beyond the scope of the conventional, clinic-based intervention setups. Using the technological advances, the Mixed Reality in Aphasia Rehabilitation (MiRAR) aims to make persons with aphasia (PwA) use their language in an ecologically valid and meaningful manner in natural communication contexts. AIM: This report aims to delineate the design and development of a Mixed Reality environment (MR: i.e., augmented + virtual realities (i.e., AR + VR)) to provide social communicative intervention for PwA. METHODS: We describe the concept and provide the details of the development and deployment of a communication-based mixed reality application for PwA in the Indian context. For this purpose, we generated 20 distinct communication scenarios and their scripts. These scenarios were implemented into the Mixed Reality environment with the help of a hired technical team. RESULTS: The 20 scenarios were successfully developed and deployed into the Mixed Reality environment for the purpose of communication intervention for PwA. The program consists of a web-based admin panel (for SLPs) and a Mixed Reality application (for the PwA). CONCLUSIONS: The MiRAR program is expected to foster the delivery of speech-language therapy in a meaningful, controlled and simulated environments by the SLPs, thus alleviating the practical restraints of conventional clinical setups. The clinical trial of this intervention program is planned in the next phase of this ongoing project.

Appraising the Conceptual and Lexical Retrieval in Persons with Fluent and Nonfluent Aphasia

Abstract Objective Conceptual knowledge refers to understanding and interpreting concepts and their relationships. Lexical knowledge is the knowledge that can be expressed through words. It entails meaning of words and their relationships. Word retrieval impairments are the most radical deficits that restrict communicative functions for individuals with aphasia. The current study aimed to compare the conceptual and linguistic impairments associated with fluent and nonfluent persons with aphasia (PWAs). Materials and Methods A total of 15 PWAs were recruited for the study, out of which, 8 were fluent aphasia and 7 were nonfluent aphasia. One picture-based conceptual task (picture comparison judgments) and one verb-based linguistic task (word comparison judgments) were used as the experimental paradigm. Results and Conclusion The findings of the study showed no significant difference in the performance of conceptual and lexical retrieval abilities in both fluent and nonfluent aphasia. The current study highlights the fact that both conceptual and lexical retrieval impairments prevail in both fluent and nonfluent aphasia.

Pars Opercularis Underlies Efferent Predictions and Successful Auditory Feedback Processing in Speech: Evidence From Left-Hemisphere Stroke.

Hearing one's own speech allows for acoustic self-monitoring in real time. Left-hemisphere motor planning regions are thought to give rise to efferent predictions that can be compared to true feedback in sensory cortices, resulting in neural suppression commensurate with the degree of overlap between predicted and actual sensations. Sensory prediction errors thus serve as a possible mechanism of detection of deviant speech sounds, which can then feed back into corrective action, allowing for online control of speech acoustics. The goal of this study was to assess the integrity of this detection-correction circuit in persons with aphasia (PWA) whose left-hemisphere lesions may limit their ability to control variability in speech output. We recorded magnetoencephalography (MEG) while 15 PWA and age-matched controls spoke monosyllabic words and listened to playback of their utterances. From this, we measured speaking-induced suppression of the M100 neural response and related it to lesion profiles and speech behavior. Both speaking-induced suppression and cortical sensitivity to deviance were preserved at the group level in PWA. PWA with more spared tissue in pars opercularis had greater left-hemisphere neural suppression and greater behavioral correction of acoustically deviant pronunciations, whereas sparing of superior temporal gyrus was not related to neural suppression or acoustic behavior. In turn, PWA who made greater corrections had fewer overt speech errors in the MEG task. Thus, the motor planning regions that generate the efferent prediction are integral to performing corrections when that prediction is violated.

Appraising Linguistic and Reading Impairments in Kannada-Speaking Persons With Central Alexia.

Alexia is an acquired condition resulting in impaired abilities to comprehend and/or read aloud written scripts secondary to lesions in the brain involved in reading processes. Just as how linguistic aspects are multi-faceted in persons with aphasia (PWAs), the reading impairments also vary extensively across each PWA depending on the type and nature of the language deficits. Each language has its unique linguistic properties. Whether the impairment is in the spoken form or written form, the dissociations in both aspects across the linguistic distinctions are paramount. Given the diverse orthographic features of Kannada, alongside inquiries into the impairment in oral language skills among individuals with acquired reading difficulties, the study emphasizes distinguishing the concurrent language processes associated with reading impairment. The study aimed to explore the relationship between spoken language and reading abilities in Kannada-speaking post-stroke survivors with acquired alexia. The study recruited 15 Kannada-speaking adults with complaints of reading impairment post-ictus through convenient sampling. The enrolled participants included both males and females with a mean age of 42.2 years (SD=15.58; range=20-68) with 16 years of formal education. The study performed three primary investigations; a) linguistic, b) oral reading, and c) reading comprehension. Linguistic tasks entailed semantics, syntax, and phonological tasks. Oral reading entailed real word and non-word reading tasks. Reading comprehension tasks entailed single-word level, sentence-level, and paragraph-level tasks. Results of overall domain performance across linguistics, oral reading, and reading comprehension revealed superior performance in linguistics (M=71.77, SD=19.18) followed by reading comprehension (M=70.55, SD=24.10) and oral reading (M=41.55, SD=24.66), which was significant (p<0.05). Performance in phonology was weakest (M=58.06, SD=12.44) compared to syntax (M=71.13) and semantics (M=85.33) on comparing PWAs' abilities within the linguistic domain. Reading abilities were compared across oral reading and reading comprehension, which significantly varied (p<0.05), and reading comprehension abilities were superior (M=72.65, SD=24.10). Task-specific variabilities were significant (p<0.05) in both oral reading and reading comprehension, wherein, real word reading (M=58.22) and comprehension at a single level (M=80.22) were better performed. Results of correlation analysis revealed semantics (r=0.494, p<0.05) and phonology (r=0.428, p>0.05) were highly positively correlated to oral reading abilities. Syntax (r=0.412, p>0.05), and semantics (r=0.377, p>0.05) were strongly positively correlated to reading comprehension abilities. The study has convincingly shown that performance on reading-related tasks reflects the functionality of central semantic, phonological, and syntactic processing elements. The literate adults routinely interact with both spoken and written language and a comprehensive assessment framework of language processing must encompass both modalities (linguistic and reading) for individuals with alexia, specific to Indian languages. Owing to the transparent writing system of the Kannada language, a multimodal phonological and lexical-based reading treatment may prove to be beneficial in remediating reading impairments among adult post-stroke survivors.

Success rates of intensive aphasia therapy: real-world data from 448 patients between 2003 and 2020.

Aphasia is a devastating consequence after stroke, affecting millions of patients each year. Studies have shown that intensive speech and language therapy (SLT) is effective in the chronic phase of aphasia. Leveraging a large single-center cohort of persons with aphasia (PWA) including patients also in the subacute phase, we assessed treatment effects of intensive aphasia therapy in a real-world setting. Data were collected at the Aachen aphasia ward in Germany between 2003 and 2020. Immediate treatment responses across different language domains were assessed with the Aachen Aphasia Test (AAT) using single-case psychometrics, conducted before and after 6-7 weeks of intensive SLT (10 h per week, median (IQR) dosage = 68 (61-76)). We adjusted for spontaneous recovery in subacute patients. Differential treatment effects between subgroups of chronicity and predictors of therapy response were investigated. A total of 448 PWA were included (29% female, median (IQR) age = 54 (46-62) years, median (IQR) time post-onset = 11 (6-20) months) with 12% in the early subacute, 15% in the late subacute and 74% in the chronic phase of aphasia. The immediate responder rate was 59%. Significant improvements in all AAT subtests und subscales were observed hinting at broad effectiveness across language domains. The degree of therapy-induced improvement did not differ between the chronicity groups. Time post-onset, dosage of therapy and aphasia severity at the beginning of treatment were predictors of immediate treatment response. Intensive therapy protocols for aphasia after stroke are yielding substantial responder rates in a routine clinical setting including a wide range of patients.

Profiling Communication Effectiveness in Persons with Aphasia in Aphasia Types

Communication problems caused by aphasia can negatively impact an individual’s ability to participate in society, and resume employment. The aim of the study was to assess various quality-of-life factors in person with aphasia and compare those factors between aphasia types. 20 (12 non-fluent; 8 fluent) Hindi-English bilingual Persons with Aphasia (PWA) were included in the study. Indian scale of Communicative effectiveness was administered to persons with aphasia. The tool consisted of various situations faced in day-to-day life. A comparison was obtained between aphasia types. Questions related to the generalization of skills acquired during therapy were taxing. Situations related to social involvement, speaking on the telephone, and communicating in various situations had an impact post-stroke. PWA faces challenges in communicating in the job environment. Persons with a fluent variant of aphasia have a lesser impact than the non-fluent type of aphasia. Hence, there is a need to work on the generalization of skills during management and considering the social context.

Reading and Writing Impairment in Persons with Crossed Aphasia: A Comparative Study

Abstract Background Persons with aphasia (PWAs) manifest multifaceted deficits like auditory comprehension, spoken language, reading, and writing to varying degrees. Of these, the most debilitating signs are reading and writing impairment. Of late, PWAs express greater interest to improve their reading and writing skills. The deficits in these skills along with deficits in spoken language limit their participation in the community. Reading and writing may be altered contrarily in various stroke conditions across the left and right hemisphere lesions, just like how linguistic impairments are mutually exclusive. Thus, it must be rational to reconcile the possible role of the right hemisphere to process reading and writing inversely alike spoken abilities. Additionally, investigations on reading and writing deficits in left cerebrovascular atrophy (CVA) aphasics and right CVA aphasics (crossed aphasia) are seldom reported in the literature with relevance to Indian population focusing Indian languages. The study aims to compare reading and writing abilities across PWAs with left CVA and right CVA (crossed aphasia). Methodology The study recruited four native Kannada speaking PWAs (6 months poststroke) aged between 40 and 70 years with impaired linguistic abilities secondary to stroke through convenient sampling. Western Aphasia Battery-Kannada was administered to identify aphasic component, specifically to evaluate the language, reading, and writing aspects in detail and the scores were analyzed based on the scoring. Results Descriptive statistics revealed both left and crossed PWAs performed equipotent on linguistics tasks. However, reading abilities were better in left CVA individuals and writing was better in crossed PWAs on comparing the mean scores. Correlation analysis revealed positive correlation between language and reading-writing abilities of left CVA PWAs. Negative correlation was evinced in crossed PWAs. Hence, reading and writing difficulties in crossed aphasia can be mostly ascribed to impairment in peripheral mechanisms involved in visual and/or kinesthetic information processing as the right hemisphere is most viable to these processes. Conclusion The study highlights the unique pattern of reading and writing abilities in crossed aphasia condition. However, careful examination of dissociations in acquired spoken language and written language abilities across differential neuronal networks through larger samples in the future research is warranted.

Core Lexicon analysis of spoken discourse production by Mandarin Chinese speakers with Aphasia

ABSTRACT Background Spoken discourse production has been increasingly recognised as an important source for assessing language competence of persons with aphasia (PWA). Most linguistic measures rely on transcripts of spoken discourse, so they have seldom been used in clinical practice. Thus, there is a need for standardized and norm-referenced measures that can be easily applied in clinical settings. Aims The present study aims to develop core lexicon lists for Mandarin Chinese PWA using AphasiaBank data elicited with different discourse production tasks and test their validity in detecting language deficiency. Methods & Procedures We selected seven semispontaneous discourse tasks within three major task types, i.e., picture descriptions, procedural discourse and story narrative, for core lexicon list development and for examining task type effects. Transcripts from 61 control speakers were split into two sets with age – and education matched: one set (n = 43) as a normative sample used to generate the core lexicon lists and the other (n = 18) as a healthy control group served as a baseline for comparison with PWA productions. Transcripts of 18 age- and education- matched PWA were retrieved from the AphasiaBank database. We selected the top 30 words with the widest distribution in the normative sample to generate core lexicon lists. Then for both PWA and control groups, we calculated agreement percentage as core lexicon scores. Outcomes & Results Core lexicon scores of PWA were significantly lower than the control group participants for all seven tasks and positively correlated with aphasia severity for two story narrative tasks, suggesting that story narrative tasks were more effective in assessing discourse productions compared with picture and procedural descriptions. In addition, core lexicon scores also correlated with lexical diversity (R scores) and discourse informativeness (Correct Information Units) for all seven tasks. Conclusions & Implications Core lexicon scores can effectively distinguish discourse production by Mandarin PWA and healthy controls and they reflect lexical diversity and informativeness of discourse. Our findings, thus, have clinical implications in that these lists could serve as an alternative transcription-less approach in quick Mandarin PWA discourse production assessment.

Preliminary evidence for two patterns of phonological similarity judgments of word-pairs by persons with Aphasia

ABSTRACT Background Phonological similarity judgments of word-pairs have been shown to reflect the structure of a phonological network of word-forms, where words are connected to each other if they differ by one phoneme. Word-pairs that are closer together in the phonological network are more likely to be rated as sounding similar than word-pairs that are farther apart in the network. This behavioral pattern indicates sensitivity to the underlying structure of the phonological network. Aims This study is an extended replication of previous research that seeks to identify if persons with aphasia (PWA), who often have phonological processing impairments, are sensitive to the large-scale structure of the phonological network. Methods and Procedures Seven PWA completed the phonological similarity judgment task. They heard two words aurally and made a binary indication if the words “sound similar”. Words in each pair differed in phonological similarity, as defined by the distance between the words in the phonological network, with values from 1 to 5. We analyzed the proportion of similar responses for word-pairs at each phonological network distance. Post-hoc analyses of individual-level performance and comparison to control samples (10 younger adults and 10 older adults) were conducted after examining the primary research question results. Outcomes and Results There were two patterns of performance. Four PWA performed similarly in ratings across all phonological network distances as younger and older adult control participants, and in concordance with previous research. There was a negative, nonlinear trend in the proportion of similar judgments as distance increased. Three PWA, however, had a different pattern of performance, such that word-pairs with distances of 3, 4, and 5 had higher proportions of similar judgments compared to the other samples of participants. Conclusion The two patterns of performance may point to clinically useful information, after further research, about phonological representations and processing in aphasia that may inform precision rehabilitation.

Community responses to persons with aphasia participating in CoActive therapeutic theatre: A pilot study.

Persons with aphasia (PWA) experience a number of communicative and social-emotional challenges. Reported experiences of PWA include but are not limited to, being misunderstood, isolated, frustrated, and infantilised. The aim of this pilot study, involving a Life Participation Approach to Aphasia (LPAA), conducted over the course of 2 years, was to understand community perceptions of aphasia while PWA engaged in an interprofessional treatment program involving speech and drama therapy. The interprofessional treatment program involved PWA participating in a therapeutic theatre program using the CoActive Therapeutic Theater (CoATT) while also receiving speech-language therapy. Each year, the PWA performed a different, original therapeutic theatre production for a public audience, at the culmination of their interprofessional treatment program. In this paper, we share data obtained from perspectives of audience members who witnessed the theatre production and aphasia education during the first year of the study and friends and family of PWA who participated in the therapeutic theatre process during the second year of the study. Responses from audience members who participated in aphasia education and witnessed the therapeutic theatre performance by the PWA during the first year, indicated an increased knowledge of aphasia. Friends and family members of PWA who witnessed their loved ones engaging in the CoATT process through interprofessional treatment, in the second year, reported that their loved ones benefited from the CoATT process, which was distinct from other therapeutic processes to their knowledge and that they were impacted by watching their loved one perform. These initial findings create footing towards understanding impact of therapeutic theatre in combination with speech-language therapy in the lives of PWA. They help us to obtain an initial appreciation of how therapeutic theatre and aphasia education help connect PWA and their community. What is already known on this subject Caregivers and communities at large play a significant role in and substantially impact the recovery of their loved ones (Dalemans etal., 2010; Grawburget etal., 2013; Kniepmann & Cupler, 2014) with aphasia. However, existing research suggests that persons with aphasia (PWA) are often misunderstood, isolated and infantilised by their communities. What this paper adds to existing knowledge The findings of our study reveal that friends, families and extended communities of PWA gain a positive and deep understanding of challenges experienced by PWA through therapeutic theatre supported by speech language therapy, based in a new CoActive Therapeutic Theatre (CoATT) model. This PWA community also agrees that therapeutic theatre in combination with speech-language therapy provides confidence and camaraderie between PWAs and strengthen connection between all constituencies. These results support the need for interprofessional intervention within the framework of a Life Participation Approach to Aphasia (LPAA). What are the potential or actual clinical implications of this work? Treatment paradigms that bring PWAs in contact with their communities using an LPAA approach can increase confidence and social engagement for PWAs potentially leading to better outcomes for their individual speech-language therapy as well as create means of educating communities about PWA, and their stories.

Phonological impairments in Hindi aphasics: Error analyses and cross-linguistic comparisons

ABSTRACT We assessed phonological and apraxic impairments in Hindi persons with aphasia (PwA) and compared them to Italian PwA reported in previous studies. Overall, we found strong similarities. Phonological errors were present across production tasks (repetition, reading and naming), most errors were non-lexical and, among those, a majority involved individual phonemes. There were significant effects of length, but not frequency. Hindi PwA, like the Italian PwA, showed strong effects of syllabic structure, with most errors occurring on consonants and weak syllabic positions, preserving syllable structure and simplifying phonemes or syllabic templates. These similarities were modulated by some language-specific patterns. Vowel insertions were more common in Hindi, possibly due to the presence of a central vowel, and segmental simplifications concentrated on marked aspiration and retroflection features. We hope our study will encourage further research in Hindi and other Indian languages. This will improve clinical diagnosis and our understanding of cross-linguistic differences.

Documenting psychosocial attitudes of persons with aphasia following semantic-based therapy: an exploratory study

Quality of life (QOL) for individuals with aphasia is very individualistic and subjective as the condition presents multifaceted impairments in communication skills. Most intervention strategies for persons with aphasia (PWA) emphasise improving communication and insignificantly focus on a person's social and emotional well-being, which are vital for effective social communication. The present study aims to analyse the effects of a semantic-based treatment approach on the QOL of PWA. The current study inculcated a “modified pre-test post-test design” to study the impact of semantic cueing for verbs and its thematic role (SCVTr) therapy among eleven Kannada-speaking PWAs. The Stroke and Aphasia Quality of Life-39 (SAQOL-39) Kannada version assessed QOL among PWAs. SAQOL-39 includes 39 physical, psychosocial, communication, and energy questions. The questionnaire was administered in pre-, mid-, post-, and follow-up phases after SCVTr therapy. The study deployed qualitative, quantitative, and visual inspection methods. The qualitative and quantitative scores for QOL measures showed pronounced effects among most participants across pre- to mid- to post-treatment phases. In addition, the results of maintenance of the QOL were observed among most participants post-SCVTr therapy. The uptrend in QOL among PWAs is attributed to the semantic activation enhanced through SCVTr protocol, near normal physical mobility, adequate social network, and family support, with a barrier-free environment. The study's findings pave the way for speech-language pathologists (SLPs) on the importance of aphasia intervention and its effect on QOL. Indeed, SLPs must observe every PWA beyond linguistic deficits and attempt to notice the psychosocial level, which may invariably vary with severity and other individualistic factors.

Understanding the experience of users of communication aids and applications through focus group discussions with people with aphasia and family members

The present study sought to identify the communication needs of persons with aphasia (PWA) and of their spouses, that could ultimately be addressed with current communication aids or applications (CA/A). Among users of CA/A we solicited their opinions and experiences with current CA/A. In contrast, among those not using CA/A, we explored why they did not use CA/A. A qualitative experiential research design was used through two in-person focus groups, one in English and one in French, at a large rehabilitation hospital in the Greater Montréal region (Canada). Participants' responses were recorded, transcribed and analyzed. The thematic analysis that ensued allowed the identification of four main themes. The first theme reflects participants' observations and experiences when communicating with aphasia. The second theme regrouped responses related to successful communication with the help of CA/A. The participants' challenges and dissatisfaction with CA/A were grouped into the third theme. Lastly, a fourth theme included participants' general views about CA/A and their wishes for further development. Participants' experience with communication difficulties following aphasia and the barriers and potential facilitators to adoption of CA/A were brought to the forefront. They also highlighted those features necessary to ensuring functional uptake of CA/A by those who would benefit from it. Finally, the importance of providing training to the communication partner and sensitizing the public to the impact of aphasia on people's daily lives and on the potential benefits of using CA/A were raised as necessary future actions.

TelePriming sentence production in aphasia.

The application of videoconferencing to the assessment and treatment of aphasia has been rapidly increasing; however, there is a need to develop treatments targeting sentence production in persons with aphasia (PWA) that can be delivered through videoconferencing. Structural priming has received recent attention as a potential training method for PWA. We investigated the feasibility and efficacy of a collaborative structural priming task delivered via the internet, TelePriming, in facilitating sentence production in PWA and healthy adults. In Study 1, young adults (YA), older adults (OA), and PWA participated in a collaborative dialogue-like priming task through videoconferencing, taking turns with an interlocutor (experimenter) to describe transitive action pictures with the goal of finding matching pictures. We measured whether participants produced more passive sentences to describe their picture after hearing their interlocutor produce passive compared to active sentences (primes). In Study 2, we compared the data from the OA and PWA of Study 1 (TelePriming) to different groups of OA and PWA, who completed the same priming task in person. All three groups showed robust priming effects in Study 1, producing more passive sentences to describe target pictures after hearing the experimenter produce passive versus active sentences. In Study 2, when controlling for demographic information (age, education) and aphasia severity, TelePriming resulted in larger priming effects for OA and PWA, compared to the in-person priming task. Survey results revealed that both OA and PWA experienced increased comfort and satisfaction with using technology following the task. Interactive message-structure alignment processes remain largely intact in PWA, and the positive effects of structural priming in a collaborative communicative task are not diminished by remote delivery. The findings demonstrate the feasibility and validity of TelePriming in OA and PWA, laying experimental groundwork for future use of TelePriming in the assessment and treatment of clinical populations with limited access to face-to-face sessions.