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Background: Research on language comprehension in aphasia has primarily focused on comprehension of isolated words and sentences. Even though previous studies have provided insights into comprehension abilities of individuals with aphasia at the word and grammatical level, our understanding of the nature and extent of their language comprehension (dis)abilities is not yet complete. In contrast to the highly restricted semantic and syntactic interpretation of sentences, discourse comprehension requires additional pragmatic and non-linguistic skills.Aims: The purpose of this study was to assess language comprehension in individuals with and without aphasia at the discourse level. In particular, it addressed the question of whether the use of direct speech, compared to indirect speech, affects comprehension of narrative discourse in Dutch aphasic and non-brain-damaged (NBD) listeners.Methods & Procedures: The Direct Speech Comprehension (DISCO) test was developed to examine the effects of manipulating direct vs. indirect speech on discourse comprehension. Twenty-three individuals with aphasia and 20 NBD participants were presented with spoken narratives that contained either direct or indirect speech reports. The narratives were presented audio-visually on an iPad, and comprehension was assessed with yes/no questions.Outcomes & Results: The performance of the participants with aphasia was significantly poorer than that of the NBD participants. Moreover, a main effect for condition type was found, indicating that narratives with direct speech reports were better understood than narratives with indirect speech reports by listeners with and without aphasia. There was no interaction between group and condition type indicating that this main effect held for both the aphasic and the NBD listeners. However, for the participants with aphasia, there was an interaction between condition and Token Test error score indicating that the positive effect of direct speech constructions diminishes for individuals with poorer comprehension.Conclusions: Direct speech constructions facilitate language comprehension in listeners with and without aphasia. One explanation for this finding is the occurrence of additional layers of communication, such as intonation and facial expression, often accompanying direct speech constructions. An alternative account is the degree of grammatical complexity: In Dutch, the syntactic construction of indirect speech requires embedding, whereas in direct speech the introductory sentence and the quote are both main clauses. The finding that the beneficial effect of direct speech on language comprehension diminishes for individuals with severe aphasia may indicate that the DISCO is too difficult for them to reveal an effect of a subtle manipulation such as that of condition type.
Age of acquisition (AOA) has frequently been shown to influence response times and accuracy rates in word processing and constitutes a meaningful variable in aphasic language processing, while its origin in the language processing system is still under debate. To find out where AOA originates and whether and how it is related to another important psycholinguistic variable, namely semantic typicality (TYP), we studied healthy, elderly controls and semantically impaired individuals using semantic priming. For this purpose, we collected reaction times and accuracy rates as well as event-related potential data in an auditory category-member-verification task. The present results confirm a semantic origin of TYP, but question the same for AOA while favouring its origin at the phonology-semantics interface. The data are further interpreted in consideration of recent theories of ageing. (C) 2016 Elsevier Ltd. All rights reserved.
Recent treatment protocols have been successful in improving working memory (WM) in individuals with aphasia. However, the evidence to date is small and the extent to which improvements in trained tasks of WM transfer to untrained memory tasks, spoken sentence comprehension, and functional communication is yet poorly understood. To address these issues, we conducted a multiple baseline study with three German-speaking individuals with chronic post stroke aphasia. Participants practised two computerised WM tasks (n-back with pictures and aback with spoken words) four times a week for a month, targeting two WM processes: updating WM representations and resolving interference. All participants showed improvement on at least one measure of spoken sentence comprehension and everyday memory activities. Two of them showed improvement also on measures of WM and functional communication. Our results suggest that WM can be improved through computerised training in chronic aphasia and this can transfer to spoken sentence comprehension and functional communication in some individuals.
Background: Agrammatic speakers have problems with grammatical encoding and decoding. However, not all syntactic processes are equally problematic: present time reference, who questions, and reflexives can be processed by narrow syntax alone and are relatively spared compared to past time reference, which questions, and personal pronouns, respectively. The latter need additional access to discourse and information structures to link to their referent outside the clause (Avrutin, 2006). Linguistic processing that requires discourse-linking is difficult for agrammatic individuals: verb morphology with reference to the past is more difficult than with reference to the present (Bastiaanse et al., 2011). The same holds for which questions compared to who questions and for pronouns compared to reflexives (Avrutin, 2006). These results have been reported independently for different populations in different languages. The current study, for the first time, tested all conditions within the same population.
Aims: We had two aims with the current study. First, we wanted to investigate whether discourse-linking is the common denominator of the deficits in time reference, wh questions, and object pronouns. Second, we aimed to compare the comprehension of discourse-linked elements in people with agrammatic and fluent aphasia.
Methods and procedures: Three sentence-picture-matching tasks were administered to 10 agrammatic, 10 fluent aphasic, and 10 non-brain-damaged Russian speakers (NBDs): (1) the Test for Assessing Reference of Time (TART) for present imperfective (reference to present) and past perfective (reference to past), (2) the Wh Extraction Assessment Tool (WHEAT) for which and who subject questions, and (3) the Reflexive-Pronoun Test (RePro) for reflexive and pronominal reference.
Outcomes and results: NBDs scored at ceiling and significantly higher than the aphasic participants. We found an overall effect of discourse-linking in the TART and WHEAT for the agrammatic speakers, and in all three tests for the fluent speakers. Scores on the RePro were at ceiling.
Conclusions: The results are in line with the prediction that problems that individuals with agrammatic and fluent aphasia experience when comprehending sentences that contain verbs with past time reference, which question words and pronouns are caused by the fact that these elements involve discourse linking. The effect is not specific to agrammatism, although it may result from different underlying disorders in agrammatic and fluent aphasia.
An important aspect of aphasia is the observation of behavioral variability between and within individual participants. Our study addresses variability in sentence comprehension in German, by testing 21 individuals with aphasia and a control group and involving (a) several constructions (declarative sentences, relative clauses and control structures with an overt pronoun or PRO), (b) three response tasks (object manipulation, sentence-picture matching with/without self-paced listening), and (c) two test phases (to investigate test-retest performance). With this systematic, large-scale study we gained insights into variability in sentence comprehension. We found that the size of syntactic effects varied both in aphasia and in control participants. Whereas variability in control participants led to systematic changes, variability in individuals with aphasia was unsystematic across test phases or response tasks. The persistent occurrence of canonicity and interference effects across response tasks and test phases, however, shows that the performance is systematically influenced by syntactic complexity.
Background: Comprehension of non-canonical sentences is frequently characterised by chance level performance in people with aphasia (PWA). Chance level performance has been interpreted as guessing, but online data does not support this rendering. It is still not clear whether the incorrect sentence processing is guided by the compensatory strategies that PWA might employ to overcome linguistic difficulties.Aims: We aim to study to what extent people with non-fluent aphasia are aware of their sentence comprehension deficits.Methods & Procedures: This study combined offline and online data to investigate the effect of word order and error-awareness on sentence comprehension in a group of PWA and non-brain damaged (NBD) participants. The offline tasks involved auditory sentence picture-matching immediately followed by a confidence rating (CR). Participants were asked to judge the perceived correctness of their previous answer. Online data consisted of eye-tracking.Outcomes & Results: Replicating previous findings, PWA had significantly worse comprehension of Theme-Agent order compared to Agent-Theme order sentences. Controls showed ceiling level sentence comprehension. CR was a poor predictor of response accuracy in PWA, but moderate-good in NBD. A total of 6.8% of judgements were classified as guessing by PWA. Post hoc gaze data analysis indicated that CR was a predictor of the fixation pattern during the presentation of the linguistic stimuli.Conclusions: Results suggest that PWA were mostly unaware of their sentence comprehension errors and did not consciously employ strategies to compensate for their difficulties.