Aphasia Language Analysis: Lexical, Syntactic, and Conversation Breakdown

Lexical Level Analysis

  • Focus: word/sentence level processing (lexical breakdown)
  • Word retrieval difficulties: semantic or phonological paraphasias
  • Variety of word types
  • Nonspecific lexical items: it, they, this, that
  • Word class distribution: mostly nouns; some verbs
  • Lexical diversity: type-token ratio
  • Efficiency: word-finding behaviours
  • Comments during retrieval: “what’s it called”, “I don’t [the word]”
  • Pauses: silent and filled (uh, um)

Lexical Breakdown: Quantity of Information

  • Assumption: as word retrieval improves, more information is conveyed more efficiently
  • Correct Information Unit (CIU): relevance of lexical items to discourse; intelligible in context; accurate to picture/topic; relevant and informative
  • CIUs work best with known content; less useful in natural conversations with unknown content
  • Key reference: Nicholas and Brookshire (1993) CIU framework

Sentence Analysis and Beyond: Grammar/Syntax and Discourse Structure

  • Grammatical accuracy and complexity
    • Omission of Subject, Verb, Object (e.g., The boy hit [the ball])
    • Omission of function words (the, a, of, to, over)
    • Use of complex sentences
  • Cohesion and Coherence
    • Reduced cohesive ties
    • Ambiguous pronouns (he, she, it) with referent difficult to identify

Tools for Lexical-Syntactic Breakdown

  • Profile of Word Errors and Retrieval in Speech (Herbert et al., 2013)
  • Correct Information Unit (Brookshire & Nicholas, 1993)
  • Analysis of verbs and argument structure (Thompson, Lange, Schneider, & Shapiro, 1997)
  • Syntactic complexity measures (Gordon, 2008; Thompson, 2013)
  • Coherence and Cohesion protocols (Curtin University Protocol; Whitworth et al., 2015)

Conversation Breakdown

  • Dynamic, collaborative nature of interaction; conversation as a joint effort
  • Potential communication breakdowns and repair strategies:
    • Joint production
    • Repetition
    • Guessing
  • Assess success of repair strategies
  • Disruptive behaviours
  • Use tests or corrections even when information is known
  • Note: SPHY 202 Lecture Week 5, 2020

Collaborative Repair

  • Milroy and Perkins (1992)
  • Repair sequence: move from non-specific items to more specific information
  • Example pattern: speaker provides info -> listener responds -> more detail provided
  • Demonstrative example: simple reference like “toilet” to illustrate repair

Disruptive Behaviours

  • Potential trouble sources: neologisms and pronoun errors
  • If the listener already understands the intended meaning, there may be no true breakdown
  • Empirical reference: Perkins, Crisp, & Walshaw (1999)

Practical Tips: Analyzing Conversation

  • CA (Conversation Analysis) is time-intensive; in clinical settings use practical tools
  • Tools:
    • CAPPA: Conversation Analysis Profile for People with Aphasia (Whitworth, Perkins, & Lesser, 1997)
    • Profile of Word Errors and Retrieval in Speech (Best et al., 2013)
    • Quantification of repair: proportion of major turns involved in repair

Rating Scales for Conversation

  • Kagan, Winckel, Black et al. (2004): Measure of Participation in Conversation
  • Measure of Skill in Supported Conversation (updated by Kagan et al., 2018)
  • Dementia measures: Mok, Steel, Russell, & Conway (2021)
  • TBI measures: Togher, Power, Tate, et al. (2010)
  • Abbreviations: MSC = Measures of Skill and Participation in Conversation; CP = conversation partner; PA = person with aphasia

Anchors for Partner with Aphasia and Conversation Partner

  • MSC anchors (PA and CP): two dimensions per anchor – Interaction and Transaction
  • Interaction (1–4):
    • 1: No evidence of revealing competence; high supervision concerns
    • 2: Some evidence; partial comfort with supervision
    • 3: Clear attempts; can be left with supervision (occasional check-in)
    • 4: Interactionally outstanding; minimal supervision required
  • Transaction (1–4):
    • 1: No participation
    • 2: Some participation; needs support
    • 3: Understands and conveys content with some guidance; can be left with check-ins
    • 4: Full participation; confident and independent
  • Note: PA = person with aphasia; CP = conversation partner

Introduction to Discourse and Intervention

  • Discourse as an outcome of therapy; generalisation from impairment-based treatment to daily discourse
  • Conversation-based interventions
  • Communication partner training

Summary

  • Provides insight into how a person with aphasia uses language in daily life
  • Assessment considerations: language sampling, multiple discourse genres
  • Language analysis: lexical and syntactic
  • Relationship to intervention: to be explored further

References (selected)

  • Best, W., Hickin, J., Howard, D., & Osborne, F. (2013). Powers: Profile Of Word Errors and Retrieval in Speech. J & R Press.
  • Kertesz, A. (2007/2006). Western Aphasia Battery test manual.
  • Kagan, A., Simmons-Mackie, N., & Shumway, E. (2018). MSC anchors and scoring procedures. Aphasia Institute.
  • Perkins, L., Crisp, J., & Walshaw, D. (1999). Exploring conversation analysis as an assessment tool for aphasia. Aphasiology.
  • Thompson, C. K., Lange, K. L., Schneider, S. L., & Shapiro, L. P. (1997). Agrammatic and non-brain-damaged subjects’ verb and argument structure production. Aphasiology.
  • Togher, L., Power, E., Tate, R., McDonald, S., & Rietdijk, R. (2010). Measuring social interactions in TBI. Aphasiology.
  • Whitworth, A., Perkins, L., & Lesser, R. (1997). Conversation Analysis Profile for People with Aphasia. Whurr.
  • Whitworth, A., Perkins, L., & Lesser, R. (2015). Beyond narrative: implicit discourse structure. Clinical Linguistics & Phonetics.
  • Mok, Z., Steel, G., Russell, C., & Conway, E. (2021). Dementia: interaction measures; Aging & Mental Health.