Undergraduate Honors Theses

Thesis Defended

Fall 2017

Document Type

Thesis

Type of Thesis

Departmental Honors

Department

Speech, Language & Hearing Sciences

First Advisor

Gail Ramsberger

Second Advisor

Kathryn Arehart

Third Advisor

Bhuvana Narasimhan

Abstract

Abstract

Background: People with aphasia (PWA) experience a range of communication difficulties. Communicative deficits typically include problems with connected speech, or discourse. Improving communication success at the level of discourse is often a primary goal in aphasia rehabilitation. This investigation questions which skills should be targeted during aphasia rehabilitation in order to most efficiently result in discourse improvement. Most often, therapy has focused on sentence level skills (e.g., word-finding or syntax/grammar) because these are recognized as areas of impairment. However, Linnik et al. (2016) recently reported on a treatment that placed greater emphasis on suprasentence level skills (e.g., organization of ideas or coherence).

Aims: The study aims to determine the sentence and suprasentence level impairments exhibited by people with aphasia when they were asked to retell the Cinderella story from memory. Moreover, this study aims to compare their performance to that of neurotypical participants. Specifically, areas of interest addressed throughout this investigation include: (1) the number of main concepts that the participants included when they retold the story, (2) the order in which the participants arranged the 5 story events, and (3) potential correlations between these components and the Western Aphasia Battery (WAB) test scores.

Methods & Procedures: Transcripts were collected from 40 participants who were asked to retell the Cinderella story from memory. The 40 Cinderella story transcripts were composed of 20 controls and 20 PWA. These transcripts, as well as WAB test results, were collected from AphasiaBank (MacWhinney et al., 2011). The 40 transcripts were each individually coded and compared to a Main Concept (MC) list discourse task called “MCRules—Cinderella” (Richardson ANALYSIS OF A STORYTELLING DISCOURSE TASK FROM APHASIC AND NEUROTYPICAL SPEAKERS 3 & Dalton, 2015), which, is a document that AphasiaBank supplies. Data from the Cinderella transcriptions were then correlated to WAB test scores for participants with aphasia.

Outcomes & Results: At large, the control participants included a greater percentage of the 34 main concepts than the aphasia participants did when they retold the story. The average percent of control participants who included each of the 34 main concepts was 50.88%; while, the average percent of aphasic participants who included each of 34 main concepts was 22.5%. Nonetheless, the neurotypical participants and aphasic participants demonstrated similarities in the specific main concepts that they chose to include when they retold the Cinderella story. There was a significant correlation (p=0.01) between the number of main concepts included by participants with aphasia and their WAB Word Fluency test scores. Results also showed that the aphasic participants made few errors and the controls made no errors in the order that 5 story events were introduced.

Conclusions: This investigation concluded that in order to improve discourse skills, aphasia rehabilitation should focus on word fluency, as opposed to discourse organization. The reason for this conclusion was twofold: (1) the results do not show a significant difference between the control and the aphasic participants’ performance on the order of events (discourse organization) portion of this investigation, and (2) the results do show a significant correlation between the WAB Word Fluency test scores and the number of main concepts that the aphasic participants included when they retold the Cinderella story, indicating potential similarities between the thought processes that are involved during a discourse task and a word fluency task.

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