Lexical access in aphasic and nonaphasic speakers

Decoding words during sentence production with ECoG reveals syntactic role encoding and structure-dependent temporal dynamics

Sentence production is the uniquely human ability to transform complex thoughts into strings of words. Despite the importance of this process, language production research has primarily focused on single words. It remains a largely untested assumption that the principles of word production generalize to more naturalistic utterances like sentences. Here, we investigate this using high-resolution neurosurgical recordings (ECoG) and an overt production experiment where ten patients produced six words in isolation (picture naming) and in sentences (scene description). We trained machine learning classifiers to identify the unique brain activity patterns for each word during picture naming, and used these patterns to decode which words patients were processing while they produced sentences. Our findings confirm that words share cortical representations across tasks, but reveal a division of labor within the language network. In sensorimotor cortex, words were consistently activated in the order in which they were said in the sentence. However, in prefrontal cortex, the order in which words were processed depended on the syntactic structure of the sentence. In non-canonical sentences (passives), we further observed a spatial code for syntactic roles, with subjects selectively encoded in inferior frontal gyrus (IFG) and objects selectively encoded in middle frontal gyrus (MFG). We suggest that these complex dynamics of prefrontal cortex may impose a subtle pressure on language evolution, potentially explaining why nearly all the world's languages position subjects before objects.

Gulf Arabic Noun and Verb Retrieval: What Matters?

Differential processing between the grammatical classes, i.e., nouns and verbs, has been studied across various linguistic disciplines in different languages, but not Arabic. The present study explores predictors of bare single nouns and bare single verbs in Gulf Arabic through a picture-naming paradigm. Aspects specific to the morpho-phonology of the language (CV skeleton, vocalic pattern) have been investigated for their roles in noun and verb retrieval. A picture-naming paradigm was carried out with 64 healthy native speakers of Gulf Arabic where participants named 282 line drawings representing nouns, and 154 line drawings representing verbs to generate naming latencies for the nouns and verbs in question. Linear regression models were fitted to analyse the relationship between grammatical class and naming latencies as well as morphological features and naming latencies. Verbs, which are more morphologically complex than nouns, were found to have higher naming latencies. Both CV skeleton and vocalic pattern impacted naming latencies and can account for the difference between verb and noun production. The results are discussed in relation to the non-concatenative morphology framework for Semitic languages.

The serial order system in word production and working memory: A case series approach

Serial order is important in verbal behavior, such as sequencing words in working memory (WM) or arranging phonemes during speech. In both WM and word production, distinct processes are found for item identity and their serial order. In the current study, we investigated whether a shared system supports the serial order of verbal items (phonemes or words) across cognitive functions (WM and production) and tasks (repetition and naming). We recruited 30 participants with chronic stroke-induced aphasia. We examined WM abilities to recall item and serial order information using immediate serial recall tasks of words. We also assessed the ability to accurately sequence phonemes in word repetition and naming tasks, with its impairment indexed by the proportion of misordered phonemes among all incorrect phonemes compared to chance in phonologically related word and nonword responses. We examined how variability of this index of serial order impairment in repetition and naming relates to item and serial order WM capacities. Our findings reveal that serial order WM capacity, but not item WM capacity, was associated with the severity of serial order impairment in repetition, indicating a shared serial order system for WM and repetition. We also found that item WM, but not serial order WM, was associated with serial order impairment in naming, implying an item WM buffer for phonemic sequencing in naming. These results suggest distinct sequencing processes for repetition and naming, each linked to different WM mechanisms. Implications for word production models and the relationship between WM and word production are discussed.

Production and Perception Errors From Speech Error Corpora Reflect Macro- and Meso-Level Structure of the Phonological Language Network

The goal of the present study was to investigate if cognitive traces of the network structure of the phonological language network, where phonological word-form neighbors are connected to each other, could be uncovered in word substitution errors. The phonological network has a set of macro-level (i.e., features characterizing global structure of the lexicon) and meso-level (i.e., features characterizing intermediate structure or subgroups within the lexicon) structural features that should be observable in speech error data if such features play a role in production and retrieval processes. A total of 1,067 single-word substitution errors, which included 965 production errors (i.e., slips of the tongue) and 102 perception errors (i.e., slips of the ear), were analyzed in the present study. Results indicated evidence of both macro- and meso-level lexicon structures in word substitution errors, providing converging evidence that structural features of the phonological network have implications for language-related processes.

# Language processing characteristics in normal pressure hydrocephalus: insights from eye-tracking analysis of incorrect responses

Introduction

In patients with Normal Pressure Hydrocephalus (NPH), the aging process results in decreased efficiency of cerebrospinal fluid circulation, leading to ventricular enlargement. This enlargement compresses several brain structures, impairing functions such as visual perception, semantic memory processing, and phonological encoding contributing to language processing difficulties. This study examines real-time language processing in NPH patients and healthy elderly (HE) controls by comparing their eye movements during correct and incorrect responses in a lexical retrieval task (LRT).

Methods

A total of 26 subjects participated, comprising 14 patients diagnosed with NPH (aged 65 or older) and 12 individuals in the HE group. A lexical retrieval task was administered as their eye movements were recorded. A Mann-Whitney U test was performed to compare LRT performance and eye-tracking metric results across different groups, respectively. Also, correlation analysis was performed to examine the relationship between LRT scores and eye-tracking scores. A two-way mixed ANOVA was conducted to assess the significance of eye-tracking metrics depending on response type (correct/incorrect). Additionally, a qualitative and quantitative comparison of heatmaps and scanpaths was conducted to visualize eye-tracking data for correct and incorrect items.

Results

The NPH group exhibited significantly lower performance in lexical retrieval compared to the HE group, accompanied by more counts and longer durations in both fixation and saccade metrics. A negative correlation was noted between LRT scores and eye-tracking metric values, with correlation coefficients predominantly at 0.50 or higher. Analysis of eye movements during correct and incorrect responses uncovered significant group and within-group effects across all metrics, with more intergroup differences during incorrect responses. Qualitative differences in eye movements were more noticeable in images associated with incorrect items.

Discussion

This study highlights previously under-explored language deficits in NPH patients using real-time visual processing analysis, underscoring the importance of targeted language interventions for these populations.

Construct Validation of the Verb Naming Test for Aphasia

PURPOSE

Although there is widespread agreement pertaining to the cognitive processes underlying spoken word production, more generally in aphasia, multiple competing accounts exist regarding the processes involved for verb production, specifically. Some have speculated that suboptimal control of certain item properties (e.g., imageability) may be partially responsible for conflicting reports in the literature, yet there remains a dearth of research on the psychometric validation of verb production tests for aphasia. The purpose of the present study was to investigate the cognitive constructs underlying the Verb Naming Test (VNT), a relatively commonly used verb production test, by expanding upon an item response theory (IRT) modeling framework we previously described.

METHOD

Using an archival data set of 107 individuals with aphasia, we specified a series of IRT models to investigate whether item covariates (argument structure, imageability), person covariates (aphasia subtype, severity), and their interactions were predictive of VNT item response patterns.

RESULTS

Across all models, covariates that were most strongly associated with lexical-semantic processing (imageability, aphasia severity) were significant predictors. In contrast, covariates that were most strongly associated with morphosyntactic processing (argument structure, aphasia subtype) were minimally predictive.

CONCLUSIONS

VNT item response patterns appear to be primarily explained by covariates representing lexical-semantic processing. In particular, we identified an important role of imageability, a covariate not controlled for in the VNT's item design, which both aligns with a body of prior research and further illustrates the challenge of differentiating morphosyntactic processing from lexical and semantic processes during word production.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.28664669.

Simon Fraser University Speech Error Database - English (SFUSED English): Methods and Design

SFUSED English (Simon Fraser University Speech Error Database - English) is the first large scale database of speech errors developed from audio recordings of spontaneous speech. This article describes the structure of the database and the standards used to construct it, including collection and classification methods, record mark-up, data quality measures, and adherence to standard practices in psycholinguistics and English linguistics. Additional information on these methods and the entire database are available on the OSF repository: https://osf.io/8c9rg/.

Combining executive function training and anomia therapy in chronic post-stroke aphasia: A preliminary study of multidimensional effects

PURPOSE

The influential relationship between executive functioning and aphasia rehabilitation outcomes has been addressed in a number of studies, but few have studied the effect of adding executive function training to linguistic therapies. The present study aimed to measure the effects of combining, within therapy sessions, executive function training and anomia therapy on naming and discourse abilities in people with chronic aphasia.

METHOD

A single-case experimental design with multiple baselines across participants was used. Four persons with chronic post-stroke aphasia received 12 sessions of a tailored treatment combining executive function training and semantic feature analysis (SFA) therapy. Naming accuracy of treated items was examined over the course of the treatment while control naming scores of untreated items and discourse measures were collected pre-treatment, immediately post-treatment, and 4 weeks post-treatment, in order to investigate the multidimensional effects of the treatment and their maintenance.

RESULT

Naming skills improved in all participants for treated and untreated items, were maintained over time, and were accompanied by improved discourse abilities. Visual and statistical analyses showed a significant treatment effect for naming skills in three out of the four participants.

CONCLUSION

A combination of executive function training and SFA treatment in people with chronic aphasia may improve both naming skills and discourse efficiency. Further studies are needed to substantiate these promising preliminary results.

sunflower: an R package for handling multiple response attempts and conducting error analysis in aphasia and related disorders

Manual classification of production errors and the allocation of speech/spelling scores are time-consuming, laborious and error-prone tasks, even when conducted by clinicians and specialized researchers. Here we present sunflower, an R package developed to improve the analysis of language production quality for Spanish data. The package offers various functions, including (1) managing dataframes containing single responses and multiple-attempt responses, (2) conducting formal similarity analyses on words as well as positional accuracy data analyses within words, and (3) the classification of errors by considering lexicality, formal similarity and semantic similarity indexes, which are obtained by means of different algorithms and artificial intelligence techniques such as word2vec. The applications of sunflower, which is the first open-source package of its kind, include assessing whether production quality improves over the course of multiple attempts, and identifying which aspects of an individual's productions are most impacted by their impairments. Other potential applications include the analysis of whether improvements arise in a patient's production quality after a given treatment, distinguishing between cases of apraxia of speech and conduction aphasia, as well as simply using the package to improve and speed up the classification of speech/spelling errors with large datasets through automation.

What we mean when we say semantic: Toward a multidisciplinary semantic glossary

Tulving characterized semantic memory as a vast repository of meaning that underlies language and many other cognitive processes. This perspective on lexical and conceptual knowledge galvanized a new era of research undertaken by numerous fields, each with their own idiosyncratic methods and terminology. For example, "concept" has different meanings in philosophy, linguistics, and psychology. As such, many fundamental constructs used to delineate semantic theories remain underspecified and/or opaque. Weak construct specificity is among the leading causes of the replication crisis now facing psychology and related fields. Term ambiguity hinders cross-disciplinary communication, falsifiability, and incremental theory-building. Numerous cognitive subdisciplines (e.g., vision, affective neuroscience) have recently addressed these limitations via the development of consensus-based guidelines and definitions. The project to follow represents our effort to produce a multidisciplinary semantic glossary consisting of succinct definitions, background, principled dissenting views, ratings of agreement, and subjective confidence for 17 target constructs (e.g., abstractness, abstraction, concreteness, concept, embodied cognition, event semantics, lexical-semantic, modality, representation, semantic control, semantic feature, simulation, semantic distance, semantic dimension). We discuss potential benefits and pitfalls (e.g., implicit bias, prescriptiveness) of these efforts to specify a common nomenclature that other researchers might index in specifying their own theoretical perspectives (e.g., They said X, but I mean Y).

Rehabilitation of post-stroke aphasia by a single protocol targeting phonological, lexical, and semantic deficits with speech output tasks: a randomized controlled trial

BACKGROUND

The defective spoken output of persons with aphasia has anomia as a main clinical manifestation. Improving anomia is therefore a main goal of any language treatment.

AIM

This study assessed the effectiveness of a novel, 2-week, rehabilitation protocol (PHOLEXSEM), focused on PHonological, SEmantic, and LExical deficits, aiming at improving lexical retrieval, and, generally, spoken output.

DESIGN

A prospective, randomized controlled trial.

SETTING

In-patient and out-patient population of the Neurorehabilitation Unit of the Istituto Auxologico Italiano IRCCS, Milan, Italy.

POPULATION

The sample comprised 44 adults with aphasia due to left brain damage; 22 of them were assigned to the experimental (PHOLEXSEM) group, whereas 22 were assigned to the control group that received the Promoting Aphasics Communicative Effectiveness (PACE) protocol.

METHODS

All participants were treated 30-min daily for two weeks. The PHOLEXSEM training included 3 sets of exercises: 1) non-word, word, and phrase repetition; 2) semantic feature analysis by naming; 3) phonemic, semantic, and verb recall. Treatment effects were evaluated with tasks and items different from those used for training, to assess generalization effects.

RESULTS

After the PHOLEXSEM treatment, repetition, naming, lexical retrieval and sentence comprehension improved more than in the control - PACE - group, with gains generalizing to non-trained items. These improvements were independent of aphasia chronicity and only marginally influenced by demographic factors.

CONCLUSIONS

The 2-week PHOLEXSEM training, by targeting spoken output, ameliorates different aspects of aphasia, ranging from speech production (i.e., phonology and lexical retrieval) to comprehension.

CLINICAL REHABILITATION IMPACT

The PHOLEXSEM training is a useful and easy-to-administer intervention to improve post-stroke language deficits in adults of different ages, levels of education, duration, type, and severity of aphasia.

Cross-modal interactions in language production: evidence from word learning

Literate adults are able to produce the same word in different language modalities-for instance, through speaking and writing. Yet how speaking and writing interact is not well understood. The present study takes a new perspective on the question of the co-activation of phonological and orthographic representations in speaking and writing by examining the acquisition of novel words. We tested how novel words get integrated into modality-specific lexicons by biasing novel word acquisition toward speaking or writing and assessing cross-modal transfer at the first stages of learning. Participants learned novel words paired with pictures of novel objects and practiced them overtly through speaking or typing. At test, typed training led to higher recall accuracy than spoken training whether words were recalled through typing or speaking. Performance in typing (RT and durations) benefited more from typed than spoken training. Crucially, performance in speaking did not benefit specifically from spoken training and was similar after spoken or typed training. Results are compatible with an asymmetric integration in the phonological and orthographic lexicons according to the modality of training, with representations created in the orthographic lexicon directly transferring to the phonological lexicon, while the opposite doesn't seem to occur. Cross-modal transfer dynamics are discussed according to the level of lexical activation.

Computer- and Smart-Tablet-Based Self-Administered Treatments in Chronic Post-Stroke Aphasia: A Systematic Review

BACKGROUND

In current clinical practice, resources remain limited and are insufficient to address the needs of people with chronic post-stroke aphasia. To improve access to speech therapy, self-administered therapies using computers or smart tablets are increasingly recommended. In addition to enabling more intensive and prolonged treatment, computer- and smart-tablet-delivered therapies can be highly enjoyable and motivating for patients.

AIMS

This systematic review aimed to identify computer- and smart-tablet-based self-administered treatments and analyze the proposed interventions in terms of treatment targets, effectiveness (considering specificity, generalization, transfer, and maintenance), and clinician involvement (during and/or prior self-administered therapies).

METHODS

Terms encompassing three main concepts (rehabilitation, self-administration, and aphasia) were used to search three electronic databases (Scopus, PubMed, and PsycINFO). Two reviewers independently screened titles and abstracts against eligibility criteria. Data extraction of included studies was completed by three reviewers.

RESULTS

Thirty-nine studies were included in this study. In terms of treatment targets, anomia is the most treated symptom in published studies (n = 24), but the existence of promising studies for other disorders means that the targets can be broadened. Therapies are effective for trained items, and gains are maintained. There is some evidence of transfer effects for treatments targeting the sentence level. Most studies offer training sessions, previous self-administered therapy, and/or observation and monitoring sessions during therapy; more rarely, self-administered therapy is supplemented with face-to-face therapy.

CONCLUSIONS

This systematic review is the first to focus specifically on self-administered technology-based therapies. It provides important evidence-based information for clinical practice in self-administered therapies via computer or smart tablet.

The Functional Origin of Oral Word Production Deficits in the Logopenic Variant of Primary Progressive Aphasia: A Systematic Review

BACKGROUND/OBJECTIVES

Oral word production (OWP) deficits are prominent in the logopenic variant of primary progressive aphasia (lvPPA); however, their functional origin remains unclear. Some studies suggest a lexical, post-lexical, or even a combined functional origin of these deficits. The aim of the present study was to synthesize and analyze the information on the functional origin of the OWP deficits in patients with lvPPA.

METHODS

A quantitative systematic literature review was carried out using four databases: CINAHL, PsycINFO, Linguistics and Language Behavior Abstracts, and PubMed. Fourteen studies, including a total of 243 patients with lvPPA, and reporting results on picture naming and/or word and/or pseudoword repetition, were selected.

RESULTS

The overall findings of this review highlighted that two main functional origins appear to explain the OWP deficits in lvPPA: a lexical impairment affecting lexical processing and a post-lexical impairment affecting phonological short-term memory. Interestingly, the possibility of a third functional origin, affecting the semantic processing level, was also suggested by some studies.

CONCLUSIONS

We concluded that the presence of different functional origins of OWP in this population may be explained, at least partially, by the diversity of assessment tasks used in studies and the varied manipulation and control of psycholinguistic properties of words (e.g., frequency, length), as well as the various interpretations and analyses of the participants' errors. Further studies are needed to substantiate these findings by examining all the components involved in OWP, carefully manipulating the psycholinguistic properties and qualitatively analyzing the errors made by lvPPA participants.

Speech Kinematics and Perioral Muscle Activity Are Influenced by Stroop Effects

PURPOSE

The current project aimed to examine the effects of two experimental cognitive-linguistic paradigms, the Stroop task and a primed Stroop task, on speech kinematics and perioral muscle activation.

METHOD

Acoustic, kinematic, and surface electromyographic data were collected from the verbal responses of 30 young adult healthy control participants in choice response, classic Stroop, and primed Stroop tasks. The classic and primed Stroop tasks included congruent and incongruent trials. Across all three tasks, the set of possible responses was limited to the same three possible color words (red, green, and black) to facilitate performance comparisons between tasks.

RESULTS

Trials with ink-word incongruence in the Stroop tasks resulted in significantly higher muscle activation in the upper lip during response selection. In addition, a prime word within the Stroop task resulted in more spatial variation in lip + jaw movements for the spoken responses. These results were accompanied by the expected longer response times for incongruent trials in both classic and primed Stroop tasks.

CONCLUSIONS

These findings may suggest that more central cognitive-linguistic interference processes may lead to inefficiencies in more peripheral speech motor control. Future research should investigate the pattern of these effects in older adults with and without motor speech disorders for research and clinical applications.

Four dimensions of naturalistic language production in aphasia after stroke

There is a rich tradition of research on the neuroanatomical correlates of spoken language production in aphasia using constrained tasks (e.g. picture naming), which offer controlled insights into the distinct processes that govern speech and language (i.e. lexical-semantic access, morphosyntactic construction, phonological encoding, speech motor programming/execution). Yet these tasks do not necessarily reflect everyday language use. In contrast, naturalistic language production (also referred to as 'connected speech' or 'discourse') more closely approximates typical processing demands, requiring the dynamic integration of all aspects of speech and language. The brain bases of naturalistic language production remain relatively unknown, however, in part because of the difficulty in deriving features that are salient, quantifiable and interpretable relative to both speech-language processes and the extant literature. The present cross-sectional observational study seeks to address these challenges by leveraging a validated and comprehensive auditory-perceptual measurement system that yields four explanatory dimensions of performance-Paraphasia (misselection of words and sounds), Logopenia (paucity of words), Agrammatism (grammatical omissions) and Motor speech (impaired speech motor programming/execution). We used this system to characterize naturalistic language production in a large and representative sample of individuals with acute post-stroke aphasia (n = 118). Scores on each of the four dimensions were correlated with lesion metrics, and multivariate associations among the dimensions and brain regions were then explored. Our findings revealed distinct yet overlapping neuroanatomical correlates throughout the left-hemisphere language network. Paraphasia and logopenia were associated primarily with posterior regions, spanning both dorsal and ventral streams, which are critical for lexical-semantic access and phonological encoding. In contrast, agrammatism and motor speech were associated primarily with anterior regions of the dorsal stream that are involved in morphosyntactic construction and speech motor planning/execution, respectively. Collectively, we view these results as constituting a brain-behaviour model of naturalistic language production in aphasia, aligning with both historical and contemporary accounts of the neurobiology of spoken language production.

The Active Ingredients of Semantic Naming Treatment: Evidence From Mandarin-English Bilingual Adults With Aphasia

PURPOSE

Following the Rehabilitation Treatment Specification System (RTSS) framework, the current study investigated the active ingredients in the modified semantic feature analysis (mSFA) targeting either noun or verb retrieval in Mandarin-English bilingual adults with aphasia (BWA).

METHOD

Twelve Mandarin-English BWA completed mSFA treatment for nouns and verbs. Eight of them completed both noun and verb treatment, while four completed either type of treatment. Performance in each step was scored and analyzed using mixed-effects modeling. Then, regression was performed to estimate the effect of treatment performance on the accuracy of naming probes for trained and semantically related items in both treated and untreated languages.

RESULTS

Participants demonstrated significant improvements in all treatment steps during both noun and verb treatment, yet the effect varied depending on the trained word category and treatment language. Moreover, all treatment components contributed significantly to the treatment outcomes. Better treatment performance in spontaneous naming was significantly associated with improved naming accuracy of the trained items in noun mSFA, while better treatment performance in spontaneous naming, feature analysis, and sentence production was significantly associated with enhanced naming of the semantically related untrained items in noun mSFA. Importantly, performance in all treatment steps of both noun and verb mSFA significantly predicted naming accuracy in the untreated language.

CONCLUSION

Findings provided strong evidence of the potential active ingredients of semantic-based naming therapy in Mandarin-English BWA and highlighted the importance of examining treatment ingredients within the RTSS framework.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.28003292.

[Intraoperative speech mapping during awake surgery]

Speech mapping during awake neurosurgery is used to identify functionally significant speech areas. Despite the widespread use of this method worldwide, there are currently a limited number of intraoperative task batteries for testing various speech subfunctions. This literature review aims to describe the cortical and subcortical representations of speech, present the main tests used to monitor speech functions in patients during awake surgeries and show the specificity of the speech regions of the brain for different types of tasks.

Bimodal aphasia and dysgraphia: Phonological output buffer aphasia and orthographic output buffer dysgraphia in spoken and sign language

We report a case of crossmodal bilingual aphasia-aphasia in two modalities, spoken and sign language-and dysgraphia in both writing and fingerspelling. The patient, Sunny, was a 42 year-old woman after a left temporo-parietal stroke, a speaker of Hebrew, Romanian, and English and an adult learner, daily user of Israeli Sign language (ISL). We assessed Sunny's spoken and sign languages using a comprehensive test battery of naming, reading, and repetition tasks, and also analysed her spontaneous-speech and sign. Her writing and fingerspelling were assessed using tasks of dictation, naming, and delayed copying. In spoken language production, Sunny showed a classical phonological output buffer (POB) impairment in naming, reading, repetition, and spontaneous production, with phonological errors (transpositions, substitutions, insertions, and omissions) in words and pseudo-words, and whole-unit errors in morphological affixes, function-words, and number-words, with a length effect. Importantly, her error pattern in ISL was remarkably similar in the parallel tasks, with phonological errors in signs and pseudo-signs, affecting all the phonological parameters of the sign (movement, handshape, location, and orientation), and whole-unit errors in morphemes, function-signs, and number-signs. Sunny's impairment was selective to the POB, without phonological input, semantic-conceptual, or syntactic deficits. This shows for the first time how POB impairment, a kind of conduction aphasia, manifests itself in a sign language, and indicates that the POB for sign-language has the same cognitive architecture as the one for spoken language. It may also indicate similar neural underpinnings for spoken and sign languages. In writing, Sunny forms the first case of a selective type of dysgraphia in fingerspelling, orthographic (graphemic) output buffer dysgraphia. In both writing and fingerspelling, she made letter errors (letter transpositions, substitutions, insertions, and omissions), as well as morphological errors and errors in function words, and showed length effect. Sunny's impairment was selective to the orthographic output buffer, whereas her reading, including orthographic input processing, was intact. This suggests that the orthographic output buffer is shared for writing and fingerspelling, at least in a late learner of sign language. The results shed further light on the architecture of phonological and orthographic production.

The Flu-ID: A New Evidence-Based Method of Assessing Fluency in Aphasia

PURPOSE

Assessing fluency in aphasia is diagnostically important for determining aphasia type and severity and therapeutically important for determining appropriate treatment targets. However, wide variability in the measures and criteria used to assess fluency, as revealed by a recent survey of clinicians (Gordon & Clough, 2022), results in poor reliability. Furthermore, poor specificity in many fluency measures makes it difficult to identify the underlying impairments. Here, we introduce the Flu-ID Aphasia, an evidence-based tool that provides a more informative method of assessing fluency by capturing the range of behaviors that can affect the flow of speech in aphasia.

METHOD

The development of the Flu-ID was based on prior evidence about factors underlying fluency (Clough & Gordon, 2020; Gordon & Clough, 2020) and clinical perceptions about the measurement of fluency (Gordon & Clough, 2022). Clinical utility is maximized by automated counting of fluency behaviors in an Excel template. Reliability is maximized by outlining thorough guidelines for transcription and coding. Eighteen narrative samples representing a range of fluency were coded independently by the authors to examine the Flu-ID's utility, reliability, and validity.

RESULTS

Overall reliability was very good, with point-to-point agreement of 86% between coders. Ten of the 12 dimensions showed good to excellent reliability. Validity analyses indicated that Flu-ID scores were similar to clinician ratings on some dimensions, but differed on others. Possible reasons and implications of the discrepancies are discussed, along with opportunities for improvement.

CONCLUSIONS

The Flu-ID assesses fluency in aphasia using a consistent and comprehensive set of measures and semi-automated procedures to generate individual fluency profiles. The profiles generated in the current study illustrate how similar ratings of fluency can arise from different underlying impairments. Supplemental materials include an analysis template, extensive guidelines for transcription and coding, a completed sample, and a quick reference guide.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.27078199.

Does the extension of free time trigger spontaneous elaborative strategies in working memory?

Elaboration has emerged as a potential maintenance mechanism involved in the substantial contribution of long-term memory (LTM) to working memory (WM) performance. The objective of the current study was to determine whether elaborative strategies could be spontaneously implemented under favorable conditions. Across four experiments, the distribution of free-time periods was manipulated in a complex span task, while keeping the total amount of free time and cognitive load constant. As elaboration requires time to be set up, Experiment 1 elicited better WM performance in a condition with fewer long free-time periods compared to a condition with many short free-time periods. However, because this benefit did not persist during delayed recall, the following experiments aimed to further investigate this effect by manipulating factors supposed to modulate elaboration. In Experiment 2, half of the participants received no specific instructions regarding strategies whereas the other half were encouraged to use elaborative strategies. In Experiment 3, the to-be-maintained stimuli did or did not have LTM representations that are essential for elaboration (i.e., words or pseudowords). Finally, the last experiment used a self-strategy report to better understand the nature of the WM maintenance strategies spontaneously employed by participants. Despite a consistent effect of free time manipulation on WM recall, the explanatory assumption of elaboration was challenged by the unexpected lack of effect on LTM recall and on the type of strategy reported. Alternative explanations stemming from well-known factors influencing WM performance are discussed, and emphasis is placed on the potential contribution of direct semantic maintenance in WM.

Cognitive components of aging-related increase in word-finding difficulty

Word-finding difficulty (WFD) is a common cognitive complaint in aging, manifesting both in natural speech and in controlled laboratory tests. Various theories of cognitive aging have addressed WFD, and understanding its underlying mechanisms can help to clarify whether it has diagnostic value for neurodegenerative disease. Two influential "information-universal" theories attribute it to rather broad changes in cognition. The processing speed theory posits a general slowdown of all cognitive processes, while the inhibitory deficit hypothesis (IDH) predicts a specific problem in suppressing irrelevant information. One "information specific" theory of language production, the transmission deficit hypothesis (TDH), posits a breakdown in retrieval of phonological word forms from a corresponding lemma. To adjudicate between these accounts, we administered an online gamified covert naming task featuring picture-word interference (PWI), previously validated to elicit similar semantic interference and phonological facilitation effects as overt naming tasks. 125 healthy adults aged 18 to 85 completed the task, along with a battery of executive function tasks and a naturalistic speech sample to quantify WFD in connected speech. PWI effects provided strong support for the TDH but limited support for IDH, in that semantic interference increased and phonological facilitation decreased across the lifespan. However, neither of these effects on single-word retrieval associated with WFD measured in connected speech. Rather, overall reaction time for word retrieval (controlling for psychomotor slowing) was the best predictor of spontaneous WFD and executive function decline, suggesting processing speed as the key factor, and that verbal reaction time may be an important clinical measure.

Psycholinguistic predictors of naming accuracy and decline in bilingual logopenic primary progressive aphasia: a cross-linguistic case study

Naming impairment is a hallmark of logopenic primary progressive aphasia (lvPPA), yet its effects in bilingualism remain understudied. This study examined naming accuracy in a 78-year-old Chinese-English bilingual woman with lvPPA over two years using a modified Boston Naming Test. Naming accuracy was higher in her second, but more frequently used language (English) than her first, but less frequently used language (Chinese). Regression analyses revealed that familiarity predicted naming in Chinese, while word length and age of acquisition influenced English. Decline was linked to age of acquisition in Chinese and emotional properties in English, highlighting language-specific patterns in bilingual lvPPA.

Cognitive modelling of concepts in the mental lexicon with multilayer networks: Insights, advancements, and future challenges

The mental lexicon is a complex cognitive system representing information about the words/concepts that one knows. Over decades psychological experiments have shown that conceptual associations across multiple, interactive cognitive levels can greatly influence word acquisition, storage, and processing. How can semantic, phonological, syntactic, and other types of conceptual associations be mapped within a coherent mathematical framework to study how the mental lexicon works? Here we review cognitive multilayer networks as a promising quantitative and interpretative framework for investigating the mental lexicon. Cognitive multilayer networks can map multiple types of information at once, thus capturing how different layers of associations might co-exist within the mental lexicon and influence cognitive processing. This review starts with a gentle introduction to the structure and formalism of multilayer networks. We then discuss quantitative mechanisms of psychological phenomena that could not be observed in single-layer networks and were only unveiled by combining multiple layers of the lexicon: (i) multiplex viability highlights language kernels and facilitative effects of knowledge processing in healthy and clinical populations; (ii) multilayer community detection enables contextual meaning reconstruction depending on psycholinguistic features; (iii) layer analysis can mediate latent interactions of mediation, suppression, and facilitation for lexical access. By outlining novel quantitative perspectives where multilayer networks can shed light on cognitive knowledge representations, including in next-generation brain/mind models, we discuss key limitations and promising directions for cutting-edge future research.

Establishing and evaluating the gradient of item naming difficulty in post-stroke aphasia and semantic dementia

Anomia is a common consequence following brain damage and a central symptom in semantic dementia (SD) and post-stroke aphasia (PSA), for instance. Picture naming tests are often used in clinical assessments and experience suggests that items vary systematically in their difficulty. Despite clinical intuitions and theoretical accounts, however, the existence and determinants of such a naming difficulty gradient remain to be empirically established and evaluated. Seizing the unique opportunity of two large-scale datasets of semantic dementia and post-stroke aphasia patients assessed with the same picture naming test, we applied an Item Response Theory (IRT) approach and we (a) established that an item naming difficulty gradient exists, which (b) partly differs between patient groups, and is (c) related in part to a limited number of psycholinguistic properties - frequency and familiarity for SD, frequency and word length for PSA. Our findings offer exciting future avenues for new, adaptive, time-efficient, and patient-tailored approaches to naming assessment and therapy.

The effects of endogenous semantic variables during productive lexical retrieval: A Behavioral-Neural Dual Swinging Model (DSM)

Conceptual preparation is the very initial step in language production. Endogenous semantic variables, reflecting the inherent semantic properties of concepts, could influence the productive lexical retrieval by modulating both conceptual activation and lexical selection. Yet, empirical understandings on this process and underlying mechanisms remain limited. Here, inspired by previous theoretical models and preliminary findings, we proposed a Behavioral-Neural Dual Swinging Model (DSM), revealing the swinging process between conceptual facilitation and lexical interference and extending to neural resource allocation during these processes. To further test the model, we examined the joint effect of semantic richness and semantic density on productive word retrieval both behaviorally and neurally, using a picture naming paradigm. Results nicely support the DSM by showing that the productive retrieval is driven by the swinging between semantic richness-induced conceptual facilitation primarily managed in semantic-related regions and semantic density-induced lexical interference managed in control-related regions. Moreover, the conceptual facilitation accumulated from semantic richness plays a decisive role, mitigating interference from competitors as well as the neural demands in control-related regions.

The adaptation of the Object and Action Naming Battery into Moroccan Arabic: Norms for name agreement, frequency, imageability, visual complexity, and age of acquisition

INTRODUCTION

The ability to name pictures has been investigated widely in healthy people and clinical populations. The Object and Action Naming Battery (OANB) is widely used for psycholinguistic research, aphasia research, and clinical practice. Normative databases for pictorial stimuli have been conducted in language processing studies to control for various psycholinguistic variables known to affect the availability of picture names. The present study provides Moroccan Arabic norms for name agreement, familiarity, imageability, visual complexity, and age of acquisition for 100 line drawings of actions and 162 line drawings of objects taken from Druks and Masterson.

METHODS AND PROCEDURES

160 healthy Moroccan Arabic-speaking individuals participated in this study. Name agreement values for the OANB items were collected from forty subjects, followed by collecting data for the psycholinguistic variables: spoken-word frequency, imageability, visual complexity, and age of acquisition from 120 participants.

RESULTS

The Moroccan Arabic OANB (MA-OANB) comprises 70 objects and 60 action pictures. 77% of the nouns and 68% of the verbs obtained 100% target responses. A minimum of 93 percent name agreement was reached for the remaining items. Norms were also collected for the following psycholinguistic variables: spoken-word frequency, imageability, age of acquisition, and visual complexity.

CONCLUSION

The stimuli can be used for various psycholinguistic investigations and also for assessment and therapeutic purposes in Morocco.

Assessing Relative Linguistic Impairment With Model-Based Item Selection

PURPOSE

A picture naming test is presented that reveals impairment to specific mechanisms involved in the naming process, using accuracy scores on curated item sets. A series of psychometric validation experiments are reported.

METHOD

Using a computational model that enables estimation of item difficulty at the lexical and sublexical stages of word retrieval, two complimentary sets of items were constructed that challenge the respective psycholinguistic levels of representation. The difference in accuracy between these item sets yields the relative linguistic impairment (RLI) score. In a cohort of 91 people with chronic left-hemisphere stroke who enrolled in a clinical trial for anomia, we assessed psychometric properties of the RLI score and then used the new scale to make predictions about other language behaviors, lesion distributions, and functional activation during naming.

RESULTS

RLI scores had adequate psychometric properties for clinical significance. RLI scores contained predictive information about spontaneous speech fluency, over and above accuracy. A dissociation was observed between performance on the RLI item sets and performance on the subtests of an independent language battery. Sublexical RLI was significantly associated with apraxia of speech and with lesions encompassing perisylvian regions, while lexical RLI was associated with lesions to deep white matter. The RLI construct was reflected in functional brain activity during naming, independent of overall accuracy, with a respective shift of activation between dorsal and ventral networks responsible for different aspects of word retrieval.

CONCLUSION

The RLI assessment satisfies the psychometric requirements to serve as a useful clinical measure.

Gesture's Role in the Communication of Adults With Different Types of Aphasia

PURPOSE

Adults with aphasia gesture more than adults without aphasia. However, less is known about the role of gesture in different discourse contexts for individuals with different types of aphasia. In this study, we asked whether patterns of speech and gesture production of individuals with aphasia vary by aphasia and discourse type and also differ from the speech and gestures produced by adults without aphasia.

METHOD

We compared the amount, diversity, and complexity of speech and gesture production in adults with anomic or Broca's aphasia and adults with no aphasia (n = 20/group) in their first- versus third-person narratives.

RESULTS

Adults with Broca's aphasia showed the lowest performance in their amount, diversity, and complexity of speech production, followed by adults with anomic aphasia and adults without aphasia. This pattern was reversed for gesture production. Speech and gesture production also varied by discourse context. Adults with either type of aphasia used a lower amount of and less diverse speech in third-person than in first-person narratives; this pattern was also reversed for gesture production.

CONCLUSIONS

Overall, our results provide evidence for a compensatory role of gesture in aphasia communication. Adults with Broca's aphasia, who showed the greatest speech production difficulties, also relied most on gesture, and this pattern was particularly pronounced in the third-person narrative context.

An inclusive multivariate approach to neural localization of language components

To determine how language is implemented in the brain, it is important to know which brain areas are primarily engaged in language processing and which are not. Existing protocols for localizing language are typically univariate, treating each small unit of brain volume as independent. One prominent example that focuses on the overall language network in functional magnetic resonance imaging (fMRI) uses a contrast between neural responses to sentences and sets of pseudowords (pronounceable nonwords). This contrast reliably activates peri-sylvian language areas but is less sensitive to extra-sylvian areas that are also known to support aspects of language such as word meanings (semantics). In this study, we assess areas where a multivariate, pattern-based approach shows high reproducibility across multiple measurements and participants, identifying these areas as multivariate regions of interest (mROI). We then perform a representational similarity analysis (RSA) of an fMRI dataset where participants made familiarity judgments on written words. We also compare those results to univariate regions of interest (uROI) taken from previous sentences > pseudowords contrasts. RSA with word stimuli defined in terms of their semantic distance showed greater correspondence with neural patterns in mROI than uROI. This was confirmed in two independent datasets, one involving single-word recognition, and the other focused on the meaning of noun-noun phrases by contrasting meaningful phrases > pseudowords. In all cases, areas of spatial overlap between mROI and uROI showed the greatest neural association. This suggests that ROIs defined in terms of multivariate reproducibility can help localize components of language such as semantics. The multivariate approach can also be extended to focus on other aspects of language such as phonology, and can be used along with the univariate approach for inclusively mapping language cortex.

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

INTRODUCTION

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.

AIM

The study aimed to explore the relationship between spoken language and reading abilities in Kannada-speaking post-stroke survivors with acquired alexia.

METHOD

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

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.

CONCLUSION

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.

An exploration of anomia rehabilitation in drug-resistant temporal lobe epilepsy

Around 40% of patients who undergo a left temporal lobe epilepsy (LTLE) surgery suffer from anomia (word-finding difficulties), a condition that negatively impacts quality of life. Despite these observations, language rehabilitation is still understudied in LTLE. We assessed the effect of a four-week rehabilitation on four drug-resistant LTLE patients after their surgery. The anomia rehabilitation was based on cognitive descriptions of word finding deficits in LTLE. Its primary ingredients were psycholinguistic tasks and a psychoeducation approach to help patients cope with daily communication issues. We repeatedly assessed naming skills for trained and untrained words, before and during the therapy using an A-B design with follow-up and replication. Subjective anomia complaint and standardized language assessments were also collected. We demonstrated the effectiveness of the rehabilitation program for trained words despite the persistence of seizures. Furthermore, encouraging results were observed for untrained items. Variable changes in anomia complaint were observed. One patient who conducted the protocol as self-rehabilitation responded similarly to the others, despite the different manner of intervention. These results open promising avenues for helping epileptic patients suffering from anomia. For example, this post-operative program could easily be adapted to be conducted preoperatively.

Focusing on the locus of the breakdown for treatment of anomia: a pilot study

The primary goal of this study was to evaluate the treatment effects of semantic feature analysis (SFA) and phonological components analysis (PCA) on word retrieval processing in persons with aphasia (PWAs). After identifying the locus of the breakdown in lexical retrieval processing, 15 monolingual native Persian speakers with aphasia were divided into two groups. After three naming trials, participants with dominant semantic deficits received SFA, and participants with primary phonological deficits were provided with PCA three times a week for eight weeks. Both approaches improved participants' naming and performance on language tests, including spontaneous speech, repetition, comprehension, and semantic processing. However, the correct naming of treated and untreated items was higher in mild-to-moderate participants, with mostly circumlocution and semantic paraphasias in the SFA group. The same holds for mild-to-moderate participants with mostly phonemic paraphasia who received PCA therapy. Moreover, the results showed that participants' baseline naming performance and semantic abilities could be associated with the treatment outcomes. Although limited by a lack of a control group, this study provided evidence supporting the possible benefits of focusing on the locus of the breakdown for treating anomia through SFA and PCA approaches, specifically in participants with mild to moderate aphasia. However, for those with severe aphasia, the treatment choice may not be as straightforward because several variables are likely to contribute to this population's word-finding difficulties. Replication with larger, well-stratified samples, use of a within-subjects alternating treatment design and consideration of treatments' long-term effects are required to better ascertain the effects of focusing on the locus of breakdown for treatment of anomia.

The relationship between semantics, phonology, and naming performance in aphasia: a structural equation modeling approach

The exploration of naming error patterns in aphasia provides insights into the cognitive processes underlying naming performance. We investigated how semantic and phonological abilities correlate and how they influence naming performance in aphasia. Data from 296 individuals with aphasia, drawn from the Moss Aphasia Psycholinguistics Project Database, were analyzed using a structural equation model. The model incorporated latent variables for semantics and phonology and manifest variables for naming accuracy and error patterns. There was a moderate positive correlation between semantics and phonology after controlling for overall aphasia severity. Both semantic and phonological abilities influenced naming accuracy. Semantic abilities negatively related to semantic, mixed, unrelated errors, and no responses. Interestingly, phonology positively affected semantic errors. Additionally, phonological abilities negatively related to each of phonological and neologism errors. These results highlight the role of semantic and phonological skills on naming performance in aphasia and reveal a relationship between these cognitive processes.

Situating word deafness within aphasia recovery: A case report

Word deafness is a rare neurological disorder often observed following bilateral damage to superior temporal cortex and canonically defined as an auditory modality-specific deficit in word comprehension. The extent to which word deafness is dissociable from aphasia remains unclear given its heterogeneous presentation, and some have consequently posited that word deafness instead represents a stage in recovery from aphasia, where auditory and linguistic processing are affected to varying degrees and improve at differing rates. Here, we report a case of an individual (Mr. C) with bilateral temporal lobe lesions whose presentation evolved from a severe aphasia to an atypical form of word deafness, where auditory linguistic processing was impaired at the sentence level and beyond. We first reconstructed in detail Mr. C's stroke recovery through medical record review and supplemental interviewing. Then, using behavioral testing and multimodal neuroimaging, we documented a predominant auditory linguistic deficit in sentence and narrative comprehension-with markedly reduced behavioral performance and absent brain activation in the language network in the spoken modality exclusively. In contrast, Mr. C displayed near-unimpaired behavioral performance and robust brain activations in the language network for the linguistic processing of words, irrespective of modality. We argue that these findings not only support the view of word deafness as a stage in aphasia recovery but also further instantiate the important role of left superior temporal cortex in auditory linguistic processing.

More than a piece of cake: Noun classifier processing in primary progressive aphasia

INTRODUCTION

Clinical understanding of primary progressive aphasia (PPA) has been primarily derived from Indo-European languages. Generalizing certain linguistic findings across languages is unfitting due to contrasting linguistic structures. While PPA patients showed noun classes impairments, Chinese languages lack noun classes. Instead, Chinese languages are classifier language, and how PPA patients manipulate classifiers is unknown.

METHODS

We included 74 native Chinese speakers (22 controls, 52 PPA). For classifier production task, participants were asked to produce the classifiers of high-frequency items. In a classifier recognition task, participants were asked to choose the correct classifier.

RESULTS

Both semantic variant (sv) PPA and logopenic variant (lv) PPA scored significantly lower in classifier production task. In classifier recognition task, lvPPA patients outperformed svPPA patients. The classifier production scores were correlated to cortical volume over left temporal and visual association cortices.

DISCUSSION

This study highlights noun classifiers as linguistic markers to discriminate PPA syndromes in Chinese speakers.

HIGHLIGHTS

Noun classifier processing varies in the different primary progressive aphasia (PPA) variants. Specifically, semantic variant PPA (svPPA) and logopenic variant PPA (lvPPA) patients showed significantly lower ability in producing specific classifiers. Compared to lvPPA, svPPA patients were less able to choose the accurate classifiers when presented with choices. In svPPA, classifier production score was positively correlated with gray matter volume over bilateral temporal and left visual association cortices in svPPA. Conversely, classifier production performance was correlated with volumetric changes over left ventral temporal and bilateral frontal regions in lvPPA. Comparable performance of mass and count classifier were noted in Chinese PPA patients, suggesting a common cognitive process between mass and count classifiers in Chinese languages.

Similarity-induced interference or facilitation in language production reflects representation, not selection

Researchers have long interpreted the presence or absence of semantic interference in picture naming latencies as confirming or refuting theoretical claims regarding competitive lexical selection. But inconsistent empirical results challenge any mechanistic interpretation. A behavioral experiment first verified an apparent boundary condition in a blocked picture naming task: when orthogonally manipulating association type, taxonomic associations consistently elicit interference, while thematic associations do not. A plausible representational difference is that thematic feature activations depend more on supporting contexts. Simulations show that context-sensitivity emerges from the distributional statistics that are often used to measure thematic associations: residual semantic activation facilitates the retrieval of words that share semantic features, counteracting learning-based interference, and training a production model with greater sequential cooccurrence for thematically related words causes it to acquire stronger residual activation for thematic features. Modulating residual activation, either directly or through training, allows the model to capture gradient values of interference and facilitation, and in every simulation competitive and noncompetitive selection algorithms produce qualitatively equivalent results.

Revealing Linguistic and Verbal Short-Term and Working Memory Abilities in People with Severe Aphasia

Background

The assessment of aphasia in people with severe deficits is hampered by a paucity of tests that are appropriate for this population and that are sensitive to their underlying linguistic and short-term and working memory (STM/WM) strengths and weaknesses. The Temple Assessment of Language and Short-Term Memory in Aphasia (TALSA) provides a means of assessing people with severe aphasia (PWSA).

Aims

The aim of this paper is to demonstrate the sensitivity of the TALSA to the underlying linguistic and STM/WM strengths and weaknesses in PWSA. We assessed eight PWSA on selected subtests of the TALSA and found that 1) the TALSA is sensitive to the underlying linguistic and verbal STM/WM abilities of PWSA, 2) the TALSA reveals a wide variety of linguistic and verbal STM/WM profiles in PWSA and, 3) the TALSA can potentially demonstrate common patterns of performance in PWSA.

Main contributions

The TALSA allows researchers to include more PWSA in the study of aphasia and enables clinicians to establish more accurate prognoses, create precisely targeted treatment plans and document incremental progress in therapy.

Conclusions

The TALSA is an important addition to the assessment of severe aphasia. It provides an in-depth evaluation of underlying linguistic and verbal STM/WM strengths and weaknesses of PWSA.

Picture naming test through the prism of cognitive neuroscience and linguistics: adapting the test for cerebellar tumor survivors-or pouring new wine in old sacks?

A picture naming test (PNT) has long been regarded as an integral part of neuropsychological assessment. In current research and clinical practice, it serves a variety of purposes. PNTs are used to assess the severity of speech impairment in aphasia, monitor possible cognitive decline in aging patients with or without age-related neurodegenerative disorders, track language development in children and map eloquent brain areas to be spared during surgery. In research settings, picture naming tests provide an insight into the process of lexical retrieval in monolingual and bilingual speakers. However, while numerous advances have occurred in linguistics and neuroscience since the classic, most widespread PNTs were developed, few of them have found their way into test design. Consequently, despite the popularity of PNTs in clinical and research practice, their relevance and objectivity remain questionable. The present study provides an overview of literature where relevant criticisms and concerns have been expressed over the recent decades. It aims to determine whether there is a significant gap between conventional test design and the current understanding of the mechanisms underlying lexical retrieval by focusing on the parameters that have been experimentally proven to influence picture naming. We discuss here the implications of these findings for improving and facilitating test design within the picture naming paradigm. Subsequently, we highlight the importance of designing specialized tests with a particular target group in mind, so that test variables could be selected for cerebellar tumor survivors.

Multilevel factors predict treatment response following semantic feature-based intervention in bilingual aphasia

Semantic feature-based treatments (SFTs) are effective rehabilitation strategies for word retrieval deficits in bilinguals with aphasia (BWA). However, few studies have prospectively evaluated the effects of key parameters of these interventions on treatment outcomes. This study examined the influence of intervention-level (i.e., treatment language and treatment sessions), individual-level (baseline naming severity and age), and stimulus-level (i.e., lexical frequency, phonological length, and phonological neighborhood density) factors on naming improvement in a treated and untreated language for 34 Spanish-English BWA who completed 40 hours of SFT. Results revealed significant improvement over time in both languages. In the treated language, individuals who received therapy in their L1 improved more. Additionally, higher pre-treatment naming scores predicted greater response to treatment. Finally, a frequency effect on baseline naming accuracy and phonological effects on accuracy over time were associated with differential treatment gains. These findings indicate that multilevel factors are influential predictors of bilingual treatment outcomes.

Why is a flamingo named as pelican and asparagus as celery? Understanding the relationship between targets and errors in a speeded picture naming task

Speakers sometimes make word production errors, such as mistakenly saying pelican instead of flamingo. This study explored which properties of an error influence the likelihood of its selection over the target word. Analysing real-word errors in speeded picture naming, we investigated whether, relative to the target, naming errors were more typical representatives of the semantic category, were associated with more semantic features, and/or were semantically more closely related to the target than its near semantic neighbours were on average. Results indicated that naming errors tended to be more typical category representatives and possess more semantic features than the targets. Moreover, while not being the closest semantic neighbours, errors were largely near semantic neighbours of the targets. These findings suggest that typicality, number of semantic features, and semantic similarity govern activation levels in the production system, and we discuss possible mechanisms underlying these effects in the context of word production theories.

Semantic representations in inferior frontal and lateral temporal cortex during picture naming, reading, and repetition

Reading, naming, and repetition are classical neuropsychological tasks widely used in the clinic and psycholinguistic research. While reading and repetition can be accomplished by following a direct or an indirect route, pictures can be named only by means of semantic mediation. By means of fMRI multivariate pattern analysis, we evaluated whether this well-established fundamental difference at the cognitive level is associated at the brain level with a difference in the degree to which semantic representations are activated during these tasks. Semantic similarity between words was estimated based on a word association model. Twenty subjects participated in an event-related fMRI study where the three tasks were presented in pseudo-random order. Linear discriminant analysis of fMRI patterns identified a set of regions that allow to discriminate between words at a high level of word-specificity across tasks. Representational similarity analysis was used to determine whether semantic similarity was represented in these regions and whether this depended on the task performed. The similarity between neural patterns of the left Brodmann area 45 (BA45) and of the superior portion of the left supramarginal gyrus correlated with the similarity in meaning between entities during picture naming. In both regions, no significant effects were seen for repetition or reading. The semantic similarity effect during picture naming was significantly larger than the similarity effect during the two other tasks. In contrast, several regions including left anterior superior temporal gyrus and left ventral BA44/frontal operculum, among others, coded for semantic similarity in a task-independent manner. These findings provide new evidence for the dynamic, task-dependent nature of semantic representations in the left BA45 and a more task-independent nature of the representational activation in the lateral temporal cortex and ventral BA44/frontal operculum.

Simon Fraser University Speech Error Database (SFUSED) Cantonese: Methods, design, and usage

The Simon Fraser University Speech Error Database (SFUSED) is a multi-purpose database of speech errors based in audio recordings. The motivation for SFUSED Cantonese, a component of this database, is to create a linguistically rich data set for exploring language production processes in Cantonese, an under-studied language. We describe in detail the methods used to collect, analyze, and explore the database, including details of team workflows, time budgets, data quality, and explicit linguistic and processing assumptions. In addition to showing how to use the database, this account supports future research with a template for investigating additional under-studied languages, and it gives fresh perspective on the benefits and drawbacks of collecting speech error data from spontaneous speech. All of the data and supporting materials are available as open access data sets.

Automating Intended Target Identification for Paraphasias in Discourse Using a Large Language Model

PURPOSE

To date, there are no automated tools for the identification and fine-grained classification of paraphasias within discourse, the production of which is the hallmark characteristic of most people with aphasia (PWA). In this work, we fine-tune a large language model (LLM) to automatically predict paraphasia targets in Cinderella story retellings.

METHOD

Data consisted of 332 Cinderella story retellings containing 2,489 paraphasias from PWA, for which research assistants identified their intended targets. We supplemented these training data with 256 sessions from control participants, to which we added 2,415 synthetic paraphasias. We conducted four experiments using different training data configurations to fine-tune the LLM to automatically "fill in the blank" of the paraphasia with a predicted target, given the context of the rest of the story retelling. We tested the experiments' predictions against our human-identified targets and stratified our results by ambiguity of the targets and clinical factors.

RESULTS

The model trained on controls and PWA achieved 50.7% accuracy at exactly matching the human-identified target. Fine-tuning on PWA data, with or without controls, led to comparable performance. The model performed better on targets with less human ambiguity and on paraphasias from participants with fluent or less severe aphasia.

CONCLUSIONS

We were able to automatically identify the intended target of paraphasias in discourse using just the surrounding language about half of the time. These findings take us a step closer to automatic aphasic discourse analysis. In future work, we will incorporate phonological information from the paraphasia to further improve predictive utility.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.24463543.

Semantic impairment in aphasia: A problem of control?

PURPOSE

The relationship between cognitive processes and language ability in aphasia has recently gained increasing attention, with some authors suggesting that control impairments may underlie difficulties with semantic tasks in aphasia. This paper aims to present an overview of the current research on the involvement of cognitive processes in semantic processing tasks and discuss the proposed relationship between cognitive control and semantic processing in aphasia.

METHOD

The role of cognitive processes in semantic processing tasks commonly used in the aphasiology literature is discussed and two theoretical approaches to semantic processing that contribute to the understanding of the nature of semantic breakdown in aphasia are outlined. Finally, we examine the evidence put forward in the Controlled Semantic Cognition framework with regard to the interpretation of impaired performance on semantic processing tasks in people with aphasia.

RESULT

Non-linguistic cognitive abilities such as working memory, inhibition and control are required by semantic processing tasks, in addition to access to conceptual information, making it difficult to dissociate these abilities. Several issues exist regarding the evidence put forward for a control deficit as the underlying cause of poor performance on semantic processing tasks in aphasia.

CONCLUSION

It remains unclear whether impairment on semantic tasks in people with aphasia is related to problems with the representation and/or processing (activation/retrieval) of meaning or problems with cognitive control (or both). Further research is still needed to fully understand how non-linguistic cognitive processes interact with semantic processing, as well as clarify and consistency the definition of control.

The 10-Word Auditory Verbal Learning Test and Vocabulary Performance in 4- and 5-Year-Old Children

BACKGROUND

Understanding the different factors that determine vocabulary development in young children is essential for the diagnosis and rehabilitation of language disorders in children. Language development is closely related to other cognitive processes such as auditory verbal learning and memory. This research focuses on the development of a novel auditory verbal learning test (AVLT) for 4- and 5-year-old children within the Dutch population. This new test is an adaptation of the common AVLT for both older children and adults, usually including a list of 15 words. Considering the lower attention span and limited executive functioning in young children, the word list of this new instrument is reduced to 10 words. Besides, a second recognition form has been developed to improve the ability to distinguish between possible underlying learning and memory deficits.

METHOD

Ninety-five preschool children (ages 4;0-5;12 [years;months]) were tested with this new AVLT 10-word test for kids (10WT-K), yielding different measures of verbal auditory memory. Forty-eight of 95 children received a recognition task with semantically unrelated items, and 47 of 95 received a recognition task with semantically related items. Three additional language skills were assessed to establish test validation: receptive and expressive vocabulary performance and nonword repetition. Outcome of the 10WT-K was related to scores on the language measures.

RESULTS

Positive correlations were found between the total score of the 10WT-K and all three aforementioned language skills. We found no correlations between frequency of error types (intrusions and repetitions) and language measures. Furthermore, children who were administered the recognition list with semantically related items showed fewer correct answers and more false-positive and false-negative responses than children who received a recognition list with semantically unrelated items.

CONCLUSIONS

The 10WT-K for young children can be used to (a) measure different aspects of auditory verbal learning and memory, (b) clarify the nature of possible verbal learning difficulties, and (c) identify a possible nature of language disorders. The word recognition task tested with semantically related items provides a more accurate measurement of individual differences, namely, in distinguishing retrieval and storage abilities. The significant relation found between auditory verbal short-term memory capacity and vocabulary performance in preschool children is a first step toward establishing test validity.

Mechanisms of brain activation following naming therapy in aphasia: A systematic review on task-based fMRI studies

The pattern of brain neuroplasticity after naming therapies in patients with aphasia can be evaluated using task-based fMRI. This article aims to review studies investigating brain reorganization after semantic and phonological-based anomia therapy that used picture-naming fMRI tasks. We searched for those articles that compared the activation of brain areas before and after aphasia therapies in the PubMed and the EMBASE databases from 1993 up to April 2020. All studies (single-cases or group designs) on anomia treatment in individuals with acquired aphasia were reviewed. Data were synthesized descriptively through tables to allow the facilitated comparison of the studies. A total of 14 studies were selected and reviewed. The results of the reviewed studies demonstrated that the naming improvement is associated with changes in the activation of cortical and subcortical brain areas. This review highlights the need for a more systematic investigation of the association between decreased and increased activation of brain areas related to anomia therapy. Also, more detailed information about factors influencing brain reorganization is required to elucidate the neural mechanisms of anomia therapy. Overall, regarding the theoretical and clinical aspects, the number of studies that used intensive protocol is growing, and based on the positive potential of these treatments, they could be suitable for the rehabilitation of people with aphasia.

Neurobiological mechanisms for language, symbols and concepts: Clues from brain-constrained deep neural networks

Neural networks are successfully used to imitate and model cognitive processes. However, to provide clues about the neurobiological mechanisms enabling human cognition, these models need to mimic the structure and function of real brains. Brain-constrained networks differ from classic neural networks by implementing brain similarities at different scales, ranging from the micro- and mesoscopic levels of neuronal function, local neuronal links and circuit interaction to large-scale anatomical structure and between-area connectivity. This review shows how brain-constrained neural networks can be applied to study in silico the formation of mechanisms for symbol and concept processing and to work towards neurobiological explanations of specifically human cognitive abilities. These include verbal working memory and learning of large vocabularies of symbols, semantic binding carried by specific areas of cortex, attention focusing and modulation driven by symbol type, and the acquisition of concrete and abstract concepts partly influenced by symbols. Neuronal assembly activity in the networks is analyzed to deliver putative mechanistic correlates of higher cognitive processes and to develop candidate explanations founded in established neurobiological principles.

Memory error speed predicts subsequent accuracy for recognition misses but not false alarms

The current study aims to test whether faster recognition memory errors tend to result from stronger misleading retrieval, making them harder to correct in subsequent decisions than slower errors, and whether this pattern holds for both miss and false-alarm errors. We used a paradigm in which each single-item Old/New recognition decision was followed by a two-alternative forced-choice (2AFC) test between a target and a lure. Each 2AFC trial had one item that had just been tested for an Old/New judgment and one item that had not been previously tested. Across 183 participants, the RTs for single-item recognition errors were used to predict accuracy in the 2AFC test using a hierarchical logistic regression model. The results showed a relationship between error RT and subsequent 2AFC accuracy that was qualified by an interaction with error type. Slower miss responses were more likely to be corrected than faster misses, but no accuracy differences were observed between slower and faster false alarms. The implications of these findings are discussed as they relate to assumptions about memory processes underlying inaccurate retrieval, using the diffusion model and the two-high-threshold model as examples of accounts that explain errors in terms of misleading retrieval and failed retrieval, respectively.

Physiological Arousal, Attentiveness, Emotion, and Word Retrieval in Aphasia: Effects and Relationships

PURPOSE

This study aimed to (a) compare physiological arousal and attentiveness during a confrontational naming task between participants with aphasia and a control group across four conditions that varied according to emotionality of presented stimuli and (b) explore relationships among physiological arousal, attentiveness, perceived arousal, and naming performance. We hypothesized that participants with aphasia would show lower levels of arousal and attentiveness than control participants and that emotional conditions would lead to increased physiological arousal and attentiveness.

METHOD

Eight participants with aphasia and 15 control participants completed a confrontational naming task under positive, negative, and neutral conditions and rated their perceived arousal after each. Electrophysiological recordings were taken during the entire experiment to obtain measures of heart rate (HR), HR variability, and skin conductance (SC). Videos of confrontational naming trials were rated based on visual signs of participant attentiveness during each trial.

RESULTS

Statistically significant group differences were found for HR, SC, and attentiveness ratings, but no differences were found in these measures among conditions. Correlational analyses revealed statistically significant relationships between attentiveness and response time, HR, and naming accuracy. Significant correlations were also found for HR and naming accuracy as well as perceived arousal and naming accuracy.

CONCLUSIONS

Findings suggest that decreased physiological arousal or attentiveness may contribute to naming deficits for people with aphasia (PWA). Assisting PWA to fully attend to and engage in therapy tasks may be important for accurate assessment of language functions and for achieving optimal benefit in treatment.