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Kintz S, Kim H, Wright HH. A preliminary investigation on core lexicon analysis in dementia of the Alzheimer's type. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:1336-1350. [PMID: 38165595 DOI: 10.1111/1460-6984.12999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 12/01/2023] [Indexed: 01/04/2024]
Abstract
BACKGROUND Core lexicon (CL) analysis is a time efficient and possibly reliable measure that captures discourse production abilities. For people with aphasia, CL scores have demonstrated correlations with aphasia severity, as well as other discourse and linguistic measures. It was also found to be clinician-friendly and clinically sensitive enough to capture longitudinal changes in aphasia. To our knowledge, CL has never been investigated in individuals with neurologically progressive disease. AIMS As a preliminary investigation, we sought to investigate (1) whether CL scores correlate with dementia severity, (2) whether CL scores correlate with measures of discourse quality, and (3) whether CL scores correlate with other measures of lexical/semantic access. METHODS & PROCEDURES Twelve participants with a cognitive impairment associated with dementia of the Alzheimer's type (DAT) completed several measures of language and cognitive ability, as well as provide a language sample from the wordless picture book, Picnic. RESULTS & CONCLUSION Results are informative, as they provide insight into characteristics of CL and provide support for potential use of CL in individuals with neurologically progressive disease. The results indicated that CL scores do correlate with dementia severity and several measures of language ability, indicating they may provide a useful measure of language abilities in DAT, but more research is needed. WHAT THIS PAPER ADDS What is already known on the subject Core lexicon (CL) analysis is an assessment measure of discourse ability, most closely related to informativeness or productivity, used in aphasiology that is easier to use and less time consuming than previous measures of informativeness, such as correct information units or type-token ratio (TTR). For people with aphasia, CL analysis correlates with aphasia severity, measures of informativeness, as well as other measures of discourse quality. It has also been shown to be faster and more reliable between scorers than other informativeness measures. What this study adds Core lexicon analysis is a new simple and online method for assessing the informativeness of a discourse sample without the need to record or transcribe the language sample. CL is receiving a lot of attention in aphasia, correlating with everything from aphasia severity to measures of productivity and lexical access, as well as measures of informativeness. Unfortunately, no one has investigated CL analysis in dementia. The study demonstrates the first evidence that CL analysis may be a useful measure for determining dementia severity and language quality in people with dementia. What are the clinical implications of this work? Core lexicon analysis may provide clinicians and researchers with an easy method for assessing the discourse of people with a cognitive impairment associated with dementia of the Alzheimer's type. This will improve initial assessment, as well as improve ongoing language assessment that may provide clues into their functional ability to communicate effectively.
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Affiliation(s)
- Stephen Kintz
- Department of Speech Language Pathology, University of Arkansas at Little Rock, Little Rock, Arkansas, USA
| | - Hana Kim
- Department of Communication Sciences & Disorders, University of South Florida, Tampa Bay, Florida, USA
| | - Heather Harris Wright
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, North Carolina, USA
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Fromm D, Dalton SG, Brick A, Olaiya G, Hill S, Greenhouse J, MacWhinney B. The Case of the Cookie Jar: Differences in Typical Language Use in Dementia. J Alzheimers Dis 2024; 100:1417-1434. [PMID: 38995772 DOI: 10.3233/jad-230844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2024]
Abstract
Background Findings from language sample analyses can provide efficient and effective indicators of cognitive impairment in older adults. Objective This study used newly automated core lexicon analyses of Cookie Theft picture descriptions to assess differences in typical use across three groups. Methods Participants included adults without diagnosed cognitive impairments (Control), adults diagnosed with Alzheimer's disease (ProbableAD), and adults diagnosed with mild cognitive impairment (MCI). Cookie Theft picture descriptions were transcribed and analyzed using CLAN. Results Results showed that the ProbableAD group used significantly fewer core lexicon words overall than the MCI and Control groups. For core lexicon content words (nouns, verbs), however, both the MCI and ProbableAD groups produced significantly fewer words than the Control group. The groups did not differ in their use of core lexicon function words. The ProbableAD group was also slower to produce most of the core lexicon words than the MCI and Control groups. The MCI group was slower than the Control group for only two of the core lexicon content words. All groups mentioned a core lexicon word in the top left quadrant of the picture early in the description. The ProbableAD group was then significantly slower than the other groups to mention a core lexicon word in the other quadrants. Conclusions This standard and simple-to-administer task reveals group differences in overall core lexicon scores and the amount of time until the speaker produces the key items. Clinicians and researchers can use these tools for both early assessment and measurement of change over time.
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Affiliation(s)
- Davida Fromm
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Sarah Grace Dalton
- Department of Speech Pathology and Audiology, Marquette University, Milwaukee, WI, USA
| | - Alexander Brick
- Department of Statistics and Data Science, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Gbenuola Olaiya
- Department of Statistics and Data Science, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Sophia Hill
- Department of Statistics and Data Science, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Joel Greenhouse
- Department of Statistics and Data Science, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Brian MacWhinney
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA
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Kim H, Berube S, Hillis AE. Core lexicon in aphasia: A longitudinal study. APHASIOLOGY 2022; 37:1679-1691. [PMID: 37822874 PMCID: PMC10564387 DOI: 10.1080/02687038.2022.2121598] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 10/13/2023]
Abstract
Background General consensus exists between clinicians as to the incorporation of discourse outcome measures into language assessment for persons with aphasia (PWA). The development of core lexicon measures (CoreLex) has enabled clinicians to reduce time and labor intensive preparatory work for discourse analysis, which has been considered as an alternative measure to quantify word retrieval ability in discourse in a clinical context. Although previous studies have investigated the quality of the measure, CoreLex has rarely been longitudinally explored. Aims We aimed to investigate the adequacy of CoreLex to document linguistic changes in PWA over time. Specifically, we examined (1) whether natural language recovery from acute to chronic stages is manifested differentially by tasks and (2) the extent to which the ability to retrieve words in isolation predicts the ability to retrieve words in context. Methods A total of 19 PWA participated in the study. They completed a language assessment including confrontation naming tasks (Boston Naming Test [BNT] and Hopkins Action Naming Assessment [HANA]) and a picture description task using the Cookie Theft picture at acute and chronic stages. Discourse samples from the picture description task were quantified using CoreLex. Results We found significant differences across tasks and time-points by PWA. Moderate correlations between the confrontation naming tasks and CoreLex were found at the acute stage but not at the chronic stage. Additionally, McNemar's tests demonstrated a significant difference in PWA's performance in CoreLex from the acute to the chronic stages. Conclusions Our findings show that performance by PWA improves over time on all tasks, but language gains are manifested differentially by tasks. Performance in confrontation naming moderately predicts word retrieval in context acutely. However, lack of correlations between confrontation naming tasks and CoreLex later endorse inadequacy of using confrontation naming tasks as a proxy measure for discourse-level performance and improvement for PWA.
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Affiliation(s)
- Hana Kim
- Department of Communication Sciences and Disorders, University of South Florida, Tampa, FL 33620
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Shauna Berube
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
| | - Argye E. Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21287
- Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD 21218
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Kim H, Schoemann AM, Wright HH. Quality of Measurement in Core Lexicon Measures. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:2919-2930. [PMID: 35858271 PMCID: PMC9911116 DOI: 10.1044/2022_jslhr-20-00722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/17/2021] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Core lexicon measures have received growing attention in research. They are intended to provide clinicians with a clinician-friendly means to quantify word retrieval ability in discourse based on normal expectations of discourse production for specific discourse elicitation tasks. To date, different criteria have been used to develop core lexicon measures by groups of researchers. The need for statistical guidance in pursuit of the psychologically robust measure has been recognized. AIMS This study was to investigate the best criterion for accurate measurement. Specifically, we focused on two criteria (frequency vs. percentage) that have previously been used for the development of core lexicon measures. METHOD Core lexicon measures consisting of five different checklists by word class (verbs, nouns, adjectives, adverbs, and function words) and developed by the two criteria were applied to language samples produced by 470 cognitively healthy adults. Performance in word retrieval ability at the discourse level was modeled as a latent variable based on the observed proportions of the production of core lexicon items in two different sets of core lexicon measures using structural equation modeling. RESULTS Results indicated that both criterion for core lexicon measures capture word retrieval ability in discourse. Greater residual variances were found in the core lexicon measure established by the percentage criterion compared to the one established by the frequency criterion. This indicates that the measure based on the percentage criterion is more affected by measurement errors. CONCLUSIONS The findings provide evidence that the frequency criterion is better to use for the development of core lexicon measures for core nouns, verbs, adjectives, and adverbs, but not for function words. However, our findings are limited to core lexicon measures based on language samples elicited by wordless picture books. This may not be easily applied to other core lexicon measures that use different discourse elicitation tasks due to the difference in quality and quantity of language samples. Ideally, the same approach should be replicated to evaluate the appropriateness of respective criteria in the development of core lexicon measures. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.20304144.
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Affiliation(s)
- Hana Kim
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD
- Department of Psychology, East Carolina University, Greenville, NC
| | | | - Heather Harris Wright
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC
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Dalton SG, Stark BC, Fromm D, Apple K, MacWhinney B, Rensch A, Rowedder M. Validation of an Automated Procedure for Calculating Core Lexicon From Transcripts. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:2996-3003. [PMID: 35917459 PMCID: PMC9911121 DOI: 10.1044/2022_jslhr-21-00473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/13/2022] [Accepted: 04/30/2022] [Indexed: 05/26/2023]
Abstract
PURPOSE The aim of this study was to advance the use of structured, monologic discourse analysis by validating an automated scoring procedure for core lexicon (CoreLex) using transcripts. METHOD Forty-nine transcripts from persons with aphasia and 48 transcripts from persons with no brain injury were retrieved from the AphasiaBank database. Five structured monologic discourse tasks were scored manually by trained scorers and via automation using a newly developed CLAN command based upon previously published lists for CoreLex. Point-to-point (or word-by-word) accuracy and reliability of the two methods were calculated. Scoring discrepancies were examined to identify errors. Time estimates for each method were calculated to determine if automated scoring improved efficiency. RESULTS Intraclass correlation coefficients for the tasks ranged from .998 to .978, indicating excellent intermethod reliability. Automated scoring using CLAN represented a significant time savings for an experienced CLAN user and for inexperienced CLAN users following step-by-step instructions. CONCLUSIONS Automated scoring of CoreLex is a valid and reliable alternative to the current gold standard of manually scoring CoreLex from transcribed monologic discourse samples. The downstream time saving of this automated analysis may allow for more efficient and broader utilization of this discourse measure in aphasia research. To further encourage the use of this method, go to https://aphasia.talkbank.org/discourse/CoreLexicon/ for materials and the step-by-step instructions utilized in this project. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.20399304.
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Stark BC, Dutta M, Murray LL, Fromm D, Bryant L, Harmon TG, Ramage AE, Roberts AC. Spoken Discourse Assessment and Analysis in Aphasia: An International Survey of Current Practices. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4366-4389. [PMID: 34554878 PMCID: PMC9132151 DOI: 10.1044/2021_jslhr-20-00708] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Purpose Spoken discourse analysis is commonly employed in the assessment and treatment of people living with aphasia, yet there is no standardization in assessment, analysis, or reporting procedures, thereby precluding comparison/meta-analyses of data and hindering replication of findings. An important first step is to identify current practices in collecting and analyzing spoken discourse in aphasia. Thus, this study surveyed current practices, with the goal of working toward standardizing spoken discourse assessment first in research settings with subsequent implementation into clinical settings. Method A mixed-methods (quantitative and qualitative) survey was publicized to researchers and clinicians around the globe who have collected and/or analyzed spoken discourse data in aphasia. The survey data were collected between September and November 2019. Results Of the 201 individuals who consented to participate, 189 completed all mandatory questions in the survey (with fewer completing nonmandatory response questions). The majority of respondents reported barriers to utilizing discourse including transcription, coding, and analysis. The most common barrier was time (e.g., lack of time). Respondents also indicated that there was a lack of, and a need for, psychometric properties and normative data for spoken discourse use in the assessment and treatment of persons with aphasia. Quantitative and qualitative results are described in detail. Conclusions The current survey study evaluated spoken discourse methods in aphasia across research and clinical settings. Findings from this study will be used to guide development of process standardization in spoken discourse and for the creation of a psychometric and normative property database. Supplemental Material https://doi.org/10.23641/asha.166395100.
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Affiliation(s)
- Brielle C. Stark
- Department of Speech, Language and Hearing Sciences and Program in Neuroscience, Cognitive Science Program, Indiana University, Bloomington, IN
| | - Manaswita Dutta
- Department of Communication Disorders and Sciences, Rush University, Chicago, IL
| | - Laura L. Murray
- School of Communication Sciences and Disorders, Western University, London, CA
| | - Davida Fromm
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA
| | - Lucy Bryant
- Graduate School of Health, University of Technology Sydney, New South Wales, Australia
| | - Tyson G. Harmon
- Department of Communication Disorders, Brigham Young University, Provo, UT
| | - Amy E. Ramage
- Department of Communication Sciences and Disorders, University of New Hampshire, Durham
| | - Angela C. Roberts
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
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Kim H, Kintz S, Wright HH. Development of a measure of function word use in narrative discourse: core lexicon analysis in aphasia. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:6-19. [PMID: 32909656 PMCID: PMC7902380 DOI: 10.1111/1460-6984.12567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/09/2020] [Accepted: 07/27/2020] [Indexed: 05/31/2023]
Abstract
BACKGROUND Although discourse-level assessments contribute to predicting real-world performance in persons with aphasia (PWA), the use of discourse measures is uncommon in clinical settings due to resource-heavy procedures. Moreover, assessing function word use in discourse requires the arduous procedure of defining grammatical categories for each word in language transcripts. AIMS The purpose of this exploratory study was twofold: (1) to develop core function word lists as a clinician-friendly means of evaluating function word use in discourse; and (2) to examine the ability of the core function word measure to differentiate PWA from cognitively healthy adults and persons with fluent aphasia from non-fluent aphasia. METHODS & PROCEDURES The 25 most commonly used function words (core function words) were extracted from narrative language samples from 470 cognitively healthy adults, which were divided into seven age groups (20s, 30s, 40s, 50s, 60s, 70s and 80s). The percent agreement of core function words for 11 PWA (fluent aphasia = 5; non-fluent aphasia = 6) and 11 age- and education-matched controls were then calculated. Percent agreement for the core function words produced was compared between the controls and the PWA group, and between participants with fluent aphasia and non-fluent aphasia. OUTCOMES & RESULTS The results indicated that PWA produced fewer core function words from the lists than the control group, and that core function word use was strongly correlated with aphasia severity. Persons with non-fluent aphasia produced fewer core function words than those with fluent aphasia, although this could be a confound of aphasia classification from the use of the Western Aphasia Battery (WAB)-Revised. CONCLUSIONS & IMPLICATIONS Core function word lists consisting of a limited number of items for quantifying function word use in discourse remain in a nascent stage of development. However, the findings are consistent with previous studies analysing the total production of function words in language samples produced by PWA. Therefore, core function words may potentially serve as a clinician-friendly manner of quantifying function words produced in discourse. What this paper adds What is already known on the subject Function word analysis in discourse requires arduous processes of identifying the error production and grammatical category of function words in discourse. Previous studies have demonstrated that core lexicon measures are an efficient, simple means of quantifying discourse in PWA. However, function words have never been considered for generating an independent core lexicon list. What this paper adds to existing knowledge As an exploratory study, we focused primarily on developing a clinician-friendly measure to evaluate function word production in discourse, motivated by the idea of an adaptation strategy within the core lexicon framework. Our findings demonstrated that by using a simple scoring system that the core lexicon measure provides, we differentiated the control group from the PWA group, and persons with fluent aphasia from persons with non-fluent aphasia. Additionally, we found significant correlations between function word production and aphasia severity determined by WAB Aphasia Quotient (AQ). What are the potential or actual clinical implications of this work? The results add empirical evidence for the utility of core function word lists for quantifying function word usage in discourse in PWA. Counting the presence and absence of function words in discourse will allow clinicians to avoid labour-intensive preparatory work, and to obtain useful diagnostic information in a less time-consuming way.
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Affiliation(s)
- Hana Kim
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
| | - Stephen Kintz
- Department of Audiology and Speech Pathology, University of Arkansas, Little Rock, AK, USA
| | - Heather Harris Wright
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, USA
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