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Lau DKY, Kong APH, Chan MSW. Sentence types and complexity of spontaneous discourse productions by Cantonese-speakers with traumatic brain injury- a preliminary report. CLINICAL LINGUISTICS & PHONETICS 2022; 36:381-397. [PMID: 34612132 DOI: 10.1080/02699206.2021.1984582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 09/12/2021] [Accepted: 09/13/2021] [Indexed: 06/13/2023]
Abstract
Previous investigations on sentence production in English-speaking individuals with traumatic brain injury (TBI) have yielded mixed conclusions based on their findings. While some studies found comparable sentence complexity between speakers with TBI and control speakers, others reported more syntactic and lexical errors, reduced sentence complexity, and erroneous word order transpositions in the sentence production of speakers with TBI. These contradictory findings could possibly be due to the use of language measures that were less sensitive to subtle syntactic impairments among speakers with TBI. In this preliminary report, the language samples obtained from 11 Cantonese-speaking participants with mild-moderate TBI in Guangzhou, with a mean age of 37.6 and mean years of education of 10 years, and nine control speakers with a similar age range and education background were analyzed using in-depth linguistic-oriented frameworks adopted from pervious works in Cantonese. The results indicated that the TBI group produced more errors, different varieties of sentence types, and lower syntactic complexity in their sentence production compared with the control group. The findings suggested that the more refined and linguistic-oriented measures used in the present study were more sensitive in identifying the subtle syntactic impairments produced by the participants with TBI.
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Affiliation(s)
- Dustin Kai-Yan Lau
- Department of Chinese and Bilingual Studies, Hong Kong Polytechnic University, Hong Kong, China
| | - Anthony Pak-Hin Kong
- School of Communication Sciences and Disorders, University of Hong Kong, Hong Kong
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Yazu H, Kong APH, Yoshihata H, Okubo K. Adaptation and validation of the main concept analysis of spoken discourse by native Japanese adults. CLINICAL LINGUISTICS & PHONETICS 2022; 36:17-33. [PMID: 33988070 DOI: 10.1080/02699206.2021.1915385] [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: 09/27/2020] [Revised: 03/24/2021] [Accepted: 04/06/2021] [Indexed: 06/12/2023]
Abstract
Many people with aphasia demonstrate problems of oral production at the discourse level. The Main Concept Analysis (MCA) for oral discourse production is a published evidence-based battery for quantifying the degree of presence, accuracy, completeness, and efficiency of targeted main concepts in oral discourse. In Japan, such a standardized tool specialized for assessing spoken discourse is currently lacking. The purpose of this study was to adapt the Japanese version of MCA for oral discourse production (the Japanese-MCA) and examine its validity and reliability. Stage 1 of the study involved the establishment of linguistically-specific main concepts (MCs) of the Japanese-MCA. Ten speech-language-hearing therapists and 60 healthy participants who were native monolingual Japanese speakers were recruited to determine MCs. Stage 2 examined the criterion validity and reliability of the Japanese-MCA. Language samples of 20 participants with aphasia, as verified by Standard Language Test of Aphasia (SLTA), and 20 healthy older participants were used. Results of Stage 1 of the study yielded normative data with a set of target MCs that were geographically and linguistically specific for use in Japan. The results also revealed the comparability of the Japanese-MCA and previously reported versions of other languages. Stage 2 findings indicated not only a high correlation of criterion validity, but also good reliability of the test. With established norms and specific scoring criteria of the Japanese-MCA, it is believed that this new tool will become a useful addition to clinical management and research of aphasia in Japan.
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Affiliation(s)
- Hitomi Yazu
- Department of Rehabilitation, Nippon Medical School Hospital, Tokyo, Japan
- Graduate School of Languages and Linguistics, Sophia University, Tokyo, Japan
| | - Anthony Pak-Hin Kong
- School of Communication Sciences and Disorders, University of Central Florida, Orlando, Florida, USA
| | - Hiroyo Yoshihata
- Graduate School of Languages and Linguistics, Sophia University, Tokyo, Japan
| | - Kimihiro Okubo
- Department of Oto-Rhino-Laryngology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
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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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McCann CM, Plourde J, Moore C, Purdy SC. Linguistic analysis in public speaking: evidence from a Gavel Club for people with aphasia. CLINICAL LINGUISTICS & PHONETICS 2021; 35:793-808. [PMID: 33021121 DOI: 10.1080/02699206.2020.1830302] [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: 07/03/2020] [Revised: 09/22/2020] [Accepted: 09/26/2020] [Indexed: 06/11/2023]
Abstract
Public speaking has been described as one of the most daunting tasks one can engage in, even more so for people with aphasia (PWA). Gavel Clubs (affiliated with Toastmasters International) were established over 20 years ago for those who want to engage in public speaking but do not meet the eligibility criteria for Toastmasters membership. This study is the first of its kind to systematically evaluate changes in the speeches of PWA attending a weekly Gavel Club. The aims were to compare Table Topics (TT) and Prepared Speeches (PS) which are two different tasks regularly performed in a Gavel Club; to measure linguistic change over time in the two speech types; and to determine the feasibility of a discourse measure for analysing public speeches. Thirty-six speeches (four each from nine PWA) were audio-recorded, transcribed and analysed using the Linguistic Communication Measure (LCM). The nine participants represented a wide range of aphasia severity. Analysis revealed that engaging in weekly speaking activities in the GC was associated with an improvement in conveying content and in grammaticality through an increase in total number of words and number of correct words produced. The LCM is a comprehensive analysis tool but proved to be challenging in its speed and utility when measuring linguistic change in public speeches of PWA. Regular GC participation appears to facilitate improved language abilities, but we have yet to find the best tool to demonstrate this.
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Affiliation(s)
- Clare M McCann
- School of Psychology (Speech Science), University of Auckland, Auckland, New Zealand
| | - Julie Plourde
- School of Psychology (Speech Science), University of Auckland, Auckland, New Zealand
| | - Celia Moore
- School of Psychology (Speech Science), University of Auckland, Auckland, New Zealand
| | - Suzanne C Purdy
- School of Psychology, University of Auckland, Auckland, New Zealand
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Kong APH. Dialectally-sensitive norms of the Spanish version of Main Concept Analysis (Span-MCA) for quantifying neurogenically impaired spoken discourse. REVISTA DE INVESTIGACIÓN EN LOGOPEDIA 2021. [DOI: 10.5209/rlog.69932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aphasia is an acquired language impairment caused by damage in the regions of the brain that support language. The Main Concept Analysis (MCA; Kong, 2016b) is a published formal assessment battery that allows the quantification of the presence, accuracy, completeness, and efficiency of content in spoken discourse produced by persons with aphasia (PWA). It utilizes a sequential picture description task (with four sets of pictures) for language sample elicitation. The MCA results can also be used clinically for targeting appropriate interventions of aphasic output. The purpose of this research is to develop a Spanish adaptation of the MCA (i.e., Span-MCA) by establishing normative data based on native unimpaired speakers of Spanish from four different dialect origins (Central American Caribbean, Andean-Pacific, Mexican, and Central-Southern Peninsular regions). A total of 91 unimpaired participants that consisted of different age groups, education levels, and dialect origins were recruited to establish four sets of dialect-specific norms and scoring criteria of Span-MCA, including target main concepts and corresponding lexical items related to the picture sets. The Span-MCA was also applied to one pilot native Spanish PWA. The normative data suggested that speakers who were younger or with a higher level of education levels produced significantly more accurate and complete main concepts in their spoken discourse. The application of Span-MCA to the pilot native Spanish PWA successfully identified impaired performance, as compared to the dialectally-sensitive norms established in this study. This study highlighted the clinical value of Span-MCA as a supplement to evaluate spoken discourse and target intervention by speech-language pathologists and related healthcare practitioners.
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Li R, Li W, Kiran S. Effect of Mandarin Verb Network Strengthening Treatment (VNeST) in Mandarin-English bilinguals with aphasia: A single-case experimental design. Neuropsychol Rehabil 2020; 31:1224-1253. [PMID: 32498670 DOI: 10.1080/09602011.2020.1773278] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study aimed to improve verb retrieval ability in Mandarin-English bilinguals with aphasia by adapting the Verb Network Strengthening Treatment (VNeST) into Mandarin Chinese. Two Mandarin-English bilingual patients with chronic post-stroke aphasia participated in this study via online conferencing system following a multiple-baseline design. Both of them completed a 10-week of Mandarin VNeST treatment, and were probed on verb retrieval ability in a sentence context in both languages. Response accuracy was analysed to investigate the treatment acquisition, within-language generalization, and cross-language generalization effects. Standardized language assessments in both languages were administered pre- and post-treatment to further examine generalization to other linguistic tasks. Error analysis was conducted to investigate the evolution of within- and cross-language errors. Both patients improved after training in Mandarin VNeST, and showed different patterns of within-language and cross-language generalizations. They also improved in a variety of standardized language tasks. Error analysis showed a decline in semantic errors over the course of treatment in both patients, with cross-linguistic errors showing a decrease during Mandarin probes and an increase during English probes in one of the patients. This study contributes to our current understanding of theories of bilingual verb processing, and provides treatment guidance in Mandarin-English bilinguals with aphasia.
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Affiliation(s)
- Ran Li
- Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA, USA
| | - Wen Li
- Wheelock College of Education and Human Development, Boston University, Boston, MA, USA
| | - Swathi Kiran
- Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA, USA
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Kong APH, Lau DKY, Cheng CYY. Analysing coherence of oral discourse among Cantonese speakers in Mainland China with traumatic brain injury and cerebrovascular accident. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 22:37-47. [PMID: 30897971 DOI: 10.1080/17549507.2019.1581256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 01/19/2019] [Accepted: 02/06/2019] [Indexed: 06/09/2023]
Abstract
Purpose: Coherence can reflect subtle language deficits in individuals with traumatic brain injury (TBI) and cerebrovascular accident (CVA). This study aimed at investigating whether global and local coherence in Cantonese-speaking adults with CVA and TBI differ from non-brain-injured (NBI) speakers. Factors contributing to the coherence ratings and impacts of elicitation tasks on coherence were examined.Method: Two clinical groups with fluent aphasia (7 CVA and 11 TBI) and 18 controls matched in age and education, who were Cantonese speakers living in China participated. Language samples of single and sequential picture description and storytelling were elicited, and subsequently analysed on global and local coherence, content sequence, and informativeness.Result: TBI speakers had impaired global and local coherence, while CVA speakers had poor global coherence. Sequence of main events produced by the three groups correlated significantly with global coherence. Attention and visuospatial skills were also significantly related to global coherence in both clinical groups. Finally, impaired language integrity was associated with problems of local coherence.Conclusion: The results were consistent with previous studies. Linguistic deficits of coherence in discourse in the two clinical groups and possible impacts of elicitation tasks on the cognitive demands and coherence ratings were discussed.
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Affiliation(s)
- Anthony Pak-Hin Kong
- School of Communication Sciences and Disorders, University of Central Florida, Orlando, FL, USA
| | - Dustin Kai-Yan Lau
- Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Chloe Yuen-Yi Cheng
- Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
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Kong APH, Tse CWK. Clinician Survey on Speech Pathology Services for People with Aphasia in Hong Kong. ACTA ACUST UNITED AC 2018. [DOI: 10.21849/cacd.2018.00409] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Kong APH, Wong CWY. An Integrative Analysis of Spontaneous Storytelling Discourse in Aphasia: Relationship With Listeners' Rating and Prediction of Severity and Fluency Status of Aphasia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 27:1491-1505. [PMID: 30458505 PMCID: PMC6436460 DOI: 10.1044/2018_ajslp-18-0015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 05/08/2018] [Accepted: 06/04/2018] [Indexed: 06/09/2023]
Abstract
Purpose This study investigated which of the three analytic approaches of oral discourse, including linguistically based measures, proposition-based measures, and story grammar, best correlated with aphasia severity and with naïve listeners' ratings on aphasic productions. The predictive power of these analytic approaches to aphasia severity and fluency status of people with aphasia (PWA) was examined. Finally, which approach best discriminated fluent versus nonfluent PWA was determined. Method Audio files and orthographic transcriptions of the storytelling task "The Boy Who Cried Wolf" from 68 PWA and 68 controls were extracted from the Cantonese AphasiaBank. Each transcript was analyzed using these 3 systems. Results The linguistic approach of discourse analysis best correlated with aphasia severity and naïve listeners' subjective ratings. Although both linguistically based and proposition-based measures significantly predicted aphasia severity, a subset of linguistic measures focusing on the quantity and efficiency of production were particularly useful for clinical estimation of the fluency status of aphasia. Conclusions The linguistically based measures appeared to be the most clinically effective and powerful in reflecting PWA's performance of spoken discourse.
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Affiliation(s)
- Anthony Pak-Hin Kong
- School of Communication Sciences and Disorders, University of Central Florida, Orlando
| | - Cherie Wan-Yin Wong
- Department of Special Education and Counselling, The Education University of Hong Kong
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Kong APH, Lam PHP, Ho DWL, Lau JK, Humphreys GW, Riddoch J, Weekes B. The Hong Kong version of the Oxford Cognitive Screen (HK-OCS): validation study for Cantonese-speaking chronic stroke survivors. AGING NEUROPSYCHOLOGY AND COGNITION 2015; 23:530-48. [PMID: 26702642 DOI: 10.1080/13825585.2015.1127321] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Anthony Pak-Hin Kong
- Department of Communication Sciences and Disorders, University of Central Florida, Orlando, FL, USA
| | - Pinky Hiu-Ping Lam
- Laboratory for Communication Sciences, The University of Hong Kong, Hong Kong SAR
| | - Diana Wai-Lam Ho
- Department of Chinese and Bilingual Studies, The Polytechnic University of Hong Kong, Hong Kong SAR
| | - Johnny King Lau
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Glyn W. Humphreys
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Jane Riddoch
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Brendan Weekes
- Laboratory for Communication Sciences, The University of Hong Kong, Hong Kong SAR
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Altmann LJP, Hazamy AA, Carvajal PJ, Benjamin M, Rosenbek JC, Crosson B. Delayed Stimulus-Specific Improvements in Discourse Following Anomia Treatment Using an Intentional Gesture. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2014; 57:439-54. [PMID: 24129014 PMCID: PMC4157115 DOI: 10.1044/1092-4388(2013/12-0224)] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Purpose: In this study, the authors assessed how the addition of intentional left-hand gestures to an intensive treatment for anomia affects 2 types of discourse: picture description and responses to open-ended questions.Method: Fourteen people with aphasia completed treatment for anomia comprising 30 treatment sessions over 3 weeks.Seven subjects also incorporated intentional left-hand gestures into each treatment trial.Results: Both groups demonstrated significant changes in trained items and improved naming of untrained items but no change in Western Aphasia Battery—Aphasia Quotient(WAB–AQ; Kertesz, 1982) scores. Changes in discourse were limited to the 3-month follow-up assessment. Several discourse measures showed significant improvements in the picture description task and declines during question responses. Additionally, the gesture group produced more words at each assessment, whereas the no gesture group produced fewer words at each assessment. These patterns led to improvements in picture descriptions and minimal declines in question responses in the gesture group. In contrast, the no gesture group showed minimal improvements in picture descriptions and production declines in question responses relative to pretreatment levels.Conclusion: The intensive treatment protocol is a successful method for improving picture naming even of untrained items.Further, the authors conclude that the intentional left-hand gesture contributed significantly to the generalization of treatment to discourse.
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Hussmann K, Grande M, Meffert E, Christoph S, Piefke M, Willmes K, Huber W. Computer-assisted analysis of spontaneous speech: quantification of basic parameters in aphasic and unimpaired language. CLINICAL LINGUISTICS & PHONETICS 2012; 26:661-680. [PMID: 22774927 DOI: 10.3109/02699206.2012.683672] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Although generally accepted as an important part of aphasia assessment, detailed analysis of spontaneous speech is rarely carried out in clinical practice mostly due to time limitations. The Aachener Sprachanalyse (ASPA; Aachen Speech Analysis) is a computer-assisted method for the quantitative analysis of German spontaneous speech that allows for a detailed assessment by means of linguistic basic parameters in an acceptable amount of time. It has previously been proven sensitive for monitoring changes over time. In this study, we present data of 52 aphasic participants whose spontaneous speech was analyzed retrospectively before and after an intensive therapy program. The measured changes are evaluated with reference to normative data of 60 non-brain-damaged speakers. Results confirm good sensitivity to document changes over time. Clinical relevance of changes is assessed with reference to critical score ranges derived from the normative data. Findings provide further evidence of the clinical applicability and usefulness of ASPA.
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Affiliation(s)
- Katja Hussmann
- Section Neurological Cognition Research, Department of Neurology, Medical School, RWTH Aachen University, Aachen, Germany.
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Kong APH. The main concept analysis in cantonese aphasic oral discourse: external validation and monitoring chronic aphasia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2011; 54:148-159. [PMID: 20719865 DOI: 10.1044/1092-4388(2010/09-0240)] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
PURPOSE The 1st aim of this study was to further establish the external validity of the main concept (MC) analysis by examining its relationship with the Cantonese Linguistic Communication Measure (CLCM; Kong, 2006; Kong & Law, 2004)-an established quantitative system for narrative production-and the Cantonese version of the Western Aphasia Battery (CAB; Yiu, 1992). The 2nd purpose of the study was to evaluate how well the MC analysis reflects the stability of discourse production among chronic Cantonese speakers with aphasia. METHOD Sixteen participants with aphasia were evaluated on the MC analysis, CAB, and CLCM in the summer of 2008 and were subsequently reassessed in the summer of 2009. They encompassed a range of aphasia severity (with an Aphasia Quotient ranging between 30.2/100 and 94.8/100 at the time of the 1st evaluation). RESULTS Significant associations were found between the MC measures and the corresponding CLCM indices and CAB performance scores that were relevant to the presence, accuracy, and completeness of content in oral narratives. Moreover, the MC analysis was found to yield comparable scores for chronic speakers on 2 occasions 1 year apart. CONCLUSION The present study has further established the external validity of MC analysis in Cantonese. Future investigations involving more speakers with aphasia will allow adequate description of its psychometric properties.
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Affiliation(s)
- Anthony Pak-Hin Kong
- Department of Communication Sciences and Disorders, University of Central Florida, Orlando, FL 32816, USA.
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