Discourse Measures From the Modern Cookie Theft Picture Description Are Sensitive to Mild Communication Deficits Not Captured by the Western Aphasia Battery-Revised Aphasia Quotient.

IF 2.3 3区医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

American Journal of Speech-Language Pathology Pub Date : 2025-03-26 DOI:10.1044/2024_AJSLP-24-00322

Lisa D Bunker, Shauna K Berube, Voss Neal, Lindsey Kelly, Catherine Kelly, Erin L Meier, Argye E Hillis

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引用次数: 0

Abstract

Purpose: The Western Aphasia Battery-Revised (WAB-R) is often used for diagnosis of aphasia. However, persons scoring above the WAB-R diagnostic cutoff may still present with language difficulties indicative of aphasia. Identification of residual language challenges is critical for treatment referral or inclusion in research. We examined differences in discourse following acute left-hemisphere stroke for those above/below the WAB-R diagnostic cutoff compared to healthy controls, as well as recovery during the first year.

Method: Sixty-eight participants with acute left-hemisphere stroke completed the WAB-R and were classified as aphasic by WAB-R (ABW; n = 42) or not aphasic by WAB-R (NABW; n = 26). They completed the Modern Cookie Theft (MCT) picture description task at two time points: acute and either 3, 6, or 12 months poststroke. Responses were analyzed for content units, total verbal output, efficiency, and lateralization of content (i.e., right vs. left side of stimulus) and compared to 49 healthy controls. Differences between groups were examined using Wilcoxon rank-sum tests. Change over time was examined using robust linear mixed-effects regression.

Results: Wilcoxon tests showed differences between healthy controls and ABW or NABW on all MCT metrics except efficiency for those NABW. Regression models showed no main effects of group or interaction between group and time point.

Conclusions: The NABW group showed deficits in verbal output, content production, and laterality on the MCT picture description task, suggesting the presence of possible aphasia and hemispatial neglect. Measures derived from the MCT may be more sensitive to residual language/communication difficulties not captured by the WAB-R. The NABW group also showed similar patterns of recovery as the ABW group, highlighting the MCT task's ability to capture change for those with mild impairments. Results support use of the MCT task in clinical settings, particularly if/when mild deficits are probable/suspected.

Supplemental material: https://doi.org/10.23641/asha.28608116.

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来自现代饼干盗窃图片描述的话语测量对西方失语症电池修正失语症商数未捕获的轻度交流缺陷敏感。

目的：Western Aphasia Battery-Revised （WAB-R）常用于失语症的诊断。然而，得分高于WAB-R诊断临界值的人可能仍然存在表明失语症的语言困难。残留语言障碍的识别对于治疗转诊或纳入研究至关重要。与健康对照相比，我们检查了WAB-R诊断临界值高于/低于急性左半球卒中患者的话语差异，以及第一年的康复情况。方法：68例急性左脑卒中患者完成WAB-R测试，并按WAB-R (ABW；n = 42)或通过WAB-R (NABW；N = 26)。他们在两个时间点完成了现代饼干盗窃（MCT）图片描述任务：急性期和中风后3、6或12个月。在内容单位、总言语输出、效率和内容的偏侧化（即刺激的右侧与左侧）方面分析了反应，并与49名健康对照进行了比较。组间差异采用Wilcoxon秩和检验。使用鲁棒线性混合效应回归检查随时间的变化。结果：Wilcoxon试验显示，除了NABW组的效率外，健康对照组与ABW组或NABW组在所有MCT指标上存在差异。回归模型显示组间无主效应，组与时间点间无交互作用。结论：NABW组在MCT图像描述任务中表现出语言输出、内容生成和偏侧性的缺陷，表明可能存在失语症和半脑忽视。来自MCT的测量可能对WAB-R未捕捉到的残留语言/沟通困难更敏感。NABW组也表现出与ABW组相似的恢复模式，突出了MCT任务捕捉轻度损伤者变化的能力。结果支持在临床环境中使用MCT任务，特别是当可能/怀疑轻度缺陷时。补充资料：https://doi.org/10.23641/asha.28608116。

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来源期刊

American Journal of Speech-Language Pathology AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-REHABILITATION

CiteScore

4.30

自引率

11.50%

发文量

353

审稿时长

>12 weeks

期刊介绍： Mission: AJSLP publishes peer-reviewed research and other scholarly articles on all aspects of clinical practice in speech-language pathology. The journal is an international outlet for clinical research pertaining to screening, detection, diagnosis, management, and outcomes of communication and swallowing disorders across the lifespan as well as the etiologies and characteristics of these disorders. Because of its clinical orientation, the journal disseminates research findings applicable to diverse aspects of clinical practice in speech-language pathology. AJSLP seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work. Scope: The broad field of speech-language pathology, including aphasia; apraxia of speech and childhood apraxia of speech; aural rehabilitation; augmentative and alternative communication; cognitive impairment; craniofacial disorders; dysarthria; fluency disorders; language disorders in children; speech sound disorders; swallowing, dysphagia, and feeding disorders; and voice disorders.