American Journal of Speech-Language Pathology最新文献

{"title":"Promoting Augmentative and Alternative Communication-Induced Language Recovery in Chronic Aphasia (PAIL-RcA): Theoretical Construct, Method, Protocol, and Treatment Resources.","authors":"Aimee Dietz, Chitrali R Mamlekar, Michelle K Hart, Cassy White","doi":"10.1044/2025_AJSLP-24-00429","DOIUrl":"10.1044/2025_AJSLP-24-00429","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this tutorial is to provide a how-to so that clinicians can successfully implement augmentative and alternative communication (AAC) as a dual-purpose tool, one that successfully and simultaneously compensates for communication breakdowns and facilitates language recovery. Moreover, readers will understand two key principles of neuroplasticity as they apply to AAC implementation for people with aphasia (PWA), as well as the theory of intersystemic reorganization, by way of a novel treatment, Promoting AAC-Induced Language-Recovery in Chronic Aphasia (PAIL-RcA).</p><p><strong>Method and procedure: </strong>Readers are provided a step-by-step overview of PAIL-RcA, as well as data sheets, cueing hierarchy, a family handout and prompt guides detailing how to successfully implement PAIL-RcA.</p><p><strong>Conclusions: </strong>PAIL-RcA is a novel AAC treatment for PWA that is theoretically driven, manualized, and proven feasible with freely available resources for clinical implementation. Although PAIL-RcA was developed for storytelling and is highlighted for use on an iPad, we encourage adaptation for implementation across a variety of AAC systems and communication purposes.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"1-16"},"PeriodicalIF":2.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Study of Listening Fatigue: Impacts of Pediatric Dysarthria on Adult Listeners.","authors":"Jennifer U Soriano, Tristan J Mahr, Paul J Rathouz, Katherine C Hustad","doi":"10.1044/2024_AJSLP-24-00259","DOIUrl":"https://doi.org/10.1044/2024_AJSLP-24-00259","url":null,"abstract":"<p><strong>Purpose: </strong>We sought to characterize fatigue of adults when listening to speech of children with cerebral palsy (CP).</p><p><strong>Method: </strong>Fifty-seven children with CP (19 without dysarthria and 38 with dysarthria) produced single-word and multiword speech samples. One hundred fourteen adult listeners completed transcription intelligibility tasks and provided listening fatigue ratings. Multiword utterances were analyzed in terms of speech rate and communication efficiency.</p><p><strong>Results: </strong>Intraclass correlations showed large individual differences for listening fatigue ratings. Pearson correlations showed negative relationships between listening fatigue and intelligibility; however, the magnitude varied depending upon utterance length and dysarthria status of child speakers. Pearson correlations between listening fatigue and speech rate and between listening fatigue and communication efficiency varied depending upon dysarthria status of child speakers. Welch's <i>t</i> test showed that listeners of children with dysarthria had higher fatigue ratings than listeners of children without dysarthria. Listeners of children with dysarthria were more fatigued following multiword utterances than single-word utterances. Best subset regression showed that the combined effect of dysarthria status, intelligibility, and speech rate best explained listening fatigue of adult listeners.</p><p><strong>Conclusions: </strong>Listeners had increased levels of fatigue when they heard dysarthric speech relative to nondysarthric speech. The needs of both speaker and listener should be considered when supporting children with CP and dysarthria to achieve successful communication.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"1-16"},"PeriodicalIF":2.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert Consensus on the Role of Speech-Language Pathologists in Working With Deaf Children Who Use American Sign Language in the United States: A Classical e-Delphi Study.","authors":"Kristen Secora, Brittany Lee, David Smith, Marie Coppola","doi":"10.1044/2025_AJSLP-24-00298","DOIUrl":"https://doi.org/10.1044/2025_AJSLP-24-00298","url":null,"abstract":"<p><strong>Purpose: </strong>Although approximately 40% of school-based speech-language pathologists (SLPs) regularly serve Deaf and hard of hearing (DHH) students, at present, there are no agreed-upon standards specifying the minimum qualifications and best practices for working with this population, especially those who use signed language. The goal of the present study is to establish expert consensus on recommended clinical training and practice for SLPs working with signing DHH children.</p><p><strong>Method: </strong>Experts in fields related to speech-language pathology and deaf education (<i>N</i> = 30, 16 DHH) participated in three rounds of a classical e-Delphi study. In Round 1, experts responded to open-ended questions about the role of SLPs working with DHH children who sign. In Rounds 2 and 3, experts rated their agreement with statements generated by fellow experts in Round 1.</p><p><strong>Results: </strong>A mixed-method design included qualitative content analysis (Round 1) and quantitative descriptive statistics (Rounds 2 and 3). Experts rated a total of 185 items in Round 2 and 186 items in Round 3. Consensus (at least 70% agreement) was met for 158 statements, with recommendations for SLPs' knowledge, attitudes, and practices. Consensus was not achieved for 28 items, including the level of American Sign Language proficiency required for SLPs.</p><p><strong>Conclusions: </strong>This study is the first to elicit input from a panel of experts seeking to establish professional standards for SLPs who work with signing DHH children. These findings contribute to the movement toward more inclusive and culturally responsive clinical practice and can inform educational standards and policy for SLPs. Future research is needed to determine whether practicing SLPs meet these recommended standards and how clinical training can support growth for standards that are not currently being met.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.28665218.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"1-37"},"PeriodicalIF":2.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitation and Interference Effects During Cognate Retrieval in a Multilingual Person With Aphasia.","authors":"Aviva Lerman, Taryn R Malcolm","doi":"10.1044/2024_AJSLP-24-00233","DOIUrl":"https://doi.org/10.1044/2024_AJSLP-24-00233","url":null,"abstract":"<p><strong>Purpose: </strong>In this study, we investigated the phenomenon of cognate status-based picture-naming abilities before and after anomia treatment in a multilingual person with poststroke aphasia whose languages vary in relation to language typology, age of acquisition, proficiency, and exposure/use in the years leading up to the stroke. We examined baseline abilities as well as the efficacy of within- and cross-language generalization.</p><p><strong>Method: </strong>In a multiple-baseline study, we measured cognate versus noncognate picture-based naming in one multilingual person with mixed transcortical aphasia in three of his languages: Swahili, English, and Hebrew. We provided 18 hrs of word retrieval treatment in English and then retested his cognate versus noncognate retrieval in all three languages.</p><p><strong>Results: </strong>At baseline, no cognate advantage was observed in English (high proficiency, early acquisition, high daily use). A cognate advantage was observed for Hebrew (late acquisition, moderate proficiency, oft-used) and potentially for Swahili (high proficiency, early acquisition, rarely used). After treatment in English, our results indicated greater interference effects for cognates relative to noncognates in Hebrew and Swahili, but not English.</p><p><strong>Conclusions: </strong>Retrieval ability may be more influenced by prestroke usage than by age of acquisition or proficiency, with a facilitative cognate advantage for less proficient and/or less used languages. Furthermore, treating a stronger language may result in interference of cognate retrieval more than noncognate retrieval in weaker languages. More studies are needed in this field to better understand the contribution of each factor and how we can manipulate them to our advantage in the aphasia clinic.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.28620785.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"1-18"},"PeriodicalIF":2.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Person-Centered Goals in Speech-Language Pathology Services for Mild Traumatic Brain Injury.","authors":"Tracey Wallace, Yalian Pei, Amy M Kemp, Rebecca Gartell, Cheryl Appleberry, Russell K Gore, Katy H O'Brien","doi":"10.1044/2025_AJSLP-24-00117","DOIUrl":"https://doi.org/10.1044/2025_AJSLP-24-00117","url":null,"abstract":"<p><strong>Purpose: </strong>Person-centered goals represent meaningful and motivating aspirations of patients and help rehabilitation professionals shape treatment plans to meet individual needs. The purpose of this research note is to describe person-centered goals identified among individuals receiving speech-language pathology services after mild traumatic brain injury (mTBI) and to consider how goals might be informed by existing self-report measures and guide treatment planning.</p><p><strong>Method: </strong>Using a retrospective chart review approach, we extracted person-centered goals of patients between the ages of 14 and 65 years who received care from a speech-language pathologist at an outpatient specialty concussion clinic between August 2019 and March 2020. Goals were coded according to impairment, activity, and participation domains; environmental setting; treatment domain; rehabilitative expectation (restorative or compensatory); as well as by alignment with items in a concussion symptom scale. Three reviewers independently coded goals, with discrepancies in ratings resolved through consensus. Data were analyzed descriptively.</p><p><strong>Results: </strong>In total, 59 patient charts met inclusion criteria. Mean patient age was 31.85 (<i>SD</i> = 17.31). Most goals were at the activity level (46%), followed by participation (32%), and impairment (22%). Return to productivity was central to patient goals, with almost half addressing return to school (49%) and 21% specifying return to work. By domain, goals were primarily cognitive in nature (62%), followed by communication (13%), emotional regulation (13%), or unspecified (12%). Almost all goals were restorative (86%). Just 37% of goals were represented on the symptom scale, as expected, those that were reflected cognitive needs.</p><p><strong>Conclusion: </strong>Person-centered goals are not well captured by standard mTBI symptom scales, thus emphasizing a need for rehabilitation providers to use problem-focused interviewing, motivational interviewing, or other person-centered methods to identify personally relevant and meaningful goals in this population.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"1-11"},"PeriodicalIF":2.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large Language Models' Ability to Assess Main Concepts in Story Retelling: A Proof-of-Concept Comparison of Human Versus Machine Ratings.","authors":"Jacquie Kurland, Vishnupriya Varadharaju, Anna Liu, Polly Stokes, Ankita Gupta, Marisa Hudspeth, Brendan O'Connor","doi":"10.1044/2025_AJSLP-24-00400","DOIUrl":"https://doi.org/10.1044/2025_AJSLP-24-00400","url":null,"abstract":"<p><strong>Purpose: </strong>Despite an abundance of manual, labor-intensive discourse analysis methods, there remains a dearth of clinically convenient, psychometrically robust instruments to measure change in real-world communication in aphasia. The Brief Assessment of Transactional Success (BATS) addresses this gap while developing automated methods for analyzing story retelling discourse. This study investigated automation of main concept (MC) analysis of stories by comparing scores from three large language models (LLMs) to those of human raters.</p><p><strong>Method: </strong>After watching/listening to each of the eight short video/audio BATS stimuli and retelling each story, 96 persons with aphasia (PWA; <i>n</i> = 48 female) engaged in topic-constrained conversations over Zoom with 94 familiar and 107 unfamiliar conversation partners (CPs). CPs then retold each story as co-constructed during their conversations with PWA. Audio files from the resulting 1,760 story retells were transcribed using Python and AssemblyAI's speech-to-text application programming interface. Each MC was first scored by human raters for presence, accuracy, and completeness. Raters used a semiautomated application, MainConcept. For each transcript, an MC composite ratio score was obtained. We evaluated three state-of-the-art LLMs: two proprietary models, GPT-4 and GPT-4o, and one open-source model, Llama-3-70B. The interrater reliability between each LLM versus human MC scoring was assessed via the Pearson correlation coefficient and reliability coefficients based on the generalizability theory (G-theory).</p><p><strong>Results: </strong>The Pearson correlation coefficients indicate strong positive linear relationships between LLM and human MC scores. G-theory reliability coefficients also indicate reliable scoring between LLM and human scoring across the spectrum of participants and conditions.</p><p><strong>Conclusions: </strong>This promising proof-of-concept study affirms the reliability of three LLMs in evaluating BATS story retell MCs and justifies ongoing investigation into their use. Providing clinicians and clinical researchers with automated tools for analyzing discourse without the need for prohibitively labor-intensive manual scoring could be a paradigm shift, potentially revolutionizing the aphasia intervention landscape.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"1-11"},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Babble Boot Camp for Infants With Down Syndrome: Piloting a Proactive, Caregiver-Led Intervention Designed to Boost Earliest Speech and Language Skills.","authors":"Beate Peter, Lizbeth Finestack, Susan Loveall, Lauren Thompson, Laurel Bruce, Nancy Scherer, Carol Stoel-Gammon, Jennifer Davis, Nancy Potter, Mark VanDam, Linda Eng, Sue Buckley","doi":"10.1044/2024_AJSLP-24-00271","DOIUrl":"https://doi.org/10.1044/2024_AJSLP-24-00271","url":null,"abstract":"<p><strong>Purpose: </strong>Down syndrome (DS) is associated with lifelong difficulties with verbal communication, beginning in infancy when vocalizations are sparse and first words emerge late. Because DS is diagnosed at or even before birth, these difficulties can be anticipated, yet there have been limited developments of systematic, proactive interventions. The purpose of the pilot study described here was to investigate feasibility and potential benefits of such an intervention toward a fully powered clinical trial.</p><p><strong>Method: </strong>We piloted Babble Boot Camp (BBC), a proactive, parent-led speech and language intervention, with 10 children with DS ages 4-16 months. Each family participated in weekly sessions via telehealth for 10 months. A pediatric speech-language pathologist coached parents to implement daily routines and activities at home, designed to foster child target behaviors and skills (e.g., increased vocalization rates, babble complexity, word productions) toward building resilience against anticipated challenges. Parents provided daylong audio recordings and questionnaire data at regular intervals.</p><p><strong>Results: </strong>Parent participation and compliance metrics in the intervention were high. All rated the intervention as acceptable, convenient, and helpful, whereas three sets of parents found aspects of the data collection time consuming. Children's linguistic environments resembled those of typical controls in terms of child utterance rates, adult word counts, and conversational turns. Babble complexity and receptive and expressive vocabularies increased over time. First words emerged earlier than expected.</p><p><strong>Conclusion: </strong>High feasibility metrics and suggestive benefits motivate a larger study to determine more specifically how the various BBC components can improve long-term outcomes for children with DS.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.28655222.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"1-17"},"PeriodicalIF":2.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of Endoscopic Evaluations of Laryngeal Function After Extubation for Research in Critically Ill Adults.","authors":"Vinciya Pandian, Sai Phani Sree Cherukuri, Mounica Koneru, Gowthami Sai Kogilathota Jagirdhar Reddy, Pooja Kota, Victor D Dinglas, Elizabeth Colantuoni, Lee Akst, Alexander T Hillel, Dale M Needham, Martin B Brodsky","doi":"10.1044/2025_AJSLP-23-00464","DOIUrl":"10.1044/2025_AJSLP-23-00464","url":null,"abstract":"<p><strong>Purpose: </strong>Flexible nasal laryngoscopy (FNL) is commonly used in intensive care units (ICUs) to assess laryngeal anatomy and function after endotracheal intubation. The use of FNL in research may differ from clinical practice due to requirements of research protocols and related data collection and documentation. This study evaluates the feasibility of performing FNL post-extubation in critically ill adults within the context of a research protocol. Understanding the feasibility of this reference standard assessment is important for supporting future studies and improving patient care.</p><p><strong>Method: </strong>This prospective study, conducted in six ICUs within a single academic medical center, consecutively enrolled adult patients who required mechanical ventilation for at least 8 hr. The primary feasibility outcome was the successful completion of FNL within 72 hr of extubation. Secondary outcomes included completion of the 3-oz water swallow test (Yale Swallow Protocol) during the FNL, patient enrollment/exclusion/withdrawal rates, time from extubation to FNL, procedure duration, and patient-reported pain (using the Wong-Baker FACES Pain Rating Scale).</p><p><strong>Results: </strong>A total of 80 patients (75%) of 107 eligible patients fully completed FNL. Among the 24 patients who did not receive FNL, eight died, seven were medically inappropriate, and seven declined FNL. The median time from extubation to FNL was 10 hr (IQR [interquartile range]: 8-12 hr), and the median FNL procedure duration was 8.5 min (IQR: 5.8-12.9 min). The median (IQR) pain score was 2 (0, 4) of 10, reflecting only mild discomfort.</p><p><strong>Conclusion: </strong>Post-extubation FNL is feasible within the context of a research protocol and well tolerated by critically ill adults.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"1-10"},"PeriodicalIF":2.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of the Fatigue Interference and Severity Scale for Aphasia.","authors":"Ellyn A Riley, Jennifer Fortin, Hannah Rembrandt, Nicole Vieyto","doi":"10.1044/2024_AJSLP-24-00328","DOIUrl":"https://doi.org/10.1044/2024_AJSLP-24-00328","url":null,"abstract":"<p><strong>Purpose: </strong>Poststroke fatigue, which is characterized by an overwhelming feeling of exhaustion that affects daily life, is prevalent among stroke survivors and can negatively affect cognition, motor function, employment, life participation, and quality of life. However, individuals with aphasia are often excluded from fatigue studies because of communication barriers, leading to underdiagnosis and an inaccurate picture of the occurrence and impact of poststroke fatigue in persons with aphasia.</p><p><strong>Method: </strong>This study aimed to develop a more aphasia-accessible tool that would be similar to the Fatigue Severity Scale (FSS), a self-reported fatigue measure commonly used to identify significant poststroke fatigue. The Fatigue Interference and Severity Scale for Aphasia (FISS-A) was developed using a modified nominal group technique involving two focus groups: individuals with aphasia and speech-language pathologists. The groups provided feedback on the format, wording, administration, and response methods of the FSS. Focus group feedback led to several key recommendations, including simplifying language, increasing text spacing and font size, incorporating images, and enabling nonverbal responses.</p><p><strong>Results: </strong>The FISS-A retains the original nine items of the FSS but presents them with lexical and syntactic modifications to enhance clarity and comprehensibility for individuals with aphasia. Visual aids and explicit instructions for providers were added to ensure an accurate administration and response collection. An additional open-ended item was included to capture any fatigue-related symptoms that were not covered by the standard items, and two visual analog scales were added to collect additional ratings of general fatigue severity and its impact on language ability.</p><p><strong>Conclusions: </strong>This study highlights the importance of creating accessible assessment tools for clinical and research purposes. Future research will focus on validating the FISS-A across diverse populations and exploring its integration into clinical practice.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"1-14"},"PeriodicalIF":2.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Detection of Very Mild Aphasia With Letter Fluency Tests.","authors":"Alycia B Laks, Andrew T DeMarco, Peter E Turkeltaub","doi":"10.1044/2025_AJSLP-24-00471","DOIUrl":"10.1044/2025_AJSLP-24-00471","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to find an efficient measure for clinicians to diagnose very mild aphasia.</p><p><strong>Method: </strong>Twenty-seven individuals with very mild aphasia who tested as not aphasic by the Western Aphasia Battery-Revised (WAB-R; NABW) were compared to 68 matched controls on 28 tests. Group-level differences were determined with independent-samples <i>t</i> tests. A univariate receiver operator characteristic (ROC) curve analysis was constructed to determine optimal cutoff points for each test. Sensitivity and specificity were calculated for the optimal cutoffs. Boolean operators of two or more tests were used to determine if combinations of tests were more sensitive and specific than single tests in classifying the NABW participants versus neurotypical controls.</p><p><strong>Results: </strong>Twenty out of 28 behavioral tests and subtests had group-level differences, with 18 surviving Bonferroni correction. Only scores derived from letter fluency and a two-letter fluency test had sensitivity and specificity ≥ .70. The Boolean combination of letter fluency and two-letter fluency tests gave a sensitivity of .89 and specificity of .81.</p><p><strong>Conclusions: </strong>The combined letter fluency and two-letter fluency tests were sensitive in detecting very mild aphasia beyond what is captured in the WAB-R. Administration takes an estimated 11 min, making it accessible to clinicians in various settings. While letter fluency tests rely on phonological and orthographic knowledge, they are also frequently used to measure executive control. Thus, this combined letter fluency test should be used in conjunction with other language and cognitive assessments to determine treatment targets.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"1-10"},"PeriodicalIF":2.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}