Lisa D Bunker, Shauna K Berube, Voss Neal, Lindsey Kelly, Catherine Kelly, Erin L Meier, Argye E Hillis
{"title":"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。","authors":"Lisa D Bunker, Shauna K Berube, Voss Neal, Lindsey Kelly, Catherine Kelly, Erin L Meier, Argye E Hillis","doi":"10.1044/2024_AJSLP-24-00322","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Method: </strong>Sixty-eight participants with acute left-hemisphere stroke completed the WAB-R and were classified as <i>aphasic by WAB-R</i> (ABW; <i>n</i> = 42) or <i>not aphasic by WAB-R</i> (NABW; <i>n</i> = 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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.28608116.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"1-21"},"PeriodicalIF":2.3000,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"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.\",\"authors\":\"Lisa D Bunker, Shauna K Berube, Voss Neal, Lindsey Kelly, Catherine Kelly, Erin L Meier, Argye E Hillis\",\"doi\":\"10.1044/2024_AJSLP-24-00322\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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.</p><p><strong>Method: </strong>Sixty-eight participants with acute left-hemisphere stroke completed the WAB-R and were classified as <i>aphasic by WAB-R</i> (ABW; <i>n</i> = 42) or <i>not aphasic by WAB-R</i> (NABW; <i>n</i> = 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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Supplemental material: </strong>https://doi.org/10.23641/asha.28608116.</p>\",\"PeriodicalId\":49240,\"journal\":{\"name\":\"American Journal of Speech-Language Pathology\",\"volume\":\" \",\"pages\":\"1-21\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-03-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Speech-Language Pathology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1044/2024_AJSLP-24-00322\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Speech-Language Pathology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1044/2024_AJSLP-24-00322","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY","Score":null,"Total":0}
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.
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.
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.
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