No AccessAmerican Journal of Speech-Language PathologyResearch Article1 Nov 2013

The Relationship of Aphasia Type and Gesture Production in People With Aphasia


    For many individuals with aphasia, gestures form a vital component of message transfer and are the target of speech-language pathology intervention. What remains unclear are the participant variables that predict successful outcomes from gesture treatments. The authors examined the gesture production of a large number of individuals with aphasia—in a consistent discourse sampling condition and with a detailed gesture coding system—to determine patterns of gesture production associated with specific types of aphasia.


    The authors analyzed story retell samples from AphasiaBank (TalkBank, n.d.), gathered from 98 individuals with aphasia resulting from stroke and 64 typical controls. Twelve gesture types were coded. Descriptive statistics were used to describe the patterns of gesture production. Possible significant differences in production patterns according to aphasia type were examined using a series of chi-square, Fisher exact, and logistic regression statistics.


    A significantly higher proportion of individuals with aphasia gestured as compared to typical controls, and for many individuals with aphasia, this gesture was iconic and was capable of communicative load. Aphasia type impacted significantly on gesture type in specific identified patterns, detailed here.


    These type-specific patterns suggest the opportunity for gestures as targets of aphasia therapy.

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    • Beattie, G., & Shovelton, H. (1999). Do iconic gestures really contribute anything to the semantic information conveyed by speech? An experimental investigation.Semiotica, 123(1/2), 1–30.
    • Behrmann, M., & Penn, C. (1984). Non-verbal communication in aphasia.British Journal of Disorders of Communication, 19, 155–176.
    • Carlomagno, S., Pandolfi, M., Martini, A., Di Iasi, G., & Cristilli, C. (2005). Coverbal gestures in Alzheimer's type dementia.Cortex, 41, 535–546.
    • Cho-Reyes, S., & Thompson, C. (2012). Verb and sentence production and comprehension in aphasia: Northwestern Assessment of Verbs and Sentences (NAVS).Aphasiology, 26, 1250–1277.
    • Cicone, M., Wapner, W., Foldi, N., Zurif, E., & Gardner, H. (1979). The relation between gesture and language in aphasic communication.Brain and Language, 8, 324–349.
    • de Ruiter, J. (2000). The production of gesture and speech.In D. McNeill (Ed.), Language and gesture (pp. 284–311). Cambridge, UK: Cambridge University Press.
    • de Ruiter, J. (2006). Can gesticulation help aphasic people speak, or rather, communicate?.International Journal of Speech-Language Pathology, 8(2), 124–127.
    • Disney, R. H. (2002). Walt Disney's Cinderella (a Little Golden Book). New York, NY: Random House.
    • Duffy, R., & Duffy, J. (1981). Three studies of deficits in pantomimic expression and pantomimic recognition in aphasia.Journal of Speech and Hearing Research, 46, 70–84.
    • Duffy, R. J., Duffy, J. R., & Mercaitis, P. A. (1984). Comparison of the performances of a fluent and a nonfluent aphasic on a pantomimic referential task.Brain and Language, 21, 260–273.
    • Efron, D. (1972). Gesture, race, and culture. The Hague, the Netherlands: Mouton.
    • Ekman, P., & Friesen, W. V. (1969). The repertoire of nonverbal behavior: Categories, origins, usage, and coding.Semiotica, 1, 49–98.
    • Glosser, G., Wiener, M., & Kaplan, E. (1986). Communicative gestures in aphasia.Brain and Language, 27, 345–359.
    • Goldin-Meadow, S., McNeill, D., & Singleton, J. (1996). Silence is liberating: Removing the handcuffs on grammatical expression in the manual modality.The Psychological Review, 103, 34–55.
    • Goodglass, H., & Kaplan, E. (1963). Disturbance of gesture and pantomime in aphasia.Brain, 86, 703–720.
    • Goodwin, C. (2000). Gesture, aphasia, and interaction.In D. McNeill (Ed.), Language and gesture (pp. 84–98). Cambridge, UK: Cambridge University Press.
    • Gullberg, M. (2006). Handling discourse: Gestures, reference, tracking, and communication strategies in early L2.Language Learning, 56(1), 155–196.
    • Haberman, S. J. (1973). The analysis of residuals in cross-classified tables.Biometrics, 29, 205–220.
    • Herrmann, M., Reichle, T., & Lucius-Hoene, G. (1988). Nonverbal communication as a compensation strategy for severely nonfluent aphasics? A quantitative approach.Brain and Language, 33, 41–54.
    • Hogrefe, K., Ziegler, W., Weidinger, N., & Goldenberg, G. (2012). Non-verbal communication in severe aphasia: Influence of aphasia, apraxia, or semantic processing.Cortex, 48, 952–962.
    • Kadish, J. (1978). A neuropsychological approach to the study of gesture and pantomime in aphasia.South African Journal of Communication Disorders, 25, 102–117.
    • Kaplan, E., Goodglass, H., & Weintraub, S. (2001). Boston Naming Test, Second Edition. Austin, TX: Pro-Ed.
    • Kendon, A. (1980). Gesticulation and speech: Two aspects of the process of utterance.In M. Key (Ed.), The relationship of verbal and nonverbal communication (pp. 207–227). The Hague, the Netherlands: Mouton.
    • Kertesz, A. (2007). Western Aphasia Battery—Revised. San Antonio, TX: The Psychological Corporation.
    • Kita, S., & Davies, T. S. (2009). Competing conceptual representations trigger co-speech representational gestures.Language and Cognitive Processes, 24, 761–775.
    • Krauss, R., & Hadar, U. (1999). The role of speech-related arm/hand gestures in word retrieval.In R. Campbell, & L. Messing (Eds.), Gesture, speech, and sign (pp. 63–116). Oxford, UK: Oxford University Press.
    • The Language Archive (n.d.). ELAN (Version 4.6.1) [Computer software].Retrieved from
    • Lanyon, L., & Rose, M. (2009). Do the hands have it? The facilitation effects of arm and hand gesture on word retrieval in aphasia.Aphasiology, 23(7/8), 809–822.
    • Le May, A., David, R., & Thomas, A. (1988). The use of spontaneous gesture by aphasic patients.Aphasiology, 2, 137–145.
    • Levelt, P. (1989). Speaking: From intention to articulation. Cambridge, MA: MIT Press.
    • Lott, P. (1999). Gesture and aphasia. Berlin, Germany: Peter Lang.
    • MacWhinney, B., Fromm, D., Forbes, M., & Holland, A. (2011). AphasiaBank: Methods for studying discourse.Aphasiology, 25(11), 1286–1307.
    • Marshall, J., Best, W., Cocks, N., Cruice, M., Pring, T., Bulcock, G., & Caute, A. (2012). Gesture and naming therapy for people with severe aphasia: A group study.Journal of Speech, Language, and Hearing Research, 55, 726–738.
    • McNeill, D. (1992). Hand and mind: What gestures reveal about thought. Chicago, IL: University of Chicago Press.
    • McNeill, D. (2000a). Growth points, catchments, and contexts.Cognitive Studies, 7(1), 22–36.
    • McNeill, D. (2000b). Introduction.In D. McNeill (Ed.), Language and gesture (pp. 1–10). Cambridge, UK: Cambridge University Press.
    • Pedelty, L. L. (1987). Gesture in aphasia (Unpublished doctoral dissertation). The University of Chicago, IL
    • Pickett, L. (1974). Assessment of gesture and pantomimic deficit in aphasic patients.Acta Symbolica, 5, 69–86.
    • Rose, M. (2006). The utility of gesture treatments in aphasia.International Journal of Speech-Language Pathology, 8(2), 92–109.
    • Rose, M., & Douglas, J. (2001). The differential facilitatory effects of gesture and visualisation processes on object naming in aphasia.Aphasiology, 15(10/11), 977–990.
    • Rose, M., & Douglas, J. (2003). Limb apraxia, pantomime, and lexical gesture in aphasic speakers: Preliminary findings.Aphasiology, 17(5), 453–464.
    • TalkBank (n.d.). AphasiaBank [Database].Retrieved from
    • Thompson, C. (2013). Northwestern Assessment of Verbs and Sentences—Revised. Manuscript in preparation
    • Wang, L., & Goodglass, H. (1992). Pantomime, praxis, and aphasia.Brain and Language, 42, 402–418.

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