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Review Article
21 February 2020

Inner Speech in Aphasia: Current Evidence, Clinical Implications, and Future Directions

Publication: American Journal of Speech-Language Pathology
Volume 29, Number 1S
Pages 560-573

Abstract

Purpose

Typical language users can engage in a lively internal monologue for introspection and task performance, but what is the nature of inner speech among individuals with aphasia? Studying the phenomenon of inner speech in this population has the potential to further our understanding of inner speech more generally, help clarify the subjective experience of those with aphasia, and inform clinical practice. In this scoping review, we describe and synthesize the existing literature on inner speech in aphasia.

Method

Studies examining inner speech in aphasia were located through electronic databases and citation searches. Across the various studies, methods include both subjective approaches (i.e., asking individuals with aphasia about the integrity of their inner speech) and objective approaches (i.e., administering objective language tests as proxy measures for inner speech ability). The findings of relevant studies are summarized.

Results

Although definitions of inner speech vary across research groups, studies using both subjective and objective methods have established findings showing that inner speech can be preserved relative to spoken language in individuals with aphasia, particularly among those with relatively intact word retrieval and difficulty primarily at the level of speech output processing. Approaches that combine self-report with objective measures have demonstrated that individuals with aphasia are, on the whole, reliably able to report the integrity of their inner speech.

Conclusions

The examination of inner speech in individuals with aphasia has potential implications for clinical practice, in that differences in the preservation of inner speech across individuals may help guide clinical decision making around aphasia treatment. Although there are many questions that remain open to further investigation, studying inner speech in this specific population has also contributed to a broader understanding of the mechanisms of inner speech more generally.

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Information & Authors

Information

Published In

American Journal of Speech-Language Pathology
Volume 29Number 1S21 February 2020
Pages: 560-573
PubMed: 31518502

History

  • Received: Sep 13, 2018
  • Revised: Jan 29, 2019
  • Accepted: May 1, 2019
  • Published online: Sep 13, 2019
  • Published in issue: Feb 21, 2020

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Authors

Affiliations

Mackenzie E. Fama
Department of Speech-Language Pathology & Audiology, Towson University, Towson, MD
Center for Brain Plasticity and Recovery, Georgetown University, Washington, DC
Peter E. Turkeltaub
Center for Brain Plasticity and Recovery, Georgetown University, Washington, DC
Research Division, MedStar National Rehabilitation Network, Washington, DC

Notes

Disclosure: The authors have declared that no competing interests existed at the time of publication.
Correspondence to Mackenzie E. Fama: [email protected]
Editor-in-Chief: Margaret Blake
Editor: Sarah Wallace
Publisher Note: This article is part of the Special Issue: Select Papers From the 48th Clinical Aphasiology Conference.

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