No access
Research Note
11 February 2021

Standardizing Assessment of Spoken Discourse in Aphasia: A Working Group With Deliverables

Publication: American Journal of Speech-Language Pathology
Volume 30, Number 1S
Pages 491-502

Abstract

Purpose

The heterogeneous nature of measures, methods, and analyses reported in the aphasia spoken discourse literature precludes comparison of outcomes across studies (e.g., meta-analyses) and inhibits replication. Furthermore, funding and time constraints significantly hinder collecting test–retest data on spoken discourse outcomes. This research note describes the development and structure of a working group, designed to address major gaps in the spoken discourse aphasia literature, including a lack of standardization in methodology, analysis, and reporting, as well as nominal data regarding the psychometric properties of spoken discourse outcomes.

Method

The initial initiatives for this working group are to (a) propose recommendations regarding standardization of spoken discourse collection, analysis, and reporting in aphasia, based on the results of an international survey and a systematic literature review and (b) create a database of test–retest spoken discourse data from individuals with and without aphasia. The survey of spoken discourse collection, analysis, and interpretation procedures was distributed to clinicians and researchers involved in aphasia assessment and rehabilitation from September to November 2019. We will publish survey results and recommend standards for collecting, analyzing, and reporting spoken discourse in aphasia. A multisite endeavor to collect test–retest spoken discourse data from individuals with and without aphasia will be initiated. This test–retest information will be contributed to a central site for transcription and analysis, and data will be subsequently openly curated.

Conclusion

The goal of the working group is to create recommendations for field-wide standards in methods, analysis, and reporting of spoken discourse outcomes, as has been done across other related disciplines (e.g., Consolidated Standards of Reporting Trials, Enhancing the Quality and Transparency of Health Research, Committee on Best Practice in Data Analysis and Sharing). Additionally, the creation of a database through our multisite collaboration will allow the identification of psychometrically sound outcome measures and norms that can be used by clinicians and researchers to assess spoken discourse abilities in aphasia.

Get full access to this article

View all available purchase options and get full access to this article.

References

Armstrong, E. (2000). Aphasic discourse analysis: The story so far. Aphasiology, 14(9), 875–892.
Beeke, S., Maxim, J., & Wilkinson, R. (2007). Using conversation analysis to assess and treat people with aphasia. Seminars in Speech and Language, 28(2), 136–147.
Boyle, M. (2014). Test–retest stability of word retrieval in aphasic discourse. Journal of Speech, Language, and Hearing Research, 57(3), 966–978.
Boyle, M. (2015). Stability of word-retrieval errors with the AphasiaBank stimuli. American Journal of Speech-Language Pathology, 24(4), S953–S960.
Brady, M. C., Kelly, H., Godwin, J., Enderby, P., & Campbell, P. (2016). Speech and language therapy for aphasia following stroke. Cochrane Database of Systematic Reviews, 6, CD000425.
Brookshire, R. H. (1983). Subject description and generality of results in experiments with aphasic adults. Journal of Speech and Hearing Disorders, 48(4), 342–346.
Brookshire, R. H., & Nicholas, L. E. (1994). Speech sample size and test–retest stability of connected speech measures for adults with aphasia. Journal of Speech and Hearing Research, 37(2), 399–407.
Bryant, L., Ferguson, A., & Spencer, E. (2016). Linguistic analysis of discourse in aphasia: A review of the literature. Clinical Linguistics & Phonetics, 30(7), 489–518.
Capilouto, G. J., Wright, H. H., & Wagovich, S. A. (2006). Reliability of main event measurement in the discourse of individuals with aphasia. Aphasiology, 20(2–4), 205–216.
Cicchetti, D. V. (1994). Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychological Assessment, 6(4), 284–290.
Clinical Centre for Research Excellence (CCRE) in Aphasia Rehabilitation. (2014). Aphasia rehabilitation best practice statements. Comprehensive supplement to the Australian aphasia rehabilitation pathway. CCRE in Aphasia Rehabilitation.
Damico, J. S., Oelschlaeger, M., & Simmons-Mackie, N. (1999). Qualitative methods in aphasia research: Conversation analysis. Aphasiology, 13(9–11), 667–679.
Dietz, A., & Boyle, M. (2018). Discourse measurement in aphasia research: Have we reached the tipping point? Aphasiology, 32(4), 459–464.
Donoghue, D., Physiotherapy Research and Older People (PROP) group., & Stokes, E. K. (2009). How much change is true change? The minimum detectable change of the Berg Balance Scale in elderly people. Journal of Rehabilitation Medicine, 41(5), 343–346.
Dutta, M., Murray, L., & Stark, B. C. (2019). Standardizing assessment of spoken discourse in aphasia: Directions for future research. Paper presented at the Clinical Aphasiology Conference, Whitefish, MT, United States.
Fergadiotis, G., Wright, H. H., & Capilouto, G. J. (2011). Productive vocabulary across discourse types. Aphasiology, 25(10), 1261–1278.
Finestack, L. H., Payesteh, B., Disher, J. R., & Julien, H. M. (2014). Reporting child language sampling procedures. Journal of Speech, Language, and Hearing Research, 57(6), 2274–2279.
Fitzpatrick, R., Davey, C., Buxton, M., & Jones, D. (1998). Evaluating patient-based outcome measures for use in clinical trials: A review. Health Technology Assessment, 2(14), 1–73.
Fromm, D., Forbes, M., Holland, A., Dalton, S. G., Richardson, J., & MacWhinney, B. (2017). Discourse characteristics in aphasia beyond the Western Aphasia Battery cutoff. American Journal of Speech-Language Pathology, 26(3), 762–768.
Gagnon, D. A., Schwartz, M. F., Martin, N., Dell, G. S., & Saffran, E. M. (1997). The origins of formal paraphasias in aphasics' picture naming. Brain and Language, 59(3), 450–472.
Galski, T., Tompkins, C., & Johnston, M. V. (1998). Competence in discourse as a measure of social integration and quality of life in persons with traumatic brain injury. Brain Injury, 12(9), 769–782.
Gearing, R. E., El-Bassel, N., Ghesquiere, A., Baldwin, S., Gillies, J., & Ngeow, E. (2011). Major ingredients of fidelity: A review and scientific guide to improving quality of intervention research implementation. Clinical Psychology Review, 31(1), 79–88.
Goodglass, H. (1993). Understanding aphasia. Academic Press.
Kim, H., Kintz, S., Zelnosky, K., & Wright, H. H. (2019). Measuring word retrieval in narrative discourse: Core lexicon in aphasia. International Journal of Language & Communication Disorders, 54(1), 62–78.
Kintz, S., & Wright, H. H. (2018). Discourse measurement in aphasia research. Aphasiology, 32(4), 472–474.
Kong, A. P.-H. (2009). The use of main concept analysis to measure discourse production in Cantonese-speaking persons with aphasia: A preliminary report. Journal of Communication Disorders, 42(6), 442–464.
MacWhinney, B. (2000). The CHILDES project: Tools for analyzing talk (3rd ed.). Erlbaum.
MacWhinney, B., Fromm, D., Forbes, M., & Holland, A. (2011). AphasiaBank: Methods for studying discourse. Aphasiology, 25(11), 1286–1307.
McNeil, M. R., Doyle, P. J., Fossett, T. R. D., Park, G. H., & Goda, A. J. (2001). Reliability and concurrent validity of the information unit scoring metric for the story retelling procedure. Aphasiology, 15(10–11), 991–1006.
McNeil, M. R., Doyle, P. J., Park, G. H., Fossett, T. R. D., & Brodsky, M. B. (2002). Increasing the sensitivity of the story retell procedure for the discrimination of normal elderly subjects from persons with aphasia. Aphasiology, 16(8), 815–822.
Meek, P. M., Nail, L. M., Barsevick, A., Schwartz, A. L., Stephen, S., Whitmer, K., Beck, S. L., Jones, L. S., & Walker, B. L. (2000). Psychometric testing of fatigue instruments for use with cancer patients. Nursing Research, 49(4), 181–190.
Murray, L. L., & Clark, H. M. (2015). Neurogenic disorders of language and cognition: Evidence-based clinical practice. Pro-Ed.
Nicholas, L. E., & Brookshire, R. H. (1993). A system for quantifying the informativeness and efficiency of the connected speech of adults with aphasia. Journal of Speech and Hearing Research, 36(2), 338–350.
Nicholas, L. E., & Brookshire, R. H. (1995). Presence, completeness, and accuracy of main concepts in the connected speech of non-brain-damaged adults and adults with aphasia. Journal of Speech and Hearing Research, 38(1), 145–156.
Nichols, T. E., Das, S., Eickhoff, S. B., Evans, A. C., Glatard, T., Hanke, M., Kriegeskorte, N., Milham, M. P., Poldrack, R. A., Poline, J.-B., Proal, E., Thirion, B., Van Essen, D. C., White, T., & Yeo, B. T. T. (2017). Best practices in data analysis and sharing in neuroimaging using MRI. Nature Neuroscience, 20(3), 299–303.
Pritchard, M., Hilari, K., Cocks, N., & Dipper, L. (2017). Reviewing the quality of discourse information measures in aphasia. International Journal of Language & Communication Disorders, 52(6), 689–732.
Pritchard, M., Hilari, K., Cocks, N., & Dipper, L. (2018). Psychometric properties of discourse measures in aphasia: Acceptability, reliability, and validity. International Journal of Language & Communication Disorders, 53(6), 1078–1093.
Richardson, J. D., Hudspeth Dalton, S. G., Shafer, J., & Patterson, J. (2016). Assessment fidelity in aphasia research. American Journal of Speech-Language Pathology, 25(4S), S788–S797.
Sim, P., Power, E., & Togher, L. (2013). Describing conversations between individuals with traumatic brain injury (TBI) and communication partners following communication partner training: Using exchange structure analysis. Brain Injury, 27(6), 717–742.
Squires, J. E., Estabrooks, C. A., O'Rourke, H. M., Gustavsson, P., Newburn-Cook, C. V., & Wallin, L. (2011). A systematic review of the psychometric properties of self-report research utilization measures used in healthcare. Implementation Science, 6(1), 83.
Stark, B. C. (2019). A comparison of three discourse elicitation methods in aphasia and age-matched adults: Implications for language assessment and outcome. American Journal of Speech-Language Pathology, 28(3), 1067–1083.
Tate, R. L. (2010). A compendium of tests, scales, and questionnaires: The practitioner's guide to measuring outcomes after acquired brain impairment. Psychology Press.
Ulatowska, H. K., Allard, L., Reyes, B. A., Ford, J., & Chapman, S. (1992). Conversational discourse in aphasia. Aphasiology, 6(3), 325–330.
Wallace, S. J., Worrall, L., Rose, T., & Le Dorze, G. (2017). Which treatment outcomes are most important to aphasia clinicians and managers? An international e-Delphi consensus study. Aphasiology, 31(6), 643–673.
Wallace, S. J., Worrall, L., Rose, T., Le Dorze, G., Breitenstein, C., Hilari, K., Babbitt, E., Bose, A., Brady, M., Cherney, L. R., Copland, D., Cruice, M., Enderby, P., Hersh, D., Howe, T., Kelly, H., Kiran, S., Laska, A.-C., Marshall, J., … Webster, J. (2019). A core outcome set for aphasia treatment research: The ROMA consensus statement. International Journal of Stroke, 14(2), 180–185.
Walter, S. D., Eliasziw, M., & Donner, A. (1998). Sample size and optimal designs for reliability studies. Statistics in Medicine, 17(1), 101–110.
Weir, J. P. (2005). Quantifying test–retest reliability using the intraclass correlation coefficient and the SEM. Journal of Strength and Conditioning Research, 19(1), 231–240.
Winstein, C. J., Stein, J., Arena, R., Bates, B., Cherney, L. R., Cramer, S. C., Deruyter, F., Eng, J. J., Fisher, B., Harvey, R. L., Lang, C. E., Mackay-Lyons, M., Ottenbacher, K. J., Pugh, S., Reeves, M. J., Richards, L. G., Stiers, W., & Zorowitz, R. D. (2016). Guidelines for adult stroke rehabilitation and recovery. Stroke, 47(6), e98–e169.
World Health Organization. (2018). International classification of functioning, disability and health. http://www.who.int/classifications/icf/en/
Wright, H. H., & Capilouto, G. J. (2009). Manipulating task instructions to change narrative discourse performance. Aphasiology, 23(10), 1295–1308.

Information & Authors

Information

Published In

American Journal of Speech-Language Pathology
Volume 30Number 1SFebruary 2021
Pages: 491-502
PubMed: 32585117

History

  • Received: Sep 12, 2019
  • Revised: Nov 21, 2019
  • Accepted: Jan 3, 2020
  • Published online: Jun 25, 2020
  • Published in issue: Feb 11, 2021

Permissions

Request permissions for this article.

Authors

Affiliations

Brielle C. Stark
Department of Speech, Hearing and Language Sciences, Indiana University Bloomington
Program in Neuroscience, Indiana University Bloomington
Manaswita Dutta
Department of Speech, Hearing and Language Sciences, Indiana University Bloomington
Laura L. Murray
School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
Lucy Bryant
Graduate School of Health, University of Technology Sydney, New South Wales, Australia
Davida Fromm
Department of Psychology, Carnegie Mellon University, Pittsburgh, PA
Brian MacWhinney
Department of Psychology, Carnegie Mellon University, Pittsburgh, PA
Amy E. Ramage
Department of Communication Sciences and Disorders, University of New Hampshire, Durham
Angela Roberts
Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
Dirk B. den Ouden
Department of Communication Sciences and Disorders, University of South Carolina, Columbia
Kris Brock
Department of Communication Sciences and Disorders, Idaho State University, Pocatello
Katy McKinney-Bock
Center for Spoken Language Understanding, Oregon Health and Science University, Portland
Eun Jin Paek
Department of Audiology and Speech Pathology, University of Tennessee Health Science Center, Knoxville
Tyson G. Harmon
Department of Communication Disorders, Brigham Young University, Provo, UT
Si On Yoon
Department of Communication Sciences and Disorders, University of Iowa, Iowa City
Charalambos Themistocleous
Department of Neurology, Johns Hopkins University, Baltimore, MD
Hyunsoo Yoo
Department of Communication Sciences and Disorders, Baylor University, Waco, TX
Katharine Aveni
Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
Stephanie Gutierrez
Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
Saryu Sharma
Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC

Notes

Disclosure: The authors have declared that no competing interests existed at the time of publication.
Correspondence to Brielle C. Stark: [email protected]
Editor-in-Chief: Melissa Duff
Editor: Sarah Elizabeth Wallace
Publisher Note: This article is part of the Special Issue: Select Papers From the 49th Clinical Aphasiology Conference.

Metrics & Citations

Metrics

Article Metrics
View all metrics



Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

For more information or tips please see 'Downloading to a citation manager' in the Help menu.

Citing Literature

  • Data-driven classification of narrative speech characteristics in stroke aphasia distinguishes neurological and strategic contributions, Cortex, 10.1016/j.cortex.2025.03.006, 186, (61-73), (2025).
  • Towards an integrated narrative analysis in nonfluent aphasia, Aphasiology, 10.1080/02687038.2025.2479793, (1-25), (2025).
  • Heterogeneity of verbal and gestural functions in spoken discourse with MCI, Journal of Neurolinguistics, 10.1016/j.jneuroling.2024.101227, 73, (101227), (2025).
  • Expanding the scope: multimodal dimensions in aphasia discourse analysis—preliminary findings, Frontiers in Human Neuroscience, 10.3389/fnhum.2024.1419311, 18, (2024).
  • Determinants of Multilevel Discourse Outcomes in Anomia Treatment for Aphasia, Journal of Speech, Language, and Hearing Research, 10.1044/2024_JSLHR-24-00030, 67, 9, (3094-3112), (2024).
  • Open Brain AI and language assessment, Frontiers in Human Neuroscience, 10.3389/fnhum.2024.1421435, 18, (2024).
  • The development of a novel, standardized, norm‐referenced Arabic Discourse Assessment Tool (ADAT), including an examination of psychometric properties of discourse measures in aphasia, International Journal of Language & Communication Disorders, 10.1111/1460-6984.13083, 59, 5, (2103-2117), (2024).
  • Four dimensions of naturalistic language production in aphasia after stroke, Brain, 10.1093/brain/awae195, 148, 1, (291-312), (2024).
  • A targeted review of prosodic production in agrammatic aphasia, Neuropsychological Rehabilitation, 10.1080/09602011.2024.2362243, 35, 4, (863-903), (2024).
  • Reliability of the Brief Assessment of Transactional Success in Communication in Aphasia, Aphasiology, 10.1080/02687038.2024.2351029, 39, 3, (363-384), (2024).
  • See more

View Options

Sign In Options

ASHA member? If so, log in with your ASHA website credentials for full access.

Member Login

View options

PDF

View PDF

Full Text

View Full Text

Figures

Tables

Media

Share

Share

Copy the content Link

Share