Descriptive discourse in fluent aphasia: The predictive role of attention, phonology, lexical retrieval and semantics

Abstract

Aims: To study the relationship between cognitive and linguistic skills (as measured through standardized tasks) over spontaneous speech elicited during a picture description task. Methods & procedures: 21 controls and 19 people with fluent aphasia matched by age and sex were evaluated using transcripts made from a picture description task coded using the CHAT format and analyzed using Computerized Language Analysis (CLAN). Indices obtained from the speech samples contained measures of lexical quantity and diversity, morphosyntactic complexity, informativeness, and speech fluency, along with different kinds of speech errors. We studied their correlations with attentional measures from Conners’ Continuous Performance Test and with standardized measures of naming, pseudoword repetition and semantic non-verbal association. We further used stepwise linear regression to analyze the predictive value of standardized linguistic and cognitive skills over discursive indices. Outcomes & results: Contrary to our initial hypothesis, there were no significant correlations between attentional scores and discourse variables in aphasic participants. Moreover, semantic association, along with naming, was the measure more related with discourse performance in people with fluent aphasia, but cognitive and linguistic standardized measures had overall little predictive power on most discourse indices. In the control group, there was a certain association of naming skills and attentional reaction time with discourse variables, but their predictive power was also low. Conclusions & implications: The current results do not support a strong relationship between basic attentional skills and performance in descriptive discourse in fluent aphasia. Although some of the standardized tasks seem to bear some relationship with spontaneous speech, there is a high amount of interindividual variability in discourse that is not captured by classical cognitive tasks routinely used in assessment. Further work on the determinants of discourse performance in aphasia and on the clinical application of discourse analysis is warranted.