ABSTRACT

Background

Despite the clinical importance of assessing the efficiency and accuracy of fluency in terms of content words production during connected speech, assessments based on discourse tasks are very time-consuming and thus not clinically feasible.

Aims

(1) Examine the relationship between single-word naming and word retrieval during discourse production. (2) Investigate the relationship between word retrieval and content word fluency derived from a simple versus naturalistic discourse tasks. (3) Develop and validate an efficient and accurate index of content word fluency that is clinically viable.

Methods

Two discourse tasks (simple picture description and naturalistic storytelling narrative) were collected from 46 participants with post-stroke aphasia, and 20 age/education matched neuro-typical controls. Each discourse sample was fully transcribed and quantitative analysis was applied to each sample to measure word retrieval and content word fluency. Three single-word naming tasks were also administered to each participant with aphasia.

Results

Correlational analyses between single-word naming and word retrieval in connected speech revealed weak/moderate relationships. Conversely, strong correlations were found between measures derived from simple picture description against naturalistic storytelling discourse tasks. Moreover, we derived a novel, transcription-less index of content word fluency from the discourse samples of an independent group (neuro-typical controls), and then we validated this index across two discourse tasks in the tested group (persons with aphasia). Correlation and regression analyses revealed extremely strong relationships between participants’ (neuro-typical controls and persons with aphasia) scores on the novel index and measures of content word fluency derived from the formal transcription and quantitative analyses of discourse samples, indicating high accuracy and validity of the new index.

Conclusions

Simple picture description rather than picture naming provides a better estimate of word retrieval in naturalistic connected speech. The novel developed index is transcription-less and can be implemented online to provide an accurate and efficient measure of content word fluency. Thus, it is viable during clinical practice for assessment purposes, and possibly as an outcome measure to monitor therapy effectiveness, which can also be used in randomised clinical trials.

中文翻译：

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一种有效、准确和临床适用的失语症实词流畅性指标

摘要

背景

尽管评估连接语音期间内容词产生的流利度的效率和准确性具有临床重要性，但基于话语任务的评估非常耗时，因此在临床上不可行。

宗旨

(1) 检验话语产生过程中单词命名与词检索的关系。(2) 研究从简单的和自然的话语任务中得出的单词检索和实词流利度之间的关系。(3) 开发并验证一个有效且准确的实词流利度指标，该指标在临床上是可行的。

方法

从 46 名患有中风后失语症的参与者和 20 名年龄/教育匹配的神经典型对照中收集了两项话语任务（简单的图片描述和自然主义的讲故事叙述）。每个话语样本都被完整转录，并对每个样本进行定量分析，以衡量单词检索和实词流畅度。还对每位患有失语症的参与者进行了三个单词命名任务。

结果

单个单词命名和连接语音中的单词检索之间的相关分析揭示了弱/中等关系。相反，在简单的图片描述与自然主义的讲故事话语任务之间发现了很强的相关性。此外，我们从一个独立组（神经典型对照）的话语样本中得出了一个新颖的、无转录的实词流利度指数，然后我们在测试组（失语症患者）的两个话语任务中验证了该指数。相关和回归分析揭示了参与者（神经典型控制和失语症患者）在小说指数上的得分与从正式转录和话语样本的定量分析中得出的实词流畅性测量之间的极强关系，

结论

简单的图片描述而不是图片命名可以更好地估计自然连接语音中的单词检索。新开发的指数是无转录的，可以在线实施，以提供准确有效的内容词流畅度测量。因此，它在临床实践中用于评估目的是可行的，并且可能作为监测治疗效果的结果测量，也可用于随机临床试验。