Differences in Connected Speech Outcomes Across Elicitation Methods

ABSTRACT

Background

Connected speech is often used to assess many aspects of an individual’s language abilities after stroke. However, it is unknown the degree to which elicitation methods differ in generating structural and syntactic aspects of connected speech, two critical components of successful communication. Quantifying the degree to which elicitation methods differ in eliciting structurally, syntactically, and lexically complex connected speech at the earliest stage of stroke before reorganization and rehabilitation of function independent of clinical diagnosis of aphasia has not been examined to date. Addressing this gap has implications for early clinical intervention as well as empirical studies of connected speech production.

Aims

We compared two common elicitation methods, picture description and storytelling on lexical, structural, and syntactic measures of connected speech in speakers during the acute stage of left hemisphere stroke.

Methods & Procedures

We measured connected speech using an automated quantitative production analysis approach (Fromm et al., 2021) in 71 native-English speaking participants (27 female; 59 ± 13 years) within an average 3.9 days from left hemisphere stroke onset. We tested the degree of agreement and consistency between elicitation methods for lexical, structural, and syntactic measures of connected speech, as well as the degree of concordance in classifying deficits across individuals.

Outcomes & Results

Storytelling elicited significantly more words and more structurally complex, lexically diverse, and syntactically accurate speech in comparison to picture description. Elicitation methods differed in measuring outcomes across participants for the lexical and syntactic, but not structural complexity aspects of connected speech where storytelling classified more participants with impairments in comparison to picture description.

Conclusions

These differences suggest storytelling provides assessment of connected speech abilities more reflective of real-world abilities where its use is particularly critical for examining individual differences and providing diagnoses of acute stroke language deficits. As a result, using storytelling as a connected speech elicitation method more effectively captures a patient’s language capabilities after stroke, consequently informing clinical diagnosis and treatment.

KEYWORDS:

• acute stroke
• connected speech
• language
• syntax
• methods

Acknowledgements

This work was presented at the Academy of Aphasia (2021). We thank Jolie Anderson, Miranda Brenneman, Cris Hamilton, Danielle Rossi, and Chia-Ming Lei for data collection. We thank Saketh Katta for his help implementing CLAN and Chia-Ming Lei for his guidance on following the QPA manual. We thank Lynn Maher for her help in diagnosing apraxia of speech in our participant population. Lastly, we thank our participants and their caregivers for their time and effort which made this work possible.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data Availability Statement

Anonymized data that support the findings of this study will be publicly available on Open Science Framework.

CRediT authorship contribution statement

Tatiana T. Schnur: Conceptualization, Visualization, Methodology, Writing – original draft, Supervision, Funding acquisition.

Sharon Wang: Formal analysis, Visualization, Writing – original draft.

Original Transcription

Participant: Uh man and woman are having a picnic and a man is flying a kite with his dog running beside him and uh someone is sailing on a sailboat and someone’s fishing on a pier and this person is playing in the sand this child (3 sec) at a house and a tree and a flag and trees and the water

Experimenter: Anything else

Participant: The man is reading a book and the woman is pouring a drink and they’re listening to the radio

Experimenter: Is that it

Participant: yes

Words Uttered

man and woman are having a picnic and a man is flying a kite with his dog running beside him and someone is sailing on a sailboat and someone is fishing on a pier and this person is playing in the sand this child at a house and a tree and a flag and trees and the water

The man is reading a book and the woman is pouring a drink and they are listening to the radio

Yes

Narrative Words

man and woman are having a picnic and a man is flying a kite with his dog running beside him and someone is sailing on a sailboat and someone is fishing on a pier and this person is playing in the sand this child at a house a tree a flag trees the water

The man is reading a book and the woman is pouring a drink and they are listening to the radio

Utterances

[man and woman are having a picnic] [a man is flying a kite with his dog running beside him] [someone is sailing on a sailboat] [someone is fishing on a pier] [this person is playing in the sand] [this child at a house] [a tree] [a flag] [trees] [the water]

[The man is reading a book] [the woman is pouring a drink] [they are listening to the radio]

Morphological Parsing following Fromm et al. (2021)

0det man and 0det woman are having a picnic

a man is flying a kite with his dog running beside him

someone is sailing on a sailboat

someone is fishing on a pier

this person is playin in the sand

this child at a house [+ gram]

a tree [+ gram]

a flag [+ gram]

trees [+ gram]

the water [+ gram]

the man is reading a book

the woman is pouring a drink

they are listening to the radio

Notes

¹ Fromm et al. (2021) demonstrated good agreement between manual scoring and automated C-QPA in all QPA measures except for auxiliary complexity..

Additional information

Funding

This work was supported by the National Institute on Deafness and Other Communication Disorders [R01DC014976].