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Background: A comprehensive aphasia assessment is necessary to diagnose the type and severity of aphasia differentially and guide appropriate interventions. One component of an aphasia assessment is the picture description task (PDT), designed to probe spontaneous speech fluency and information content. Most aphasia assessments use black-and-white line drawings (LD) to elicit spontaneous language samples from people with aphasia (PWA). However, recent studies reported two visuographic variables: (1) colour (over black and white) and (2) photograph (over LD), that tended to encourage easier and faster comprehension and increased overall naturalistic language production from neurologically healthy individuals as well as PWA. Additionally, a suitable stimulus for a PDT should always be culturally relevant to the target population. Therefore, we suggest that a new PDT must include a culturally appropriate colour photograph (CP). Aims: To investigate if a culturally appropriate CP elicits longer and more complex utterances than a culturally appropriate black-and-white LD from neurologically healthy native Bangla speakers. Methods & Procedures: A total of 30 participants (mean age = 36.03 years) were recruited based on self-reports of no known impairments in cognition, language, vision and hearing. All were of middle socioeconomic status with at least 12 years of formal education. A culturally appropriate CP was selected showing multiple characters performing various functions. Later, an artist prepared the black-and-white LD of that CP. The elicited language samples using these two pictures were transcribed and coded following preset transcription and coding guidelines. The transcribed samples were further analysed using the Bangla adaptation of Systematic Analysis of Language Transcripts (SALT) software. To identify the differences in language production between these two picture types, investigators used four measurement variables: mean length of utterances (MLU), complexity index (CI), total number of words (TNW) and words per minute (WPM). Outcomes & Results: Of the four measures, only MLU showed a statistically significant difference between the CP and the black-and-white LD. CI demonstrated a strong correlation with MLU for the CP, which indicates that the participants who produced higher MLU for the CP also produced a higher CI for the CP. There were no significant differences between the two picture types for CI, TNW and WPM. Conclusions & Implications: This study found that the grammatical complexity, as measured by MLU, of spontaneous language production of neurologically healthy adults was higher when a CP was used in a PDT. A CP may also be beneficial for PWA to produce complex language samples.

Many people with aphasia have inadequate language skills for functional communication thereby necessitating well-designed augmentative and alternative communication (AAC) interfaces. Using both a grid and a VSD interface with single word hotspots by neurologically healthy adults, across ages and with different technology experiences, this study examines the utility of these interfaces prior to investigating their use with people with aphasia in future studies. Participants include 18 young adults, 24 older adults with technology experience, and 20 older adults with limited technology experience. The older adult groups were matched for mean age and for sex. Participants described pictures with each interface, and performance was measured based on four dependent variables: (a) the total number of correct information units (CIUs), (b) the percentage of CIUs, (c) CIUs per minute, and (d) preferred interface. There was a significant difference between older adults and the young adult group for the total number of CIUs (p < 0.001) and CIUs per minute (p < 0.001). Despite the changes in technology experience between the two older groups, there was no significant difference in performance. Additionally, there was no significant difference in performance across the two interfaces in any of the groups. Findings suggest age does impact performance on AAC. However, the difference in technology experience in older adult groups did not affect performance. Furthermore, both interfaces used in the current study were equally beneficial when describing pictures by healthy adults. Augmentative and alternative communication (AAC) systems involve various interface designs. Consequently, the comparative utility of these interfaces must be examined across populations and communicative functions. Advancement in technology has given rise to numerous high-tech AAC interface designs. However, older adults with acquired language difficulties whose technology experience is limited may become reluctant to use high-tech AAC. Hence, the influence of technology experience on high-tech AAC performance should be investigated. Prior to examining interfaces with individuals with acquired language difficulties, the current study examined the use of a) grid display and b) visual scene display (VSD) with single word hotspots, by healthy adults of different ages and technology experiences. The study revealed that older adults with limited technology experience were equally competent in using high-tech AAC interfaces, as those with technology experience. Hence, an individual's technology experience should not be considered a deterrent to using high-tech AAC interfaces. Additionally, the study found no differences in performance between the two interfaces, making it essential to consider user's personal preference when adopting AAC interface designs. [ABSTRACT FROM AUTHOR]

Background: Communication of people with Parkinson's disease (PwPD) is negatively affected. For PwPD with communication difficulties, it is important to use self‐assessment tools as a primary assessment approach to evaluate their perspectives on communication. It is also important to evaluate PwPDs with self‐assessment scales in order to determine in which situations their communicative effectiveness is affected and to include them in the intervention plan. Aims: To create a Turkish version of the Communicative Effectiveness Survey‐Revised (CES‐R), to examine its validity and reliability, and to investigate its applicability in PwPD. Method: The study included 106 PwPD and 106 healthy participants. The original form of the CES‐R was adapted into Turkish according to international guidelines. Every participant completed the Turkish version of CES‐R and the Voice Handicap Index‐10 form. The adapted scale was retested 2 weeks later. Outcomes and Results: Because the Kaiser‐Meyer‐Olkin coefficient was 0.956 in the exploratory factor analysis of the CES‐R and p < 0.01 for Bartlett's Test, the data set is 'perfectly' suitable for factor analysis. In the explanatory factor analysis applied in the CES‐R scale, the total explanatory ratio of the two dimensions was determined as 63.5%, and the validity condition was met. Cronbach's alpha coefficient was 0.958 in the PwPD group and 0.955 in the control group and the scale was found to be at the 'high reliability' level. Conclusion: The CES‐R is a valid, reliable, and useable self‐assessment scale for Turkish PwPD. Furthermore, this adaptation research was developed to assess possible communication difficulties for PwPD. With this tool, difficulties in communication skills that can be identified by a comprehensive evaluation should also be studied in the intervention processes. What this paper adds: What is already known on the subject: Self‐assessment tools are suggested as a primary use when evaluating people with Parkinson's disease (PwPD) with communication difficulties. The CES‐R is one of these self‐assessment scales. However, the validity and reliability study of the Communicative Effectiveness Survey‐Revised (CES‐R) in Turkish has not been conducted. What this paper adds to existing knowledge: This study demonstrates the validity and reliability of the Turkish CES‐R scale and its applicability to PwPD. Furthermore, this scale can be used in assessment procedures for possible communication difficulties for PwPD. What are the potential or actual clinical implications of this work?: The scale, which is unidimensional in the literature, was found to have two dimensions with eigenvalues > 1 in the Discovery Factor analysis in this study. The first dimension was named communication in general situations (CGS) and the second dimension was named communication in difficult situations (CDS). It is thought that this scale will be useful in research and clinics for the comprehensive assessment of PwPD with communication difficulties before and after treatment. [ABSTRACT FROM AUTHOR]

Background: Efficacy studies have demonstrated the benefit of group conversation therapy for a person with aphasia (PWA). However, a PWA typically participates in individual therapy prior to group therapy. Stimulation therapy (ST) is the most common type of individual aphasia therapy. Ultimately, the outcome of therapy is to enable the PWA to communicate effectively with others, which suggests the need for conversation therapy (CT). Little efficacy data exist to demonstrate the benefit of CT between a PWA and a clinician, in part because no clear treatment outcome measures have been established. More information is needed to identify optimal ways to measure CT outcomes. Aim: To identify ways to measure CT outcomes and to determine if there is a change in linguistic complexity and total talk time during conversation, samples were taken during CT and ST in two PWAs. Methods & Procedures: Seventeen 6-min conversational samples per PWA were analyzed from a prior single-subject AB[subscript 1]AB[subscript 2]A alternating treatment study with randomized ordering of interventions across participants. Data were analyzed for seven measures of linguistic complexity using Systematic Analysis of Language Transcripts (SALT). Efficiency was measured using correct information units (CIUs) per minute and total talk time. Outcomes & Results: Per cent of complex utterances and propositional density were higher following CT. Four out of seven linguistic measures increased following ST. Total talk time was significantly greater for one PWA during CT compared with ST. No differences were found in CIUs/min across treatment types. Conclusion & Implications: Linguistic complexity and efficiency appear to be conversational treatment outcome measures that are sensitive to change, which researchers might consider using.

Purpose: There is a pressing need for psychometrically sound naming materials for Spanish/English bilingual adults. To address this need, in this study the authors examined the psychometric properties of An Object and Action Naming Battery (An O&A Battery; Druks & Masterson, 2000) in bilingual speakers. Method: Ninety-one Spanish/English bilinguals named O&A Battery items in English and Spanish. Responses underwent a Rasch analysis. Using correlation and regression analyses, the authors evaluated the effect of psycholinguistic (e.g., imageability) and participant (e.g., proficiency ratings) variables on accuracy. Results: Rasch analysis determined unidimensionality across English and Spanish nouns and verbs and robust item-level psychometric properties, evidence for content validity. Few items did not fit the model, there were no ceiling or floor effects after uninformative and misfit items were removed, and items reflected a range of difficulty. Reliability coefficients were high, and the number of statistically different ability levels provided indices of sensitivity. Regression analyses revealed significant correlations between psycholinguistic variables and accuracy, providing preliminary construct validity. The participant variables that contributed most to accuracy were proficiency ratings and time of language use. Conclusions: Results suggest adequate content and construct validity of O&A items retained in the analysis for Spanish/English bilingual adults and support future efforts to evaluate naming in older bilinguals and persons with bilingual aphasia.

Purpose: To present a primarily conceptual introduction to item response theory (IRT) and Rasch models for speech-language pathologists (SLPs). Method: This tutorial introduces SLPs to basic concepts and terminology related to IRT as well as the most common IRT models. The article then continues with an overview of how instruments are developed using IRT and some basic principles of adaptive testing. Conclusion: IRT is a set of statistical methods that are increasingly used for developing instruments in speech-language pathology. While IRT is not new, its application in speech-language pathology to date has been relatively limited in scope. Several new IRT-based instruments are currently emerging. IRT differs from traditional methods for test development, typically referred to as classical test theory (CTT), in several theoretical and practical ways. Administration, scoring, and interpretation of IRT instruments are different from methods used for most traditional CTT instruments. SLPs will need to understand the basic concepts of IRT instruments to use these tools in their clinical and research work. This article provides an introduction to IRT concepts drawing on examples from speech-language pathology.

Purpose: To provide preliminary evidence of the construct validity of the Communicative Effectiveness Survey (CES) for individuals with dysarthria and idiopathic Parkinson's disease (PD). Method: In a prospective, quasi-experimental design, 25 participants each were assigned to 3 groups (N = 75): PD and dysarthria, non-PD and no dysarthria, and PD significant others (SOs). Mean CES ratings were used to test for significant differences between the PD and non-PD group, and PD and SO rating of PD's communicative effectiveness. Multiple linear regression tested for significant predictors of CES ratings for PD group only using sentence intelligibility and spontaneous speech intelligibility scores as predictor variables. Results: The PD group rated their CES significantly lower than did the non-PD group. The PD group rated their CES significantly higher than their SOs rated them. Neither speech intelligibility score was a significant predictor of CES ratings. In follow-up analysis, the Hoehn and Yahr PD staging accounted for 47% of the variability in CES ratings for the PD group participants. Conclusions: This study provides preliminary evidence of the CES's construct validity. Clinicians and researchers who assess and treat individuals with PD may consider adding an additional assessment to the traditional clinical measures (i.e., speech intelligibility) by obtaining a measure of communicative effectiveness. (Contains 5 tables and 1 figure.)

Purpose: There is a pressing need for psychometrically sound naming materials for Spanish/English bilingual adults. To address this need, in this study the authors examined the psychometric properties of An Object and Action Naming Battery (An O&A Battery; Druks & Masterson, 2000) in bilingual speakers. Method: Ninety-one Spanish/English bilinguals named O&A Battery items in English and Spanish. Responses underwent a Rasch analysis. Using correlation and regression analyses, the authors evaluated the effect of psycholinguistic (e.g., imageability) and participant (e.g., proficiency ratings) variables on accuracy. Results: Rasch analysis determined unidimensionality across English and Spanish nouns and verbs and robust item-level psychometric properties, evidence for content validity. Few items did not fit the model, there were no ceiling or floor effects after uninformative and misfit items were removed, and items reflected a range of difficulty. Reliability coefficients were high, and the number of statistically different ability levels provided indices of sensitivity. Regression analyses revealed significant correlations between psycholinguistic variables and accuracy, providing preliminary construct validity. The participant variables that contributed most to accuracy were proficiency ratings and time of language use. Conclusions: Results suggest adequate content and construct validity of O&A items retained in the analysis for Spanish/English bilingual adults and support future efforts to evaluate naming in older bilinguals and persons with bilingual aphasia. Key Words: bilingual, Rasch, naming, validity, verbs, The United States has the fifth largest Spanish-speaking population in the world, with 28 million residents who report speaking Spanish as their primary language. Of these, 50% report speaking English [...]

Suboptimal treatment adherence is a barrier to dysphagia management and contributes significantly to severe health conditions. However, there has been no consensus as to which variables contributing to adherence are [...]

Background. Up to 65% of individuals demonstrate poststroke cognitive impairments, which may increase hospital stay and caregiver burden. Randomized stroke clinical trials have emphasized physical recovery over cognition. Neuropsychological assessments [...]

The study's purpose was to investigate the item-level psychometric properties of the Communicative Effectiveness Survey (CES) using Rasch analysis, an item response theory model. The CES (8-item 7-category rating scale) [...]

The results of an expiratory muscle strength training (EMST) program is described in the rehabilitation of mixed dysarthria in a patient with Lance-Adams syndrome secondary to a motor vehicle accident [...]

Background: In aphasia research, to improve a study's reliability, the aphasia journals compel their authors to report fidelity. Aphasia researchers are mostly concerned about Type I and Type II errors to maintain the level of confidence. However, the third type (Type III error) can significantly affect the study outcomes and question the research fidelity. Objective: This study explains the methodology of how investigators maintained research fidelity in the context of hiring and training remote data collectors and conducted a multi-site data collection. Methods: The present study used a descriptive analysis design to explicate the three-step process of remote data collection: (1) remotely selecting and training data collectors, (2) remotely supervising data collection and data management, and (3) optimizing and monitoring screening/assessment fidelity. At the initial step, investigators interviewed seven candidates and short-listed four of them, who were trained using a standard training protocol and participated in a mock data collection. For the next two steps, data collectors video-recorded each study session and e-shared the data with the investigator, who watched all the video-recordings and provided necessary feedback with a focus on the screening sections. The screenings were a part of the inclusion-exclusion criteria. Results: Two data collectors (both clinical psychologists) with the highest scores were selected and received final training. One-to-one e-supervision by the investigator resulted in significant improvement in data collectors' performance. Only 4% of the total collected sample size was excluded, and 99 participants' data were analyzed. Conclusion: The present study adds information on maintaining research fidelity for remote data collection, where limited studies exist. [ABSTRACT FROM AUTHOR]

Background Efficacy studies have demonstrated the benefit of group conversation therapy for a person with aphasia (PWA). However, a PWA typically participates in individual therapy prior to group therapy. Stimulation therapy (ST) is the most common type of individual aphasia therapy. Ultimately, the outcome of therapy is to enable the PWA to communicate effectively with others, which suggests the need for conversation therapy (CT). Little efficacy data exist to demonstrate the benefit of CT between a PWA and a clinician, in part because no clear treatment outcome measures have been established. More information is needed to identify optimal ways to measure CT outcomes. Aim To identify ways to measure CT outcomes and to determine if there is a change in linguistic complexity and total talk time during conversation, samples were taken during CT and ST in two PWAs. Methods & Procedures Seventeen 6-min conversational samples per PWA were analyzed from a prior single-subject AB1AB2A alternating treatment study with randomized ordering of interventions across participants. Data were analyzed for seven measures of linguistic complexity using Systematic Analysis of Language Transcripts (SALT). Efficiency was measured using correct information units (CIUs) per minute and total talk time. Outcomes & Results Per cent of complex utterances and propositional density were higher following CT. Four out of seven linguistic measures increased following ST. Total talk time was significantly greater for one PWA during CT compared with ST. No differences were found in CIUs/min across treatment types. Conclusion & Implications Linguistic complexity and efficiency appear to be conversational treatment outcome measures that are sensitive to change, which researchers might consider using. [ABSTRACT FROM AUTHOR]

Background: Few studies have investigated conversation therapy between a person with aphasia and a clinician. Furthermore, little information exists on generalisation of impairment-based stimulation treatment to conversational outcomes. Aim: The purpose of this preliminary study was to compare the effects of stimulation therapy and conversation therapy on conversational outcome measures in two cases. Method: We employed a single-subject AB1AB2A design with randomised ordering of interventions across two participants. Primary outcomes included 6-minute conversations coded for discourse functions of an utterance. Outcomes & Results: The participant who received stimulation therapy first demonstrated improved conversational outcomes after the first phase. The participant who received conversation therapy first demonstrated improved conversational outcomes after the first phase. Although improvements were made in each type of therapy, the highest gains in conversational production were during or following conversation therapy in either treatment order for both participants. Conclusion: Both types of therapy produced gains in conversational abilities. However, the small number of participants limits the generalisability of this study. Future research is needed to determine which participants may benefit most from conversation therapy and to improve the clinical feasibility of conducting and measuring conversational therapy. [ABSTRACT FROM AUTHOR]