Modeling the relationship between discourse and confrontation naming

Fergadiotis, Gerasimos and Crone, Caroline and Wright, Heather Harris (2014) Modeling the relationship between discourse and confrontation naming. [Clinical Aphasiology Paper]

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Abstract

The cardinal deficit of people with aphasia (PWA) is anomia (Goodglass & Wingfield, 1997). In single word retrieval, as in picture naming tasks, this deficit is believed to be indicative of disruption in two cognitive processes: (i) accessing a semantic description of the target concept, and/or (ii) retrieval of a fully phonologically specified representation (e.g., Dell, 1986). During discourse, in addition to these core processes that serve word retrieval of single words, production also depends on “…factors external to the lexicon…” (p. 169, Wilshire & McCarthy, 2002). The latter processes might influence the selection of lexical items based on syntactic, structural, and/or pragmatic criteria that can be either automatic or meta-cognitive. The current study investigates the implicit assumption that performance in single-word, picture naming tasks is directly and strongly related to word retrieval performance during discourse production. To establish a diagnosis and quantify its severity, and determine the effect of treatment in various communication disorders, speech language pathologists often use confrontation naming tests (CNTs). In CNT’s, basic drawings or pictures are presented to the PWA who is asked to name its target. The results of the test are then used to determine what steps should be taken post-injury to support the client’s word-production/word retrieval process and which therapeutic approach may maximize the rehabilitation outcome. However, according to Herbert, et al (2008) CNTs may not fully take into account their non-native disposition. First, in typical conversation speakers do not name pictured objects. Also, in CNTs, examinees name bare nouns or verbs and there are no elements in which to attach these words (i.e. not conversational context). Second, the main ideas communicated in discourse may not be necessarily planned: based on Dell’s model, access to word specific semantic features, retrieval of the word form, and encoding the corresponding phonemes of that word are all part of the natural steps that occur, typically without premeditated action in the healthy, non-injured brain (Martin, 2012). Based on these premises authors have argued that decontextualized tasks such as CNT’s may “… [bear] little resemblance to the online, multifaceted word retrieval required during conversation” (Mayer & Murray, 2003, p. 482). This position carries significant clinical and research implications because it directly challenges the idea of using CNT’s to make inferences about discourse production; and, argues that perhaps the decontextualized nature of such tests may mislead professionals when diagnosing and treating PWA if they are to rely solely upon them to make inferences about discourse production. The specific aims of this study were: 1. To assess whether there is a relationship between performance in CNT’s and the proportion of paraphasias in three different types of discourse when accounting for construct irrelevant variance (i.e. random noise and irrelevant systematic variance). 2. To determine the magnitude of the relationship between error free estimates of word retrieval at the single and discourse level. 3. To determine the relationship between observed scores in CNT’s and number of paraphasias in discourse.

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