Comparing linguistic complexity and efficiency in conversations from Stimulation Therapy and Conversation Therapy in Aphasia

Savage, Meghan Collins and Donovan, Neila J. (2014) Comparing linguistic complexity and efficiency in conversations from Stimulation Therapy and Conversation Therapy in Aphasia. [Clinical Aphasiology Paper]

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Abstract

The ultimate goal for speech language pathology interventions for people with aphasia (PWA) is to be able to converse as normally as possible (Armstrong & Mortensen, 2006). However, there are numerous approaches to aphasia therapy as well as various outcome measures. For instance, Stimulation therapy (ST) relies on structured repetition and drill to elicit language, while conversation therapy (CT) uses client-clinician conversation and conversation analysis to improve everyday language. Most speech language pathologists use standardized tests or rating forms to measure treatment progress rather than measuring conversations (Boles, 1998). We aimed to compare differences in linguistic complexity and efficiency in conversational outcomes in two treatment types, ST and CT. Researchers have examined the verbal abilities of PWA and aging adults by analyzing language samples (Capilouto et al., 2005; Kemper & Sumner, 2001); however few people have examined linguistic complexity in conversation as a treatment outcome measure. Conversational efficiency measured in Correct Information Units (CIUs)/minute is a valid and reliable way to measure improvement in connected speech (Nicholas and Brookshire, 1993). Efficiency can be measured by calculating CIUs/minute or % CIUs. Researchers have used %CIUs to measure efficiency in conversations (Doyle, Goda & Spencer, 1995) and CIUs/minute in story-telling (Jacobs, 2001). However, no one has reported using CIUs/minute to measure efficiency during conversational interactions. To address this we asked the following questions: 1. Does CT lead to a greater increase in linguistic complexity than ST based on the following measures of linguistic complexity: a) Mean length of utterance (in words) (MLU)? b) Type/token ratio (TTR)? c) Number of different words (NDW)? d) Percent of utterance responses? e) Percent of simple utterances? f) Percent of complex utterances? g) Propositional density? 2. Does ST lead to improved efficiency of conversation? 3. Does CT lead to improved efficiency of conversation? 4. Is conversational efficiency different when ST is compared to CT? 5. Is there a difference between clinician and participant total talk time during conversation probes taken during both treatments?

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