A transcription-less quantitative analysis of aphasic discourse elicited with an adapted version of the Amsterdam-Nijmegen Everyday Language Test (ANELT)

Figures & data

Table 1. Characteristics of PWA ‘Language in the brain’ corpus (n = 17)

		Age	TPO	Clinical impression	Aetiology ^c	Secondary	Education
PWA		(yrs) ^a	(yrs) ^b	severity of aphasia		diagnosis ^d	(Verhage, 1964)
31	f	61	2;4	residual	ICVA LH	n/a	4
32	m	58	~ 1;5	residual	ICVA LH	n/a	6
40	m	36	5;0	residual	ICVA LH	n/a	6
41	m	59	0;8	residual	ICVA LH	n/a	7
42	f	40	2;4	moderate	ICVA LH	AOS	6
43 ^e	m	76	md	severe	ICVA LH	n/a	md
45	m	69	25;3	residual	HCVA LH	n/a	4
46	f	24	2;9	severe	ICVA LH	n/a	5
47	m	59	1;7	moderate	ICVA LH	n/a	6
50	m	54	~ 3;0	mild	ICVA RH	n/a	6
51	f	70	6;7	moderate	ICVA LH	n/a	5
52	m	57	2;0	severe	ICVA LH	AOS	6
53	m	66	2;5	mild	ICVA LH	n/a	5
54	m	54	4;2	moderate	TACI LH	n/a	md
55	f	53	12;8	moderate	ICVA LH	n/a	5
56	f	54	23;8	moderate	ICVA LH	n/a	5
57	m	78	4;10	moderate	ICVA LH	n/a	5
M		56;11	6;4				Mdn 5
SD		13;11	7;8				Range 4 to 7

Notes. All participants were premorbidly right-handed, except for participant 50. ^{a, b} Years (yrs) refer to the age versus time post-onset (TPO) during the ANELT administration. ^c ICVA = ischemic cerebrovascular accident, TACI = total anterior circulation infarct, HCVA = hemorrhagic cerebrovascular accident, LH = left hemisphere, RH = right hemisphere. ^d AOS = apraxia of speech. ^e For PWA 43, the exact TPO is unknown, but well into chronic phase (at least 6 months post-onset). His level of education was also unknown (but probably 3 or below).

Table 2. Characteristics of the PWA ‘SimpTell’ corpus (n = 8)

		Age	TPO	Syntactic	Aphasia severity (STT) ^d		Secondary	Aetiology^f	Handedness
PWA		(yrs)^a	(yrs)^b	structure^c	(raw score & interpretation)		diagnosis ^e
1	m	56;10	2;6	1	25.5	mild	AOS	TACI, LH	right
2	f	62;1	1;9	2	22.5	mild	n/a	ICVA, LH	right
4	m	46;6	5;2	2	32.5	no aphasia	AOS	ICVA, LH	right
5	m	57;8	6;10	1	n/a	n/a ^g	AOS	ICVA, LH	mixed
6	f	55;9	8;8	2	31.5	no aphasia	AOS	ICVA, LH	left
8	m	57;9	6;4	1	16.0	severe	AOS	ICVA, LH	right
9	m	49;6	1;0	1	18.5	moderate	AOS	ICVA, LH	mixed
10	m	44;8	17;2	1	25.0	mild	n/a	ICVA, LH	right
M		53;10	6;2		24.5	mild
SD		6;2	5;2		6.1

Notes. ^{a, b} Years (yrs) refer to the age versus time post-onset (TPO) during the pre-therapy measurements (T1). ^c Syntactic structure of participants’ speech output rated on the 6-point scale of the subtest Spontaneous Speech of the Dutch Aachen Aphasia Test (AAT; Graetz, De Bleser, & Willmes, 1992). 1 = mostly one or two word utterances; almost no inflection forms or function words; 2 = short, simple sentences, which are mostly syntactically incomplete; frequent absence of function words and inflected forms. ^d Severity of aphasia is expressed as the raw score on the shortened (36-item) version of the Token Test (STT; De Renzi & Faglioni, 1978). The notion’no aphasia’means that the PWA scored at or above the cut-off score for aphasia, which means that receptive language impairments could not/no longer be objectified with the STT. ^e Aphasia accompanied by Apraxia of speech (AOS); however, at least 95% intelligible speech output. ^f TACI = Total anterior circulation infarct, ICVA = ischemic cerebrovascular accident, HCVA = hemorrhagic cerebrovascular accident. ^g Because of colour blinedness the STT could not be administered in this participant. For that reason he was presented with some test items (only those that did not contain coloured pictures) of Subtest 9 and 10 of the CAT-NL (Visch-Brink et al., 2014), on which he scored 20/26 and 14/24 respectively. Even if he could have given a correct response to the test items that were not adminstered, he would have scored below cut-off (aphasia objectifiable, severity mild to moderate).

Table 3. ANELT-CU scenario 1 (Shoe) translated from Dutch (Ruiter et al., 2016)

PreambleThe heel/sole of the shoe needs to be repaired	● WHAT (CU 1)	● WHAT (CU 2)	Score 2/2
	- Heel/sole - That ^1	- Worn out/broken - In need of reparation
Request
I want to know how much it costs.	O WHO (CU 3)	O DOING (CU 4)	O WHAT (CU 5)	Score 1/ 3
	- I	- Knowing	- Costs
OR
The employee indicates how much it costs	O WHO (CU 3)	O DOING (CU 4)	O WHAT (CU 5)
	- You	- Indicating	- Costs
OR
The employee has to repair the shoe.	O WHO (CU 3)	● DOING (CU 4)	O WHAT (CU 5)
	- You	- Repairing	- Shoe/heel/sole - That
				Total score: 3/5

Note. ¹ (Only) in scenarios in which pictures are used, demonstrative pronouns are scored as a CU in the preamble. In those cases, the use of demonstrative pronouns should be combined with pointing to the picture. In scenarios without pictures, demonstrative pronouns are only scored as CUs if the antecedent is explicitly stated in one of the preceding utterances.

Table 4. Intra-class correlations (ICCs) for ANELT-CU-Tr and ANELT-CU+Tr

	ANELT-CU-Tr			ANELT-CU+Tr
Scenario	ICC	95%CI	p value	ICC	95%CI	p value
	Single measures (two raters)
Overall	.973	[.769, .995]	< 0.01	.983	[.903, .997]	< 0.01
1_Shoe	.655	[-.020, .920]	< 0.05	.709	[.040, .935]	< 0.05
2_Socker	.834	[.355, .965]	< 0.01	.974	[.876, .995]	< 0.01
3_Appointment	.857	[.401, .974]	< 0.01	.935	[.492, .989]	< 0.01
4_Glasses	.961	[.823, .992]	< 0.01	.875	[.500, .974]	< 0.01
5_Friend	.991	[.962, .998]	< 0.01	.991	[.958, .998]	< 0.01
6_Bouquet	.910	[.631, .981]	< 0.01	.945	[.762, .989]	< 0.01
7_Birthday	.768	[.218, .948]	< 0.01	.881	[.519, .975]	< 0.01
8_Child	.985	[.932, .997]	< 0.01	.973	[.873, .995]	< 0.01
9_Reminder	.897	[.524, .979]	< 0.01	.867	[.506, .971]	< 0.01
10_Local authority	.424	[-.270, .846]	ns	.800	[.330, .956]	< 0.01
	Average measures (five raters)
Overall	.960	[.918, .984]	< 0.01	.906	[.796, .963]	< 0.01
4_Glasses	.989	[.955, .999]	< 0.01	.889	[.562, .992]	< 0.01
5_Friend	.982	[.926, .999]	< 0.01	.895	[.586, .993]	< 0.01
6_Bouquet	.862	[.320, .991]	0.01	.930	[.719, .995]	< 0.01
10_Local authority	.861	[.470, .990]	< 0.01	.887	[.546, .992]	< 0.01

Notes. For explanation see text.

Table 5. Summary of the results obtained with the exploratory factor analyses for both the ANELT-CU-Tr and the ANELT-CU+Tr (n = 24)

	Rotated Factor Loadings
	ANELT-CU-Tr		ANELT-CU+Tr
Scenario	Factor 1	Factor 2	Factor 1	Factor 2
1_Shoe	.87	-.12	.84	.22
2_Socker	.86	-.11	.76	-.13
3_Appointment	.73	.36	.60	-.06
4_Glasses	.51	.22	.56	-.23
5_Friend	.45	.25	.52	-.29
6_Bouquet	-.18	.88	.39	-.34
7_Birthday	.10	.65	-.14	-.93
8_Child	.03	.57	.06	-.77
9_Reminder	.31	.51	.51	-.61
10_Local authority	.30	.48	.23	-.43
Eigenvalues	4.92	1.39	5.01	1.35
% of variance	49.21	13.93	50.07	13.52

Notes. Factor loadings over 0.40 appear in bold.

Table 6. Overall percentage CUs (SD) for both neurologically healthy speakers (NHS, n = 31) and Persons with aphasia (PWA, n = 25)

Outcome measure	NHS		PWA		M difference	Bca 95% CI ^a	Bootstrapped Welch’s t test
ANELT-CU-Tr	63.64	(10.48)	43.99	(19.26)	- 19.65	[-27.96, -11.33]	t (1,35) = 21.003, p = .000
ANELT-CU+Tr	64.03	(10.25)	44.41	(19.16)	- 19.62	[-28.01, -12.19]	t (1,25) = 21.310, p = .000

Note. Degrees of freedom are rounded to the nearest integer.

^aBca 95% CI = Bias corrected accelerated 95% confidence interval

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