Comparing verbal and aided single sentence productions in Malayalam-speaking adults with aphasia: a preliminary investigation

ABSTRACT

The primary aim of the study was to investigate the semantic and syntactic aspects of verbal and aided single sentence productions in adults with aphasia and neurotypical adults to determine which mode allowed the exchange of information more effectively. The participants of this study included 20 adults with aphasia and 20 neurotypical adults who were native speakers of Malayalam, an Indo-Dravidian language spoken in the south-western state of Kerala in India. Thirteen action picture stimuli were constructed to elicit single sentences. The participants were expected to describe the action picture in a single sentence using spoken language as well as using Picture Communication Symbols (PCS). The semantic aspect of each sentence produced was analysed using Correct Information Unit (CIU) analyses, and the syntactic aspects were measured using (i) percentage of grammatically complete sentences, (ii) percentage of the correct number of verbs, and (iii) total number of syntactic errors. A sentence production accuracy scale was constructed to obtain a combined score for semantic and syntactic aspects of each sentence produced. The results suggested that while both verbal and aided modes were effectively used for the exchange of information by neurotypical adults and adults with anomic aphasia, the aided mode was used more effectively by adults with Broca’s aphasia. To conclude, the study highlights the importance of (a) using visual symbols even for those with mild aphasia as it tends to improve phonological and articulatory abilities, (b) use of symbols to construct simple sentences to communicate in adults with severe aphasia, (c) evaluation of the ability to use alternate modes of communication and also the preferred mode of communication in adults with aphasia.

KEYWORDS:

• Sentence construction
• symbols
• speech
• aphasia
• Malayalam

Acknowledgments

We thank the Director of All India Institute of Speech and Hearing, Mysore, India for permitting us to carry out the research. The study was conducted as a part of the first author’s doctoral dissertation.

Disclosure statement

The authors report no conflict of interest.

Notes

¹ The Test of Aphasia in Malayalam consists of four language subtests (i.e., spontaneous speech, auditory comprehension, naming, and repetition) and three performance sub tests (i.e., reading and writing, arithmetic, and praxis). The stimuli used in the test were translated from WAB in English and modified to suit the linguistic principles of Malayalam and the Indian cultural context. The number of stimuli under each sub test, administration, scoring, and interpretation of results are similar to WAB. The test was validated on five Malayalam-English bilingual neurotypical adults by administering it along with WAB in English. After validation, the test was field tested on 100 neurotypical adults, eight monolingual adults with aphasia and three Malayalam-English bilingual adults with aphasia. In the current study, the type of aphasia and severity of language impairment in adults with aphasia was determined based on the Test of Aphasia in Malayalam.

² BCC-K is a clinical assessment tool to diagnose cognitive and linguistic deficits in Kannada (an Indo-Dravidian language) speaking adults with acquired neurological disorders. The BCC-K contains sub tests under linguistic and cognitive domain. The linguistic domain consists of tasks to assess comprehension, expression, repetition, naming, reading, and writing. The cognitive domain consists of tasks to assess attention, memory, and executive functioning. Normative data was obtained on 210 neurotypical adults and validated on 45 adults with neurological impairment such as aphasia, dementia and cognitive communication disorder. The inter-rater reliability for the test as measured using Cronbach’s alpha is 0.98.