Drawing as a window to event conceptualisation: Evidence from two people with aphasia

Abstract

Background: There is growing interest in how problems with “thinking for speaking” (Slobin, 1996) interact with language impairment in aphasia (Marshall, 2009). Evidence to date has come from language production tasks, or from non-linguistic input-focused tasks that bear little relation to the processes involved in event communication. The current study describes a novel approach using a non-linguistic communication task, the Event Drawing Task, to investigate event conceptualisation in two people with aphasia, only one of whom is hypothesised to have problems at this level.

Aims: The study aims to identify similarities and differences between the event drawing performance of the two aphasic participants and a group of 12 non-brain-damaged controls. Intact event conceptualisation (participant “Bob”) would predict a similar performance to controls, while event conceptualisation problems (participant “Jack”) would predict differences from control performance.

Methods & Procedures: “Bob” and “Jack” both had severe nonfluent aphasia resulting from a single stroke. A number of background language and event-processing assessments were carried out to gain a profile of their abilities. The Event Drawing Task required participants to communicate 32 short video clips of events using only drawing. Five theoretically motivated analyses were performed on the data from the Event Drawing Task, which targeted specific aspects of event conceptualisation. Patterns within control performance were identified, which formed the basis for detailed comparison with the performance of the two people with aphasia.

Outcomes & Results: As predicted, Bob's performance on the Event Drawing Task mirrored that of controls in all analyses, while Jack's performance differed widely from the controls' on a number of parameters. Importantly, characteristics of Jack's event drawing performance provide further evidence for an event conceptualisation impairment.

Conclusions: The findings confirm that event conceptualisation problems may be an additional source of deficit in aphasia. Furthermore, they suggest that these problems are likely to affect non-linguistic, as well as linguistic, forms of communication. This has both theoretical and clinical implications. It suggests that we need to consider “thinking for communication” more generally, in both the assessment and remediation of severe aphasia.

Keywords:

• Drawing
• Event conceptualisation
• Severe aphasia

Acknowledgments

This study was undertaken whilst the first author was in receipt of a research fellowship from The Tavistock Trust for Aphasia. We are grateful to Mike Coleman, Division of Psychology and Language Science, University College London, for his help with the preparation of the Event Drawing Task. We also thank the 12 control participants and “Bob” and “Jack”, who gave up their time to take part in the study.

Notes

¹ Participants in this pilot study were eight women and two men, mean age 29.0 years (range 24–36), educated to mean 3.2 years post-secondary (range 0–5).

² The label Source/Goal is used here to refer to the entity that does not also have the role of Actor.

³ Given the basic nature of the events drawn and the schematic form of drawing involved, the scoring was unproblematic and did not yield any doubtful cases. Two other investigators carried out reliability checks on a limited sample of control data to ensure consistency of scoring.

⁴ A chance level of 0.5 was used in this analysis, as the Theme was never drawn first, suggesting that controls were making a two-way choice.

⁵ This procedure is a variation of the generalised linear model (GLM), designed for repeated measures with data from a wide variety of distributions. In this instance, the data were assumed to follow a binomial distribution and the link function in GEE was the logit.

⁶ Pseudonyms have been used to maintain confidentiality.

⁷ For example, one clip shows a woman giving flowers to a man. The target outcome photograph shows the man holding the flowers, the role distractor shows the woman holding the flowers, while the event distractor shows the man holding a camera (Cairns et al., 2007).

⁸ For example, one clip shows a girl chasing a boy, both of whom are in shot at the start of the scene. The camera then focuses on the girl. The target verb is chase, the perspective distractor is flee, and the lexical distractor is kick.

⁹ For example, in the sending event, the final scene in the video clip shows one person posting a letter, while the target outcome photograph shows a different person in a different location reading the letter.