Cue responsiveness as a measure of emerging language ability in aphasia

ABSTRACT

Background

Prior research suggests that initial aphasia severity, lesion size, and lesion location are the most salient factors in predicting recovery outcomes. While these factors provide important prognostic information, information that is individualized and readily available to clinicians is limited. Deficits in naming are common to all aphasia types and are routinely targeted in aphasia assessment and treatment, with cues provided to facilitate lexical retrieval.

Objectives

In this study, we examine aphasia recovery factors that are readily available to clinicians, examining whether a person’s ability to improve naming with cues, indicating “stimulability,” will be predictive of future word retrieval.

Methods

Ten participants with aphasia following a left-hemisphere stroke participated in initial assessment, seven of whom met criteria for longitudinal assessment. Stroke and early clinical recovery data were collected for all participants. At four timepoints over one year we evaluated longitudinal participants’ naming ability and measured the proportion of successful lexical retrieval with the presentation of phonemic, feature, and sentence cues.

Results

For all participants, multiple descriptive factors regarding recovery, including lesion information, information from the acute inpatient timeframe, and communication opportunities, were examined. For individuals followed longitudinally, naming stimulability did not consistently predict naming accuracy at the subsequent assessment timepoint. Individuals’ attempts at naming emerged as a metric related to future naming performance warranting further evaluation.

Conclusions

Multiple factors related to recovery must be considered when providing prognostic information. Naming stimulability and attempts at naming provide some information regarding future performance, but are not consistently reliable across timepoints.

KEYWORDS:

• Aphasia
• naming
• stimulability
• prognosis
• recovery

Supplemental data

Supplemental data for this article can be accessed on the publisher’s website.

Acknowledgments

The authors wish to thank Dr. David Caplan, who provided consultation for project development and analyses. We also offer our appreciation to Dr. David Lin, Founder of the Center for Neurotechnology and Neurorecovery group at Massachusetts General Hospital, who is studying motor variables across the first year following stroke and provided support for project development and participant recruitment. Finally, we offer our sincere thanks to graduate student assistant Heidi Blackham, CF-SLP, who assisted in naming battery and connected speech transcription, as well as production coding.

Declaration of Interest

The authors have no conflicts of interest to report.

Institutional Review Board Approval

This study was approved by the Institutional Review Board (IRB) of Mass General Brigham Healthcare (IRB# 2018P001593).

Notes

¹ P41 was unable to participate in T3 testing due to an unrelated hospitalization.

Additional information

Funding

This work was supported by institutional funding from MGH Institute of Health Professions to support participant compensation.