An efficient, accurate and clinically-applicable index of content word fluency in Aphasia

Figures & data

Table 1. Participant’s demographic information.

Demographic variables	Neuro-typical adult group (N = 20)	Aphasia group (N = 46)
Sex: Male: female ratio Age: Mean (range, SD)	9:11 68.85 (57–84, 8.47)	32:14 63.21 (44–87, 11.93)
Education: Mean (range, SD)	14 (9–19, 2.8)	12.65 (9–19, 2.59)
Time-post stroke onset: Mean months (range, SD)	N/A	69.43 (16–280, 48.86)
BDAE* aphasia classification:	N/A	Fluent aphasia: Anomia = 20 Conduction = 4 Transcortical Sensory = 1 Non-fluent aphasia: Transcortical Mixed = 1 Broca’s = 9 Mixed non-fluent = 8 Global = 3

* BDAE = Boston Diagnostic Aphasia Examination (Goodglass & Kaplan, 1983).

Table 2. Descriptive statistics of the measures extracted from the discourse samples produced by the neuro-typical and aphasia groups.

Discourse	Measure	Neuro-typical group			Aphasia group
		Mean	SD	Range	Mean		SD		Range
Storytelling narrative	-Length (number of tokens) -Duration (seconds) -CIU -NDW -Target-checklist*	265.3 128.58 253.85 99.90 63.65	140.41 64.64 136.86 32.41 32.75	101–706 43–322 99–672 55–184 26–165		156.7 190.2 109.2 51.37 30.6		114.53 109.78 96.78 35.03 21.94		8–454 42–620 0–409 0–140 0–85
Picturedescription	-Length (number of tokens) -Duration (seconds) -CIU -NDW -Target-checklist*	107.65 49.32 102.95 57.85 27.5	49.14 26.02 47.81 18.08 10.49	56–252 27–118 53–243 32–117 15 – 55		66.57 95.09 45.26 27.91 13.22		59.70 66.22 41.9 19.39 11.48		6–315 11–310 2–211 2–90 0–60

All measures were significantly different between the two groups across both discourse tasks (p < 0.01).

* The index measure developed in this study.

Figure 1. Correlations between word retrieval during picture naming and discourse production in post-stroke aphasia. Scatterplots illustrating the correlations between picture naming accuracy (y-axis) and word retrieval during two discourse tasks measured using NDW (x-axis). Significant correlations (p < 0.01) are indicated with an asterisk. BNT = Boston Naming Test (Kaplan et al., 1983), CNT = 64-item Cambridge Naming Test (Bozeat et al., 2000), ANB = action pictures from the Object and Action Naming Battery (Druks & Masterson, 2000).

Figure 2. Correlations of word retrieval and content word fluency between different discourse tasks in post-stroke aphasia. Scatterplots illustrating the correlations of word retrieval measured using NDW (left), and content word fluency measured using CIU (right) between simple picture description (y-axis) and naturalistic storytelling narrative (x-axis). Asterisks indicate significant correlations (p < 0.001).

Figure 3. Correlations of content word fluency between scores on the new transcription-less index and CIU produced during discourse in post-stroke aphasia. Scatterplots illustrating the correlations between scores on the new transcription-less index (y-axis) and content word fluency measured using the formal transcription and quantitative scoring approach (x-axis) during storytelling narrative (left) and picture description (right). Asterisks indicate significant correlations (p < 0.001).

Table

ID	CNB	BNT	ANB	Rep	Noun PWM	Verb PWM	WPM	Sent	Ravens	Brixton	Digit- F	Digi-B
NH	93.75	88.33	85.71	100.0	98.98	100.00	98.44	90.63	94.44	70.91	62.50	57.14
Ebe	82.81	38.33	78.57	81.25	94.90	96.88	100.0	75.00	66.67	47.27	50.00	28.57
KA	84.38	61.67	77.55	96.25	95.92	93.75	100.0	78.13	77.78	65.45	87.50	42.86
PBL	34.38	15.00	36.73	38.75	94.90	96.88	100.0	71.88	97.22	80.00	37.50	0.00
DL	78.13	76.67	95.92	85.00	98.98	100.00	100.0	100	94.44	74.55	62.5	42.86
TK	15.63	08.33	45.92	35.00	85.71	96.88	100.0	87.50	69.44	54.55	37.50	42.86
MH	06.25	05.00	27.55	13.75	78.57	84.38	100.0	59.38	80.56	74.55	25.00	28.57
DCs	67.19	43.33	89.80	72.50	100.00	100.00	100.0	93.75	100.0	81.82	62.50	57.14
KS	31.25	13.33	70.41	93.75	75.51	65.63	71.88	84.38	86.11	52.73	100.0	57.14
RH	3.13	01.67	36.73	21.25	94.90	100.00	96.88	62.50	83.33	61.82	25.00	28.57
WE	78.13	55.00	71.43	71.25	95.92	93.75	100.0	84.38	91.67	70.91	62.5	42.86
Gha	87.50	78.33	79.59	91.25	96.94	100.00	95.31	93.75	83.33	69.09	50.00	42.86
DF	87.50	50.00	84.69	93.75	89.80	87.50	100.0	62.50	88.89	43.64	37.50	28.57
RL	84.38	63.33	82.65	61.25	97.96	96.88	96.88	62.50	80.56	72.73	62.50	57.14
JBr	93.75	85.00	86.73	97.50	98.98	100.00	100.0	96.88	97.22	67.27	75.00	71.43
Ebo	89.06	55.00	91.84	100.0	94.90	87.50	100.0	87.50	97.22	69.09	50.00	57.14
WC	54.69	55.00	72.45	76.25	95.92	100.00	98.44	75.00	52.78	70.91	62.50	42.86
BH	95.31	66.67	80.61	100.0	87.76	87.50	98.44	78.13	66.67	67.27	62.50	57.14
JS	89.06	43.33	69.39	90.00	97.96	100.00	100.0	81.25	100.0	65.45	50.00	57.14
AL	93.75	88.33	82.65	100.0	95.92	100.00	100.0	84.38	91.67	60.00	87.50	85.71
MB	87.50	73.33	87.76	87.50	98.98	100.00	100.0	93.75	97.22	76.36	50.00	28.57
DM	75.00	71.67	86.73	73.75	100.00	96.88	98.44	56.25	91.67	50.91	37.50	00.00
PW	04.69	05.00	11.22	00.00	83.67	90.63	100.0	56.25	50.00	34.55	25.00	00.00
JW	65.63	38.33	69.39	65.00	91.84	100.00	96.88	90.63	88.89	61.82	87.50	28.57
Mad	84.38	76.67	77.55	95.00	94.90	100.00	98.44	81.25	83.33	63.64	62.50	00.00
RR	54.69	23.33	54.08	51.25	92.86	90.63	98.44	56.25	88.89	43.64	25.00	28.57
AD	53.13	50.00	46.94	57.50	90.82	84.38	96.88	68.75	63.89	30.91	75.00	42.86
KL	4.69	01.67	19.39	06.25	77.55	87.50	92.19	28.13	88.89	61.82	00.00	00.00
GP	71.88	56.67	72.45	95.00	100.00	96.88	98.44	78.13	97.22	78.18	37.50	28.57
JSc	71.88	53.33	68.37	90.00	80.61	100.00	98.44	75.00	77.78	43.64	62.50	42.86
AG	87.50	78.33	70.41	77.50	91.84	93.75	100.0	87.50	75.00	56.36	100.0	100.0
DC	4.69	00.00	0.00	00.00	90.82	93.75	100.0	75.00	88.89	76.36	37.50	42.86
CH	84.38	60.00	77.55	92.50	94.90	100.00	100.0	84.38	91.67	76.36	50.00	28.57
AS	06.25	01.67	0.00	36.25	56.12	59.38	76.56	50.00	47.22	47.27	25.00	0.00
MD	46.88	38.33	8.16	50.00	71.43	46.88	96.88	12.50	38.89	58.18	37.50	28.57
AB	76.56	41.67	26.53	86.25	92.86	90.63	95.31	75.00	88.89	88.89	37.50	28.57
PR	60.94	38.33	74.49	85.00	88.78	93.75	100.0	87.50	80.56	50.91	75.00	0.00
GL	68.75	31.67	50.00	100.0	95.92	96.88	96.88	65.63	91.67	58.18	37.50	28.57
DB	07.81	08.33	23.47	85.00	74.49	75.00	64.06	31.25	86.11	40.00	37.50	28.57
JM	00.00	00.00	0.00	01.25	72.45	75.00	78.13	46.88	91.67	91.67	25.00	0.00
DR	14.06	03.33	6.12	88.75	73.47	84.38	62.50	46.88	83.33	65.45	37.50	0.00
Gho	25.00	16.67	81.22	62.50	64.29	46.88	85.94	43.75	61.11	34.55	25.00	00.00
JB	39.06	10.00	9.18	43.75	71.43	75.00	100	34.38	77.78	60.00	75.00	42.86
PM	59.38	51.67	54.08	65.00	84.69	90.63	92.19	62.50	47.22	30.91	25.00	28.57
CF	43.75	20.00	29.59	70.00	84.69	84.38	89.06	68.75	91.67	50.91	25.00	00.00
DBb	00.00	00.00	0.00	37.50	62.24	68.75	57.81	12.50	30.56	38.18	25.00	00.00

Scores are given as percentages.

Abbreviations: CNB = Cambridge Naming Battery (Bozeat et al., 2000); BNT = Boston Naming Test (Kaplan et al., 1983); ANB = action pictures from the Object and Action naming Battery (Druks & Masterson, 2000); Rep = immediate word repetition from the Psycholinguistic Assessments of Language Processing in Aphasia (Kay et al., 1992); Noun PWM = Noun picture-to-word matching (Alyahya et al., 2018b); Verb PWM = Verb picture-to-word matching (Alyahya et al., 2018a); WPM = spoken word-to-picture matching test from the Cambridge Semantic Battery (Bozeat et al., 2000); Sent = spoken sentence comprehension subtest from the Comprehensive Aphasia Test (Swinburn et al., 2005); Raven = Raven’s Coloured Progressive Matrices (Raven, 1962); Brixton = Brixton Spatial Rule Anticipation Task (Burgess & Shallice, 1997); Digit F = forward digit span (Wechsler, 1987); Digit B = backward digit span (Wechsler, 1987).

Table

Target words	Acceptable Inflections	Acceptable synonyms and their inflections
“Dinner Party” Storytelling Narrative (Fletcher & Birt, 1983)
Man		Husband, Chap
Is	Was
Phone	Phones, Phoning	Ring, Rings, Ringing
Dinner	Dinners
Prepare	Prepares, Preparing, Prepared,
Meal	Meals	Food, Foods
Lady		Wife, Women
Cook	Cooks, Cooking, Cooked
Wash	Washes, Washing
Put	Puts, Putting
Fish	Fishes
Table	Tables
Candle	Candles
Cat	Cats
Get	Gets, Getting, Gotten
Dress	Dresses, Dressing, Dressed
Are	Were
Had
Come	Comes, Coming, Came	Arrive, Arrives, Arriving, Arrived
Have	Has
Look	Looks, Looking, Looked
Go	Goes, Going, Gone
Run	Runs, Running, Ran	Dash, Dashes, Dashing, Dashed
Chip	Chips
Shop	Shops
“Cookie Theft” picture description (Goodglass & Kaplan, 1983)
Mother		Mum, Lady, Woman
Is	Was
Look	Looks, Looking, Looked
Wash	Washes, Washing, Washed
Sink	Sinks
Overflow	Overflows, Overflowing, Overflowed
Water
Floor
Children		Kids
Boy
Stool
Go	Goes, Going, Gone
Fall	Falls, Falling
Get	Gets, Getting, Got
Cookie	Cookies	Biscuit, Biscuits
Jar
Girl

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