On the coherence of information highlighted by narrators with aphasia

Abstract

Background: A central purpose of narration is to convey one's point of view about a narrated event. One's expressed evaluation of a narrated event (modalising language) is often differentiated from one's expression of the time, place, person, and event proper (referential language). Use of narrative evaluative devices highlights information in narratives. Previous findings provide evidence that the frequency of use, co-occurrence and distribution of evaluative devices are similar for narratives of speakers with and without aphasia, suggesting a preservation of evaluative or modalising language in aphasia.

Aims: This study complements prior research on structural aspects of evaluative devices by examining the distribution and overall coherence of the content emphasised by evaluative devices in the personal narratives of speakers with aphasia, as compared to that of narratives produced by demographically similar speakers without aphasia.

Methods & Procedures: Participants were 33 demographically matched, English-speaking, middle-aged adults. Of these, 17 had aphasia, and 16 had no neurological disorder. Each group included similar proportions of three demographic subgroups: African-American males, African-American females, and Caucasian females. Each participant told a personal narrative of a frightening experience. Narrative evaluative content was analysed for its proportion of use on and off the main event line, and for its overall coherence.

Outcomes & Results: The distribution and coherence of highlighted/evaluated semantic content were similar for narratives of individuals with and without aphasia. Notably, some aphasic participants produced coherent evaluative/modalising content with incoherent referential content.

Conclusions: The relatively intact ability of individuals with aphasia to assign prominence to information in narratives sheds light on the neurological underpinnings of modalising language, and suggests possible skills associated with the ability of aphasic persons to “communicate better than they talk” (Holland, 1977). The clinical potential for assessment and treatment that incorporates narrative evaluative devices and modalising language needs to be further explored.

Keywords:

• Aphasia
• Discourse
• Narrative
• Evaluative devices
• Modalising
• Semantics

Acknowledgments

The authors extend thanks to our many participant volunteers, and to the facilities, institutions, and individuals who have referred them: Ashley Court at Turtle Creek, Dallas; Baylor Institute for Rehabilitation; Callier (Dallas) Aphasia Group; Community Partners Program (a collaborative programme of the University of Texas at Dallas and Baylor Institute for Rehabilitation); Department of Assistive and Rehabilitative Services – Division for Determination Services; Friendship West Baptist Church; Harris Methodist Forth Worth Hospital; HealthSouth Dallas Medical Center; HealthSouth Plano Medical Center; Methodist Dallas Medical Center; Mobility Foundation Stroke Center, UT Southwestern Medical School; North Texas Stroke Survivors (P. Boland); Parkland Hospital and Healthcare System; South Dallas Communication Groups Program (UTD Center for Brain Health) with Saint John Missionary Baptist Church, Jubilee UMC, St. Paul AME, and St. Luke's “Community” UMC; The Stroke Center – Dallas; Texas Health Resources; the University of North Texas Speech and Hearing Center Adult Communication Therapy Program; the University of Texas at Dallas, Communication and Learning Center; Barbara Punch, Gina Jackson, and Emily Frisch; and students of the University of North Texas Department of Speech and Hearing Sciences. We also extend thanks to Beverly Moshay and Veronica Lewis for their assistance with data collection, and to Craig Stewart for his assistance with analysis. This research was supported by grants from the University of North Texas Faculty Research Grant Fund; the NIH/NIDCD (1R03DC005151-01); and the University of Texas at Dallas (Callier Center for Communication Disorders, and Dean of the School of Behavioral and Brain Sciences). Our thanks to two anonymous reviewers for their helpful suggestions and insightful comments.