On the measures of fluency in the assessment of spontaneous speech production by aphasic subjects

Abstract

Traditionally, ‘fluency’ is used first to refer to an aphasic syndrome and second to describe only a symptom, a defining speech output feature. Both of these uses may be questioned. Different dimensions of fluency, for instance articulatory agility and use of grammatical words, may be found independent; thus fluency does not identify with a consistent association of speech characteristics. When these dimensions are considered separately, other methodological and theoretical problems arise because the several decisions which are made in assessing the rate and ease of speaking do not relate explicitly to current models of speech production. The alternatives to fluency measures are various qualitative analyses of speech on the morpheme and sentence levels. Nevertheless, the inclusion of temporal variables remains useful when combined with a description of the morphological and structural aspects of the performance, when narratives are studied on the discourse level and, in a clinical setting, when therapists have specifically to deal with changes in fluency during the treatment of single cases of aphasia.