Conceptualisation Deficits in Aphasia - Welcome to Cass ......Conceptualisation Deficits in Aphasia RON: “tap, hose, and pixies, elf, woman, long hair - no, short - no, bob, and

Conceptualisation Deficits in Aphasiaa

What Evidence can be Gained from a

Picture Description Task?

Inga Hameister & Lyndsey Nickels

@IngaHameister

What is Conceptualisation?

Generating a

preverbal message

CONCEPTUALISER

(Levelt, 1989)


Macroplanning

Microplanning

+

CONCEPTUALISER

(Levelt, 1989)

• Forming speaking

intention

• Selecting information

with regard to speaking

intention

• Ordering information

=


Macroplanning

Microplanning

+

CONCEPTUALISER

(Levelt, 1989)

=

• Taking perspective

• Forming semantic

relations between

elements of the

message

• Determining argument

structure


What happens if our

speaking is impaired?

Conceptualisation Deficits in Aphasia

RON:

“tap, hose, and pixies, elf,

woman, long hair - no, short - no,

bob, and pixie and then

swimming woman, and cap,

obviously, and (gestures

goggles)“ (Cairns et al., 2007)

4 cases of individuals with aphasia with hypothesised

conceptualisation deficits (Cairns et al., 2007; Marshall, Pring, & Chiat, 1993;

Dean & Black, 2005; Byng, Nickels and Black, 1994)

Reported symptoms:

1. Deficits in focusing on the central elements (Cairns et al., 2007)

Conceptualisation Deficits in Aphasia

4 cases of individuals with aphasia with hypothesised

conceptualisation deficits (Cairns et al., 2007; Marshall, Pring, & Chiat, 1993;

Dean & Black, 2005; Byng, Nickels and Black, 1994)

Reported symptoms:

1. Deficits in focusing on the central elements (Cairns et al., 2007)

2. Assigning information to fore- and background

3. Identifying semantic relations between individual events

• verbal and non-verbal

Other symptomatic similarities

1. Non-fluent agrammatic speech

2. Verb-retrieval difficulties

3. Reduced verb-argument structure

Aim of the Study

1. Evaluating prevalence of conceptualisation

deficits

2. Identifying key symptoms in a standard

diagnostic task

METHOD

“Cat Rescue“ - Scenario

Nicholas and Brookshire (1993)

Method

Participants:

50 healthy participants and 50 PWA

• Randomly selected from AphasiaBank database (MacWhinney

et al., 2011)

• Exclusion: neglect, hemianopia

Procedure:

Extract …

1. “Verb Naming Test” (VNT) scores of PWA

2. “Western Aphasia Battery” (WAB) scores

• Object naming

• Aphasia quotient (WAB-AQ)

3. Transcripts of picture descriptions

Concept analysis of picture descriptions

Concept analysis:

Identifying and analysing relevant main concepts (Nicholas &

Brookshire,1995, Capilouto et al., 2005, Richardson & Dalton, 2016)

• What is relevant?

• What is a concept?

Analysing picture descriptions of healthy participants

1. Listing all phrases that contain 1 verb and add a new

idea to the narrative

• 182 different phrases

Method

The cat ran up the tree

vs.

The cat climbed the tree

Concept analysis:









2. 3 raters identified phrases that express the same idea

• 61 different ideas = concepts

Method

The man thinks he is a

squirrel

Concept analysis:









2. 3 raters identified phrases that express the same idea

• 61 different ideas = concepts

3. Identify concepts that are mentioned by ≥60% of

controls

• 10 main concepts

Method

10 main concepts

1 The cat climbed/ is in the tree [*motion or static]

2Any mention of the girl [*concerned/ playing/ wants the

cat back]

3 The man climbed/ is in the tree [*motion or static]

4The man wants to get the cat [*motivation to climb the

tree]

5 The ladder was lost

6 Any mention of the dog [*comes/ barks/ is worried]

7 Someone called the fire brigade

8 The fire brigade comes

9 The fire brigade brings a ladder

10 The fire brigade rescues/ helps them

Method

Concept analysis:

Picture descriptions of PWA analysed for:

1. Number of main concepts

2. Order of main concepts

3. Number of words & verbs

Verbal and non-verbal reactions were taken into

account

• correct main concept = 1) “The cat is in the tree”

&

2) “{points: cat} up the tree.”

RESULTS

Results

Number of main concepts:

Group of PWA produced significantly fewer main

concepts than controls

• Cut-off = 7 main concepts

0

5

10

15

20

25

1 2 3 4 5 6 7 8 9 10

# p

art

icip

an

ts (

max.

50)

# main concepts

Controls Aphasia

Mean: 8.41

SD: 1.43

Mean: 6.1

SD: 1.92

Results





“Dog” concept produced by more PWA than controls

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Any mention of the "GIRL" Any mention of the "DOG"

% o

f p

art

icip

an

ts w

ho

pro

du

ced

th

e c

on

cep

ts

Concepts

Controls Aphasia

*p<.01

Results






0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Any mention of the "GIRL" Any mention of the "DOG"

% o

f p

art

icip

an

ts w

ho

pro

du

ced

th

e c

on

cep

ts

Concepts

Controls Aphasia

*p<.01

Results






Low number of main concepts significantly correlated

with:

• Higher severity of impairment

• Low number of words

• Low proportion of verbs

• Low VNT score

Results

Order of Concepts:

Mean concept order produced by controls

Individual concept order of participant

Calculate an error-in-order ratio

Results

Order of Concepts:


PWA produced different concept order than controls

Especially in the beginning

Results

Order of Concepts:

Beginning:

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

CAT/MAN/GIRL as first 3 concepts FIRE BRIGADE as last concept

% o

f p

art

icip

an

ts w

ho

pro

du

ced

th

e o

rder

Order

Controls

Aphasia

*p<.001

End:

Results

Order of Concepts:


PWA produced different concept order than controls

Especially in the beginning

High error-in-order ratio was significantly correlated

with:

• Low VNT Score

Discussion and

Conclusion

Discussion and Conclusion

Concept analysis provides valuable information about

conceptualisation skills of PWA

1. Significantly smaller number of main concepts in some

PWA

• Suggests deficits to identify most important information

2. Significantly different concept order in some PWA

• Suggests deficits to identify relations between individual

events

• Suggests deficits to weight the importance of individual

information units and to assign them to fore- and

background

Discussion and Conclusion

Verb retrieval seems to be crucial

• Data derived from database: no further testing of these

participants possible

• Influence of other factors need to be further investigated

Picture descriptions provide valuable information about

conceptualisation processes

• Number of main concepts and order of concepts are

potential markers of conceptual deficits in aphasia

Order of concepts seems to be less influenced by

linguistic features

• Reliable marker of conceptualisation deficits?

References Byng, S., Nickels, L., & Black, M. (1994). Replicating Therapy for Mapping Deficits in Agrammatism - Remapping

the Deficit. Aphasiology, 8(4), 315-341

Cairns, D. (2006). Processing Events: Investigating Event Conceptualisation in Aphasia. (Doctor of Philosophy),

City University London, London.

Cairns, D., Marshall, J., Cairns, P., & Dipper, L. (2007). Event processing through naming: Investigating event

focus in two people with aphasia. Language and Cognitive Processes, 22(2), 201-233

Capilouto, G., Wright, H. H., & Wagovich, S. A. (2005). CIU and main event analyses of the structured discourse of

older and younger adults. Journal of Communication Disorders, 38(6), 431-444.

Dean, M. P., & Black, M. (2005). Exploring event processing and description in people with aphasia. Aphasiology,

19(6), 521-544

Dipper, L. T., Black, M., & Bryan, K. L. (2005). Thinking for speaking and thinking for listening: The interaction of

thought and language in typical and non-fluent comprehension and production. Language and Cognitive

Processes, 20(3), 417-441

Levelt, W. J. M. (1989). Speaking : from intention to articulation. Cambridge, Mass.: MIT Press.

MacWhinney, B., Fromm, D., Forbes, M., & Holland, A. (2011). AphasiaBank: Methods for studying discourse.

Aphasiology, 25(11), 1286-1307.

Marshall, J. (2009). Framing ideas in aphasia: the need for thinking therapy. International Journal ofLanguage

Communication Disorders, 44(1), 1-14.

Nicholas, L. E., & Brookshire, R. H. (1993). A system for scoring main concepts in the discourse of non-brain-

damaged and aphasic speakers. Clinical Aphasiology, 21, 87-99.

Nicholas, L. E., & Brookshire, R. H. (1995). Presence, Completeness, and Accuracy of Main Concepts in the

Connected Speech of Non-Brain-Damaged Adults and Adults with Aphasia. Journal of Speech and Hearing

Research, 38(1), 146-156.

Richardson, J. D., & Dalton, S. G. (2016). Main concepts for three different discourse tasks in a large non-clinical

sample. Aphasiology, 30(1), 45-73.

Slobin, D. I. (1996). From "Thought and Language" to "Thinking for Speaking". In J. J. Gumperz & S. C. Levinson

(Eds.), Rethinking Linguistic Relativity (pp. 70 - 96). Cambridge: Cambridge University Press.

Documents

Conceptualisation Deficits in Aphasia - Welcome to Cass ......Conceptualisation Deficits in Aphasia RON: “tap, hose, and pixies, elf, woman, long hair - no, short - no, bob, and