Measuring Inner Speech Objectively and Subjectively in Aphasia

Background: Many people with aphasia and people without brain injury talk to themselves in their heads, i.e., have “inner speech.” Inner speech may be more preserved compared with spoken speech for some people with aphasia and may serve a variety of functions (e.g., emotion regulation), which motivates us to provide a high-fidelity characterization of it. Researchers have used multiple methods to measure this internal phenomenon in the past, which we combine here for the first time in a single study. Aims: We compare performance between individuals with and without aphasia on inner speech tasks that assess inner speech “inthe- moment” to general subjective impressions of inner speech to tease apart the relationship of aphasia severity to inner speech. Methods and Procedures: Twenty people with mild-moderate aphasia and twenty neurotypical controls completed several inner speech tasks, including objective silent rhyme judgements (picture, written, and auditory), subjective reports of inner speech during naming, and subjective rating scales about inner speech experience more generally. Outcomes and Results: In-the-moment inner speech during silent rhyming tasks was associated with aphasia severity only for picture and written rhyming but not auditory rhyming. In-the-moment inner speech reports during silent naming were not associated with aphasia severity, nor were the subjective ratings about general inner speech experience. Individuals with and without aphasia demonstrated a variety of subjective general inner speech experiences, demonstrating heterogeneity of this phenomenon more broadly. Conclusions: Methods of measuring inner speech complement each other and speak to different facets of the inner speech phenomenon, and clinicians and researchers must carefully choose the method(s) that will provide the information about inner speech that they desire

Religious affiliation and intimacy task appraisal during emerging adulthood: A comparison of Orthodox and Reform Jewish women

This mixed methods study assessed the similarities and differences between emerging adult Reform and Orthodox Jewish women\u27s intimacy task appraisals. The study focused specifically on Orthodox and Reform women attending college, as this population is fully exposed to cultural norms and expectations related to finding romantic partners. For the quantitative portion of this study, 82 participants completed a life task appraisal measure, Personal Projects Analysis (PPA), which assessed their experience of the search for intimacy. For the qualitative portion, 10 women participated in semi-structured interviews guided by the method of phenomenology, and provided detailed information about the issues they encounter as they seek intimacy as well as the influence of their religious affiliation on this task. Quantitative findings indicated that Orthodox and Reform women\u27s intimacy task appraisals differed significantly on 1 of 5 PPA subscales. This subscale, Effort/Evaluation, included items assessing personal investment in finding intimacy with a romantic partner and included an evaluative aspect, namely participants\u27 evaluations of their own potential to successfully achieve intimacy goals and their perceptions of others\u27 appraisals of their success. Contrary to expectations, there were no significant differences between Reform and Orthodox participants\u27 responses on the Stress/Challenge subscale. Qualitative findings showed both similarities and differences between Orthodox and Reform women\u27s experiences of finding intimacy. Both groups described a sense that they receive messages about intimacy from their families, religious communities, and peer groups. Orthodox women described feeling stress around community expectations to find a potential marital partner during the emerging adult years, while Reform women struggled with community expectations to date and eventually marry within the Jewish faith. Orthodox women described observations of potentially serious emotional consequences of their perceived community expectation to find a potential marital partner during emerging adulthood, including feelings of loneliness and exclusion experienced by those who do not meet expectations according to the preferred timeline. The findings suggest that emerging adult Orthodox and Reform women\u27s experiences of achieving intimacy goals are affected by the cultural context of their religious community. They also indicate that there are unique cultural dynamics to which clinicians must attend in order to achieve competency to work with young Jewish women

A comparison of three discourse elicitation methods in aphasia and age-matched adults: implications for language assessment and outcome

Purpose: Discourse analysis is commonly used to assess language ability and to evaluate language change following intervention in aphasia. The purpose of this study was to identify differences in language produced during different discourse tasks in a large aphasia group and age- and education-matched control group. Methods: Four structured discourse tasks across three discourse types (expositional, narrative and procedural) were evaluated in a group of adults with aphasia (N=90) and an age-matched control group (N=84) drawn from AphasiaBank. CLAN software was used to extract primary linguistic variables (mean length of utterance, propositional density, type-token ratio, words per minute, open-closed class word ratio, noun-verb ratio and tokens), which served as proxies for various language abilities. Using a series of repeated measures ANCOVAs, with significantly correlated demographic and descriptive variables as covariates, main effects of discourse type were evaluated. Results: Despite an impoverished output from the aphasia group (i.e. the control group produced significantly more overall output), there was a main effect of discourse type on most primary linguistic variables in both groups, suggesting that, in adults with and without language impairments, each discourse type taxed components of the spoken language system to varying extents. Post hoc tests fleshed out these results, demonstrating that, for example, narrative discourse produced speech highest in propositional density. Conclusion: Each discourse type taxes the language system in different ways, verifying the importance of using several discourse tasks, and selecting the most sensitive discourse tasks, when evaluating specific language abilities and outcomes

A Comparison of Three Discourse Elicitation Methods in Aphasia and Age-Matched Adults: Implications for Language Assessment and Outcome

Purpose: Discourse analysis is commonly used to assess language ability and to evaluate language change following intervention in aphasia. The purpose of this study was to identify differences in language produced during different discourse tasks in a large aphasia group and age- and education-matched control group. Methods: Four structured discourse tasks across three discourse types (expositional, narrative and procedural) were evaluated in a group of adults with aphasia (N=90) and an age-matched control group (N=84) drawn from AphasiaBank. CLAN software was used to extract primary linguistic variables (mean length of utterance, propositional density, type-token ratio, words per minute, open-closed class word ratio, noun-verb ratio and tokens), which served as proxies for various language abilities. Using a series of repeated measures ANCOVAs, with significantly correlated demographic and descriptive variables as covariates, main effects of discourse type were evaluated. Results: Despite an impoverished output from the aphasia group (i.e. the control group produced significantly more overall output), there was a main effect of discourse type on most primary linguistic variables in both groups, suggesting that, in adults with and without language impairments, each discourse type taxed components of the spoken language system to varying extents. Post hoc tests fleshed out these results, demonstrating that, for example, narrative discourse produced speech highest in propositional density. Conclusion: Each discourse type taxes the language system in different ways, verifying the importance of using several discourse tasks, and selecting the most sensitive discourse tasks, when evaluating specific language abilities and outcomes

Gender-affirming services in speech-language pathology: a survey of current practices

Purpose: To investigate speech language pathologists’ (SLP) education on, knowledge of, familiarity with, and comfort/confidence in providing services to transgender and other gender-diverse individuals. Method: N=201 SLPs were surveyed online between December 2019 and March 2020, representing practitioners in the USA, Australia, Ireland, Canada, South Africa, and Italy. Empirical data was collected using a mixed-method online survey to evaluate trends in service provision to clients across the gender spectrum. Results: Most respondents identified as cisgender, were between the ages of 26-35 or over 45, and reported having worked with at least one gender-diverse client across their clinical career. SLPs working in facilities dedicated to gender-affirmative care were more likely to have worked with a member of our demographic of interest, and were also more likely to report strong confidence in use of demographic specific terms, like “gender fluid”, “gender dysphoria”, and “gender expression”, and were more likely to report consulting outside sources (conferences, colleagues, personal research) for further information on gender-diverse populations than those working in other spaces. Most respondents indicated hearing and knowing gender-relevant terminology, with mixed agreement about confidence in using said terms in a clinical setting. When asked about feeling confident and comfortable in clinically providing services to this population, the majority indicated that they would not. Conclusions: We discuss critical implications of the work as it pertains to current SLP practices, and also recommend future directions for the field, with the goal of moving toward a field-wide practice where all areas of service delivery are gender-inclusive and gender-affirmative