Stuttering generalization self-measure: preliminary development of a self-measuring tool

Objectives: The reader will become knowledgeable about 1) the relationship between stuttering severity and speech-anxiety level, and 2) the importance of assessing the generalization effect in different social speaking situations. Additionally, the reader will understand the processes of validating the Stuttering Generalization Self-Measure. Abstract Introduction: Generalization of treatment is considered a difficult task for clinicians and people who stutter (PWS), and can constitute a barrier to long-term treatment success. To our knowledge, there are no standardized tests that collect measurement of the behavioral and cognitive aspects alongside the client’s self-perception in real-life speaking situations. Purpose: This paper describes the development of a Stuttering Generalization Self-Measure (SGSM). The purpose of SGSM is to assess 1) stuttering severity and 2) speech-anxiety level during real-life situations as perceived by PWS. Additionally, this measurement aims to 3) investigate correlations between stuttering severity and speech-anxiety level within the same real-life situation. Method: The SGSM includes speaking situations that are developed to cover a variety of frequent speaking situations. These items were created according to five listener categories (family and close friends, acquaintances, strangers, persons of authority, and giving a short speech to small audience). Forty-three participants (22 PWS, and 21 control) aged 18 to 53 years were asked to complete the assessment in real-life situations. Results: Preliminary analyses indicated that test-retest reliability was high for both groups. Discriminant validity was also achieved as the SGSM scores significantly differed between the two groups for stuttering and speech-anxiety. Convergent validity was confirmed by significant correlations between the SGSM and other speech-related anxiety measures

Lesions impairing regular versus irregular past tense production

We investigated selective impairments in the production of regular and irregular past tense by examining language performance and lesion sites in a sample of twelve stroke patients. A disadvantage in regular past tense production was observed in six patients when phonological complexity was greater for regular than irregular verbs, and in three patients when phonological complexity was closely matched across regularity. These deficits were not consistently related to grammatical difficulties or phonological errors but were consistently related to lesion site. All six patients with a regular past tense disadvantage had damage to the left ventral pars opercularis (in the inferior frontal cortex), an area associated with articulatory sequencing in prior functional imaging studies. In addition, those that maintained a disadvantage for regular verbs when phonological complexity was controlled had damage to the left ventral supramarginal gyrus (in the inferior parietal lobe), an area associated with phonological short-term memory. When these frontal and parietal regions were spared in patients who had damage to subcortical (n = 2) or posterior temporo-parietal regions (n = 3), past tense production was relatively unimpaired for both regular and irregular forms. The remaining (12th) patient was impaired in producing regular past tense but was significantly less accurate when producing irregular past tense. This patient had frontal, parietal, subcortical and posterior temporo-parietal damage, but was distinguished from the other patients by damage to the left anterior temporal cortex, an area associated with semantic processing. We consider how our lesion site and behavioural observations have implications for theoretical accounts of past tense production

The relation between content and structure in language production: an analysis of speech errors in semantic dementia

In order to explore the impact of a degraded semantic system on the structure of language production, we analysed transcripts from autobiographical memory interviews to identify naturally-occurring speech errors by eight patients with semantic dementia (SD) and eight age-matched normal speakers. Relative to controls, patients were significantly more likely to (a) substitute and omit open class words, (b) substitute (but not omit) closed class words, (c) substitute incorrect complex morphological forms and (d) produce semantically and/or syntactically anomalous sentences. Phonological errors were scarce in both groups. The study confirms previous evidence of SD patients’ problems with open class content words which are replaced by higher frequency, less specific terms. It presents the first evidence that SD patients have problems with closed class items and make syntactic as well as semantic speech errors, although these grammatical abnormalities are mostly subtle rather than gross. The results can be explained by the semantic deficit which disrupts the representation of a pre-verbal message, lexical retrieval and the early stages of grammatical encoding

Measures of functional, real-world communication for aphasia: a critical review

Purpose: Aphasia is a language impairment caused by acquired brain damage such as stroke. For successful rehabilitation, a thorough understanding of naturalistic, real-world communication is imperative, as this is the behaviour speech and language therapy (SLT) ultimately aims to improve. In the field of aphasiology, there currently is a lack of consensus about the way in which communication should be measured. Underlying this is a fundamental lack of agreement over what real-world communication entails and how it should be defined. Method: In this critical review, we review the instruments that are currently used to quantify functional, real-world communication in people with aphasia (PWA). Each measure is checked against a newly proposed, comprehensive, theoretical framework of situated language use, which defines communication as: (1) interactive, (2) multimodal, and (3) based on context (common ground). Results: The instrument that best fits the theoretical definition of situated language use and allows for the quantification of communicative ability is the Scenario Test. Conclusions: This article provides a start in a more systematic and theoretically founded approach to the study and measurement of functional, real-world communication in aphasia. More work is needed to develop an instrument that can quantify communicative ability across different aphasia types and severities

Ever decreasing circles: speech production in semantic dementia

We explored the impact of a degraded semantic system on lexical, morphological and syntactic complexity in language production. We analysed transcripts from connected speech samples from eight patients with semantic dementia (SD) and eight age-matched healthy speakers. The frequency distributions of nouns and verbs were compared for hand-scored data and data extracted using text-analysis software. Lexical measures showed the predicted pattern for nouns and verbs in hand-scored data, and for nouns in software-extracted data, with fewer low frequency items in the speech of the patients relative to controls. The distribution of complex morpho-syntactic forms for the SD group showed a reduced range, with fewer constructions that required multiple auxiliaries and inflections. Finally, the distribution of syntactic constructions also differed between groups, with a pattern that reflects the patients’ characteristic anomia and constraints on morpho-syntactic complexity. The data are in line with previous findings of an absence of gross syntactic errors or violations in SD speech. Alterations in the distributions of morphology and syntax, however, support constraint satisfaction models of speech production in which there is no hard boundary between lexical retrieval and grammatical encoding

TMS SMART – scalp mapping of annoyance ratings and twitches caused by Transcranial Magnetic Stimulation

Background: The magnetic pulse generated during transcranial magnetic stimulation (TMS) also stimulates cutaneous nerves and muscle fibres, with the most commonly reported side effect being muscle twitches and sometimes painful sensations. These sensations affect behaviour during experimental tasks, presenting a potential confound for ‘online’ TMS studies. New method: Our objective was to systematically map the degree of disturbance (ratings of annoyance, pain, and muscle twitches) caused by TMS at 43 locations across the scalp. Ten participants provided ratings whilst completing a choice reaction time task, and ten different participants provided ratings whilst completing a 'flanker' reaction time task. Results: TMS over frontal and inferior regions resulted in the highest ratings of annoyance, pain, and muscle twitches caused by TMS. We predicted the difference in reaction times (RT) under TMS by scalp location and subjective ratings. Frontal and inferior scalp locations showed the greatest cost to RTs under TMS (i.e., slowing), with midline sites showing no or minimal slowing. Increases in subjective ratings of disturbance predicted longer RTs under TMS. Critically, ratings were a better predictor of the cost of TMS than scalp location or scalp-to-cortex distance. The more difficult ‘flanker’ task showed a greater effect of subjective disturbance. Comparison with existing methods: We provide the data as an online resource (www.tms-smart.info) so that researchers can select control sites that account for the level of general interference in task performance caused by online single-pulse TMS. Conclusions: The peripheral sensations and discomfort caused by TMS pulses significantly and systematically influence RTs during single-pulse, online TMS experiments. The raw data are available at www.tms-smart.info and https://osf.io/f49vn

Prevalence of pain flashbacks in post-traumatic stress disorder arising from exposure to multiple traumas or childhood traumatization

Background: Flashbacks are a form of multisensory memory that are experienced with a ‘happening in the present’ quality. Pain flashbacks are a re-experiencing of pain felt at the time of a traumatic event. It is unclear how common pain flashbacks are. Aims: The current study was designed primarily to assess the prevalence of pain flashbacks in a sample of patients with post-traumatic stress disorder (PTSD). Methods: We assessed the prevalence of pain flashbacks over a period of two years in patients (n = 166) referred to a psychological trauma service in the UK. Patients underwent a clinical screen for PTSD, and completed a self-report measure of pain flashbacks. Results: Pain flashbacks were classified as present in 49% of a sample of complex trauma patients meeting criteria for PTSD. Pain flashbacks were positively associated with the extent of pain at the time of trauma. Conclusions: Pain re-experiencing in PTSD, and its relative absence in non-clinical populations, supports an account of memory in which perceptual details can be re- experienced when memories have been encoded under conditions of extreme stress. It may be possible to conceptualize some cases of unexplained pain as pain flashbacks, or of having a trauma origin

When semantics aids phonology: a processing advantage for iconic word forms in aphasia

Iconicity is the non-arbitrary relation between properties of a phonological form and semantic content (e.g. “moo”, “splash”). It is a common feature of both spoken and signed languages, and recent evidence shows that iconic forms confer an advantage during word learning. We explored whether iconic forms conferred a processing advantage for 13 individuals with aphasia following left-hemisphere stroke. Iconic and control words were compared in four different tasks: repetition, reading aloud, auditory lexical decision and visual lexical decision. An advantage for iconic words was seen for some individuals in all tasks, with consistent group effects emerging in reading aloud and auditory lexical decision. Both these tasks rely on mapping between semantics and phonology. We conclude that iconicity aids spoken word processing for individuals with aphasia. This advantage may be due to a stronger connection between semantic information and phonological forms

Motion seen and understood: interactions between language comprehension and visual perception.

Embodied theories of cognition state that the body plays a central role in cognitive representation. Under this description semantic representations, which constitute the meaning of words and sentences, are simulations of real experience that directly engage sensory and motor systems. This predicts interactions between comprehension and perception at low levels, since both engage the same systems, but the majority of evidence comes from picture judgements or visuo-spatial attention therefore it is not clear which visual processes are implicated. In addition, most of the work has concentrated on sentences rather than single words although theories predict that the semantics of both should be grounded in simulation. This investigation sought to systematically explore these interactions, using verbs that refer to upwards or downwards motion and sentences derived from the same set of verbs. As well as looking at visuo-spatial attention, we employed tasks routinely used in visual psychophysics that access low levels of motion processing. In this way we were able to separate different levels of visual processing and explore whether interactions between comprehension and perception were present when low level visual processes were assessed or manipulated. The results from this investigation show that: (1) There are bilateral interactions between low level visual processes and semantic content (lexical and sentential). (2) Interactions are automatic, arising whenever linguistic and visual stimuli are presented in close temporal contiguity. (3) Interactions are subject to processes within the visual system such as perceptual learning and suppression. (4) The precise content of semantic representations dictates which visual processes are implicated in interactions. The data is best explained by a close connection between semantic representation and perceptual systems when information from both is available it is automatically integrated. However, it does not support the direct and unmediated commitment of the visual system in the semantic representation of motion events. The results suggest a complex relationship between semantic representation and sensory-motor systems that can be explained by combining task specific processes with either strong or weak embodiment

Coming of age: a review of embodiment and the neuroscience of semantics

Over the last decade, there has been an increasing body of work that explores whether sensory and motor information is a necessary part of semantic representation and processing. This is the embodiment hypothesis. This paper presents a theoretical review of this work that is intended to be useful for researchers in the neurosciences and neuropsychology. Beginning with a historical perspective, relevant theories are placed on a continuum from strongly embodied to completely unembodied representations. Predictions are derived and neuroscientific and neuropsychological evidence that could support different theories is reviewed; finally, criticisms of embodiment are discussed. We conclude that strongly embodied and completely disembodied theories are not supported, and that the remaining theories agree that semantic representation involves some form of Convergence Zones (Damasio, 1989) and the activation of modal content. For the future, research must carefully define the boundaries of semantic processing and tackle the representation of abstract entities