Giving Voice to People With Dementia and Their Carers: The Impact of Communication Difficulties on Everyday Conversations

People living with dementia are an under-served group, whose voices are often excluded from research studies due to their speech, language and communication difficulties. As part of a larger study into language processing in dementia, we invited five people with dementia and their carers to tell us about how dementia impacts on their everyday conversations. We also wanted to gain insights into their views on communication strategies to circumvent these difficulties. Aware of the limitations of a standard focus group methodology for this population, we adapted this approach to provide people with dementia the opportunity to be active research participants. To amplify their voices and to enable carers to be as open as possible we ran the groups separately. Each was facilitated by a speech and language therapist. Both groups used communication accessible materials, to create an inclusive environment that valued contributions from all participants. The topic guide remained the same for all participants, ensuring equity in posing the same core questions. Focus groups were video recorded and transcribed. Reflexive thematic analysis was selected as the most appropriate method to ensure overarching themes identified were based in the data. In our analysis the main theme was sense-making; participants experienced and tried to make sense of dementia through the lens of interaction. Four subthemes were also identified, 1. It’s a journey, 2. You have to make the most of things, 3. Ask the right questions and it just flows-strategies in conversation, and 4. Dealing with people. Multimodal adaptations to a focus group methodology have given voice to people with dementia as well as their carers. They characterise dementia and identify useful strategies based on observations of what changes for them in everyday conversations

Language production and implicit statistical learning in typical development and children with acquired language disorders: an exploratory study

Statistical properties of language provide important cues for language learning and may be processed by domain-general cognitive systems. We investigated the relationship between implicit statistical learning (the unconscious detection of statistical regularities in input) and language production. Twenty typically developing (TD) children and nine children with acquired language disorders (ALD) (aged 6 to 18 years) took part in a Boston Cookie Theft picture description task. Using a computerized analysis, we investigated statistical properties, such as usage frequency of words and collocation strength of word combinations. Participants also completed a non-linguistic serial reaction time (SRT) task, which tested non-verbal, implicit statistical learning in the visual-motor modality. We determined age effects, and compared language production and SRT performance between both groups. Older TD children produced more connected language, more words, less frequent function words, more rare or novel combinations, and showed better statistical learning. Children with ALD produced less connected language, more weakly collocated combinations, displayed less lexical diversity and showed poorer statistical learning. Post-hoc analyses found correlations between statistical learning and statistical properties of spoken language. Given the rarity and heterogeneity of children with ALD, group size was small and the study should be considered exploratory. However, we note that results are compatible with the view that language production draws on statistical learning and that impairment of statistical learning can be related to language disorders

The language profile of formal thought disorder

Formal thought disorder (FTD) is clinically manifested as disorganized speech, but there have been only few investigations of its linguistic properties. We examined how disturbance of thought may relate to the referential function of language as expressed in the use of noun phrases (NPs) and the complexity of sentence structures. We used a comic strip description task to elicit language samples from 30 participants with schizophrenia (SZ), 15 with moderate or severe FTD (SZ + FTD), and 15 minimal or no FTD (SZ−FTD), as well as 15 first-degree relatives of people with SZ (FDRs) and 15 neurotypical controls (NC). We predicted that anomalies in the normal referential use of NPs, sub-divided into definite and indefinite NPs, would identify FTD; and also that FTD would also be linked to reduced linguistic complexity as specifically measured by the number of embedded clauses and of grammatical dependents. Participants with SZ + FTD produced more referential anomalies than NC and produced the fewest definite NPs, while FDRs produced the most and thus also differed from NC. When referential anomalies were classed according to the NP type in which they occurred, the SZ + FTD group produced more anomalies in definite NPs than NC. Syntactic errors did not distinguish groups, but the SZ + FTD group exhibited significantly less syntactic complexity than non-SZ groups. Exploratory regression analyses suggested that production of definite NPs distinguished the two SZ groups. These results demonstrate that FTD can be identified in specific grammatical patterns which provide new targets for detection, intervention, and neurobiological studies

Artificial grammar learning in Williams syndrome and in typical development: the role of rules, familiarity and prosodic cues

Artificial grammar learning (AGL) is an empirical paradigm which investigates basic pattern- and structural processing in different populations. It can inform how higher cognitive functions, such as language use, take place. Our study used AGL to assess how children with Williams syndrome (WS) (n=16) extract patterns in structured sequences of synthetic speech, how they compare to typically developing (TD) children (n=60), and how prosodic cues affect learning. The TD group was divided into: a group whose non-verbal abilities (NVMA) were within the range of the WS group, and a group whose chronological age (CA) was within the range of the WS group. TD children relied mainly on rule-based generalization when making judgements about sequence acceptability, whereas children with WS relied on familiarity with specific stimulus combinations. The TD participants whose NVMA were similar to the WS group, showed less evidence of relying on grammaticality than TD participants whose CA was similar to the WS group. In absence of prosodic cues, the children with WS did not demonstrate evidence of learning. Results suggest that, in WS children, the transition to rule-based processing in language does not keep pace with TD children and may be an indication of differences in neuro-cognitive mechanisms

Frequency in Language Analysis Tool

Software for language analysis based on usage-frequency (work in progress

Intact and impaired fundamentals of syntax : Artificial grammar learning in healthy speakers and people with aphasia

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Artificial grammar learning in individuals with Down syndrome: the role of prosodic cues

The artificial grammar learning (AGL) paradigm allows investigation of cognitive processing and learning under controlled conditions. We compared AGL between 17 individuals with Down syndrome (DS) aged 3-12 years and 60 typically developing (TD) individuals aged 5-18 years and examined age effects, whether prosodic cues affected learning, and the effect of familiarity of stimulus sequences. In general, the TD group strongly outperformed the DS group. In both groups, older children demonstrated better learning. Prosody did not affect learning in the TD group but had a positive effect in the DS group. While limited by the small group size, our results identify factors that affect or support language learning in DS individuals. This may have clinical and educational implications, as DS individuals may need stimuli augmented with prosodic cues to make them more accessible (e.g., through song)

Artificial grammar learning in individuals with Down syndrome: the role of prosodic cues

The artificial grammar learning (AGL) paradigm allows investigation of cognitive processing and learning under controlled conditions. We compared AGL between 17 individuals with Down syndrome (DS) aged 3-12 years and 60 typically developing (TD) individuals aged 5-18 years and examined age effects, whether prosodic cues affected learning, and the effect of familiarity of stimulus sequences. In general, the TD group strongly outperformed the DS group. In both groups, older children demonstrated better learning. Prosody did not affect learning in the TD group but had a positive effect in the DS group. While limited by the small group size, our results identify factors that affect or support language learning in DS individuals. This may have clinical and educational implications, as DS individuals may need stimuli augmented with prosodic cues to make them more accessible (e.g., through song)