Linda Armstrong’s research while affiliated with Glasgow Caledonian University and other places

Background: Discourse analysis as a clinical tool in speech and language therapy remains underused, at least partly because of the time-consuming nature of the process of transcription that currently precedes it. If transcription-less discourse analysis were valid and reliable, then there would be the clinical opportunity to use this method in order to describe a person's communication impairment (for example aphasia), to help plan therapy and to measure outcomes. Aims: This study aimed to address the potential of transcription-less discourse analysis as a valid and reliable procedure for the measurement of gesture use, topic use, turn taking, repair, conversational initiation, topic initiation, and concept use. Methods & Procedures: Ten individuals with aphasia were audio- and video-recorded participating in a number of discourse tasks from three different discourse genres (conversation, procedural, and picture description). With the same analytical frameworks, the resulting data were compared using transcription-based discourse analysis and a transcription-less method in which the analysis was made directly from the recordings. Outcomes & Results: Validity was measured by comparing transcription-based and transcription-less analyses. Overall the results from that comparison demonstrated the potential of the latter method - none of the measures gave significant differences between scores from the two methods. The main (non-significant) disparities related to some aspects of gesture use and repair. The inter-rater reliability of the transcription-less method was also acceptable in general. Reliability was measured by the intraclass correlation coefficient (ICC) for the continuous measurements: it was strongest for the gesture totals and varied among the attributes of turn taking and repair. For the categorical measures (topic and conversation initiation and concept analysis) the percentage agreement was very good. Conclusions: These results indicate the potential availability of a valid and reliable transcription-less approach to analysis that speech and language therapists can apply to analyse their clients' discourse.

Although it is common for descriptions of communication ability in people with right hemisphere brain damage (RHBD) to include discourse deficits that affect pragmatic effectiveness, reports of these deficits are often made from subjective observations based on single cases. To date there is also very little objective information about spontaneous change over time in a representative clinical population in either discourse-specific or other aspects of language ability. In this study a group of eight individuals with post-stroke RHBD were assessed at 1 month and 6 months post-onset. The Discourse Comprehension Test was administered and seven discourse samples were elicited (three conversational, three procedural and a picture description). Detailed analyses of these samples included length, syntactic complexity, physical and illustrative gestures, verbal disruption, cohesion and topic coherence. A high level of intra-rater reliability was achieved in the analyses. Very few significant differences were evident over time in the language and discourse features measured and there were no apparent task effects. Reasons for this lack of ‘spontaneous recovery’ are discussed and some research implications drawn from this exploratory study.

Background : In a previous report of topic use in semi-structured conversations (Brady, Mackenzie, & Armstrong, 2003), we did not find the often-described gross topic deficit in participants with right hemisphere brain damage (RHBD) when compared to non-brain-damaged participants (NBD). Discourse genre is known to affect the production of discourse, so topic use was further explored in this population using procedural discourse and picture description tasks. Aims : To explore topic coherence and management in procedural and descriptive discourse in individuals with RHBD as a result of stroke. Methods & Procedures : Four discourse samples (three procedural and one picture description) were elicited from 17 individuals with RHBD at 1 and 6 months post-stroke and from a matched NBD group of 51. The samples were transcribed and analysed in terms of topic coherence and management. T-tests were used to compare the groups on a variety of measures of topic use. Intra-rater, inter-rater, and test–retest reliability were evaluated. Outcomes & Results : As in our study of topic use in semi-structured conversations, no widespread or consistent difference between NBD and RHBD individuals was indicated in their procedural and descriptive discourse data. Some differences in subdivision of topic structure and in the use of fillers may be worthy of further exploration. There was no notable task effect. Conclusions : Again there is little support in our data for the perception that, as a group, people with RHBD experience significant topic use deficits. Over seven discourse tasks, including semi-structured conversation, procedures, and picture description, no consistent topic use deficit was noted among the individuals with RHBD in our analyses. Reasons for this apparent lack of difference/difficulty are discussed. Clinical implications and some indications for possible further experimental study in the area of topic use in people with RHBD post-stroke are described.

Background: Right hemisphere brain damage (RHBD) has been linked to a diverse range of discourse-level communicative deficits generally based on subjective impressions. Investigative evidence to support or refute the reports is limited and what evidence is available is frequently restricted in the conclusions it can make as a result of small sample sizes, inadequate reporting of onset time, and site of lesion. Comparisons with matched NBD individuals' performance are rare. Many of the descriptions could reflect a difficulty with the use of topic. Disorganised, verbose, tangential discourse with poor topic maintenance may reflect difficulties with the structural aspects of topic use, i.e., topic coherence. Other descriptions of discourse with an excessive focus on details, personalisations, and anecdotal elements are also prevalent but are not reflected within a topic coherence model. They may be linked to a deficit in the management of topic on an utterance by utterance level. Aims: To explore topic coherence and topic management during semi-structured conversational discourse by individuals with RHBD as a result of stroke. Methods & Procedures: Three cue-elicited conversational discourse samples were taken from a group of 17 individuals with post-stroke RHBD and a matched group of 51 non-brain-damaged individuals. The participants with RHBD were sampled at 1 and 6 months post-stroke. Discourse samples were transcribed and analysed in terms of topic coherence and management. The intra-test, inter-test, and test-retest reliability of the analysis was also evaluated. Outcomes & Results: The method of discourse sampling and the topic coherence and management analyses used proved to be reliable. There was no indication of a widespread consistent difference in the use of topic by the RHBD and NBD groups during the discourse samples. The exploratory results suggest the individuals with RHBD had some difficulties with topic coherence at subdivisional levels in comparison to NBD individuals. The groups' use of main topics differed little. Some differences between the RHBD and NBD individuals' use of fillers and repetition were observed. The proportion of on-topic utterances rather than off-topic or topic-shading utterances also indicated some between-group differences. Conclusions: These exploratory results provide little support for the perception that the RHBD population experiences widespread topic difficulties. The results highlight specific elements of discourse topic use that may differ between the RHBD and NBD individuals, but which requires further targeted investigation.