Attention and Connected Speech in a Stroke Population

Breanne Young (2012). Attention and Connected Speech in a Stroke Population Professional Doctorate, School of Psychology, The University of Queensland.

       
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Author Breanne Young
Thesis Title Attention and Connected Speech in a Stroke Population
School, Centre or Institute School of Psychology
Institution The University of Queensland
Publication date 2012-06
Thesis type Professional Doctorate
Supervisor Dr. Gail Robinson
Total pages 166
Total black and white pages 166
Language eng
Subjects 17 Psychology and Cognitive Sciences
1701 Psychology
1702 Cognitive Sciences
170102 Developmental Psychology and Ageing
170101 Biological Psychology (Neuropsychology, Psychopharmacology, Physiological Psychology)
Abstract/Summary Abstract Background: Connected speech is a continuous sequence of utterances produced during spoken language or discourse. To produce connected speech one must first conceptualise a message. Theories of language production and recent research in neurological patients emphasise several important conceptual processes involved in the production of connected speech including the ability to produce multiple novel ideas or propositions (productivity and novelty) and link these in a cohesive and coherent manner (cohesion and coherence). These processes occur at a stage that is prior to that of linguistic formulation of the message and may be subserved by distinct neural regions in the right hemisphere or diffuse regions in both hemispheres. Broader cognitive functions such as attention may mediate these processes. Sustained and selective attention are two attentional processes thought to be necessary for production of connected speech. Study Aims: The primary aim of the study is to investigate the conceptual processes important during prelinguistic formulation of connected speech, and the underlying cognitive mechanisms, in stroke. A second aim is to explore whether distinct neural regions differentially support conceptual preparation processes and core language abilities that are fundamental to the production of connected speech, and subsequently ascertain the role of attention in these processes. The final aim is to explore whether the connected speech profile in stroke patients or the relationship between attention and conceptual processes differs depending on the method used to elicit speech. Method: Eighteen stroke patients and 19 healthy matched controls undertook a detailed assessment of neuropsychological and language functioning including four tasks designed to elicit narrative connected speech, including two picture-elicited, and two self-generated narrative tasks. A detailed multi-level analysis of within and between-sentence processing ability was conducted on speech samples. Healthy controls were compared to stroke patients. Where differences were observed, further analyses were undertaken to determine the locus of these deficits (right vs. left hemisphere). Results: Cognitive baseline measures showed stroke patients were impaired on a range of attention, executive function and verbal fluency measures but overall were not aphasic. Despite this, impairments in novel idea generation, cohesion and coherence in connected speech were observed in the stroke group. Left hemisphere lesions largely accounted for differences between stroke group and controls on microlinguistic (within-sentences) abilities. Stroke patients with right and left hemisphere lesions were impaired on macrolinguistic measures of novelty, cohesion and coherence, although patients with right hemisphere lesions were more impaired.. Selective and sustained attention was found to be important for producing narrative speech that was novel and coherent. However, these results differed as a function of the method used to elicit speech. Selective attention was associated with novelty, coherence and cohesion during both picture-elicited and self-generated narrative production tasks, while sustained attention was only associated with novelty and coherence during self-generated narratives. Selective attention was also associated with reduced novelty and coherence in stroke patients with right hemisphere lesions. Conclusions: In sum, impairments in novel idea generation, cohesion and coherence in connected speech may occur in stroke, even without the presence of aphasia. Further, attention appears to play a role in conceptual processes such as novelty, cohesion and coherence; however, attention could not entirely account for impairments in connected speech, suggesting other cognitive or mediating mechanisms may be involved. The study has important theoretical and clinical implications. It informs models of assessment, treatment and planning for rehabilitation of language disorders and contributes to the current understanding of how connected speech is produced.
Keyword connected speech
Discourse
conceptual preparation
attention
Executive function
stroke
Dynamic aphasia
neuropsychology
cognitive

 
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Created: Fri, 21 Jun 2013, 12:44:37 EST by Breanne Young on behalf of Faculty of Social & Behavioural Sciences