Date of Award

Spring 2025

Project Type

Thesis

Program or Major

Communication Sciences and Disorders

Degree Name

Master of Science

First Advisor

Amy E Ramage

Second Advisor

Kathryn Greenslade

Third Advisor

Sarah Grace Dalton

Abstract

Purpose: Standardized aphasia assessments focus on diagnosing and measuring language impairments, but do not capture how well individuals with aphasia (PWA) communicate in everyday contexts. Thus, there is a mismatch between the clinical measures used to quantify aphasia severity and real-world communication. This study aims to bridge that gap by employing naïve listeners’ in an effort toward social validity of a measure of lexical typicality (CoreLexicon) by establishing its relationship with aphasia severity and communicative successMethods: Audio samples of picture descriptions from twenty-four people with aphasia were gathered from existing data at two timepoints (mean between testing = 15.4 months) and analyzed for CoreLexicon, or the standardized typically used words to describe a picture, to verify its relationship with aphasia severity and change over time. Forty-eight naïve listeners were recruited to listen to these picture descriptions and retell what they had heard. CoreLexicon scores were also analyzed for these retellings to evaluate communicative success. Naïve listeners further rated the informativeness of the PWAs’ descriptions on a direct magnitude estimation scale, providing a metric of social validity for CoreLexicon as an indicator of informativeness. Results: Reliability for the CoreLexicon scores and informativeness ratings was >90% indicating excellent point to point agreement. CoreLexicon scores were highly correlated with aphasia severity within the PWA group. CoreLexicon scores for the PWA samples and the naïve listeners’ retellings were also highly correlated. Additionally, CoreLexicon scores from both groups correlated with the informativeness ratings. No clinically relevant changes over time were observed in the PWAs for any variables. Generalized linear models revealed that PWAs’ CoreLexicon scores were uniquely predictive of how well the naïve listeners understood the picture descriptions (i.e., the CoreLexicon score for their retellings) and their ratings of informativeness. Conclusions: CoreLexicon is a reliable method for clinicians to utilize that may characterize word retrieval impairments at the discourse level and is relevant to standardized assessment of the impairment on an aphasia test. Further, the inclusion of core words in discourse is predictive of the perceived informativeness of a PWA’s spoken narrative. These findings support the use of CoreLexicon as a meaningful indicator of informativeness and highlight the clinical relevance of interventions that target lexical retrieval of such typical terms for spoken discourse in people with aphasia.

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