Conceptualisation Deficits in Aphasiaa
What Evidence can be Gained from a
Picture Description Task?
Inga Hameister & Lyndsey Nickels
@IngaHameister
What is Conceptualisation?
Generating a
preverbal message
CONCEPTUALISER
(Levelt, 1989)
What is Conceptualisation?
Macroplanning
Microplanning
+
CONCEPTUALISER
(Levelt, 1989)
• Forming speaking
intention
• Selecting information
with regard to speaking
intention
• Ordering information
=
What is Conceptualisation?
Macroplanning
Microplanning
+
CONCEPTUALISER
(Levelt, 1989)
=
• Taking perspective
• Forming semantic
relations between
elements of the
message
• Determining argument
structure
What is Conceptualisation?
What happens if our
speaking is impaired?
Conceptualisation Deficits in Aphasia
RON:
“tap, hose, and pixies, elf,
woman, long hair - no, short - no,
bob, and pixie and then
swimming woman, and cap,
obviously, and (gestures
goggles)“ (Cairns et al., 2007)
4 cases of individuals with aphasia with hypothesised
conceptualisation deficits (Cairns et al., 2007; Marshall, Pring, & Chiat, 1993;
Dean & Black, 2005; Byng, Nickels and Black, 1994)
Reported symptoms:
1. Deficits in focusing on the central elements (Cairns et al., 2007)
Conceptualisation Deficits in Aphasia
4 cases of individuals with aphasia with hypothesised
conceptualisation deficits (Cairns et al., 2007; Marshall, Pring, & Chiat, 1993;
Dean & Black, 2005; Byng, Nickels and Black, 1994)
Reported symptoms:
1. Deficits in focusing on the central elements (Cairns et al., 2007)
2. Assigning information to fore- and background
3. Identifying semantic relations between individual events
• verbal and non-verbal
Other symptomatic similarities
1. Non-fluent agrammatic speech
2. Verb-retrieval difficulties
3. Reduced verb-argument structure
Aim of the Study
1. Evaluating prevalence of conceptualisation
deficits
2. Identifying key symptoms in a standard
diagnostic task
METHOD
“Cat Rescue“ - Scenario
Nicholas and Brookshire (1993)
Method
Participants:
50 healthy participants and 50 PWA
• Randomly selected from AphasiaBank database (MacWhinney
et al., 2011)
• Exclusion: neglect, hemianopia
Procedure:
Extract …
1. “Verb Naming Test” (VNT) scores of PWA
2. “Western Aphasia Battery” (WAB) scores
• Object naming
• Aphasia quotient (WAB-AQ)
3. Transcripts of picture descriptions
Concept analysis of picture descriptions
Concept analysis:
Identifying and analysing relevant main concepts (Nicholas &
Brookshire,1995, Capilouto et al., 2005, Richardson & Dalton, 2016)
• What is relevant?
• What is a concept?
Analysing picture descriptions of healthy participants
1. Listing all phrases that contain 1 verb and add a new
idea to the narrative
• 182 different phrases
Method
The cat ran up the tree
vs.
The cat climbed the tree
Concept analysis:
Identifying and analysing relevant main concepts (Nicholas &
Brookshire,1995, Capilouto et al., 2005, Richardson & Dalton, 2016)
• What is relevant?
• What is a concept?
Analysing picture descriptions of healthy participants
1. Listing all phrases that contain 1 verb and add a new
idea to the narrative
• 182 different phrases
2. 3 raters identified phrases that express the same idea
• 61 different ideas = concepts
Method
The man thinks he is a
squirrel
Concept analysis:
Identifying and analysing relevant main concepts (Nicholas &
Brookshire,1995, Capilouto et al., 2005, Richardson & Dalton, 2016)
• What is relevant?
• What is a concept?
Analysing picture descriptions of healthy participants
1. Listing all phrases that contain 1 verb and add a new
idea to the narrative
• 182 different phrases
2. 3 raters identified phrases that express the same idea
• 61 different ideas = concepts
3. Identify concepts that are mentioned by ≥60% of
controls
• 10 main concepts
Method
10 main concepts
1 The cat climbed/ is in the tree [*motion or static]
2Any mention of the girl [*concerned/ playing/ wants the
cat back]
3 The man climbed/ is in the tree [*motion or static]
4The man wants to get the cat [*motivation to climb the
tree]
5 The ladder was lost
6 Any mention of the dog [*comes/ barks/ is worried]
7 Someone called the fire brigade
8 The fire brigade comes
9 The fire brigade brings a ladder
10 The fire brigade rescues/ helps them
Method
Concept analysis:
Picture descriptions of PWA analysed for:
1. Number of main concepts
2. Order of main concepts
3. Number of words & verbs
Verbal and non-verbal reactions were taken into
account
• correct main concept = 1) “The cat is in the tree”
&
2) “{points: cat} up the tree.”
RESULTS
Results
Number of main concepts:
Group of PWA produced significantly fewer main
concepts than controls
• Cut-off = 7 main concepts
0
5
10
15
20
25
1 2 3 4 5 6 7 8 9 10
# p
art
icip
an
ts (
max.
50)
# main concepts
Controls Aphasia
Mean: 8.41
SD: 1.43
Mean: 6.1
SD: 1.92
Results
Number of main concepts:
Group of PWA produced significantly fewer main
concepts than controls
• Cut-off = 7 main concepts
“Dog” concept produced by more PWA than controls
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Any mention of the "GIRL" Any mention of the "DOG"
% o
f p
art
icip
an
ts w
ho
pro
du
ced
th
e c
on
cep
ts
Concepts
Controls Aphasia
*p<.01
Results
Number of main concepts:
Group of PWA produced significantly fewer main
concepts than controls
• Cut-off = 7 main concepts
“Dog” concept produced by more PWA than controls
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Any mention of the "GIRL" Any mention of the "DOG"
% o
f p
art
icip
an
ts w
ho
pro
du
ced
th
e c
on
cep
ts
Concepts
Controls Aphasia
*p<.01
Results
Number of main concepts:
Group of PWA produced significantly fewer main
concepts than controls
• Cut-off = 7 main concepts
“Dog” concept produced by more PWA than controls
Low number of main concepts significantly correlated
with:
• Higher severity of impairment
• Low number of words
• Low proportion of verbs
• Low VNT score
Results
Order of Concepts:
Mean concept order produced by controls
Individual concept order of participant
Calculate an error-in-order ratio
Results
Order of Concepts:
Mean concept order produced by controls
PWA produced different concept order than controls
Especially in the beginning
Results
Order of Concepts:
Beginning:
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
CAT/MAN/GIRL as first 3 concepts FIRE BRIGADE as last concept
% o
f p
art
icip
an
ts w
ho
pro
du
ced
th
e o
rder
Order
Controls
Aphasia
*p<.001
End:
Results
Order of Concepts:
Mean concept order produced by controls
PWA produced different concept order than controls
Especially in the beginning
High error-in-order ratio was significantly correlated
with:
• Low VNT Score
Discussion and
Conclusion
Discussion and Conclusion
Concept analysis provides valuable information about
conceptualisation skills of PWA
1. Significantly smaller number of main concepts in some
PWA
• Suggests deficits to identify most important information
2. Significantly different concept order in some PWA
• Suggests deficits to identify relations between individual
events
• Suggests deficits to weight the importance of individual
information units and to assign them to fore- and
background
Discussion and Conclusion
Verb retrieval seems to be crucial
• Data derived from database: no further testing of these
participants possible
• Influence of other factors need to be further investigated
Picture descriptions provide valuable information about
conceptualisation processes
• Number of main concepts and order of concepts are
potential markers of conceptual deficits in aphasia
Order of concepts seems to be less influenced by
linguistic features
• Reliable marker of conceptualisation deficits?
References Byng, S., Nickels, L., & Black, M. (1994). Replicating Therapy for Mapping Deficits in Agrammatism - Remapping
the Deficit. Aphasiology, 8(4), 315-341
Cairns, D. (2006). Processing Events: Investigating Event Conceptualisation in Aphasia. (Doctor of Philosophy),
City University London, London.
Cairns, D., Marshall, J., Cairns, P., & Dipper, L. (2007). Event processing through naming: Investigating event
focus in two people with aphasia. Language and Cognitive Processes, 22(2), 201-233
Capilouto, G., Wright, H. H., & Wagovich, S. A. (2005). CIU and main event analyses of the structured discourse of
older and younger adults. Journal of Communication Disorders, 38(6), 431-444.
Dean, M. P., & Black, M. (2005). Exploring event processing and description in people with aphasia. Aphasiology,
19(6), 521-544
Dipper, L. T., Black, M., & Bryan, K. L. (2005). Thinking for speaking and thinking for listening: The interaction of
thought and language in typical and non-fluent comprehension and production. Language and Cognitive
Processes, 20(3), 417-441
Levelt, W. J. M. (1989). Speaking : from intention to articulation. Cambridge, Mass.: MIT Press.
MacWhinney, B., Fromm, D., Forbes, M., & Holland, A. (2011). AphasiaBank: Methods for studying discourse.
Aphasiology, 25(11), 1286-1307.
Marshall, J. (2009). Framing ideas in aphasia: the need for thinking therapy. International Journal ofLanguage
Communication Disorders, 44(1), 1-14.
Nicholas, L. E., & Brookshire, R. H. (1993). A system for scoring main concepts in the discourse of non-brain-
damaged and aphasic speakers. Clinical Aphasiology, 21, 87-99.
Nicholas, L. E., & Brookshire, R. H. (1995). Presence, Completeness, and Accuracy of Main Concepts in the
Connected Speech of Non-Brain-Damaged Adults and Adults with Aphasia. Journal of Speech and Hearing
Research, 38(1), 146-156.
Richardson, J. D., & Dalton, S. G. (2016). Main concepts for three different discourse tasks in a large non-clinical
sample. Aphasiology, 30(1), 45-73.
Slobin, D. I. (1996). From "Thought and Language" to "Thinking for Speaking". In J. J. Gumperz & S. C. Levinson
(Eds.), Rethinking Linguistic Relativity (pp. 70 - 96). Cambridge: Cambridge University Press.