Improving discourse is often targeted in aphasia treatment because it is an important skill for meaningful conversation and interaction. The aphasia literature offers a variety of methods to analyze and treat discourse impairments in aphasia, however, there is no true consensus on what the best method is for discourse analysis. Very few studies have utilized listener perception as a method to capture discourse-related changes in aphasia. However, many researchers in other areas of speech-language pathology (e.g. dysarthria, fluency) use listener perceptions and rating scales as a valid measure to assess connected speech. The overarching goal of this study is to determine whether people with aphasia (PWA) and naïve listeners perceive changes in discourse associated with conversational treatment. A questionnaire, the Discourse Rating Scale for Aphasia, was created based on three constructs of discourse analysis in aphasia: macrolinguistic, microlinguistic, and functional features. Six PWA and nine naïve listeners listened to 30-35 second speech samples obtained before and after conversational treatment and rated their judgments on the questionnaire. We examined the relationship between the ratings on the Discourse Rating Scale for Aphasia (DRSA) and standardized language tests to validate the items and rating scale. Additionally, we looked for descriptive pre and post differences within the data to determine whether the DRSA was sensitive to treatment. It was found that each item and total DRSA score correlated highly with standardized tests of language in aphasia. We did not find strong evidence for the DRSA’s sensitivity to treatment; however, we discuss the clinical implications of utilizing listener perception in the assessment of discourse in aphasia. / Communication Sciences

Introduction: Conversation treatment for individuals with aphasia (IwAs) aims to enhance language and communication skills within naturalistic settings. Group dynamics, including psychosocial support (PSS) and vicarious learning (VL), are important components of this treatment. However, the lack of established aphasia-friendly methods for quantifying group dynamics impedes understanding of its contribution to treatment efficacy. This study addresses three key research goals: (1) Can group dynamics be reliably quantified? (2) Do measures of group dynamics vary with group size or time? (3) Are group dynamics linked to changes in self-reported psychosocial health measures? Methods: IwAs were assigned to participate in either a large group or dyadic condition as part of a larger study. Participants completed multiple standardized assessments before and after receiving conversation treatment for one hour twice a week for ten weeks. A coding system was developed to track PSS and VL during sessions. Video recordings of sessions at the start (Session 2) and end (Session 19) of the treatment period were analyzed for five large groups and six dyads, with seven additional dyads coded for Session 19 after reliability was confirmed. Intrarater and interrater reliability were assessed by recoding 21% of the videos randomly. Results: To address the first research goal, group dynamics were defined and then a code was created to represent occurrences of PSS and VL. After establishing a reliable coding system, instances of PSS and VL were compared across size conditions to address the second research goal. The results suggested that PSS differed between conditions later in treatment, but VL did not. For research goal three, the data suggest that large groups experience larger gains in quality of life measures, possibly due to increased exposure to PSS. Conclusion: Findings indicate that group dynamics can be reliably tracked and used for quantitative analysis. PSS was more common in groups than dyads later in the 10 week treatment period, but VL did not vary across conditions or at the start or end of treatment. Further, there is some evidence that PSS in larger groups contributes to improvements in quality of life measures. / Communication Sciences