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Creating a theoretical framework to underpin discourse assessment and intervention in aphasia

Dipper, L. ORCID: 0000-0002-5918-3898, Marshall, J., Boyle, M., Hersh, D., Botting, N. and Cruice, M. (2021). Creating a theoretical framework to underpin discourse assessment and intervention in aphasia. Brain Sciences,

Abstract

Discourse (a unit of language longer than a single sentence) is fundamental to everyday communication. People with aphasia (a language impairment occurring most frequently after stroke, or other brain damage) have communication difficulties which lead to less complete, less coherent, and less complex discourse. Although there are multiple reviews of discourse assessment and an emerging evidence base for discourse intervention, there is no unified theoretical framework to underpin this research. Instead, disparate theories are recruited to explain different aspects of discourse impairment; or symptoms are reported without a hypothesis about the cause. What is needed is a theoretical framework that would clarify the specific linguistic skills that create completeness, coherence, and complexity (i.e. richness) in discourse; and illuminate both the processes involved in discourse production and the reasons for breakdown. This paper reports a review and synthesis of the theoretical literature relevant to spoken discourse in aphasia discourse; and we propose a novel theoretical framework which unites these disparate sources. This framework is currently being tested as the foundation for LUNA (Linguistic Underpinnings of Narrative in Aphasia) treatment research. In this paper we outline the novel framework and exemplify how it might be used to guide clinical practice and research. Future collaborative research is needed to progress this framework into a processing model for spoken discourse.

Publication Type: Article
Publisher Keywords: discourse, narrative, storytelling, connected speech, aphasia, theory
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Departments: School of Health Sciences > Language & Communication Science
Date Deposited: 27 Jan 2021 10:07
URI: https://openaccess.city.ac.uk/id/eprint/25556
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