Phase III Development of a Valid, Reliable, Clinically Feasible Measure of Transactional Success in Aphasic Conversation: Modernizing Methods of Acquisition and Analysis of Discourse Data

摘要 失语症是一种影响至少250万美国人的语言障碍，其评估和治疗模型 逐步从基于减值的框架转向基于参与的框架。然而，不存在有效、 可靠、临床实用的工具，用于直接测量对话中的收益，对话是最频繁的交流方式 老年人的日常生活活动能力。拟议研究的长期目标是提供一个理论上的 为临床医生和临床研究人员提供扎实、实用、自动化的工具，以评估交易方面的变化 在不转录和分析失语症话语的情况下成功对话，这是一种时间和资源密集型 妨碍将对话话语纳入治疗结果的技能。我们建议填补这一空白 与最近试行的对话中交易成功简短评估(BATS)。看完之后 和/或听短的(2.5分钟)BATS视频/音频刺激，失语症患者(PWA)在 独白的话语任务，然后与一个对故事天真的对话伙伴接触，然后 复述这个故事。拟议研究的目标有两个：目标1将证明 BATS及其在评估交易成功方面的有效性。可靠性系数将计算为 视频/音频刺激的替代形式，由核心词汇、主要概念和 综合评级。测量误差的多个潜在来源的大小为 估计以确定最佳数据收集条件(例如，对话伙伴的熟悉度)。证据： 会聚和判别检验将评估BATS衡量的程度 作为联合行动、全面交流和背景，是表征所处环境的三个核心要素 语言使用沟通模式，这使PWA能够更好地沟通而不是交谈。目标2将 研究失语症语篇的先进自动化方法。开源的自然文本分析工具 语言处理平台将与Python程序对接，以评估核心词典和主题相似性 《对话伙伴》中的故事重述。试点数据表明，使用自动化方法评估微环境 语篇的宏观语言特征用来揭示失语症患者会话中的交易成功是可行的。 这项研究具有创新性，因为它应用了21世纪的视频会议技术来提供一种新颖的 用于在开发自动化软件应用程序的同时评估对话中的交易成功的工具 使为PWA服务的临床医生和临床研究人员能够使用该工具，即使在偏远地区也是如此。这个 贡献重大，因为它将克服衡量真实世界功能的主要障碍 失语症对治疗的反应。整合了BATS话语的三个层面(PWA故事重述，二元 对话和对话伙伴重述)到AphasiaBank将创建一个丰富的、共享的在线数据库 研究PWA如何成功地在会话中共同构建意义。该项目反映了当前的优先事项 在NIDCD语音、演讲和语言研究战略计划的第三和第四领域。

SUMMARY Models for assessing and treating aphasia, a language disorder affecting at least 2.5 million Americans, have gradually moved from an impairment-based to a participation-based framework. However, there exist no valid, reliable, clinically practical tools for directly measuring gains in conversation, the most frequent communicative activity of daily life in older adults. The long-range goal of the proposed study is to provide a theoretically grounded, practical, automated tool for clinicians and clinical researchers to assess changes in transactional success in conversation without transcribing and analyzing aphasic discourse, a time- and resource-intensive skill that hinders the inclusion of conversational discourse in treatment outcomes. We propose to fill this gap with the recently piloted Brief Assessment of Transactional Success in conversation (BATS). After watching and/or listening to short (2.5 minute) BATS video/audio stimuli, people with aphasia (PWA) retell the story in a monologic discourse task and then engage with a conversation partner who is naïve to the story, who then retell the story. The objectives of the proposed study are twofold: Aim 1 will demonstrate the reliability of the BATS and its validity in assessing transactional success. Reliability coefficients will be calculated for alternate forms of the video/audio stimuli as assessed by core lexicons, main concepts and comprehensiveness ratings. The magnitude of multiple potential sources of measurement error will be estimated to identify optimal data collection conditions (e.g., conversation partner familiarity). Evidence of converging and discriminant validation will evaluate the degree to which the BATS measures constructs such as joint action, total communication, and context, the three core elements that characterize the situated language use model of communication, and that enable PWA to communicate better than they talk. Aim 2 will advance automated methods of studying discourse in aphasia. Text analysis tools from open-source natural language processing platforms will interface with Python programs to assess core lexicons and topic similarity in conversation partner story retells. Pilot data suggests that use of automated methods for assessing micro- and macrolinguistic features of discourse to reveal transactional success in conversation in aphasia is feasible. This research is innovative because it applies 21st century videoconferencing technology to deliver a novel tool for assessing transactional success in conversation, while developing an automated software application to make the tool accessible to clinicians and clinical researchers who serve PWA, even in remote areas. The contribution is significant in that it will overcome a major obstacle in measuring real-world functional response to therapy in aphasia. Incorporating the three levels of BATS discourse (PWA story retells, dyadic conversations, and conversation partner retells) into AphasiaBank will create a rich, shared online database for studying how PWA succeed in co-constructing meaning in conversation. This project reflects current priorities in Areas 3 and 4 in the NIDCD strategic plan for Voice, Speech, and Language Research.