Impaired Lexical Selection and Fluency in Post-Stroke Aphasia.
Mona Roxana Botezatu, Daniel Mirman
PMID 31598028WHAT IT FOUND
In people with post-stroke aphasia, less fluent speech was linked to greater difficulty recognising words that sound similar to many other words.
This suggests that trouble selecting the right word during listening may share mechanisms with trouble speaking fluently.
Key findings
01Participants with lower fluency scores showed a larger negative impact of phonological neighborhood density on word recognition accuracy than those with higher fluency scores.
02The relationship between fluency and word recognition difficulty was not explained by overall aphasia severity or receptive vocabulary size.
03Individuals with larger receptive vocabularies exhibited larger neighborhood density effects, indicating that general lexical deficits did not drive the fluency finding.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study used a case series design with a small sample of 19 people with aphasia, so it identifies an association but cannot prove that lexical selection deficits cause non-fluent speech. Fluency was measured with the Western Aphasia Battery, which the authors describe as a coarse measure that may not capture specific aspects of speech production like grammatical complexity or motor planning. The experimental task required visual word recognition, which could theoretically confound results if visual deficits were present, although the authors argue that visual deficits would affect all words equally rather than specifically high-density words. The group with aphasia did not show a significant overall difference in performance between high and low density words, meaning the effect was only visible when looking at the relationship with fluency scores within the group.
Declared interests
The authors report no conflict of interest.
The easy way to misread this
Do not conclude that this study proves that training lexical selection will improve speech fluency. The research shows an association between how people speak and how they listen, but it was an observational case series without an intervention, so it does not test whether therapy targeting this mechanism works.