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Discourse Measures From the Modern Cookie Theft Picture Description Are Sensitive to Mild Communication Deficits Not Captured by the Western Aphasia Battery–Revised Aphasia Quotient.

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Title: Discourse Measures From the Modern Cookie Theft Picture Description Are Sensitive to Mild Communication Deficits Not Captured by the Western Aphasia Battery–Revised Aphasia Quotient.
Authors: Bunker, Lisa D.1 lbunke@midwestern.edu, Berube, Shauna K.2, Neal, Voss3, Kelly, Lindsey3, Kelly, Catherine4, Meier, Erin L.5, Hillis, Argye E.3,6
Source: American Journal of Speech-Language Pathology. May2025, Vol. 34 Issue 3, p1100-1120. 21p.
Subject Terms: *Aphasia, *Retrospective studies, *Comparative studies, Diagnosis of aphasia, NIH Stroke Scale, Task performance, Research funding, Questionnaires, Mann Whitney U Test, Ischemic stroke, Convalescence, Medical records, Acquisition of data, Neuroradiology, Data analysis software, Health outcome assessment, Regression analysis
Abstract: Purpose: The Western Aphasia Battery–Revised (WAB-R) is often used for diagnosis of aphasia. However, persons scoring above the WAB-R diagnostic cutoff may still present with language difficulties indicative of aphasia. Identification of residual language challenges is critical for treatment referral or inclusion in research. We examined differences in discourse following acute left-hemisphere stroke for those above/below the WAB-R diagnostic cutoff compared to healthy controls, as well as recovery during the first year. Method: Sixty-eight participants with acute left-hemisphere stroke completed the WAB-R and were classified as aphasic by WAB-R (ABW; n = 42) or not aphasic by WAB-R (NABW; n = 26). They completed the Modern Cookie Theft (MCT) picture description task at two time points: acute and either 3, 6, or 12 months poststroke. Responses were analyzed for content units, total verbal output, efficiency, and lateralization of content (i.e., right vs. left side of stimulus) and compared to 49 healthy controls. Differences between groups were examined using Wilcoxon rank-sum tests. Change over time was examined using robust linear mixed-effects regression. Results: Wilcoxon tests showed differences between healthy controls and ABW or NABW on all MCT metrics except efficiency for those NABW. Regression models showed no main effects of group or interaction between group and time point. Conclusions: The NABW group showed deficits in verbal output, content production, and laterality on the MCT picture description task, suggesting the presence of possible aphasia and hemispatial neglect. Measures derived from the MCT may be more sensitive to residual language/communication difficulties not captured by the WAB-R. The NABW group also showed similar patterns of recovery as the ABW group, highlighting the MCT task’s ability to capture change for those with mild impairments. Results support use of the MCT task in clinical settings, particularly if/when mild deficits are probable/suspected. [ABSTRACT FROM AUTHOR]
Copyright of American Journal of Speech-Language Pathology is the property of American Speech-Language-Hearing Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Education Research Complete
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  Data: Discourse Measures From the Modern Cookie Theft Picture Description Are Sensitive to Mild Communication Deficits Not Captured by the Western Aphasia Battery–Revised Aphasia Quotient.
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  Data: <searchLink fieldCode="AR" term="%22Bunker%2C+Lisa+D%2E%22">Bunker, Lisa D.</searchLink><relatesTo>1</relatesTo><i> lbunke@midwestern.edu</i><br /><searchLink fieldCode="AR" term="%22Berube%2C+Shauna+K%2E%22">Berube, Shauna K.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Neal%2C+Voss%22">Neal, Voss</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Kelly%2C+Lindsey%22">Kelly, Lindsey</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Kelly%2C+Catherine%22">Kelly, Catherine</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Meier%2C+Erin+L%2E%22">Meier, Erin L.</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Hillis%2C+Argye+E%2E%22">Hillis, Argye E.</searchLink><relatesTo>3,6</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22American+Journal+of+Speech-Language+Pathology%22">American Journal of Speech-Language Pathology</searchLink>. May2025, Vol. 34 Issue 3, p1100-1120. 21p.
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  Data: *<searchLink fieldCode="DE" term="%22Aphasia%22">Aphasia</searchLink><br />*<searchLink fieldCode="DE" term="%22Retrospective+studies%22">Retrospective studies</searchLink><br />*<searchLink fieldCode="DE" term="%22Comparative+studies%22">Comparative studies</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnosis+of+aphasia%22">Diagnosis of aphasia</searchLink><br /><searchLink fieldCode="DE" term="%22NIH+Stroke+Scale%22">NIH Stroke Scale</searchLink><br /><searchLink fieldCode="DE" term="%22Task+performance%22">Task performance</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Questionnaires%22">Questionnaires</searchLink><br /><searchLink fieldCode="DE" term="%22Mann+Whitney+U+Test%22">Mann Whitney U Test</searchLink><br /><searchLink fieldCode="DE" term="%22Ischemic+stroke%22">Ischemic stroke</searchLink><br /><searchLink fieldCode="DE" term="%22Convalescence%22">Convalescence</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+records%22">Medical records</searchLink><br /><searchLink fieldCode="DE" term="%22Acquisition+of+data%22">Acquisition of data</searchLink><br /><searchLink fieldCode="DE" term="%22Neuroradiology%22">Neuroradiology</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Health+outcome+assessment%22">Health outcome assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Regression+analysis%22">Regression analysis</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Purpose: The Western Aphasia Battery–Revised (WAB-R) is often used for diagnosis of aphasia. However, persons scoring above the WAB-R diagnostic cutoff may still present with language difficulties indicative of aphasia. Identification of residual language challenges is critical for treatment referral or inclusion in research. We examined differences in discourse following acute left-hemisphere stroke for those above/below the WAB-R diagnostic cutoff compared to healthy controls, as well as recovery during the first year. Method: Sixty-eight participants with acute left-hemisphere stroke completed the WAB-R and were classified as aphasic by WAB-R (ABW; n = 42) or not aphasic by WAB-R (NABW; n = 26). They completed the Modern Cookie Theft (MCT) picture description task at two time points: acute and either 3, 6, or 12 months poststroke. Responses were analyzed for content units, total verbal output, efficiency, and lateralization of content (i.e., right vs. left side of stimulus) and compared to 49 healthy controls. Differences between groups were examined using Wilcoxon rank-sum tests. Change over time was examined using robust linear mixed-effects regression. Results: Wilcoxon tests showed differences between healthy controls and ABW or NABW on all MCT metrics except efficiency for those NABW. Regression models showed no main effects of group or interaction between group and time point. Conclusions: The NABW group showed deficits in verbal output, content production, and laterality on the MCT picture description task, suggesting the presence of possible aphasia and hemispatial neglect. Measures derived from the MCT may be more sensitive to residual language/communication difficulties not captured by the WAB-R. The NABW group also showed similar patterns of recovery as the ABW group, highlighting the MCT task’s ability to capture change for those with mild impairments. Results support use of the MCT task in clinical settings, particularly if/when mild deficits are probable/suspected. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of American Journal of Speech-Language Pathology is the property of American Speech-Language-Hearing Association and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1044/2024_AJSLP-24-00322
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        Text: English
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      – SubjectFull: Aphasia
        Type: general
      – SubjectFull: Retrospective studies
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      – SubjectFull: Comparative studies
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      – SubjectFull: Diagnosis of aphasia
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      – SubjectFull: NIH Stroke Scale
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      – TitleFull: Discourse Measures From the Modern Cookie Theft Picture Description Are Sensitive to Mild Communication Deficits Not Captured by the Western Aphasia Battery–Revised Aphasia Quotient.
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              Text: May2025
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