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Picture naming tasks are frequently used to evaluate speech and language abilities in clinical populations, either as part of a larger language assessment battery or as a standalone assessment of [...], Purpose: Meaningful changes in picture naming responses may be obscured when measuring accuracy instead of quality. A statistic that incorporates information about the severity and nature of impairments may be more sensitive to the effects of treatment. Method: We analyzed data from repeated administrations of a naming test to 72 participants with stroke aphasia in a clinical trial for anomia therapy. Participants were divided into two groups for analysis to demonstrate replicability. We assessed reliability among response type scores from five raters. We then derived four summary statistics of naming ability and their changes over time for each participant: (a) the standard accuracy measure, (b) an accuracy measure adjusted for item difficulty, (c) an accuracy measure adjusted for item difficulty for specific response types, and (d) a distance measure adjusted for item difficulty for specific response types. While accuracy measures address the likelihood of a correct response, the distance measure reflects that different response types range in their similarity to the target. Model fit was assessed. The frequency of significant improvements and the average magnitude of improvements for each summary statistic were compared between treatment groups and a control group. Effect sizes for each modelbased statistic were compared with the effect size for the standard accuracy measure. Results: Interrater and intrarater reliability were near perfect, on average, though compromised somewhat by phonological-level errors. The effects of treatment were more evident, in terms of both frequency and magnitude, when using the distance measure versus the other accuracy statistics. Conclusions: Consideration of item difficulty and response types revealed additional effects of treatment on naming scores beyond those observed for the standard accuracy measure. The results support theories that assume naming ability is decomposable into subabilities rather than being monolithic, suggesting new opportunities for measuring treatment outcomes. Supplemental Material: https://doi.org/10.23641/asha.17019515

Purpose: A picture naming test is presented that reveals impairment to specific mechanisms involved in the naming process, using accuracy scores on curated item sets. A series of psychometric validation experiments are reported. Method: Using a computational model that enables estimation of item difficulty at the lexical and sublexical stages of word retrieval, two complimentary sets of items were constructed that challenge the respective psycholinguistic levels of representation. The difference in accuracy between these item sets yields the relative linguistic impairment (RLI) score. In a cohort of 91 people with chronic left-hemisphere stroke who enrolled in a clinical trial for anomia, we assessed psychometric properties of the RLI score and then used the new scale to make predictions about other language behaviors, lesion distributions, and functional activation during naming. Results: RLI scores had adequate psychometric properties for clinical significance. RLI scores contained predictive information about spontaneous speech fluency, over and above accuracy. A dissociation was observed between performance on the RLI item sets and performance on the subtests of an independent language battery. Sublexical RLI was significantly associated with apraxia of speech and with lesions encompassing perisylvian regions, while lexical RLI was associated with lesions to deep white matter. The RLI construct was reflected in functional brain activity during naming, independent of overall accuracy, with a respective shift of activation between dorsal and ventral networks responsible for different aspects of word retrieval. Conclusion: The RLI assessment satisfies the psychometric requirements to serve as a useful clinical measure. [ABSTRACT FROM AUTHOR]

Persons with sensorineural hearing loss often report that talkers seem to be 'mumbling' or are otherwise difficult to understand even when the target speech is clearly audible. This difficulty is [...], Purpose: Age-related sensorineural hearing loss can dramatically affect speech recognition performance due to reduced audibility and suprathreshold distortion of spectrotemporal information. Normal aging produces changes within the central auditory system that impose further distortions. The goal of this study was to characterize the effects of aging and hearing loss on perceptual representations of speech. Method: We asked whether speech intelligibility is supported by different patterns of spectrotemporal modulations (STMs) in older listeners compared to young normal-hearing listeners. We recruited 3 groups of participants: 20 older hearing-impaired (OHI) listeners, 19 age-matched normal-hearing listeners, and 10 young normal-hearing (YNH) listeners. Listeners performed a speech recognition task in which randomly selected regions of the speech STM spectrum were revealed from trial to trial. The overall amount of STM information was varied using an up-down staircase to hold performance at 50% correct. Ordinal regression was used to estimate weights showing which regions of the STM spectrum were associated with good performance (a "classification image" or CImg). Results: The results indicated that (a) large-scale CImg patterns did not differ between the 3 groups; (b) weights in a small region of the CImg decreased systematically as hearing loss increased; (c) CImgs were also nonsystematically distorted in OHI listeners, and the magnitude of this distortion predicted speech recognition performance even after accounting for audibility; and (d) YNH listeners performed better overall than the older groups. Conclusion: We conclude that OHI/older normal-hearing listeners rely on the same speech STMs as YNH listeners but encode this information less efficiently. Supplemental Material: https://doi.org/10.23641/asha. 7859981

Background: Aphasia therapy is an effective approach to improve language function in chronic aphasia. However, it remains unclear what prognostic factors facilitate therapy response at the individual level. Here, we utilized data from the POLAR (Predicting Outcomes of Language Rehabilitation in Aphasia) trial to (a) determine therapy-induced change in confrontation naming and long-term maintenance of naming gains and (b) examine the extent to which aphasia severity, age, education, time postonset, and cognitive reserve predict naming gains at 1 week, 1 month, and 6 months posttherapy. Method: A total of 107 participants with chronic (= 12 months poststroke) aphasia underwent extensive case history, cognitive-linguistic testing, and a neuroimaging workup prior to receiving 6 weeks of impairment-based language therapy. Therapy-induced change in naming performance (measured as raw change on the 175-item Philadelphia Naming Test [PNT]) was assessed 1 week after therapy and at follow-up time points 1 month and 6 months after therapy completion. Change in naming performance over time was evaluated using paired t tests, and linear mixed-effects models were constructed to examine the association between prognostic factors and therapy outcomes. Results: Naming performance was improved by 5.9 PNT items (Cohen's d = 0.56, p < .001) 1 week after therapy and by 6.4 (d = 0.66, p < .001) and 7.5 (d = 0.65, p < .001) PNT items at 1 month and 6 months after therapy completion, respectively. Aphasia severity emerged as the strongest predictor of naming improvement recovery across time points; mild (ß = 5.85-9.02) and moderate (ß = 9.65-11.54) impairment predicted better recovery than severe (ß = 1.31-3.37) and very severe (ß = 0.20-0.32) aphasia. Age was an emergent prognostic factor for recovery 1 month (ß = -0.14) and 6 months (ß = -0.20) after therapy, and time postonset (ß = -0.05) was associated with retention of naming gains at 6 months posttherapy. Conclusions: These results suggest that therapy-induced naming improvement is predictable based on several easily measurable prognostic factors. Broadly speaking, these results suggest that prognostication procedures in aphasia therapy can be improved and indicate that personalization of therapy is a realistic goal in the near future. [ABSTRACT FROM AUTHOR]

Amplitude-modulated (AM) and frequency-modulated (FM) sounds are the building blocks of nearly all natural and complex sounds. Important examples include communication signals from speech to vocalizations in diverse species from [...], Purpose: This study investigated the ability to use spatial information in mixed-modulated (MM) sounds containing concurrent frequency-modulated (FM) and amplitude-modulated (AM) sounds by exploring patterns of interference when different modulation types originated from different loci as may occur in a multisource acoustic field. Method: Interaural delay thresholds were measured from 5 normal-hearing adults for an AM sound in the presence of interfering FM and vice versa as a function of interferer modulation rate. In addition, the effects of near versus remote interferer rates, and fixed versus randomized interferer interaural delay, were investigated. Results: AM interfered with lateralization of FM at all modulation rates. However, the FM interfered with AM lateralization only when the FM rate was higher than the AM rate. This rate asymmetry was surprising given the prevalence of low-frequency dominance in lateralization, but was predicted by a cross-correlation model of binaural interaction. Effects were similar for fixed and randomized interferer interaural delays. Conclusions: The results suggest that in multisource environments, sources containing different modulation types significantly interfere with localization in complex ways that reveal interactions between modulation type and rate. These findings contribute to the understanding of auditory object formation and localization. KEY WORDS: sound localization, modulation, AM, FM, interference

Purpose: We present a 20-item naming test, the Severity-Calibrated Aphasia Naming Test (SCANT), that can serve as a proxy measure for an aphasia severity scale that is derived from a thorough test battery of connected speech production, single-word production, speech repetition, and auditory verbal comprehension. Method: We use lasso regression and cross-validation to identify an optimal subset from a set of 174 pictures to be named for prediction of aphasia severity, based on data from 200 participants with left-hemisphere stroke who were quasirandomly selected to represent the full impairment scale. Data from 20 healthy controls (i.e., participant caretakers/spouses) were also analyzed. We examine interrater reliability, test–retest reliability, sensitivity and specificity to the presence of aphasia, sensitivity to therapy gains, and external validity (i.e., correlation with aphasia severity measures) for the SCANT. Results: The SCANT has extremely high interrater reliability, and it is sensitive and specific to the presence of aphasia. We demonstrate the superiority of predictions based on the SCANT over those based on the full set of naming items. We estimate a 15% reduction in power when using the SCANT score versus the full test battery’s aphasia severity score as an outcome measure; for example, to maintain the same power to detect a significant group average change in aphasia severity, a study with 25 participants using the full test battery to measure treatment effectiveness would require 30 participants if the SCANT were to be used as the testing instrument instead. Conclusion: We provide a linear model to convert SCANT scores to aphasia severity scores, and we identify a change score cutoff of four SCANT items to obtain a high degree of confidence based on test–retest SCANT data and the modeled relation between SCANT and aphasia severity scores. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the relationship between word production rates (WPRs) and phonological error rates (PERs) in generative and responsive tasks in logopenic progressive aphasia (lvPPA). We examined whether a portion of the reduced WPR during generative tasks related directly to phonological impairments affecting PER on all tasks, irrespective of other task differences that contributed to WPR. Method: Two cognitive psychometric models were hypothesized and fit to the total number of words produced and the number of phonological errors produced by 22 participants on 10 tasks. Bayesian inference was used to construct posterior distributions of participant ability and task difficulty parameters. Model fit statistics were compared. Association strengths for average generative WPR and average responsive PER were also evaluated with linear least-squares regression. Results: Average generative WPR and average responsive PER were significantly associated (r = -.77, p = .00002). A cognitive psychometric model that assumed reduced WPR on generative tasks reflects a portion of general phonological impairment yielded better fit than a model that ignored performance differences between generative and responsive tasks. Generative fluency tasks that elicited few phonological errors still reflected phonological impairment, via suppression. Individual participants were estimated to suppress between 62%and 93% of phonological errors on generative tasks that would have emerged on responsive tasks. Conclusions: Suppression of phonological errors may present as decreased WPR on generative tasks in lvPPA. Failure to account for this suppression tendency may lead to overestimation of phonological ability. The findings indicate the need to account for task demands in assessing lvPPA. [ABSTRACT FROM AUTHOR]