Dual-task effects on story retell in aphasia (Harmon et al., 2019)

Purpose: The aims of the study were to determine dual-task effects on content accuracy, delivery speed, and perceived effort during narrative discourse in people with moderate, mild, or no aphasia and to explore subjective reactions to retelling a story with a concurrent task.
Method: Two studies (1 quantitative and 1 qualitative) were conducted. In Study 1, participants with mild or moderate aphasia and neurotypical controls retold short stories in isolation and while simultaneously distinguishing between high and low tones. Story retell accuracy (speech productivity and efficiency), speed (speech rate, repetitions, and pauses), and perceived effort were measured and compared. In Study 2, participants completed semistructured interviews about their story retell experience. These interviews were recorded, transcribed orthographically, and coded qualitatively using thematic analysis.
Results: The dual task interfered more with spoken language of people with aphasia than controls, but different speed–accuracy trade-off patterns were noted. Participants in the moderate aphasia group reduced accuracy with little alteration to speed, whereas participants in the mild aphasia group maintained accuracy and reduced their speed. Participants in both groups also reported more negative emotional and behavioral reactions to the dual-task condition than their neurotypical peers. Intentional strategies for coping with the cognitive demands of the dual-task condition were only reported by participants with mild aphasia.
Conclusion: The findings suggest that, although communicating with a competing task is more difficult for people with aphasia than neurotypical controls, participants with mild aphasia may be better able to cope with cognitively demanding communication situations than participants with moderate aphasia.

Supplemental Material S1. Intrarater and interrater reliability for spoken language codes.

Supplemental Material S2. Perceived effort ratings among participants with mild, moderate, or no aphasia in single task and dual task conditions. ST = single task condition, DT = dual task condition. Boxes show inter-quartile range and whiskers extend to the upper and lower quartiles.

Supplemental Material S3. Correlations between assessment scores and story retell accuracy and speed.

Supplemental Material S4. Interview guide.

Supplemental Material S5. Initial codebook.

Harmon, T. G., Jacks, A., Haley, K. L., & Bailliard, A. (2019). Dual-task effects on story retell for participants with moderate, mild, or no aphasia: Quantitative and qualitative findings. Journal of Speech, Language, and Hearing Research, 62, 1890–1905. https://doi.org/10.1044/2019_JSLHR-L-18-0399