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Right hemisphere stroke discourse in the modern Cookie Theft picture (Berube et al., 2022)

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posted on 08.09.2022, 22:27 authored by Shauna K. Berube, Emily Goldberg, Shannon M. Sheppard, Alexandra Zezinka Durfee, Delaney Ubellacker, Alexandra Walker, Colin M. Stein, Argye E. Hillis

Purpose: Adults with right hemisphere damage demonstrate differences in connected speech compared to controls, but systematic, quantitative methods to capture these differences are lacking. The current study aimed to (a) investigate if measures using the Modern Cookie Theft picture description would identify discourse differences in acute right hemisphere stroke, and (b) examine if discourse differences were associated with documented cognitive impairment.

Method: Eighty-four participants completed the Modern Cookie Theft picture description within 5 days of right hemisphere stroke. Descriptions were analyzed for multiple microlinguistic characteristics. Medical charts were retrospectively reviewed for documented presence of cognitive impairment.

Results: Individuals with acute right hemisphere stroke produced fewer content units, total syllables, and lower left–right content unit ratios compared to controls, indicating a paucity of informativeness. Presence of cognitive impairment was associated with fewer content units produced.

Conclusions: Multiple measures of microlinguistic discourse characteristics differentiated adults with right hemisphere stroke from controls, highlighting variations in both the quantity and quality of connected speech. Findings continue to underscore the contribution and correlation between cognitive skills and discourse performance. Future work is needed to assess the relationship between particular cognitive domains and discourse production as well as to investigate longitudinal changes to discourse production during stroke recovery.

Supplemental Material S1. Transcripts and measure examples for impairments in content units (CUs), number of syllables (Syll), syllables per CU (SyllCU), and left–right CU (LRCU) for individuals with RH stroke and healthy controls.

Berube, S. K., Goldberg, E., Sheppard, S. M., Durfee, A. Z., Ubellacker, D., Walker, A., Stein, C. M., & Hillis, A. E. (2022). An analysis of right hemisphere stroke discourse in the modern Cookie Theft picture. American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2022_AJSLP-21-00294

Publisher Note: This article is part of the Special Issue: Select Papers From the 50th Clinical Aphasiology Conference.


This work was supported by National Institutes of Health/National Institute on Deafness and Other Communication Disorders grants R01 DC05375, P50 DC014664, and R01DC015466 awarded to Argye E. Hillis.