Evaluating change in the conversation (Obermeyer et al., 2020)

Purpose: The purpose of this project was to evaluate the effect of a discourse-level treatment, Attentive Reading with Constrained Summarization–Written (ARCS-W), on conversational discourse. ARCS-W aims to improve spoken and written output by addressing the cognitive–linguistic requirements of discourse production through constrained summarization of novel material.
Method: This is an experimentally controlled case study with a single participant, Bill. Three conversation samples were collected at pretreatment, and a single conversation was collected 1 month after treatment. The participant completed 24 ARCS-W treatment sessions, and each session included reading and then summarizing a novel current event article following specific constraints (use lexically precise words, stay on topic, use complete sentences) in speaking and writing. Conversation outcomes evaluated the success of each utterance (1–4 scale), grammaticality, and the proportion of utterances with relevant content (relevant utterances). Additionally, behavioral manifestations of word-finding difficulty were evaluated in conversation.
Results: Bill improved communicative success at the utterance level based on the minimal detectable change. He also demonstrated reductions in behavioral manifestations of lexical retrieval difficulty based on decreases in the percentage of false starts (e.g., t*, t*), mazes (e.g., uh, s*, um), and abandoned utterances. Bill did not increase the proportion of relevant utterances or grammatical utterances n conversation.
Conclusions: This case study provides preliminary evidence of the potential impact of ARCS-W treatment in conversation. Additionally, the measures implemented to evaluate conversation represent a promising adaptation of a novel methodology to capture change in conversation.

Supplemental Material S1. Visual depiction of behaviors associated with lexical retrieval difficulty across three pretreatment conversations and a 1-month posttreatment conversation.

Supplemental Material S2. Visual depiction of post-hoc analysis results evaluating the proportion of behavior associated with lexical retrieval difficulty in N&B (Nicholas & Brookshire, 1993) tasks and Story retelling from the Discourse Comprehension Test (Brookshire & Nicholas, 1993).

Obermeyer, J. A., Leaman, M. C., & Edmonds, L. A. (2020). Evaluating change in the conversation of a person with mild aphasia after Attentive Reading with Constrained Summarization-Written treatment. American Journal of Speech-Language Pathology. https://doi.org/10.1044/2020_AJSLP-19-00078