Communication Sciences and Disorders Commons^™

Narrative Discourse Predictors Of Response To Naming Intervention In Aphasia, Dirk B. Den Ouden, Laura Giglio, Sigfus Kristinsson, Leonardo Bonilha, Deena Schwen Blackett, Brielle C. Stark, Janina Wilmskoetter, Julius Fridriksson

Communication Sciences and Disorders Faculty Articles and Research

Purpose:

Method:

Aphasia Therapy In An Arabic-Speaking Individual After Stroke: A Case Report, Mohammed F. Alharbi Dr

Internet Journal of Allied Health Sciences and Practice

Purpose: This case report describes the clinical application and preliminary outcomes of Arabic-adapted Semantic Feature Analysis (SFA), Phonological Components Analysis (PCA), and Verb Network Strengthening Treatment (VNeST) in an Arabic-speaking adult with post-stroke aphasia and highlights language-specific factors that affect the adaptation of these interventions to Arabic. Methods: The participant was a 53-year-old right-handed native Arabic-speaking man who developed moderate to severe nonfluent transcortical motor aphasia after a left middle cerebral artery stroke. One month after stroke onset, he underwent assessment with the Short Aphasia Test for Gulf Arabic speakers, which showed relatively preserved auditory comprehension and repetition but marked …

Exploring The Quality-Of-Life Impact Of Driving For People With Aphasia, Kaleigh Welch, Emily Huddleston

Appalachian Student Healthcare Research Review

Purpose: This study explored how driving ability or loss affects the social, emotional, and practical quality of life of people with aphasia (PWA). Given that driving is a key marker of independence, identity, and community participation, the study aimed to understand how individuals with aphasia experience driving resumption or cessation and how these experiences shape daily functioning and psychosocial well‑being.

Methods: Semi-structured interviews were conducted with seven adults with aphasia recruited from a university-based aphasia group. Interviews were completed in a private university clinic room. Open-ended questions elicited participants’ feelings, experiences, and perceptions regarding driving or not driving after aphasia. …

Clinical Case Study: The Effects Of Task Dynamics And Saltatory Pneumotactile Stimulation On Cerebral Oxygenation, Cognitive Performance, And Sensorimotor Function In An Adult Following Left Ischemic Mca Stroke, Bridget Slagle

College of Education and Human Sciences: Dissertations, Theses, and Student Research

In the chronic stage of stroke recovery, neuroplasticity is thought to require external influence, and is often considered to be experience-dependent, or “Hebbian,” plasticity. Current studies have been investigating multiple ways to induce plasticity to enhance recovery, including investigating the role of sensory stimulation in cortical priming to enhance the effects of rehabilitation interventions.

This case study of an 80-year-old female with aphasia after L-MCA ischemic stroke included 18 neurotherapeutic sessions over 10 weeks. Each session included pneumotactile somatosensory stimulation to the glabrous hand and perioral face, delivered to both the left and right side via the GALILEO, as well …

Main Concept Analysis As A Predictor Of Aphasia Severity: Semantic, Phonological, And Executive Influences On Main Concept Performance, Chathurvedi Ganguru

Senior Theses

Main Concept Analysis is a discourse-based measure that captures the essential information conveyed during narrative speech and may serve as a functional indicator of communication ability in aphasia. This study will examine whether Main Concept composite scores derived from the Cinderella narrative task are associated with aphasia severity and identify the linguistic and cognitive factors that influence Main Concept performance. Participants will be drawn from the baseline cohort of the POLAR study and will include approximately 100 individuals with chronic post-stroke aphasia. Baseline measures include Western Aphasia Battery Aphasia Quotient, Pyramids and Palm Trees Test, Philadelphia Repetition Test, and Wechsler …

Psychological Impacts Of Caring For Individuals With Fluent Versus Nonfluent Aphasia, Allisyn Rae Converse

Student Theses and Dissertations

This investigation sought to explore the mental health differences between caregivers of individuals with fluent aphasia versus caregivers of individuals with nonfluent aphasia with a focus on their levels of depression, anxiety, and stress. This study had a quantitative, non-experimental between group research design, utilizing a Qualtrics survey including the Hospital Anxiety and Depression Scale and the Perceived Stress scale to collect all data. Both caregivers of individuals with nonfluent and fluent aphasia can experience psychological impacts of serving as a caregiver such as elevated stress, anxiety, and depression. However, this study reveals that caregivers of individuals with nonfluent aphasia …

Cortical Hierarchy And Aphasia Severity: The Sensorimotor–Association Gradient Modulates Lesion Effects Within Language-Specific Networks, Ida Rangus, Natalie Busby, Nicholas Riccardi, Sigfus Kristinsson, Janina Wilmskoetter, Dirk B. Den Ouden, Chris Rorden, Roger Newman-Norlund, Julius Fridriksson Ph.D., Leonardo Bonilha

Faculty Publications

Aphasia severity after stroke varies widely and is not fully explained by lesion size or location. We propose that incorporating the brain’s sensorimotor-association (S-A) gradient, reflecting cortical hierarchy, offers a biologically grounded framework for predicting language outcomes. In 236 individuals with chronic left-hemisphere stroke, we examine whether the hierarchical position of lesions in language-specific (LS) and domain-general (DG) areas modulates aphasia severity. We parcellate lesions using a cortical atlas and weigh them by each region’s S-A rank. We apply hierarchical linear regression to test whether S-A ranking and its interaction with lesion volume improves prediction of Western Aphasia Battery-Revised Aphasia …

Integrating Perspectives Of People With Aphasia: A Holistic Approach To Community Aphasia Groups Within An Intensive Comprehensive Aphasia Program, Mckinlee A. Mihelish

Graduate Student Theses, Dissertations, & Professional Papers

Introduction: People with aphasia (PWA) experience chronic communication deficits that impact daily life. Community Aphasia Groups (CAGs) are commonly used to address these challenges and have demonstrated psychosocial and communicative benefits; however, they lack standardized structure and are implemented with variability across settings. Additionally, much of the existing research focuses on group-level outcomes rather than participant-driven priorities, limiting clinicians’ ability to tailor interventions. This study examined what PWA want from CAG participation and how these priorities may change over time.

Methods: This quantitative study investigated priority changes among PWA participating in a CAG within a summer 2025 Intensive Comprehensive Aphasia …

Perspectives Of Poetry: Peering Into Poetry And Aphasia, Kristian M. Perez

Graduate Studies Theses and Dissertations 2026

People with aphasia often experience significant barriers to communication, emotional expression, and participation in meaningful life activities following stroke or neurological injury. Although poetry and creative expression have been explored in broader therapeutic contexts, limited research has examined how people with aphasia perceive poetry. The purpose of this qualitative study was to explore the perspectives of people with aphasia regarding definitions of poetry, level of interest in poetry and the factors influencing said interest. Semi-structured interviews were conducted with adults with aphasia recruited through convenience sampling. Participants responded to questions before and after exposure to the poem Trust by Mark …

From Measures To Meaning: A Case Study On Co-Defining Aphasia Recovery Outcomes With Patient Experts, Ann Blair Kennedy, Amy Neira, Katie Parris, Sebrena Brink, Patients With Aphasia Panel, Nabil Natafgi, Dirk B. Den Ouden, Sara Sayers, Leonardo Bonilha, Julius Fridriksson

Communication Sciences and Disorders Faculty Articles and Research

Background

People with post-stroke aphasia are often excluded from shaping the research meant to support their recovery. Communication barriers, research norms, and traditional outcome frameworks contribute to a lack of meaningful involvement, particularly in the identification of patient-centered outcomes. While participatory models in aphasia research are emerging, few examples describe how individuals with communication disabilities can lead or co-create research priorities.

Main body

This case study describes a structured, collaborative effort to center the voices of people with aphasia in identifying meaningful outcomes for recovery. Through a partnership between the Patient Engagement Studio (PES) and the Center for the Study …

Naming Practice Effects And Inconsistencies Relate To Treatment Outcome In People With Aphasia, Janina Wilmskoetter, Katherine Blackwood, Sigfus Kristinsson, Grant Walker, Julius Fridriksson, Deena Schwen Blackett, Dirk B. Den Ouden, Chris Rorden, Argye E. Hillis, Gregory Hickok, Sara Sayers, Leigh Ann Spell, Leonardo Bonilha

Communication Sciences and Disorders Faculty Articles and Research

Background and aims

Method

Partial Least Squares Multimodal Analysis Of Brain Network Correlates Of Language Deficits In Aphasia, Sigfus Kristinsson Ph.D., Dirk B. Den Ouden, Chris Rorden, Roger Newman-Norlund, Lisa Johnson, Janina Wilmskoetter, Ezequiel Gleichgerrcht, Argye E. Hillis, Gregory Hickok, Julius Fridriksson Ph.D., Leonardo Bonilha

Faculty Publications

Lesion-symptom mapping techniques are essential to determine brain regions critical for language functions. However, high collinearity in neuroimaging and behavioural data remains a challenge for distinguishing neural substrates supporting multiple language domains (shared variance) and those subserving specific language functions (unique variance). Here, we employed a novel approach to multimodal lesion-symptom mapping using multivariate partial least squares regression to delineate the latent structure of lesion-behavioural mapping in aphasia and decompose the shared and unique neural determinants of language impairments. A total of 86 participants with chronic (>12-month post-stroke) aphasia after left hemisphere strokes were examined. Language impairment was assessed …

Partial Least Squares Multimodal Analysis Of Brain Network Correlates Of Language Deficits In Aphasia, Sigfus Kristinsson, Dirk B. Den Ouden, Chris Rorden, Roger Newman-Norlund, Lisa Johnson, Janina Wilmskoetter, Ezequiel Gleichgerrcht, Argye E. Hillis, Gregory Hickok, Julius Fridriksson, Leonardo Bonilha

Communication Sciences and Disorders Faculty Articles and Research

Lesion-symptom mapping techniques are essential to determine brain regions critical for language functions. However, high collinearity in neuroimaging and behavioural data remains a challenge for distinguishing neural substrates supporting multiple language domains (shared variance) and those subserving specific language functions (unique variance). Here, we employed a novel approach to multimodal lesion-symptom mapping using multivariate partial least squares regression to delineate the latent structure of lesion-behavioural mapping in aphasia and decompose the shared and unique neural determinants of language impairments. A total of 86 participants with chronic (>12-month post-stroke) aphasia after left hemisphere strokes were examined. Language impairment was assessed …

Benchmarking Machine Learning Models In Lesion-Symptom Mapping For Predicting Language Outcomes In Stroke Survivors, Deepa Tilwani, Christian O'Reilly, Nicholas Riccardi, Valerie L. Shalin, Dirk B. Den Ouden, Julius Fridriksson, Svetlana V. Shinkareva, Amit P. Sheth, Rutvik H. Desai

Communication Sciences and Disorders Faculty Articles and Research

Several decades of research have investigated the neural connections between stroke-induced brain damage and language difficulties. Typically, lesion-symptom mapping (LSM) studies that address this connection have relied on mass univariate statistics, which do not account for multidimensional relationships between variables. Machine learning (ML) techniques, which can capture these intricate connections, offer a promising complement to LSM methods. To test this promise, we benchmarked ML models on structural and functional MRI to predict aphasia severity (N = 238) and naming impairment (N = 191) for a cohort of chronic-stage stroke survivors. We used nested cross-validation to examine performance along …

Assessing Functional Communication In Persons With Aphasia: A Scoping Review Of Formal And Informal Measures, Lauren Hammond, Thomas Christensen, Julius Fridriksson, Dirk B. Den Ouden

Communication Sciences and Disorders Faculty Articles and Research

Background

The communicative effectiveness of persons with aphasia (PWA) has been assessed through a range of functional communication measures. However, variability in interpretations of what is covered by the term “functional communication” may have resulted in challenges to the implementation of appropriate and consistent patient-centred evaluations, with different measures focusing on subsets of the components of functional communication.

Aims

This paper aims to examine the current literature on informal and formal evaluation of functional communication in PWA and to identify gaps in currently available assessment tools.

Methods

This scoping review included studies published between 1965 and 2024 that assessed functional …

Vocal And Articulatory Speech Control Deficits In Individuals With Post-Stroke Aphasia, Roozbeh Behroozmand, Zeinab Khoshhal Mollasaraei, Vahid Nejati, Ayoub Daliri, Julius Fridriksson Ph.D.

Faculty Publications

Individuals with post-stroke aphasia exhibit deficits in regulating vocal (i.e., laryngeal) pitch control during speech vowel production; however, it is not determined whether such deficits also exist when they control their supra-laryngeal speech articulators during word production. To address this question, 19 subjects with post-stroke aphasia and 20 controls were tested under an altered auditory feedback paradigm in which they received + 30% shifts in their vowel first-formant frequency during word production. In addition, 17 aphasia subjects and 19 controls from the same groups also completed steady vowel vocalizations while receiving randomized pitch shifts at ± 100 cents. Consistent with …

Exploring The Impact Of Yoga On Self-Perception In People With Aphasia, Meta Riley Hurm

Mahurin Honors College Capstone Experience/Thesis Projects

Instances of complex diagnoses and acquired language loss, such as aphasia, are often accompanied by a variety of deficits in quality of life. Most notably, individuals’ self-perceptions can be altered by these diagnoses, as new life complications bring about the necessity for major adjustments. This study utilized interpretative phenomenological analysis (IPA) to analyze the effects of participation in an adapted yoga program on self-perception, specifically evoking change in identity, emotional health, sense of community, and self-acceptance. Through interviews with six individuals with a primary aphasia diagnosis, findings revealed three major superordinate themes of self-perception: identity, self-care, and attunement. Participants' answers …

Clinicians Perspective On The Implementation Of Person-Centered Care In Persons With Aphasia, Carmen S. Alderman

Theses and Dissertations--Communication Sciences and Disorders

This paper examines speech-language pathologist perspective on implementing person-centered care for persons with aphasia. Person-centered care is based on the social model, which emphasizes the importance of including the client. The survey addressed clinicians’ use of person-centered care related to collaborative goal setting and treatment planning, as well as facilitators and barriers to implementing person-centered care for individuals with aphasia based on the view of practicing clinicians across a variety of settings. The results indicated most speech-language pathologists have heard of person-centered care, understand the importance of involving clients in goal setting, ask clients about their preferences when setting goals, …

Practicing Clinicians' Views Of The Life Participation Approach To Aphasia Therapy, Stephanie H. Mays

Theses and Dissertations--Communication Sciences and Disorders

The Life Participation Approach to Aphasia therapy (LPAA) aligns with a person-centered, functional approach to speech therapy. Past research has demonstrated that persons with aphasia (PWA) benefit from this approach and prefer it when compared to the traditional medical model to therapy. However, a disconnect between PWA preferences and SLP treatment approaches in therapy persists. This study aims to identify both barriers and facilitators that SLPs face when implementing LPAA. Five CCC-SLPs practicing in the state of KY with experience working with PWA were recruited as participants. Participants were placed into two focus groups, with each group meeting for 2-3 …

An Aphasia Friendly Questionnaire For Post-Stroke Fatigue, Abigail Best

Williams Honors College, Honors Research Projects

A stroke is when there is lack of blood flow to part of the brain. It can cause permanent damage, such as paralysis, sensory changes, difficulty with speech and language (such as aphasia), and decreased memory. Within this project, we will discuss individuals post-stroke who are diagnosed with aphasia, which is the inability to understand and express language. Currently, there are minimal resources available to help a healthcare worker define and assess the fatigue level of a patient post-stroke who is also diagnosed with aphasia. The first objective of this research is to discuss stroke and aphasia. The second objective …

Generative Ai Applied To Aac For Aphasia: A Pilot Study Of Aphasia-Gpt, Dallin J. Bailey, Francesca Herget, Derek Hansen, Forrest Burton, Grant Pitt, Tyson Harmon, David Wingate

Faculty Publications

Background

People with aphasia may be supported by augmentative and alternative communication systems, but further development is necessary to improve the communication support such systems provide. Advances in artificial intelligence methods of natural language processing may provide improved support for people with aphasia, but development and testing involving people with aphasia is critical.

Aims

The purpose of the study is to describe the development and pilot testing of a new AAC system for people with aphasia, a mobile web app named Aphasia-GPT.

Methods & Procedures

Aphasia-GPT is specifically designed to receive spoken input from a user with aphasia; it then …

Verbal Working Memory And Syntactic Comprehension Segregate Into The Dorsal And Ventral Streams, Respectively, William Matchin, Zeinab K. Mollasaraei, Leonardo Bonilha, Christopher Rorden, Gregory Hickok, Dirk B. Den Ouden, Julius Fridriksson

Communication Sciences and Disorders Faculty Articles and Research

Syntactic processing and verbal working memory are both essential components to sentence comprehension. Nonetheless, the separability of these systems in the brain remains unclear. To address this issue, we performed causal-inference analyses based on lesion and connectome network mapping using MRI and behavioural testing in two groups of individuals with chronic post-stroke aphasia. We employed a rhyme judgement task with heavy working memory load without articulatory confounds, controlling for the overall ability to match auditory words to pictures and to perform a metalinguistic rhyme judgement, isolating the effect of working memory load (103 individuals). We assessed non-canonical sentence comprehension, isolating …

Telerehabilitation For Aphasia (Terra) Phase Ii Trial Design, Christy Cassarly, Alexandra Basilakos, Lisa Johnson, Janina Wilmskoetter, Jordan Elm, Argye E. Hillis, Leonardo Bonilha, Chris Rorden, Gregory Hickok, Dirk B. Den Ouden, Julius Fridriksson

Communication Sciences and Disorders Faculty Articles and Research

Background and purpose

Methods

Dr. Audrey Holland's Crazy Patchwork Quilt: A Thematic Analysis, Jessica D. Richardson, Sarah Grace Hudspeth Dalton, Honey Isabel Hubbard, Maya Henry

Speech Pathology and Audiology Faculty Research and Publications

Dr. Audrey Holland was a friend to people with aphasia and related disorders, care partners, community advocates, students, clinicians, educators, researchers, and more. Her profound impact extended across these diverse communities within aphasiology and speech-language pathology. Through her words and deeds, Audrey established a rich legacy that continues to guide and inspire countless individuals. A careful examination of her contributions reveals a roadmap for those seeking to embark on a similar journey of compassion and influence. To pay tribute to our mentor and friend, we conducted a thematic analysis of her solo works to identify enduring themes, laugh-out-loud anecdotes, and …

Establishing Quality Indicators And Implementation Priorities For Post-Stroke Aphasia Services Through End-User Involvement, Kirstine Shrubsole, Marissa Stone, Dominique A. Cadilhac, Monique F. Kilkenny, Emma Power, Elizabeth Lynch, John E. Pierce, David A. Copland, Erin Godecke, Bridget Burton, Emily Brogan, Sarah J. Wallace

Research outputs 2022 to 2026

Background: Currently, there are no agreed quality standards for post-stroke aphasia services. Therefore, it is unknown if care reflects best practices or meets the expectations of people living with aphasia. We aimed to (1) shortlist, (2) operationalise and (3) prioritise best practice recommendations for post-stroke aphasia care.

Methods: Three phases of research were conducted. In Phase 1, recommendations with strong evidence and/or known to be important to people with lived experience of aphasia were identified. People with lived experience and health professionals rated the importance of each recommendation through a two-round e-Delphi exercise. Recommendations were then ranked for importance and …

Lcd 106: Introduction To Communication Sciences And Disorders, Yael Neumann

Open Educational Resources

This course will provide an introduction to the development and disorders of speech, language, and communication in children and adults. Disorders such as autism, aphasia, stuttering, and learning disabilities will be discussed. Differences noted in culturally and linguistically diverse communities will also be addressed. The course activities will give students an experiential appreciation of the experience of communication challenges and supporting people with those challenges. Information about the professions of Speech-Language Pathology (SLP), Audiology, and Speech and Hearing Science will be reviewed as potential career paths.

Long-Range White Matter Fibres And Post-Stroke Verbal And Non-Verbal Cognition, Rebecca W. Roth, Deena Schwen Blackett, Ezequiel Gleichgerrcht, Janina Wilmskoetter, Chris Rorden, Roger Newman-Norlund, Souvik Sen, Julius Fridriksson Ph.D., Natalie Busby, Leonardo Bonilha

Faculty Publications

Among stroke survivors, linguistic and non-linguistic impairments exhibit substantial inter-individual variability. Stroke lesion volume and location do not sufficiently explain outcomes, and the neural mechanisms underlying the severity of aphasia or non-verbal cognitive deficits remain inadequately understood. Converging evidence supports the idea that white matter is particularly susceptible to ischaemic injury, and long-range fibres are commonly associated with verbal and non-verbal function. Here, we investigated the relationship among post-stroke aphasia severity, cognition, and white matter integrity. Eighty-seven individuals in the chronic stage of stroke underwent diffusion MRI and behavioural testing, including language and cognitive measures. We used whole-brain structural connectomes …

Persevering Through Communication Challenges: A Qualitative Descriptive Exploration Of Communication Experiences In Aphasia, Tyson G. Harmon, Camille Williams, Garrett Cardon, William S. Evans

Faculty Publications

Background

People with aphasia often experience activity limitations and participation restrictions despite wanting to engage in communication activities that are satisfying and meaningful. Communication partner support, the complexity of the communication environment, and the thoughts and feelings of people with aphasia have important implications for both language processing and communicative participation. The perspectives of PWA about the role that environmental and personal factors (e.g. thoughts and feelings) play in their communication experiences could inform clinical practice.

Aims

To qualitatively explore the communication experiences of people with aphasia and how environmental demands and personal factors (especially emotional responses) affect these experiences. …

Under Pressure: The Interplay Of Hypertension And White Matter Hyperintensities With Cognition In Chronic Stroke Aphasia, Jade Hannan, Natalie Busby, Rebecca Roth, Janina Wilmskoetter, Roger Newman-Norlund Ph.D., Chris Rorden, Leonardo Bonilha, Julius Fridriksson Ph.D.

Faculty Publications

While converging research suggests that increased white matter hyperintensity load is associated with poorer cognition, and the presence of hypertension is associated with increased white matter hyperintensity load, the relationship among hypertension, cognition and white matter hyperintensities is not well understood. We sought to determine the effect of white matter hyperintensity burden on the relationship between hypertension and cognition in individuals with post-stroke aphasia, with the hypothesis that white matter hyperintensity load moderates the relationship between history of hypertension and cognitive function. Health history, Fazekas scores for white matter hyperintensities and Wechsler Adult Intelligence Scale Matrix Reasoning subtest scores for …

The Acceptability Of Relationship-Centered Communication Partner Training For Couples Impacted By Aphasia: A Mixed Methods Pilot Investigation, Kathryn-Anne Pertab, Tyson G. Harmon, Jonathan Sandberg, Jon L. Pertab, William S. Evans

Faculty Publications

Purpose: This study explored the acceptability and impact of Relationship-Centered Communication Partner Training (RC-CPT) in couples impacted by aphasia. In particular, couples considered whether discussing their relationship roles and responsibilities was important and relevant to the changes they desire. Preliminary quasi-experimental data regarding perceived communication confidence and the marriage relationship were also obtained.

Method: Three couples participated in RC-CPT across two sessions. Surveys were used to measure communication confidence and the marital relationship before and after participation in RC-CPT. The quantitative findings were analyzed using descriptive statistics. Couples also participated in a semi-structured interview about the acceptability of RC-CPT, during …