Abstract/Summary

Background Despite agreement that both discourse production and executive functions are impaired in people with aphasia, very little is known regarding real-time time planning and production of discourse in aphasia or the potential role of executive function abilities. Temporal speech measures, such as duration of pausing and pause location within the discourse structure, also remain poorly understood. Thus, studying pause behaviors in the context of their relationship with measures of executive functioning stands to inform us about the real-time planning and production of discourse. Aim To investigate the relationship between executive functions and discourse production in people with aphasia, using pauses as a reflection of real-time clause planning and clause type and length as measures of offline clause planning. Methods & Procedures People with aphasia (n = 16) produced spoken Cinderella stories and completed several executive function tasks. The stories were coded for clause type (e.g. independent, dependent) and number of words per clause. Using speech analysis software, discourse samples were also coded with respect to the location (between-, within- clauses), number, and duration of pauses. A composite pause behavior measure was derived from duration and number of silent and filled pauses. Similarly, a composite executive function measure was derived from the following tests: Verbal fluency, trail making, Stroop, and digit span. Mixed effects models were used to examine the effect of executive functioning ability on pause behavior, their location, clause type, and clause length (number of words). Outcomes & Results Executive functions were related to pause location such that participants with relatively better executive function (relative to other participants in the sample) produced more pauses between than within clauses; in contrast, the participants with relatively poorer executive function produced more pauses within than between clauses. Participants with better executive function produced more pauses in independent than minor (i.e. erroneous) clauses, while those with poorer executive function produced more pauses in minor than independent clauses. Regarding diversity of clause types, persons with poorer executive function produced more minor clauses than those with better executive function. Executive function ability did not influence number of words in the clause. Conclusions Individuals with relatively higher and lower performance on executive function tasks produced different types of clauses and showed different patterns of pause behavior as a function of clause type.