Background
Production-based discourse assessment is an ecologically valid approach for investigating whether PWA have efficient verbal communication skills despite language impairments. A substantial body of research has focused on macro- and micro-linguistic discourse analyses in various languages, predominantly in English, and across different discourse domains, including productivity, informational content, and morphosyntactic elaboration. Besides, cross-linguistic studies have significantly advanced our understanding of aphasia by examining how language-specific structural properties influence the manifestation of linguistic deficits.
Aim
Despite the large number of discourse studies and a growing interest in building databases and automated tools, researchers and clinicians still face difficulties in analysing various aspects of discourse in a systematic and cross-linguistically valid way. To date, there is no unified cross-linguistic core outcome set of discourse measures. Advancing cross-linguistic discourse assessment in aphasia requires addressing theoretical, methodological, and practical challenges to identify and select reliable and valid discourse outcome measures for various languages, considering clinicians’ needs, expectations, and consensus-based directions. This paper addresses the first considerations and challenges for incorporating multi-level, cross-linguistic, and typological perspectives into discourse assessment, with the aim of elaborating a cross-linguistic discourse core outcome set of measures (CLD-COS). Key features of commonly used discourse measures and their cross-linguistic operability are discussed, taking into account potential validity, standardization, and interpretability across languages.
Clinical implications
Clinicians have a limited number of effective production-based measures for discourse assessment applicable across languages. Clinicians and PWA, particularly those in multilingual and multicultural contexts, will benefit from a unified CLD-COS of measures supported by relevant constructs. In light of the considerations regarding discourse analysis across various languages, and the clinical needs reported in recent studies, this discussion represents an initial effort to pinpoint key issues involving multi-level and multi-component discourse analysis methods supported by evidence- and consensus-based practices.
Halima Sahraoui, Silvia Martínez-Ferreiro, Eva Soroli
Disease Category: Neurology
Disease Name: Aphasia
Age Range: 0 - 100
Sex: Either
Nature of Intervention: Any
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