Article

Speech-language pathologists considering the use of gesture as a therapeutic modality for clients with aphasia must first evaluate the integrity of their cleints' gesture systems. Questions arise with respect to which behaviours to assess and how to assess the chosen behaviours. There has been a long-held belief that tests of limb apraxia and pantomime provide valid information about candidacy for gesture-based interventions, yet the theoretical and empirical basis of this assumption is limited. Further, the relationship between conversational gesture skill and limb apraxia in co-occurring aphasia has been largely unexplored. It is possible that a client's gesture performance in natural conversation provides more valid information about gesture treatment candidacy than do tests of limb apraxia. Aims: This study aimed to investigate the relationship between the presence of limb apraxia and conversational gesture use in speakers with nonfluent aphasia. Following the assumption that limb praxis and conversational gesture reflect differing underlying processing, it was hypothesised that speakers with aphasia and limb apraxia would produce the full range of conversational gesture types in a conversational context. Further, it was hypothesised that speakers with demonstrated pantomime deficits on formal tests of pantomime would produce pantomimes naturally in conversation. Thus, a dissociation would be demonstrated between the processing responsible for gesture production as measured in limb apraxia tests and that subserving the production of conversational gesture. Methods & Procedure: Seven participants with nonfluent aphasia and ideomotor and conceptual limb apraxia conversed in a semi-structured conversation with the researcher. All arm and hand gestures produced by the participants were counted and rated according to guidelines provided by Hermann, Reichle, and Lucius-Hoene (1988), and the time they spent in either gesture or spoken expression was compared. Correlations were calculated between limb apraxia scores and proportions of meaning-laden gestures used in conversation. Outcomes & Results: All seven participants produced a wide range of gesture types. Participants with limited verbal output produced large amounts of meaning-laden gesture. Importantly, even participants with severe limb apraxia produced high proportions of meaning-laden gestures (codes and pantomimes) in the natural setting. There were no significant relationships found between scores on limb apraxia tests and natural gesture use. Conclusions: Patients with nonfluent aphasia and limb apraxia may still use meaningful conversational gesture in naturalistic settings. Tests of limb apraxia may be poor predictors of use of lexical gesture. Thus, clinicians are advised to sample lexical gesture use in spontaneous interactions.

Langue : ANGLAIS

Tiré à part : OUI

Identifiant basis : 2003227116