Self-initiated self-repairs of connected speech and novel vocabulary learning during the first year of recovery from aphasia: four longitudinal case studies

Background: Self-initiated self-repair of problems in speech production has been suggested to be associated with aphasia treatment gains and recovery, but the topic has been little studied. Similarly, the ability to learn novel words has been associated with anomia treatment benefits, although longitudinal data on such learning is lacking. Aims: The present study’s aim was to examine whether and how self-initiated self-repairs in connected speech and the ability to learn novel vocabulary reflected recovery from aphasia as measured with cognitive-linguistic tests. Additionally, our aim was to explore whether self-initiated repair and novel word learning changed in parallel during recovery. Methods & Procedures: Four people with aphasia (PWA) (2 anomic, 1 Wernicke, and 1 global aphasia) were tested in the subacute (11 to 68 days post stroke) and chronic (12 months post stroke) phases of recovery with cognitive-linguistic tests, connected speech tasks, and a computerized learning task. In the learning task, PWA associated 6 pseudowords with 6 unfamiliar referents. The associations were learned from an ambiguous setup with feedback. At both time points, learning was measured as correct immediate recognition of the items and recognition maintenance one week post-training. The proportion of self-initiated self-repairs and the proportion of unrepaired problems in connected speech were used as measures of self-repair behavior. Outcomes & Results: All participants initiated self-repairs both in the subacute and chronic phases, and their self-repairs were most often related to aphasic difficulties in speech production. Between the subacute and chronic phases, self-repairs changed both in quality and quantity. The proportion of self-repair elements decreased in 4/4 participants and the proportion of unrepaired problem segments decreased in 3/4 participants. Of the participants, 3/4 showed significant novel word learning and/or maintenance already in the subacute phase and 4 /4 in the chronic phase. Conclusion: Reduction in self-initiated self-repairs of speech reflected recovery from aphasia. Novel word learning improved during aphasia recovery from the subacute to the chronic phase. Novel word learning was possible even in subacute, severe aphasia and even in an ambiguous task set-up with no explicitly provided word-referent connections. Novel word learning and self-initiated self-repairs did not change in a clearly parallel manner; however, these findings need to be tested with a larger sample.