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In Brief...

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Accent on aphasia
Caroline Newton and Carolyn Bruce draw attention to the practical implications of research which suggests that an unfamiliar accent can have a subtle but significant effect on comprehension in people with aphasia, and possibly other communication difficulties too. ne consequence of the rise in immigration and internal migration in the UK in recent years is that listeners frequently encounter speakers with different accents. In the NHS a culturallydiverse health workforce is beneficial in many ways, not least in providing a shared language and background for the range of patients receiving care; but there may be challenges too. Research amongst adults with no communication or cognitive difficulties has shown that an unfamiliar accent has a detrimental effect on comprehension, and that listeners have greater difficulty with foreign accents than with regional accents (Adank et al., 2009). A similar pattern of difficulty has been observed in adults with aphasia (Dunton et al., 2011). If such an individual has difficulty understanding someone with a different accent, this may have significant implications for their rehabilitation and participation in the community. This study involved 12 adults with chronic aphasia, due to a dominant hemisphere stroke, with an average age of 60 years. The participants presented with a wide range of communication difficulties and levels of severity. We asked them to listen to six narratives from the Discourse Comprehension Test (Brookshire & Nicholas, 1997) prior to answering eight yes-no questions for each story. Three stories were presented in a standard accent familiar to all the listeners (Southern Standard British English), and three in an unfamiliar Glaswegian accent. The questions were presented in Southern Standard British English. We found no difference in participants overall performance on the task between the familiar and unfamiliar accents. This is unsurprising, given previous accent research with people with aphasia, where significant difficulties in comprehension tasks have only been observed for foreign accents. It is also possible that listeners linguistic and world knowledge and the context provided in the narratives aided comprehension in the task. However, we did observe an effect of accent in an analysis of the type of information required by the questions: the participants made significantly more errors on questions tapping implied information (which has to be inferred from other information in the narrative) than those drawing on stated information (which is given in the narrative) in the unfamiliar accent. No such difference was found for the narratives in the familiar accent. These findings pose challenges for speech and language therapists, and all those who work with people with aphasia. Although regional accents may not cause the same level of comprehension difficulty as a foreign accent, our research shows that problems with some unfamiliar accents may only become evident with increasing processing demands. For example, the increased demands of an unfamiliar accent combined with complex information may be particularly problematic for people with aphasia. There may also be implications for work with other client groups: for example, there is some evidence that children with speech difficulties (Nathan & Wells, 2001) as well as people with dementia (Mahendra et al., 1999) also have particular difficulty understanding information presented in an unfamiliar accent. Speech and language therapists therefore need to be aware of the possible impact that their own accent, as well as others, may have on the performance of clients and be able to make adjustments to clients assessment and management. Adjustments might include involving a familiar-accented speaker in the assessment process, using recorded materials that expose the client to a range of accents within the therapy sessions, and making a recording of therapy materials by a family member. Caroline Newton (email and Carolyn Bruce are lecturers at University College London.
References Adank, P., Evans, B., Stuart-Smith, J. & Scott, S.K. (2009) Comprehension of familiar and unfamiliar native accents under adverse listening conditions, Journal of Experimental Psychology: Human Perception and Performance 35, pp.520-529. Brookshire, R.H. & Nicholas, L.E. (1997) Discourse Comprehension Test (2nd edn.) New Mexico: PICA Programs. Dunton, J., Bruce, C. & Newton, C. (2011) Investigating the impact of unfamiliar speaker accent on auditory comprehension in adults with aphasia, International Journal of Language & Communication Disorders 46(1), pp.63-73. Mahendra, N., Bayles, K.A. & Tomoeda, C.K. (1999) Effect of an unfamiliar accent on the repetition ability of normal elders and individuals with Alzheimers disease, Journal of Medical SpeechLanguage Pathology 7, pp.223230. Nathan, L. & Wells, B. (2001) Can children with speech difficulties process an unfamiliar accent?, Applied Psycholinguistics 22, pp.343361.

So many journals, so little time! Editor Avril Nicoll gives a brief flavour of articles that have got her thinking.

In recent years we have become increasingly aware of laryngopharyngeal reflux, its influence on the voice and the available drug treatment to complement our intervention. Randhawa, Mansuri & Rubins Is dysphonia due to allergic laryngitis being misdiagnosed as laryngopharyngeal reflux? is a timely and well-constructed reminder to keep thinking critically to avoid clients receiving treatment that is inappropriate, ineffective and potentially harmful. The authors note the small sample size of 15 and plan to take their initial results to a full-scale study. As they say, The clinical applicability would be massive, as it would lead to a change in the trend of current practice (p.4). Logopedics Phoniatrics Vocology (2010) 35, pp.1-5 In Imitation therapy for non-verbal toddlers, Gill, Mehta, Fredenburg & Bartlett are to be commended for their patience in conducting a study that took 7 years to get a series of 5 participants, and spanned two editions of the Preschool Language Scale! Thorough information is included about the rationale for the therapy, how it was conducted and the results. These support the authors conclusion that the outcome was encouraging (p.104) and give sufficient detail to enable readers to consider using the approach. It was therefore a real shame to then be told that, Whether the participants in this study eventually produced normal language is unknown at this time (p.106). Child Language Teaching & Therapy (2011) 27(1), pp.97-108 Regular readers will know I am exercised by what can be problematic relationships between speech and language therapists and educational psychologists. I hope McConnellogues Professional roles and responsibilities in meeting the needs of children with speech, language and communication needs: joint working between educational psychologists and speech and language therapists will be read by our profession too. She argues for commissioning of protocols and procedures for interagency working, particularly the sharing of information (p.60), as Ultimately it was concerns about sharing information without prior consent...which prevented the development of a communication system between EPs and SLTs as a result of the current pilot study (p.61). Practical steps for individual professionals are also suggested. Educational Psychology in Practice (2011) 27(1), pp.53-64