(Kiosk 1) Generality and Utility of Queuing for Functional Conversational Speech in Pure Expressive Aphasia

Case Diagnosis: Left subdural hematoma (SDH)

Case Description or Program Description: A 70 y/o female presented to the ED with right side weakness and slurred speech. She was found to have a left SDH which was evacuated. On admission to acute inpatient rehabilitation strength on the right and LLE was 5/5, 4/5 RUE proximally, 3 distally. On testing by physicians and speech therapy the patient had normal comprehension but moderate expressive aphasia as manifested by significant deficient in production of propositional speech. The patient could repeat phrases normally. Interestingly, she could also continue sequences: Physician “1,2,3,” the patient continued, “4,5,6,…,10”; Physician: “Monday,Tuesday,” patient continued “Wednesday,…,Sunday.” She could count by 2’s to 10 after prompting with “2,4.” The patient was able to read out loud with full comprehension.

Setting: Acute inpatient rehabilitation

Assessment/Results: Speech therapy tested the patient on production of antonyms and synonyms. She produced 10/10 antonyms, e.g., physician: “big (cold),” patient response, “small (hot)”. However, the patient was not able to produce synonyms and appeared flummoxed. Interestingly, when prompted with “sick,” she said, “tired” as an antonym—as in “sick and tired.” When asked what she had for breakfast on morning rounds, the patient produced little speech. However, when queued with “coffee,” she said, “No, tea.”

Discussion (relevance): The ability of queuing and prompting to evoke and invoke useful speech in this patient with pure expressive aphasia seem to be a general, extensive, and widely conversationally and functionally applicable. Patients’ entire vocabulary might be able to be accessed with appropriate/relevant queues or prompts.

Conclusions: Further testing of queuing/prompting to produce functional, conversational speech in patients with (pure) expressive aphasia is warranted. An AI driven app to do this dynamically is under development.