Discourse analysis in aphasia: A clinical tutorial (Dutta et al., 2025)

Purpose: Spoken discourse is integral to everyday communication; improving discourse outcomes is a primary goal for individuals with aphasia and their families. Consequently, the application of discourse analysis in aphasia assessment and treatment has gained increasing attention in both research and clinical settings. Despite its recognized value among researchers and clinicians, several barriers—such as limited time, inadequate training, and lack of resources—continue to impede the widespread use of discourse analysis into clinical practice. To facilitate its broader adoption, speech-language pathologists require access to comprehensive resources that include information on discourse tasks, outcome measures, psychometric properties, and practical examples of how to implement spoken discourse assessments effectively. The purpose of this tutorial is to equip clinicians with this knowledge, promoting the consistent and effective application of discourse analysis in clinical settings.
Method: This tutorial, developed by members of the FOQUSAphasia Writing Group—comprising both researchers and clinical practitioners—offers an overview of recommended spoken discourse collection and analysis procedures, outcome measures, and their psychometric properties, as well as factors to consider when planning to conduct discourse assessments. It includes a series of case studies (severe aphasia, latent or very mild aphasia, bilingual aphasia, and primary progressive aphasia) that illustrate the utility of discourse analysis for varied clinical contexts and shows how the choice of tasks and measures can reveal meaningful insights tailored to the individual being assessed. In addition, the tutorial provides practical recommendations and considerations for incorporating discourse analysis into clinical aphasia services, along with suggestions for future research.
Conclusions: Spoken discourse production can be an important indicator of communication ability in individuals with aphasia. This tutorial is intended to support clinicians by providing evidence-based, practical ways for integrating discourse analysis into aphasia assessment and treatment. Our collation of information and case studies should encourage clinicians to apply spoken discourse-based approaches, ultimately improving outcomes for individuals with aphasia.
Supplemental Material S1. Reliability and validity evidence supporting the use of spoken discourse variables at different cognitive-linguistic levels.
Supplemental Material S2. Discourse sample excerpts from Cases 3 (Zulfekar) and 4 (James).
Supplemental Material S3. Supplementary references.
Dutta, M., Murray, L. L., Park, H., Burklow, E., Bose, A., Kim, H., Greenslade, K., Ramage, A. E., Combs, C., Balasubramanian, A., & Casilio, M. (2025). Let’s chat about spoken discourse: A tutorial to support use of spoken discourse analysis when providing aphasia clinical services. American Journal of Speech-Language Pathology, 34(4), 1931–1966. https://doi.org/10.1044/2025_AJSLP-24-00534

研究目的：口语语篇（spoken discourse）是日常沟通不可或缺的组成部分；提升语篇表达效果是失语症（aphasia）患者及其家属的核心诉求。因此，语篇分析（discourse analysis）在失语症评估与治疗中的应用，逐渐受到研究与临床领域的广泛关注。尽管研究者与临床医师已认识到其价值，但时间有限、培训不足、资源匮乏等诸多障碍，仍阻碍了语篇分析在临床实践中的普及。为推动其更广泛的应用，言语语言治疗师（speech-language pathologists）需要获取涵盖语篇任务、结局指标、心理测量学特性（psychometric properties），以及有效实施口语语篇评估实操案例的全面资源。本教程旨在帮助临床医师掌握此类知识，促进语篇分析在临床场景中得到一致且高效的应用。

研究方法：本教程由FOQUSAphasia写作小组（FOQUSAphasia Writing Group）成员开发，小组成员兼具研究者与临床从业者双重身份，内容涵盖推荐的口语语篇采集与分析流程、结局指标及其心理测量学特性，以及规划语篇评估时需考量的各类因素。教程包含一系列案例研究（重度失语症、隐匿性或极轻度失语症、双语失语症（bilingual aphasia）、原发性进行性失语症（primary progressive aphasia）），用以说明语篇分析在不同临床场景中的应用价值，并展示如何通过选择合适的任务与指标，为评估对象提供个性化的精准分析结果。此外，本教程还提供了将语篇分析融入失语症临床服务的实操建议与注意事项，以及未来研究方向的相关建议。

研究结论：口语语篇产出可作为失语症患者沟通能力的重要评估指标。本教程旨在为临床医师提供基于证据的实操方法，助力其将语篇分析整合至失语症评估与治疗流程中。我们整理的相关资料与案例研究，应能鼓励临床医师应用基于口语语篇的干预方案，最终改善失语症患者的康复结局。

补充材料S1：支持在不同认知语言学层面使用口语语篇变量的信度（reliability）与效度（validity）证据。
补充材料S2：案例3（祖尔费卡尔）与案例4（詹姆斯）的语篇样本节选。
补充材料S3：补充参考文献。
杜塔（M. Dutta）、默里（L. L. Murray）、朴（H. Park）、伯克洛（E. Burklow）、博斯（A. Bose）、金（H. Kim）、格林斯莱德（K. Greenslade）、拉梅奇（A. E. Ramage）、卡姆斯（C. Combs）、巴拉苏布拉马尼亚姆（A. Balasubramanian）与卡西利奥（M. Casilio）（2025）。《让我们聊聊口语语篇：支持失语症临床服务中口语语篇分析应用的教程》。《美国言语语言病理学杂志》（American Journal of Speech-Language Pathology），34(4)，1931–1966。https://doi.org/10.1044/2025_AJSLP-24-00534