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Writing personal narratives with aphasia

Authors Charlotte Johansson
Lena Hartelius
Åsa Wengelin
Ingrid Behrns
Published in Stem-, Spraak- en Taalpathologie. 16th International Science of Aphasia Conference. Sept. 17-22 2015, Aveiro, Portugal.
Volume 20
Issue 1
Pages 67-69
ISSN 0924-7025
Publication year 2015
Published at Department of Swedish
Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Pages 67-69
Language en
Keywords aphasia, writing process, narrative
Subject categories Logopedics and phoniatrics


Aphasia is an acquired language disorder most often caused by stroke. It can entail difficulties finding words, formulating sentences and understanding spoken language. In most individuals with aphasia, the ability to read and write is affected. Given the increasing importance of reading and writing in modern society, both professionally and socially, this significantly reduces their quality of life and their participation in daily life. Most research into aphasia and writing has examined writing and spelling at word level only. To obtain a full picture of someone’s writing ability, not only the final text but also the process leading up to it must be studied. Keystroke-logging software allows text production to be studied as it unfolds in real time. This makes it possible to analyse writing behaviour based on, for example, patterns of pauses and revisions. The present study is part of a larger study to investigate aphasia and the writing process with a focus on syntax in written narratives. Methods Participants The participants were 18 adults (fourteen men and four women aged 53–92) with post-stroke aphasia, recruited through speech and language pathologists and local aphasia associations. Besides the presence of post-stroke aphasia, the criteria for inclusion were for the participants to be adults with Swedish as their first language. The exclusion criterion was a history of developmental reading and writing impairment or any other neurological disabilities that could affect participation in the study. There was also a reference group whose participants did not suffer from stroke or aphasia but were otherwise selected using the same inclusion and exclusion criteria as the participants in the aphasia group. The participants wrote their personal narratives on computers. Data were collected using the ScriptLog keystroke-logging software. The topic for the narrative was, ‘The last time I made someone happy’, which was written on the screen as memory support. There was no time limit for the writing task. A researcher was present during the writing but did not in any way elicit or influence the writing or typing. The subsequent analyses were based on the following parameters: total time on task; active writing time as a percentage of total time on task; number of pauses within words; number of words in the final text; and number of spelling mistakes. The results were compared with the (preliminary) results of the reference group. Results The analysis of 18 participants’ narratives showed that writing is a far more time-consuming task for the participants with aphasia than for those without. The participants with aphasia produced significantly shorter narratives but spent significantly more time on the task, meaning that their percentage of active writing time was significantly lower than that of the reference group. Further, the number of pauses within words was significantly higher for the participants with aphasia. Frequent pausing within words may indicate that a writer lacks automatised spelling ability. The writers with aphasia made few revisions, or none at all, and they made mainly local revisions (where the cursor is not moved across several words, sentences or paragraphs). The participants in the reference group, by contrast, made more revisions, and these were more likely to be long-distance ones. Finally, the narratives produced by the participants with aphasia contained few spelling mistakes. Discussion The results illustrate the difficulties faced by people with aphasia when writing narratives. To them, this is a time-consuming and effortful task. The narratives written by the participants with aphasia are conspicuously short compared with those of the reference group. The finding that the narratives produced by the people with aphasia generally have good spelling further emphasises the importance of examining the entire writing process rather than just the final text when it comes to people with aphasia. It should be added that a dictation task (which has been used in earlier research) does not seem to reveal the difficulties with functional writing that are apparent in a narrative task. Many of the participants commented themselves that spelling took so much effort that they tended to ‘lose track’ and found it difficult to complete the narrative task.

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