Purpose: Executive function (EF) deficits commonly co-occur with other linguistic and non-linguistic deficits in aphasia. The questions about whether, and to what extent, people with aphasia (PWA) present deficits on different executive functions (EFs) is relatively understudied. Method: In this study, four EFs, set-switching, updating, inhibition, and dual task processing were evaluated in aphasia and healthy groups. Three groups of participants: 30 healthy young, 30 healthy old, and 10 PWA were assessed on four tasks, Colour Trails Test (CTT 1 and 2), Conners’ Continuous Performance Test II (CPT II), n-back (1- and 2-back), and divided attention task that tapped into different EFs. In order to examine performance differences on the EF tasks between the participant groups, repeated measures and multivariate analysis of variances with follow-up pairwise comparisons were computed. Pearson product-moment correlations were conducted to evaluate the strength and direction of the association between aphasia severity (on Western Aphasia Battery-Revised) and executive functioning. Result: PWA demonstrated significantly diminished performance on all EF tasks in comparison to healthy groups and differences were distinct on the higher-level complexity tasks such as the 2-back and CTT 2. The healthy older group demonstrated elevated response times on the CTT, CPT II, and divided attention tasks, and decreased sensitivity scores on the CPT II and n-back in comparison to the younger group. Also, aphasia severity correlated with reduced performance on selective EF measures. Conclusion: This study emphasises the importance of investigating EF deficits in PWA and its potential relationship to language behaviour. Understanding EF is critical for comprehension of linguistic and non-linguistic deficits and in planning treatment for PWA.

Purpose: Despite the growing clinical and research advances in communication sciences and disorders (CSD), health disparities persist by race/ethnicity and socioeconomic status among patients. A diverse CSD workforce can improve access to services and reduce health care disparities for diverse populations. Increasing diversity of the workforce begins with recruiting and training a diverse student body in CSD academic programs. In the absence of relevant literature in CSD, the primary objective of this tutorial is to introduce readers to successful diversity and inclusion programs in health-related disciplines such as nursing, medicine, rehabilitation sciences, public health, and clinical psychology, as well as provide recommendations for developing a racially and ethnically diverse and inclusive CSD academic program. Conclusions: We group the evidence from other health-related academic programs for increasing diversity and inclusion under three headings—(a) recruitment, (b) inclusion, and (c) retention of underrepresented racial and ethnic minority (UREM) students. Based on this information, we have designed the Recruit–Equip–Access–Progress model to illustrate the strategies for a diverse and inclusive CSD training program. We recommend the following for UREM students in this model—(a) developing pipeline programs, institutional partnerships, and holistic admissions reviews; (b) equipping students with academic and financial supports; (c) providing students access to faculty and peer mentors; and (d) evaluating outcomes and processes associated with student and program success. Given the limited literature concerning successful diversity initiatives in our field, we encourage administrators and educators to implement these strategies, systematically evaluate the outcomes, and publish the results for other programs to adopt.

Purpose: Although there are several reports of attention deficits in aphasia, studies are typically limited to a single component within this complex domain. Furthermore, interpretation of results is affected by small sample size, intraindividual variability, task complexity, or nonparametric statistical models of performance comparison. The purpose of this study is to explore multiple subcomponents of attention in persons with aphasia (PWA) and compare findings and implications from various statistical methods—nonparametric, mixed analysis of variance (ANOVA), and linear mixed-effects model (LMEM)—when applied to a small sample size. Method: Eleven PWA and nine age- and education-matched healthy controls (HCs) completed the computer-based Attention Network Test (ANT). ANT examines the effects of four types of warning cues (no, double, central, spatial) and two flanker conditions (congruent, incongruent) to provide an efficient way to assess the three subcomponents of attention (alerting, orienting, and executive control). Individual response time and accuracy data from each participant are considered for data analysis. Results: Nonparametric analyses showed no significant differences between the groups on the three subcomponents of attention. Both mixed ANOVA and LMEM showed statistical significance on alerting effect in HCs, orienting effect in PWA, and executive control effect in both PWA and HCs. However, LMEM analyses additionally highlighted significant differences between the groups (PWA vs. HCs) for executive control effect, which were not evident on either ANOVA or nonparametric tests. Conclusions: By considering the random effect of participant ID, LMEM was able to show deficits in alerting and executive control ability in PWA when compared to HCs. LMEM accounts for the intraindividual variability based on individual response time performances instead of relying on measures of central tendencies.

Purpose: The neural basis of language processing partially overlaps with executive system processing mediated by a network of frontal, parietal, and subcortical areas of the brain, thereby suggesting the significant interaction of executive functioning on linguistic abilities. It is critical that speech language pathologists understand the nature of executive function (EF) and their relationship with respect to speech and language. The purpose of this paper is to analyze the literature and evaluate the role of EF on language processing and deficits in communication disorders. Methods: The following paper is a comprehensive literature review of the existing evidence regarding the influence of EF on language processing in adult neurogenic cognitive-communication disordered populations. The review includes relevant research studies from participants of all age groups and severities published in the last three decades. Results: Research evidence with relevance to major adult neurogenic cognitive-communication disorders including Aphasia, Traumatic Brain Injury, Right Hemisphere Damage, and Parkinson’s Disease are discussed. The paper addresses how the impact may vary with respect to the different components of language (semantics versus discourse pragmatics), different modalities of language (production versus comprehension), as well as complexities of language tasks. Several research studies provide support for the influence of different EF processes such as switching, shifting, inhibition, sequencing, working memory, and processing speed, on language processing in these clinical population. Conclusions: Through the information presented here, professionals, both clinicians and researchers in the field of communication sciences and disorders can gain a thorough knowledge of the interaction of language and executive functioning and a prospect to develop an integrative framework for assessment and intervention of cognitive-communication disorders.

Respiratory and neurological complications in patients in various stages of COVID-19 emphasize the r...

Purpose: This article presents a viewpoint highlighting concerns regarding currently available assessments of working memory in adults with neurogenic communication disorders. Additionally, we provide recommendations for improving working memory assessment in this population.Method: This viewpoint includes a critique of clinical and experimental working memory tests relevant to speech-language pathologists. We consider the terminology used to describe memory, as well as discuss language demands and test construction.Results: Clinical and experimental testing of working memory in adults with neurogenic communication disorders is challenged due to theoretical, methodological, and practical limitations. The major limitations are characterized as linguistic and task demands, presentation and response modality effects, test administration, and scoring parameters. Taking these limitations into consideration, several modifications to working memory testing and their relevance to neurogenic populations are discussed.Conclusions: The recommendations provided in this article can better guide clinicians and researchers to advocate for improved tests of working memory in adults with neurogenic communication disorders. Future research should continue to address these concerns and consider our recommendations.