Thin Versus Thick Description: Analyzing Representations of People and Their Life Worlds in the Literature of Communication Sciences and Disorders Purpose Evidence-based practice relies on clinicians to translate research evidence for individual clients. This study, the initial phase of a broader research project, examines the textual resources of such translations by analyzing how people with acquired cognitive-communication disorders (ACCD) and their life worlds have been represented in Communication Sciences and ... Supplement Article
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Supplement Article  |   November 01, 2015
Thin Versus Thick Description: Analyzing Representations of People and Their Life Worlds in the Literature of Communication Sciences and Disorders
 
Author Affiliations & Notes
  • Julie A. Hengst
    University of Illinois at Urbana–Champaign
  • Suma Devanga
    University of Illinois at Urbana–Champaign
  • Hillary Mosier
    University of Illinois at Urbana–Champaign
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Julie A. Hengst: hengst@illinois.edu
  • Editor: Anastasia Raymer
    Editor: Anastasia Raymer×
  • Associate Editor: Emma Power
    Associate Editor: Emma Power×
Article Information
Hearing Disorders / Normal Language Processing / Language Disorders / Aphasia / Attention, Memory & Executive Functions / Supplement: Select Papers From the 44th Clinical Aphasiology Conference
Supplement Article   |   November 01, 2015
Thin Versus Thick Description: Analyzing Representations of People and Their Life Worlds in the Literature of Communication Sciences and Disorders
American Journal of Speech-Language Pathology, November 2015, Vol. 24, S838-S853. doi:10.1044/2015_AJSLP-14-0163
History: Received September 16, 2014 , Revised February 6, 2015 , Accepted April 10, 2015
 
American Journal of Speech-Language Pathology, November 2015, Vol. 24, S838-S853. doi:10.1044/2015_AJSLP-14-0163
History: Received September 16, 2014; Revised February 6, 2015; Accepted April 10, 2015

Purpose Evidence-based practice relies on clinicians to translate research evidence for individual clients. This study, the initial phase of a broader research project, examines the textual resources of such translations by analyzing how people with acquired cognitive-communication disorders (ACCD) and their life worlds have been represented in Communication Sciences and Disorders (CSD) research articles.

Method Using textual analysis, we completed a categorical analysis of 6,059 articles published between 1936 and 2012, coding for genre, population, and any evidence of thick representations of people and their life worlds, and a discourse analysis of representations used in 56 ACCD research articles, identifying thin and thick representations in 4 domains (derived from the International Classification of Functioning, Disability, and Health) and across article sections.

Results The categorical analysis identified a higher percentage of ACCD articles with some evidence of thick representation (30%) compared with all CSD articles (12%) sampled. However, discourse analysis of ACCD research articles found that thick representations were quite limited; 34/56 articles had thin representational profiles, 19/56 had mixed profiles, and 3/56 had thick profiles.

Conclusions These findings document the dominance of thin representations in the CSD literature, which we suggest makes translational work more difficult. How clinicians translate such evidence will be addressed in the next research phase, an interview study of speech-language pathologists.

Recently in the student room at our university's speech-language pathology clinic, one of us (Hengst) noticed a poster on the wall characterizing elements of evidence-based practice for clinicians. 1   In the center was a triangle with “evidence” in the middle; “client performance and values” ran down the left side, “clinical judgment” down the right, and “empirical research” along the base of the triangle. Scattered around the triangle in the background were statements reminding clinicians that they should attend to all three sides of the triangle, look for evidence to support treatment decisions, use a dynamic client-centered approach, and interpret research in relation to the individual client. It was our interest in understanding this last responsibility—how clinicians interpret empirical research in planning treatments for specific individuals—that led us to develop a research program designed to systematically examine the translational resources and practices of our field.
We were particularly interested in the relationship between how the research literature represents people with acquired cognitive-communication disorders (ACCD) and how clinicians then interpret and translate this evidence for individual clients functioning in specific contexts (e.g., families, community, workplaces). We suspect that there is a tension between the categorical and abstract representations typical of population-based accounts of ACCD and the development of evidence-based treatment plans designed to meet the unique needs of individual clients. To explore this possible tension, we planned our research on the translational practices within Communication Sciences and Disorders (CSD) in two phases. The initial phase, reported here, was designed to characterize with greater precision how people with ACCD and the everyday communicative contexts of their life worlds have been represented in the research literature of the field. The next phase will draw on these initial findings to interview practicing clinicians about how they interpret and use the research literature as evidence for designing clinical interventions. Reporting on the first phase of the research, this article considers how individuals with communicative disorders (and particularly with ACCD) have been represented in research articles in CSD journals.
Background
Case studies documenting patterns of cognitive, linguistic, and physical disruptions experienced by individuals with brain damage have been a key basis of theory and research on the brain and communication disorders over the past 150 years. Narratives of discovery in neuropsychology are typically written around hallmark cases such as Broca's descriptions of “Tan” (e.g., Selnes & Hillis, 2000); the case of Phineas Gage (e.g., Damasio, 1994); or patient “H.M.” in the literature on amnesia (e.g., Manns, 2004). Some key figures in neuropsychology have stressed the value of case studies for making generalizable knowledge in the field. Arguing for the critical role of rich case studies in developing scientific accounts of brain-behavior relations, Luria (1968, 1972)  and Sacks (1970, 1984)  have both offered rich, clinical narratives, providing thick descriptions of the impacts of brain injuries on the lives of individuals. In addition, the fit of individual cases with current diagnostic categories has been assessed in order to evaluate theoretical frameworks (e.g., Duff, Wszalek, Tranel, & Cohen, 2008).
More recently, the research literature in CSD has also been driven by the goal of building population-based knowledge, leading clinicians and researchers to argue for specifying diagnostic categories, and standardizing subject descriptions in research reports (e.g., McNeil & Pratt, 2001; Myers, 2001). Our sense was that the growing orientation to population-based perspectives has led the CSD research literature to shift increasingly to thinner, more categorical descriptions of research participants with much less attention to thick descriptions of clinical cases. In any case, to more systematically describe the research literature, we have undertaken an extensive textual analysis designed to characterize patterns of thin and thick representation of persons with ACCD in the research literature from 1936 to 2012 and how those patterns fit into the broader CSD literature of this period.
Thick Versus Thin Descriptions
Thick description is a term that is often central to discussion of the goals of qualitative research methods and case studies. The notion of thick description is grounded in the anthropologist Clifford Geertz's (1973)  adaptation of Gilbert Ryle's philosophical account of thick description. Geertz argued that the study of cultures is fundamentally an interpretive process that requires thick description of social behaviors, structures, and activities. For Geertz, thick description requires researchers not only to describe an action, such as briefly contracting one's right eyelid, but to interpret that action as a blink, a twitch, or a wink, the latter perhaps deployed conspiratorially, in parody, in rehearsal, or for deception. In this way, thick description integrates behavioral details of social interactions with dynamic cultural patterns in order to animate specific actions with meaning. In contrast thin description attends to isolated dimensions of interactions, such as basic observational protocols (e.g., contracting one's right eyelid), and to classifications from predetermined categories and stable models (e.g., grammatical rules). Marcus (1998)  argued that thin accounts of behavior, driven by theoretical frameworks unanchored from details of people's lives, limit “the space of potential discovery” and reduce the depth of our understanding of complex “processes and relationships in the world (which require a bedrock of very thick description indeed)” (p. 18).
We would argue that clinical reasoning about individual cases involves a specialized form of thick description that requires an understanding of clients' (dis)abilities in relation to the activities and practices of their everyday life worlds. Thus, we suspect that research evidence that includes thick description—evidence that is closer to the complexity of those life worlds—will more closely resemble the problem space that clinicians face as they translate research for specific clinical cases. The next phase of the research will investigate the process of translation more directly. For the current study, we have adapted these notions of thick and thin description to analyze the representations of people and their social worlds in the research literature of CSD. We have identified thin representations as ones characterized by decontextualized models or frameworks, usually oriented to identifying central tendencies and focused on demographic and disciplinary categories. In contrast, thick representations are those that include contextualized, dynamic, and interpretive accounts, often including more personalized representations of people and their social worlds.
Characterizing the Research Literature
If the research literature in CSD has been increasingly oriented to making population-based knowledge (e.g., specifying diagnostic categories and standardizing subject descriptions in research reports), then we would expect research reports to primarily use thin representations of people. We anticipated that even case study research designs would use thin descriptions when relating findings to the broader literature. We also expected, as is typical of medical and allied health professions more broadly, that clinical case reports would be used primarily to exemplify diagnostic and treatment practices. Although such case reports are more often included in textbooks (e.g., Lesser & Perkins, 1999; Tanner, 2006), we anticipated that researchers might also use case exemplars in certain sections of research reports. Thus, a key aim of our analysis was to identify how and where representations of individuals with ACCD appeared in the common genres (e.g., research reports, clinical case reports, and review articles) and research paradigms (e.g., experimental studies, discourse analysis, and case studies) of the CSD research literature.
In this article, we examine the representations of people with ACCD and their social worlds, and we consider how they fit with such representations in the broader CSD research literature. Analyzing articles in five research journals across eight decades, this study has three broad aims:
  1. to characterize the CSD literature over the past 80 years by identifying the total number of peer-reviewed articles, the types or genres of articles published, and the number of articles with any evidence of thick representation of people (e.g., detailed descriptions of people and/or their life worlds);

  2. to characterize the subset of CSD literature researching ACCD by identifying the number of ACCD research articles, the types of research designs used, and the number of ACCD articles with any evidence of thick representation of people (e.g., detailed descriptions of people and/or their life worlds); and

  3. to detail how people with ACCD and their life worlds are represented through closer discourse analysis of a small sample of research articles (the majority addressing issues of ACCD) by identifying specific examples of thin and thick representation across all article sections (e.g., background, method, results, discussion), and the overall representational profile for each article.

Method
The textual analysis used in this study draws on methodologies from genre studies (e.g., Atkinson, 1999; Bazerman, 1988), science studies (e.g., Coopmans, Vertesi, Lynch, & Woolgar, 2014; Mol, 2002), and text linguistics (e.g., Biber & Conrad, 2009). The design supports an analysis of the representations of people and their life worlds in the CSD research literature, with a particular interest in representations of people with ACCD, such as aphasia, right hemisphere disorder, traumatic brain injury, dementia, primary progressive aphasia, and so on. Our research team included the lead investigator (Hengst), three funded graduate research assistants (Devanga, Mosier, Sherrill), and eight undergraduate student research assistants enrolled for independent study credit (see Acknowledgments). The study involved selecting target CSD journals and completing two analyses: a categorical analysis of all articles and a discourse analysis of a core set of research articles. The procedures for journal selection and the two analyses are described below.
Journal Selection
Our goal was to select journals central to CSD, including those that specialize in (or routinely include research on) ACCD, that had long and early publication histories, as well as ones currently in publication, and that we had full access to (electronically or in print). We settled on the following five journals.
  1. The Journal of Speech and Hearing Disorders (JSHD), published by the American Speech-Language-Hearing Association (ASHA) from 1936 to 1990 (a total of 217 issues in 55 volumes).

  2. The American Journal of Speech-Language Pathology (AJSLP), launched by ASHA in 1991 to replace JSHD (a total of 83 issues in 22 volumes as of 2013).

  3. The Journal of Speech and Hearing Research (JSHR), launched by ASHA in 1958 and currently published as the Journal of Speech, Language, and Hearing Research (JSLHR; a total of 260 issues in 56 volumes as of 2013).

  4. The British Journal of Disorders of Communication (BJDC, 1966–1991), launched by the Royal College of Speech and Language Therapists in 1966, renamed the European Journal of Disorders of Communication (EJDC, 1992–1997), and currently published as the International Journal of Language and Communication Disorders (IJLCD, 1998–present; a total of 162 issues in 49 volumes as of 2013).

  5. Aphasiology, a Routledge publication launched in 1987 (a total of 276 issues in 27 volumes as of 2013).

Analysis 1: Categorical Description of Peer-Reviewed Articles
The categorical analysis addresses the first two aims of the study, to characterize the CSD literature broadly and the subset of research articles focusing on ACCD specifically. Given the large number of articles in these journals, we decided to undertake analysis of just over half of all articles published per decade (between 1936 and 2012) for each of these five journals. To sample the literature systematically, we selected all articles published in even-numbered volumes for full decades of publication by each journal and in all volumes for partial decades of publication. If even-numbered volumes were not fully available to us, we filled in with an equal number of issues from odd-numbered volumes. Our sampling identified a total of 6,059 peer-reviewed articles for categorical analysis. Table 1 lists the total number of articles sampled per decade per journal. Across the first six decades (1936–1989), the number of articles published per year increased steadily; as a result, over half of our sample was published between 1990 and 2012. This change reflected an increase in both the number of journals in operation and the number of articles published per year in each journal. For example, in the 1940s only one of our five target journals was in operation, and we identified only 187 articles in the 5 years we sampled that decade. In contrast, in the 1990s, which was the peak decade of our sample, four of the journals were in operation, and we identified 1,335 articles for review in the 5 years sampled.
Table 1. Sample set for categorical analysis of Communication Sciences and Disorders (CSD) literature. The total number of articles reviewed are listed by journal and decade. This sample is just over half of all articles published in these journals.
Sample set for categorical analysis of Communication Sciences and Disorders (CSD) literature. The total number of articles reviewed are listed by journal and decade. This sample is just over half of all articles published in these journals.×
Decade JSHD AJSLP JSHR/JSLHR BJDC/EJDC/IJLCD Aphasiology Totals
1930s 104 a 104
1940s 187 187
1950s 181 77 a 258
1960s 198 270 80 a 548
1970s 268 352 86 706
1980s 254 374 95 190 a 913
1990s 175 a 614 263 283 1,335
2000s 157 521 148 310 1,136
2010s 102 a 366 a 152 a 252 a 872
Totals 1,192 434 2,574 824 1,035 6,059
Note. JSHD = Journal of Speech and Hearing Disorders; AJSLP = American Journal of Speech-Language Pathology; JSHR/JSLHR = Journal of Speech and Hearing Research/Journal of Speech, Language, and Hearing Research; BJDC/EJDC/IJLCD = British Journal of Disorders of Communication/European Journal of Disorders of Communication/International Journal of Language and Communication Disorders.
Note. JSHD = Journal of Speech and Hearing Disorders; AJSLP = American Journal of Speech-Language Pathology; JSHR/JSLHR = Journal of Speech and Hearing Research/Journal of Speech, Language, and Hearing Research; BJDC/EJDC/IJLCD = British Journal of Disorders of Communication/European Journal of Disorders of Communication/International Journal of Language and Communication Disorders.×
a Partial decades.
Partial decades.×
Table 1. Sample set for categorical analysis of Communication Sciences and Disorders (CSD) literature. The total number of articles reviewed are listed by journal and decade. This sample is just over half of all articles published in these journals.
Sample set for categorical analysis of Communication Sciences and Disorders (CSD) literature. The total number of articles reviewed are listed by journal and decade. This sample is just over half of all articles published in these journals.×
Decade JSHD AJSLP JSHR/JSLHR BJDC/EJDC/IJLCD Aphasiology Totals
1930s 104 a 104
1940s 187 187
1950s 181 77 a 258
1960s 198 270 80 a 548
1970s 268 352 86 706
1980s 254 374 95 190 a 913
1990s 175 a 614 263 283 1,335
2000s 157 521 148 310 1,136
2010s 102 a 366 a 152 a 252 a 872
Totals 1,192 434 2,574 824 1,035 6,059
Note. JSHD = Journal of Speech and Hearing Disorders; AJSLP = American Journal of Speech-Language Pathology; JSHR/JSLHR = Journal of Speech and Hearing Research/Journal of Speech, Language, and Hearing Research; BJDC/EJDC/IJLCD = British Journal of Disorders of Communication/European Journal of Disorders of Communication/International Journal of Language and Communication Disorders.
Note. JSHD = Journal of Speech and Hearing Disorders; AJSLP = American Journal of Speech-Language Pathology; JSHR/JSLHR = Journal of Speech and Hearing Research/Journal of Speech, Language, and Hearing Research; BJDC/EJDC/IJLCD = British Journal of Disorders of Communication/European Journal of Disorders of Communication/International Journal of Language and Communication Disorders.×
a Partial decades.
Partial decades.×
×
Coding Categories
For each issue analyzed, all peer-reviewed articles were identified and counted, then each was categorized by (a) genre type (i.e., review, research, pedagogy, or other); (b) target population or disorder addressed (i.e., ACCD, school-age language and social pragmatic disorders, stuttering/voice disorders, motor-speech disorders, or other), and (c) any evidence of thick representations of people in the article, particularly of participants or clients (e.g., mention of social validity, anecdotes about participants' lives, participants' responses to treatment or research tasks, transcripts or quotations from clients or participants, descriptions of home or community environment). We coded all research articles by type of research design (i.e., group experimental or quasi-experimental; single-subject experimental design; descriptive, interpretive, and clinical case studies; survey studies; or longitudinal and mixed studies).
Consensus Coding Procedures
Each journal was assigned to a coding team (two to four research assistants per team), and each issue was assigned to a primary coder on that team. The primary coder initially identified and read all peer-reviewed articles in the issue and documented her preliminary coding decisions by hand on the data sheet for each article. A second coder (one of the authors) reviewed all preliminary coding decisions, and the two coders discussed and resolved any discrepancies. To promote consistency across teams and to continually refine the coding in light of the growing (and changing) body of texts, the full research team met regularly to discuss and update coding protocols, discuss current articles being coded by the team, and, when needed because of updates, to recode previously coded articles. Final coding decisions for all articles per issue were tabulated and recorded on a spreadsheet for each journal. The spreadsheets were then used to generate descriptive statistical analysis of coding counts and percentages.
Analysis 2: Discourse Analysis of Representations of People With ACCD in Research Articles
The discourse analysis addressed the third study aim by detailing ways representations of individuals with ACCD and their life worlds were included in different sections (e.g., background, method, results, discussion) of research reports devoted to these populations. To sample across journals, decades, and research paradigms, we selected 56 articles by using the following criteria on the basis of the categorical analysis: a minimum of four articles per decade, a minimum of two articles per journal each decade, and at least one article from all research paradigms. In addition, given our particular interest in understanding uses of thick description in different research genres, we decided to aim for a 3:1 ratio of articles coded as having any evidence of thick representation to those coded as having no evidence of thick representation. The 56 articles selected for this analysis are listed in the Appendix. The majority report research related to aphasia (44/56), with the remaining reporting research on apraxia of speech, traumatic brain injury, dementia, primary progressive, or other related disorders. Also, 41/56 of the research reports had been coded as containing some evidence of thick representations of people.
To guide the detailed discourse analysis of representations of individuals with ACCD and their life worlds, we adapted categories from the biopsychosocial framework of the International Classification of Functioning, Disability and Health (ICF; World Health Organization, 2002). We searched the text of each article for representations of (a) people and their identities, (b) body structures/functions, (c) people's activities and participation, and (d) people's internal (e.g., moods, motivations) and social (e.g., networks, barriers, supports in the community) contexts. Representations oriented primarily to static demographic and disciplinary categories were coded as thin representations, whereas representations primarily oriented to contextualized and individual perspectives or interpretations were coded as thick representations (see Table 2).
Table 2. Descriptions of thin and thick representations of people and their life worlds, across four International Classification of Functioning, Disability and Health (ICF)-derived domains, used to guide discourse analysis of 56 core acquired cognitive-communication disorders (ACCD) research articles.
Descriptions of thin and thick representations of people and their life worlds, across four International Classification of Functioning, Disability and Health (ICF)-derived domains, used to guide discourse analysis of 56 core acquired cognitive-communication disorders (ACCD) research articles.×
Domain Thin representations Thick representations
(A) People/identities Labels on the basis of ability, demographic category, generic roles Personally meaningful labels (names, initials, pseudonyms) and social roles and relationships
(e.g., aphasic subjects; nonaphasic group; ID#) (e.g., Mary; her son)
(B) Body structures/functions Informal and formal assessments (medical, behavioral) of deficits and strengths using professional terminology People's accounts of their experiences and evaluations of their abilities, in personal terms
(e.g., left middle cerebral artery infarct; impaired auditory comprehension) (e.g., participant reports he can't remember names of places)
(C) Activities/participation Informal and formal assessments of target abilities, communication needs, and patterns of participation in specific activity domains People's accounts in their own experiences, abilities, communication needs, and patterns of participation in their everyday activities
(e.g., assessment of ADLs) (e.g., family's collaborative effort; “getting back to playing golf”; life story, ambitions)
(D) Internal/social contexts Informal and formal assessments and reports, in disciplinary terms, of people's internal states, and social barriers or supports People's accounts in personal terms of their internal states and social barriers or supports
(e.g., quantifying and measuring anxiety and depression; access to AAC device) (e.g., Mary uses her device at a coffee house every morning)
Note. ID = identification; ADL = activities of daily living; AAC = augmentative and alternative communication.
Note. ID = identification; ADL = activities of daily living; AAC = augmentative and alternative communication.×
Table 2. Descriptions of thin and thick representations of people and their life worlds, across four International Classification of Functioning, Disability and Health (ICF)-derived domains, used to guide discourse analysis of 56 core acquired cognitive-communication disorders (ACCD) research articles.
Descriptions of thin and thick representations of people and their life worlds, across four International Classification of Functioning, Disability and Health (ICF)-derived domains, used to guide discourse analysis of 56 core acquired cognitive-communication disorders (ACCD) research articles.×
Domain Thin representations Thick representations
(A) People/identities Labels on the basis of ability, demographic category, generic roles Personally meaningful labels (names, initials, pseudonyms) and social roles and relationships
(e.g., aphasic subjects; nonaphasic group; ID#) (e.g., Mary; her son)
(B) Body structures/functions Informal and formal assessments (medical, behavioral) of deficits and strengths using professional terminology People's accounts of their experiences and evaluations of their abilities, in personal terms
(e.g., left middle cerebral artery infarct; impaired auditory comprehension) (e.g., participant reports he can't remember names of places)
(C) Activities/participation Informal and formal assessments of target abilities, communication needs, and patterns of participation in specific activity domains People's accounts in their own experiences, abilities, communication needs, and patterns of participation in their everyday activities
(e.g., assessment of ADLs) (e.g., family's collaborative effort; “getting back to playing golf”; life story, ambitions)
(D) Internal/social contexts Informal and formal assessments and reports, in disciplinary terms, of people's internal states, and social barriers or supports People's accounts in personal terms of their internal states and social barriers or supports
(e.g., quantifying and measuring anxiety and depression; access to AAC device) (e.g., Mary uses her device at a coffee house every morning)
Note. ID = identification; ADL = activities of daily living; AAC = augmentative and alternative communication.
Note. ID = identification; ADL = activities of daily living; AAC = augmentative and alternative communication.×
×
Discourse analysis was completed on each article. The analysis involved the researcher first reading the entire article and recording all major headings used (e.g., background, method, results, discussion), then searching each section for examples of thin and thick representations of individuals with ACCD. Thus, the discourse analysis presented a profile of the types of representations of people with ACCD and their life worlds used in each article.
Results
This section presents results first of the categorical analysis of the literature and then of the discourse analysis of 56 research articles. We use results of the categorical analysis of the 6,059 articles to present portraits of the CSD literature broadly and of research on ACCD specifically. We use results of the discourse analysis of the 56 articles to examine types of representations more closely, providing specific examples of thin and thick representations used across articles and of representational patterns within articles presented here as representational profiles.
Categorical Description of the Research Literature
The coding of all sampled articles in these five journals offers a general portrait of publication patterns in CSD over this period, focusing on issues of article genre and target population and identifying any use of thick (or more detailed) representations of people in the articles published (see Table 3). Overall, 79% (4,770) of the 6,059 articles sampled were coded as research articles, 22% of the total (1,352/6,059) were coded as addressing aphasia or other ACCD, and only 12% of the total (748/6,059) were coded as including any evidence of thick representations of people. The percentage of research articles published in these journals has increased across decades, with less than 50% coded as research in the 1930–1940s (with only JSHD in publication), 70% to 78% in the 1950–1970s (with JSHD and JSHR in publication), and 78% to 88% in 1980–2012 (with JSHD; AJSLP; JSHR/JSLHR; BJDC/EJDC/IJLCD; and Aphasiology in publication). The percentage of articles focusing on ACCD populations has also increased across decades, from under 10% in the 1930–1970s to 23% to 28% in the 1980s–1990s and over 30% from 2000 to 2012. However, the percentages of articles coded as including any evidence of thick representations has remained relatively small, ranging from a low of 5% in 1930s to a high of 18% in the 1940s and then stabilizing at 15% to 16% for the past three decades (1990–2012).
Table 3. Total number of articles sampled across journals listed by decade, with the number and percent of total articles identified as research genre, as acquired cognitive-communication disorders (ACCD) focused, and as displaying any evidence of thick representations of people.
Total number of articles sampled across journals listed by decade, with the number and percent of total articles identified as research genre, as acquired cognitive-communication disorders (ACCD) focused, and as displaying any evidence of thick representations of people.×
Decade Total no. articles Research genre
ACCD focused
Thick representation
No. % No. % No. %
1930s 104 50 48 1 1 5 5
1940s 187 64 34 8 4 33 18
1950s 258 182 71 10 4 16 6
1960s 548 388 71 34 6 56 10
1970s 706 552 78 62 9 61 9
1980s 913 729 80 209 23 66 7
1990s 1,335 1,055 79 369 28 201 15
2000s 1,136 981 86 349 31 177 16
2010s 872 769 88 310 36 133 15
Totals 6,059 4,770 79 1,352 22 748 12
Table 3. Total number of articles sampled across journals listed by decade, with the number and percent of total articles identified as research genre, as acquired cognitive-communication disorders (ACCD) focused, and as displaying any evidence of thick representations of people.
Total number of articles sampled across journals listed by decade, with the number and percent of total articles identified as research genre, as acquired cognitive-communication disorders (ACCD) focused, and as displaying any evidence of thick representations of people.×
Decade Total no. articles Research genre
ACCD focused
Thick representation
No. % No. % No. %
1930s 104 50 48 1 1 5 5
1940s 187 64 34 8 4 33 18
1950s 258 182 71 10 4 16 6
1960s 548 388 71 34 6 56 10
1970s 706 552 78 62 9 61 9
1980s 913 729 80 209 23 66 7
1990s 1,335 1,055 79 369 28 201 15
2000s 1,136 981 86 349 31 177 16
2010s 872 769 88 310 36 133 15
Totals 6,059 4,770 79 1,352 22 748 12
×
Our coding also found differences across journals that were broadly consistent with their different missions. As shown in Table 4, our coding indicated that JSHR/JSLHR published the highest percentage of research articles, 93% (2,401/2,574), a rate consistently high across decades (84%–95%), and that Aphasiology published the highest percentage of articles related to ACCD populations, 92% (950/1,038), ranging from 73% to 98% across decades. Although the percentage of articles coded as including any evidence of thick representation was low across journals, there were noteworthy differences here as well with the highest percentage of articles including thick representation in Aphasiology (28%) and the lowest in JSHR/JSLHR (6%). It is important to note the large role Aphasiology has played in driving the increase in ACCD-focused articles since 1986, and thus how influential this one journal has been in the analyses we present here.
Table 4. Total number of articles sampled listed by journal, with the number and percent of total articles identified as research genre, as acquired cognitive-communication disorders (ACCD) focused, and as displaying any evidence of thick representations of people.
Total number of articles sampled listed by journal, with the number and percent of total articles identified as research genre, as acquired cognitive-communication disorders (ACCD) focused, and as displaying any evidence of thick representations of people.×
Journal (years published) Articles sampled Research
ACCD
Thick representation
No. % No. % No. %
JSHD (1936–1990) 1,192 754 63 71 6 124 10
AJSLP (1991–present) 434 315 73 52 12 51 12
JSHR/JSLHR (1958–present) 2,574 2,401 93 138 5 159 6
BJDC/EJDC/IJLCD (1966–present) 824 557 68 141 17 126 15
Aphasiology (1987–present) 1,035 743 72 950 92 288 28
Totals 6,059 4,770 79 1,352 22 748 12
Note. JSHD = Journal of Speech and Hearing Disorders; AJSLP = American Journal of Speech-Language Pathology; JSHR/JSLHR = Journal of Speech and Hearing Research/Journal of Speech, Language, and Hearing Research; BJDC/EJDC/IJLCD = British Journal of Disorders of Communication/European Journal of Disorders of Communication/International Journal of Language and Communication Disorders.
Note. JSHD = Journal of Speech and Hearing Disorders; AJSLP = American Journal of Speech-Language Pathology; JSHR/JSLHR = Journal of Speech and Hearing Research/Journal of Speech, Language, and Hearing Research; BJDC/EJDC/IJLCD = British Journal of Disorders of Communication/European Journal of Disorders of Communication/International Journal of Language and Communication Disorders.×
Table 4. Total number of articles sampled listed by journal, with the number and percent of total articles identified as research genre, as acquired cognitive-communication disorders (ACCD) focused, and as displaying any evidence of thick representations of people.
Total number of articles sampled listed by journal, with the number and percent of total articles identified as research genre, as acquired cognitive-communication disorders (ACCD) focused, and as displaying any evidence of thick representations of people.×
Journal (years published) Articles sampled Research
ACCD
Thick representation
No. % No. % No. %
JSHD (1936–1990) 1,192 754 63 71 6 124 10
AJSLP (1991–present) 434 315 73 52 12 51 12
JSHR/JSLHR (1958–present) 2,574 2,401 93 138 5 159 6
BJDC/EJDC/IJLCD (1966–present) 824 557 68 141 17 126 15
Aphasiology (1987–present) 1,035 743 72 950 92 288 28
Totals 6,059 4,770 79 1,352 22 748 12
Note. JSHD = Journal of Speech and Hearing Disorders; AJSLP = American Journal of Speech-Language Pathology; JSHR/JSLHR = Journal of Speech and Hearing Research/Journal of Speech, Language, and Hearing Research; BJDC/EJDC/IJLCD = British Journal of Disorders of Communication/European Journal of Disorders of Communication/International Journal of Language and Communication Disorders.
Note. JSHD = Journal of Speech and Hearing Disorders; AJSLP = American Journal of Speech-Language Pathology; JSHR/JSLHR = Journal of Speech and Hearing Research/Journal of Speech, Language, and Hearing Research; BJDC/EJDC/IJLCD = British Journal of Disorders of Communication/European Journal of Disorders of Communication/International Journal of Language and Communication Disorders.×
×
We also used the categorical analysis to characterize the subset of articles addressing ACCD. As noted above, in the issues sampled for these five journals between 1936 and 2012, we identified 1,352 peer-reviewed ACCD articles (952 of which were published in Aphasiology). Compared with our coding of all articles, the subgroup of ACCD articles (see Table 5) displayed a slightly smaller majority of articles 69% (937) coded for genre as research (vs. 79% overall) and a noticeably larger percentage 30% (403) coded as containing any evidence of thick representation (vs. 12% overall).
Table 5. Total number of acquired cognitive-communication disorders (ACCD) articles across decades, with the number and percentages of these coded as research and as displaying any evidence of thick representations of people. The last column shows the number of ACCD research articles coded with any evidence of thick representation of people in relation to the total number or ACCD research articles, and the percentage.
Total number of acquired cognitive-communication disorders (ACCD) articles across decades, with the number and percentages of these coded as research and as displaying any evidence of thick representations of people. The last column shows the number of ACCD research articles coded with any evidence of thick representation of people in relation to the total number or ACCD research articles, and the percentage.×
Decade Total no. ACCD articles Research genre
Thick representation
Research articles + thick representation
No. % No. % No. %
1930s 1 1 100 1 100 (1/1) 100
1940s 8 3 38 8 100 (3/3) 100
1950s 10 7 70 6 60 (5/7) 71
1960s 34 15 44 17 50 (12/15) 80
1970s 62 33 53 10 16 (9/33) 27
1980s 209 115 55 21 10 (16/115) 14
1990s 369 226 61 129 35 (86/226) 38
2000s 349 297 85 102 29 (94/297) 32
2010s 310 239 77 109 35 (98/239) 41
Totals 1,352 936 69 403 30 (324/936) 35
Table 5. Total number of acquired cognitive-communication disorders (ACCD) articles across decades, with the number and percentages of these coded as research and as displaying any evidence of thick representations of people. The last column shows the number of ACCD research articles coded with any evidence of thick representation of people in relation to the total number or ACCD research articles, and the percentage.
Total number of acquired cognitive-communication disorders (ACCD) articles across decades, with the number and percentages of these coded as research and as displaying any evidence of thick representations of people. The last column shows the number of ACCD research articles coded with any evidence of thick representation of people in relation to the total number or ACCD research articles, and the percentage.×
Decade Total no. ACCD articles Research genre
Thick representation
Research articles + thick representation
No. % No. % No. %
1930s 1 1 100 1 100 (1/1) 100
1940s 8 3 38 8 100 (3/3) 100
1950s 10 7 70 6 60 (5/7) 71
1960s 34 15 44 17 50 (12/15) 80
1970s 62 33 53 10 16 (9/33) 27
1980s 209 115 55 21 10 (16/115) 14
1990s 369 226 61 129 35 (86/226) 38
2000s 349 297 85 102 29 (94/297) 32
2010s 310 239 77 109 35 (98/239) 41
Totals 1,352 936 69 403 30 (324/936) 35
×
The pattern of evidence of thick representation in ACCD articles across decades was complex. In the few articles from the 1930s and 1940s, 100% were categorized as having some evidence of thick representations. That percentage then dropped to 50% and 60% in the 1950s and 1960s, respectively. In the 1970s and 1980s, there was a sharp reduction in that percentage (to 16% and then to 10%), even as the total number of ACCD articles began to grow in the late 1980s. In the 1990s, the number of publications devoted to ACCD rose sharply, and at the same time there was a marked increase (to 35%) in articles that were categorized as having any evidence of thick representation. That rate has since continued at roughly that level (29% in the 2000s and 35% so far in this decade). As seen in the last column in Table 5, the percentage of ACCD research articles that were also coded as having any thick representation mirrored the overall pattern of thick representation in ACCD article in general over these decades. Nevertheless, it is interesting to note that of ACCD articles coded as having some thick representation, most (i.e., 324/403, 80%) were also coded as research articles, a pattern that was fairly consistent across decades and journals. Thus, in the ACCD articles reviewed, thick representations of people were not limited to (or even most prevalent in) nonresearch genres (e.g., pedagogy).
In addition, although research articles on ACCD using case study designs were more often coded for evidence of thick representation, some articles across all research designs were identified as including it. For example, among all ACCD research articles published in Aphasiology coded for any evidence of thick representation (744), the highest percentage was for clinical, interpretive, and clinical case study designs (44%), followed by single-subject experimental designs (24%), survey designs (14%), mixed or longitudinal designs (9%), and finally, group experimental and quasi-experimental designs (8%). As noted above, the analysis clearly pointed to the dominant role Aphasiology has played in publishing research articles on ACCD. Overall, 82% of all of the research articles we identified on ACCD that were published in these journals since 1936 appeared in that one journal, even though it has only been published since 1987.
Ways of Representing People With ACCD in Research Articles
The discourse analysis of representations of people with ACCD and their life worlds was completed on 56 research articles. By identifying and categorizing patterns of thin and thick representations of people with ACCD across all sections in each article, this analysis allowed us to describe specific examples of representations of people used in these articles and also to develop full profiles for each article.
Examples of Representations in ACCD Research Articles
Adapting the ICF framework, we systematically analyzed patterns of representations of people and their life worlds, looking across the articles for both thin and thick representations of people, body structures/functions, activities/participation, and internal/social contexts (see Table 2). Thin representations were broadly defined as ones based on demographic and disciplinary categories, reported in professional terminology, and/or limited to specific tasks, protocols, or assessments. In contrast, thick representations were broadly defined as drawing on personal accounts and interpretations, reported in personal terms (often as direct reports or quotations), and/or relating to everyday activities and experiences. Thus, thin representations tend to be decontextualized, fitting people to predetermined labels and categories, whereas thick representations tend to be more contextualized, dynamic, and personal, often unique to an individual's life. In this way, thick representations work to bring particulars of individual lives into the research account, often tempering, informing, or challenging disciplinary categories and interpretations.
All of the articles included representations of people and body structures/functions. Thin representations of people included labels on the basis of broad demographic categories and relationships (e.g., English speaker, spouse, 67-year-old man, patient, client, subject, participant) and disciplinary labels related to clinical profiles or diagnoses (e.g., Broca's aphasia, PWA, right-handed man). Thin representations of body structures and functions typically included medical and behavioral test results, diagnoses, and informal behavioral descriptions (e.g., coronary artery bypass, Western Aphasia Battery [Kertesz, 1982 ]–Aphasia Quotient [WAB-AQ] 70.5, ability to decrease verbosity, agraphia). In some articles, thin representations of people were given in terms of group identities and characteristics (e.g., severe chronic aphasics, patients, control group,training group, people with traumatic brain injury [TBI], average age was 50.3 years, age-matched normal). In contrast, thick representations typically used personal names, initials, or pseudonyms (e.g., Bob, Jack, Mr. S.) and represented abilities/disabilities in terms of the individual's experience of a problem (e.g., Jack could no longer use his right arm), sometimes reported in their own words (e.g., “I often can't recall an appropriate word or phrase or construct, what I judge to be a coherent sentence”). Thick representations often detailed patient/client responses with direct quotations of their written or spoken utterances (e.g., he said “tweak” for “tea”). Some representations blended characteristics of both thick and thin, for example, by modifying categorical labels with more personalized details (e.g., congenitally deaf-mute trilingual: sign language, Czech, German; a right-handed man employed by a world-wide insurance company) or using personal possessive pronouns (e.g., his wife and children; he developed his own strategies to cover some of his deficits).
Most of the articles made little or no reference to individuals' everyday activities and participation. Thin representations of activities and contexts typically included researchers' or clinicians' impressions about the quality of the person's participation in the research or clinical activities; the person's apparent interests, motives, and goals (e.g., poor motivation, dramatic and expressive style); and/or the person's adjustment to the ACCD on the basis of results of formal and informal measures, such as rating scales and questionnaires designed to assess functional communication, anxiety, or depression (e.g., improving psychological well-being on a scale of social dysfunction). Thick representations typically included the individual's (and/or their family's) representations of their response to the research or clinical activities (One day, after about 25 stimulations, he looked at the therapist and said, “We going to argue about this?”), their own stories (or observations or recordings) of communication experiences within and outside of the research project, and representation of their own motivations and goals.
Characterizing Article Profiles
By analyzing representations across article sections and across the four ICF-derived domains, we developed profiles for each of the 56 articles. Analysis of these profiles led us to identify three dominant patterns: articles that were completely or almost completely thin, articles that were marked by thick representation across sections and domains, and articles that had a more mixed pattern of thin and thick representations.
Patterns of representation within specific articles often related to research design and research questions. In studies driven by general theoretical questions (e.g., where the aim of the research was to test a specific linguistic theory) and in studies designed to identify population norms or characteristics of differential diagnoses, the research articles focused on the theoretical or disciplinary frameworks being investigated and rarely on the contexts and problems of individual participants. Such articles were typically categorized as having a thin representational profile. In contrast, interpretive case studies that by design attended to the particulars of individual's lives, typically involved thick representations in some cases throughout the article. It should be noted that articles with thick representational profiles always included some thin representations that identified participants in terms of disciplinary, population-based categories (e.g., diagnoses and test scores). Of course, a number of studies also displayed mixed profiles. For example, some types of research (e.g., surveys, discourse analyses, clinical case studies) addressed questions related to individuals and their life worlds by design but did not end up having an overall profile of thick representation.
In the next three sections, we look more closely at four recently published articles. One illustrates a typical profile dominated by thin representation; one, a typical profile dominated by thick representation; and two, more mixed profiles. Again, we want to underscore here that thin and thick are descriptive terms about patterns of representing people with ACCD and their life worlds, not evaluations of the value of the research presented.
A Profile of Thin Representation
Table 6 presents the profile of an article written by Yiu and Worrall (1996)  that we characterized as thin representation overall, which is consistent with the way this article was coded in the categorical analysis (i.e., no evidence of thick representation of participants and their life worlds). This article reports a controlled (quasi-experimental) group study (30 subjects) of discourse production by English and Cantonese speakers with agrammatic aphasia, fluent nonagrammatic aphasia, or no aphasia. The aim of this study was to compare Chinese and English agrammatism (a general theoretical question of linguistics) in order to determine if function words are subject to disruptions in agrammatic aphasia regardless of the linguistic and morphologic variations across languages. After the abstract, the article (24 pages in length) is organized with canonical research genre headings—Introduction, Method, Results, and Discussion. The representations of people and their identities (the As on Table 6) used throughout the article are uniformly thin, reflecting the characteristics of individuals critical to the research—their primary language (i.e., Cantonese, English), their aphasic diagnosis (i.e., agrammatic, fluent nonagrammatic, nonaphasic), their role in the research (i.e., subjects), and research group identifiers (e.g., Cantonese-speaking agrammatic subjects). In terms of body structure and function (Bs on the table), the article presents disciplinary categorizations and representations (e.g., WAB-AQ subtest scores) and general characterizations of language abilities (e.g., “limited use of morphemes”) relevant to the linguistic questions being explored. The article only references activities and participation (Cs on the table) of the subjects in relation to the research (and only in the methods sections) and does not reference people's participation in activities outside of the research. This article does not represent internal or social contexts at all, either thin or thick representations (as shown in Table 6 by N/A recorded for Ds in all cells). Another striking feature of this article was its absence of any references to individuals and its consistent representation of participants in terms of groups, whether in labeling the subjects, in the findings, or in the interpretations. We suspect it would be a challenge for clinicians to interpret the theoretical and population-based claims from this linguistic study as evidence that could directly inform their work with individual clients.
Table 6. An example of an article profile with thin representation.
An example of an article profile with thin representation.×
Headings (page no.) Thin representations Thick representations
Abstract (p. 623) A. Cantonese-speaking agrammatic subjects; English-speaking agrammatic subjects A. N/A
B. N/A B. N/A
C. N/A C. N/A
D. N/A D. N/A
Introduction (pp. 623–627) A. Chinese-speaking agrammatic subjects A. N/A
B. Broca's/nonfluent type aphasia B. N/A
C. N/A C. N/A
D. N/A D. N/A
Method (pp. 627–630) A. Four subject groups (English or Cantonese agrammatic, fluent nonagrammatic, and nonaphasic groups) A. N/A
B. Mean WAB-AQ subtest scores for aphasic groups (Table 1); slow, halting speech; limited use of morphemes; fragmentary sentences B. N/A
C. Research Task—Elicited Narrative speech C. N/A
D. N/A D. N/A
Results (pp. 630–640) A. Subject groups; Cantonese subjects A. N/A
B. Fluent aphasia; results of linguistic measures (e.g., MLU) presented by groups (Tables 2, 3, & 4; Figures 1 & 2) B. N/A
C. N/A C. N/A
D. N/A D. N/A
Discussion (pp. 640–642) A. Cantonese aphasia subjects A. N/A
B. Shorter MLU; elliptical sentences B. N/A
C. N/A C. N/A
D. N/A D. N/A
Note. Examples of representations of people and their life worlds are listed by A = people/identities, B = body structures/functions, C = activities/participation, D = contexts, internal/external; see Table 2. N/A = not applicable; WAB-AQ = Western Aphasia Battery–Aphasia Quotient; MLU = mean length of utterance. Yiu, E. M., & Worrall, L. E. (1996) . Agrammatic production: A cross-linguistic comparison of English and Cantonese. Aphasiology, 10(6), 623–647.
Note. Examples of representations of people and their life worlds are listed by A = people/identities, B = body structures/functions, C = activities/participation, D = contexts, internal/external; see Table 2. N/A = not applicable; WAB-AQ = Western Aphasia Battery–Aphasia Quotient; MLU = mean length of utterance. Yiu, E. M., & Worrall, L. E. (1996) . Agrammatic production: A cross-linguistic comparison of English and Cantonese. Aphasiology, 10(6), 623–647.×
Table 6. An example of an article profile with thin representation.
An example of an article profile with thin representation.×
Headings (page no.) Thin representations Thick representations
Abstract (p. 623) A. Cantonese-speaking agrammatic subjects; English-speaking agrammatic subjects A. N/A
B. N/A B. N/A
C. N/A C. N/A
D. N/A D. N/A
Introduction (pp. 623–627) A. Chinese-speaking agrammatic subjects A. N/A
B. Broca's/nonfluent type aphasia B. N/A
C. N/A C. N/A
D. N/A D. N/A
Method (pp. 627–630) A. Four subject groups (English or Cantonese agrammatic, fluent nonagrammatic, and nonaphasic groups) A. N/A
B. Mean WAB-AQ subtest scores for aphasic groups (Table 1); slow, halting speech; limited use of morphemes; fragmentary sentences B. N/A
C. Research Task—Elicited Narrative speech C. N/A
D. N/A D. N/A
Results (pp. 630–640) A. Subject groups; Cantonese subjects A. N/A
B. Fluent aphasia; results of linguistic measures (e.g., MLU) presented by groups (Tables 2, 3, & 4; Figures 1 & 2) B. N/A
C. N/A C. N/A
D. N/A D. N/A
Discussion (pp. 640–642) A. Cantonese aphasia subjects A. N/A
B. Shorter MLU; elliptical sentences B. N/A
C. N/A C. N/A
D. N/A D. N/A
Note. Examples of representations of people and their life worlds are listed by A = people/identities, B = body structures/functions, C = activities/participation, D = contexts, internal/external; see Table 2. N/A = not applicable; WAB-AQ = Western Aphasia Battery–Aphasia Quotient; MLU = mean length of utterance. Yiu, E. M., & Worrall, L. E. (1996) . Agrammatic production: A cross-linguistic comparison of English and Cantonese. Aphasiology, 10(6), 623–647.
Note. Examples of representations of people and their life worlds are listed by A = people/identities, B = body structures/functions, C = activities/participation, D = contexts, internal/external; see Table 2. N/A = not applicable; WAB-AQ = Western Aphasia Battery–Aphasia Quotient; MLU = mean length of utterance. Yiu, E. M., & Worrall, L. E. (1996) . Agrammatic production: A cross-linguistic comparison of English and Cantonese. Aphasiology, 10(6), 623–647.×
×
Overall, articles with profiles of thin representations of individuals with ACCD were the most common, with 34 of the 56 articles displaying this pattern. As expected, all 15 of the articles identified by the categorical analysis as having no evidence of thick representations of people were characterized as having thin representational profiles. However, 19 articles that had been coded as containing some evidence of thick representation were also characterized as having overall thin profiles. These articles often addressed issues related to individuals' lives (e.g., impact of treatment on home language), used patient reporting instruments, and/or included some details about clients' responses on specific tasks. However, such thick representations were limited to the clinical or research task (e.g., transcriptions of client talk on research tasks), were characterized from the perspective of the clinician/researcher, or reported as test scores or grouped data. In spite of occasional isolated uses of thick representations, articles characterized with thin representational profiles were marked by depersonalized or group labels for individuals with ACCD and their body structures/functions across all article sections, thin representations of participant responses to the research or treatment, and an absence of any discussion of personal goals and activities outside of the clinical or research context.
A Profile of Thick Representation
Table 7 presents the profile of a research article written by Purves, Logan, and Marcella (2011)  that we characterized as having a profile of thick representation overall. The article reports a qualitative (interpretive) case study that used ethnographic methods with the aim of detailing one client's particular processes and decisions as he worked with clinicians to program his “voice” into an augmentative and alternative communication system and use it for his own purposes. An unusual feature of this article is that the target participant for the case study, Skip Marcella, is also a coauthor (the third author). After the abstract, this relatively short article (12 pages in length) is organized in a less typical fashion for a research genre, with an introduction (untitled) and eight main headings. The abstract and introduction provide few representations of people, and the ones that are included are fairly general (whether thin or thick). Typical of interpretive studies, the abstract introduces the theoretical and disciplinary concepts grounding the study, which are then detailed in the introduction. The next four sections provide details about the methodology and the case. The Background to the Case Study in particular draws on thick representations by introducing the participants by name (i.e., Skip, Barbara, Heidi), describing both their research and professional roles (e.g., third author), and narrating specific activities/participation—crediting Skip (a man with nonfluent aphasia) with prompting this study through his request for support in learning to use the computer program SentenceShaper® (Linebarger & Romania, 2000), and telling a brief anecdote about what “attracted Skip's attention” to the possibilities of using this program. Table 7 also shows that in the sections titled Overview of Procedures and Participants there were thick representations of activities and participation outside of research settings (e.g., “Skip draws on his background running a printing/desktop publishing business to create written documents, cartoon drawings depicting life with aphasia, and powerpoint [sic] presentations”) and of internal and external contexts (e.g., discussion of Skip's background in publishing and his cartoon drawings depicting life with aphasia). These sections also included thin representations to characterize Skip's body structure/functions (e.g., “cerebrovascular accident from trauma to left carotid artery,” WAB-AQ). The next three sections presented the results of the project, including detailed descriptions of the concrete product (e.g., what he recorded into SentenceShaper), using both thin representations of Skip's words to characterize discourse features (e.g., number of words) and thick representations (quoting the personal introduction he wrote and recorded for this text). In the Conclusion section, the article returned to thin representations of people and contexts, as the coauthors tie the research back to disciplinary goals and categories.
Table 7. An example of an article profile with thick representation.
An example of an article profile with thick representation.×
Headings (page no.) Thin representations Thick representations
Abstract (p. 688) A. A man with nonfluent aphasia and apraxia A. N/A
B. N/A B. N/A
C. N/A C. The creativity with which a man with aphasia integrates components of a therapeutic process into a repertoire of tools to support communication
D. N/A D. N/A
Introduction (pp. 688–689) A. How persons with aphasia manage and negotiate their evolving identities A. N/A
B. N/A B. A familiar person's voice
C. N/A C. N/A
D. Their social worlds D. N/A
Background to the Case Study (p. 690) A. People with nonfluent aphasia A. Skip, third author; first author, Barbara; second author, Heidi
B. Nonfluent aphasia complicated by apraxia B. N/A
C. N/A C. That attracted Skip's attention when the first author (Barbara) invited him to try the program and think about ways he might like to use it
D. SentenceShaper program D. N/A
Methodology (pp. 690–691) A. The particular case A. N/A
B. N/A B. N/A
C. N/A C. Targeted events in the rehabilitation process
D. N/A D. N/A
Overview of Procedures (p. 691) A. Two participants A. Skip, Heidi, Barbara
B. N/A B. Skip's SentenceShaper recordings
C. N/A C. Heidi's interpretations of process in clinic; stories of Skip's speaking activities outside of clinic
D. N/A D. Skip as an expert in living with aphasia; embedded it firmly in the context of his own life
Participants (pp. 692–693) A. N/A A. Skip, Heidi, Barbara; Skip was a powerful public speaker
B. CVA from trauma to left carotid artery, 27 months post onset, WAB-AQ of 54; nonfluent aphasia B. His oral production; he often needs to make multiple attempts
C. Speech characterized by word-finding impairments, articulatory distortions, writes single words C. Acknowledged as a powerful public speaker, even if he can't actually speak very well; Heidi described her interpretation of her role…as that of a volunteer who could support Skip
D. N/A D. Skip draws on background running a printing/desktop publishing business to create written documents, cartoon drawings depicting life with aphasia
The Text (pp. 693–694) A. Group members A. Skip
B. The text contains 628 words, 46 sentences B. The reading Skip chose to record; Skip's person introduction to his recording—“As a result of a motorcycle accident in 2001, I have a speech impairment called aphasia.”
C. N/A C. N/A
D. N/A D. N/A
Findings (pp. 694–696) A. A second listener A. Skip, Heidi, Barbara
B. Melodic Intonation Therapy B. Used playback to self-prompt attempts
C. Mean number of words recorded was 2.95, 72.1% intelligibility; relied on Heidi for multiple repetitions C. Skip and Heidi reviewed the recording and re-recorded some segments; Skip recalled using Melodic Intonation Therapy in earlier therapy, experiences Heidi drew on to support Skip
D. N/A D. Re-recording some segments that…though intelligible to both listeners, did not satisfy Skip. Skip chose to leave some of these in his recording.
Discussion (pp. 696–697) A. A person with aphasia A. Skip, Heidi, Barbara
B. N/A B. Skip's “best” recording was self-determined
C. N/A C. Skip continues to refine his narrative
D. SentenceShaper; listeners D. Skip's commitment in time and effort
Conclusion (p. 698) A. People with aphasia A. N/A
B. N/A B. N/A
C. N/A C. N/A
D. Clinicians; to help people with aphasia achieve personal goals D. N/A
Note. Examples of representations of people and their life worlds are listed by A = people/identities, B = body structures/functions, C = activities/participation, D = contexts, internal/external, see Table 2. N/A = not applicable, CVA = cerebrovascular accident, WAB-AQ = Western Aphasia Battery–Aphasia Quotient. Purves, B. A., Logan, H., & Marcella, S. (2011) . Intersections of literal and metaphorical voices in aphasia. Aphasiology, 25(6–7), 688–699.
Note. Examples of representations of people and their life worlds are listed by A = people/identities, B = body structures/functions, C = activities/participation, D = contexts, internal/external, see Table 2. N/A = not applicable, CVA = cerebrovascular accident, WAB-AQ = Western Aphasia Battery–Aphasia Quotient. Purves, B. A., Logan, H., & Marcella, S. (2011) . Intersections of literal and metaphorical voices in aphasia. Aphasiology, 25(6–7), 688–699.×
Table 7. An example of an article profile with thick representation.
An example of an article profile with thick representation.×
Headings (page no.) Thin representations Thick representations
Abstract (p. 688) A. A man with nonfluent aphasia and apraxia A. N/A
B. N/A B. N/A
C. N/A C. The creativity with which a man with aphasia integrates components of a therapeutic process into a repertoire of tools to support communication
D. N/A D. N/A
Introduction (pp. 688–689) A. How persons with aphasia manage and negotiate their evolving identities A. N/A
B. N/A B. A familiar person's voice
C. N/A C. N/A
D. Their social worlds D. N/A
Background to the Case Study (p. 690) A. People with nonfluent aphasia A. Skip, third author; first author, Barbara; second author, Heidi
B. Nonfluent aphasia complicated by apraxia B. N/A
C. N/A C. That attracted Skip's attention when the first author (Barbara) invited him to try the program and think about ways he might like to use it
D. SentenceShaper program D. N/A
Methodology (pp. 690–691) A. The particular case A. N/A
B. N/A B. N/A
C. N/A C. Targeted events in the rehabilitation process
D. N/A D. N/A
Overview of Procedures (p. 691) A. Two participants A. Skip, Heidi, Barbara
B. N/A B. Skip's SentenceShaper recordings
C. N/A C. Heidi's interpretations of process in clinic; stories of Skip's speaking activities outside of clinic
D. N/A D. Skip as an expert in living with aphasia; embedded it firmly in the context of his own life
Participants (pp. 692–693) A. N/A A. Skip, Heidi, Barbara; Skip was a powerful public speaker
B. CVA from trauma to left carotid artery, 27 months post onset, WAB-AQ of 54; nonfluent aphasia B. His oral production; he often needs to make multiple attempts
C. Speech characterized by word-finding impairments, articulatory distortions, writes single words C. Acknowledged as a powerful public speaker, even if he can't actually speak very well; Heidi described her interpretation of her role…as that of a volunteer who could support Skip
D. N/A D. Skip draws on background running a printing/desktop publishing business to create written documents, cartoon drawings depicting life with aphasia
The Text (pp. 693–694) A. Group members A. Skip
B. The text contains 628 words, 46 sentences B. The reading Skip chose to record; Skip's person introduction to his recording—“As a result of a motorcycle accident in 2001, I have a speech impairment called aphasia.”
C. N/A C. N/A
D. N/A D. N/A
Findings (pp. 694–696) A. A second listener A. Skip, Heidi, Barbara
B. Melodic Intonation Therapy B. Used playback to self-prompt attempts
C. Mean number of words recorded was 2.95, 72.1% intelligibility; relied on Heidi for multiple repetitions C. Skip and Heidi reviewed the recording and re-recorded some segments; Skip recalled using Melodic Intonation Therapy in earlier therapy, experiences Heidi drew on to support Skip
D. N/A D. Re-recording some segments that…though intelligible to both listeners, did not satisfy Skip. Skip chose to leave some of these in his recording.
Discussion (pp. 696–697) A. A person with aphasia A. Skip, Heidi, Barbara
B. N/A B. Skip's “best” recording was self-determined
C. N/A C. Skip continues to refine his narrative
D. SentenceShaper; listeners D. Skip's commitment in time and effort
Conclusion (p. 698) A. People with aphasia A. N/A
B. N/A B. N/A
C. N/A C. N/A
D. Clinicians; to help people with aphasia achieve personal goals D. N/A
Note. Examples of representations of people and their life worlds are listed by A = people/identities, B = body structures/functions, C = activities/participation, D = contexts, internal/external, see Table 2. N/A = not applicable, CVA = cerebrovascular accident, WAB-AQ = Western Aphasia Battery–Aphasia Quotient. Purves, B. A., Logan, H., & Marcella, S. (2011) . Intersections of literal and metaphorical voices in aphasia. Aphasiology, 25(6–7), 688–699.
Note. Examples of representations of people and their life worlds are listed by A = people/identities, B = body structures/functions, C = activities/participation, D = contexts, internal/external, see Table 2. N/A = not applicable, CVA = cerebrovascular accident, WAB-AQ = Western Aphasia Battery–Aphasia Quotient. Purves, B. A., Logan, H., & Marcella, S. (2011) . Intersections of literal and metaphorical voices in aphasia. Aphasiology, 25(6–7), 688–699.×
×
Analyzing patterns of representation throughout the articles, we concluded that only three of the 56 articles could be characterized as having an overall thick representational profile. As seen here, articles with thick representational profiles displayed several features. First, they included some (usually thick) representation of all four ICF-derived categories of people and their social worlds (i.e., people/identities; body structures/functions; activities/participations; and contexts internal/external). Second, they strategically utilized a range of both thin (i.e., disciplinary) and thick (i.e., personal) representations of people with ACCD across different article sections. Third, when thin representations were used strategically to address theoretical and disciplinary issues, they were often mixed with thick, more personal representations, such as use of personal pronouns (e.g., his…), characterizations of specific actions (e.g., he often had to make multiple attempts), and personal stories or interpretations (e.g., stories of Skip's public speaking activities).
Profiles With Mixed Representation
We also identified articles with mixed profiles. These articles included both thin and thick representations of people and their life worlds; however, the thick representations were less sustained across sections and/or across domains. In this section, we briefly discuss two of these articles (without providing the full table profiles), one by Togher, McDonald, Code, and Grant (2004)  and the second by Sacchett and Black (2010) .
Togher et al. (2004)  report a group treatment study to assess the feasibility of training community personnel (i.e., police officers) to be more effective communication partners for community members with communication disorders associated with TBI. Grounded in social approaches to treatment, the study focuses on enhancing community supports, and it uses a group design to assess the impact of the approach. After the abstract, this 23-page article is organized with a mix of content specific headings for the literature reviewed (Training Communication Skills in People With TBI; Theoretical Approaches to Training Communication Partners; Communication Partner Training in Traumatic Brain Injury; Why Train the Police?) and canonical research genre headings for the remainder of the article (Method, Results, Discussion, and Conclusions). Thin representations of people and identities, both as individuals and groups, were used across the article (e.g., 20 male police recruits, 20 male participants with TBI, training or control group, X or Y group, use of identification numbers and letters). Body structures and functions of TBI participants were also thinly represented and included medical background and communication diagnoses. The results presented group findings, but also characterized details of data for specific cases, including offering simple transcripts of pre- and posttreatment conversational data. Although typically relying on thin representations, the article also attended to participant activities and participation (e.g., genre shifted from a service encounter to a chat; C2 talked about going to the local club, catching a taxi; police reported anecdotally that learning generic structures of interaction was most useful), as well as to internal and social contexts (e.g., depression; may be viewed as patronizing by person with TBI).
Sacchett and Black (2010)  is a 24-page article reporting a study of event drawing by two people with aphasia and a control group of 12 people without brain damage. The article uses atypical headings that allow the authors to report the control group and aphasia data separately (Event Drawing Task: Design and Control Testing; Participants With Aphasia; Discussion of Data From Participants With Aphasia; Conclusions and Clinical Implications). Throughout the article, thin representations are used to describe people and their identities (e.g., people with aphasia; non-brain-damaged controls; English-speaking adults) and demographic information about control participants listed on a table (i.e., participant number, age, sex, occupation, age on leaving F/T education). The two participants with aphasia, however, were represented throughout by name (e.g., Bob, Jack), and some information was provided about their social worlds (e.g., lived alone in a warden- controlled flat with few social contacts). In addition to reporting scores on formal assessments (a form of thin representation), some individual performances were included (e.g., examples of Bob's written picture description). The article presented Bob's and Jack's individual data and example images of individual drawings labeled by participant (e.g., Bob, Jack, Control 7, Control 8). The clinical implications section also represented possible clinical tasks that would be appropriate for Jack specifically, based on the detailed case data presented in the study.
Of the 56 articles analysis, we characterized 19 as having a mixed representational profile. Mixed article profiles combined features of both thin and thick representational profiles. First, similar to thick representational profiles, they included some representation of all four domains of people and their social worlds (i.e., people/identities, body structures/functions, activities/participations, and contexts internal/external), but thick representations in these mixed articles tended to focus on the research participation (or other specific domains) rather than detailing patterns of participation in activities beyond the research or clinical settings. Second, they often referred to people individually (e.g., using participant numbers, initials, or personal names). Third, although they used a range of both thin (i.e., disciplinary) and thick (i.e., personal) representations of people, thin representations dominated the report. As in these two examples, mixed articles typically connected representations of people to clinical activities.
Discussion
The goal of this study was to characterize the ways people and their life worlds, especially people with ACCD, have been represented in our field's literature over the past eight decades. The findings reported here clearly document the dominance of thin representation in the CSD literature overall. Given the prominent role of case study research in clinical neurology, especially in earlier decades, we suspected that the literature on ACCD would display a greater amount of thick representation. However, our findings only partially supported that expectation. The categorical analysis did identify a notably higher percentage of ACCD articles with some evidence of thick representation (30%) than for all CSD articles (12%), and that percentage was particularly high (from 50% to 100%) from 1930 to 1970 when the total number of ACCD articles was small. However, in the finer-grained discourse analysis of the 56 ACCD research articles (a sample which by selection was heavily weighted for articles with some evidence of thick representation), we found that specific uses of thick representations were actually quite limited. Indeed, 19 of the 41 articles coded as displaying some evidence of thick representation were classified through close discourse analysis as having overall profiles of thin representation of individuals with ACCD. In fact, a majority of the articles (34/56) were classified as having thin representational profiles, marked by use of thin representations across all article sections and usually with references only to the first two ICF-derived domains (people, body structures/functions). In addition, only three of the 56 articles were characterized as having a thick representational profile, that is, as displaying use of thick representations for all four ICF-derived domains and across all article sections. It is interesting to note that for two of the three articles with thick profiles, a participant with ACCD was included as a coauthor in the study, which perhaps made thick representations more available. Articles identified with mixed representational profiles (19/56 articles) included some representations (thin/thick) across all domains and some thick representations across article sections, but rarely attended to participants' life worlds beyond the immediate clinical or research tasks. In analyzing representations across the ICF-derived domains, the rarity of representations of the everyday life worlds of people with ACCD was particularly striking.
The discourse analysis clearly documents that the ACCD research literature in CSD has not widely taken up calls by Luria (1968, 1972)  and Sacks (1970, 1984)  to systematically use rich case studies to develop scientific accounts of brain-behavior relations. The stark absence of theorized representations of people in their life worlds, of what Geertz (1973)  and Marcus (1998)  meant by thick description, is perhaps not surprising given that our professional education and disciplinary scholarship have largely ignored the humanistic social sciences (anthropology, sociology, cultural psychology, interactional sociolinguistics) that have specialized in studying life worlds and the complexities of everyday communication. Instead, the limited use of thick representations documented here seems to reflect the field's attention to detailing client behaviors (e.g., differential diagnosis and clinical profiles, multiple response patterns during recovery and in response to treatment), to obtaining client reactions to interventions (e.g., social validity), to differentiating people from disorders (e.g., person-first language), to addressing meaningful goals for clients (e.g., quality of life outcome measures), and to actively involving clients in the rehabilitation process (e.g., social approaches to treatment).
This textual analysis has led us to additional questions about the CSD literature itself. For example, we plan to adapt the close discourse analysis coding used here to examine the representation of people and their life worlds in other genres (e.g., pedagogical) in the CSD literature. In addition, as we analyzed the representations of individuals with ACCD, we often noted marked differences between the ways different categories of people (e.g., researchers, participants, and clinicians) were represented within the same article, and the ways different peoples' voices and perspectives were expressed. Thus, we also plan to extend the discourse analysis of the current set of 56 articles to examine these differences. Furthermore, as noted in the introduction, the textual analysis presented here is the initial step in a broader project to examine how clinicians translate the research literature in their work with individual clients.
Our analysis of thin and thick representations across different domains and genres from this study will allow us to systematically investigate how clinicians read, understand, and use evidence from articles representing different profiles. We have designed a protocol that will use examples of these different kinds of representations as stimuli for individual or group interviews with practicing clinicians, as well as asking them to identify materials they routinely use. In addition, this analysis of the research literature will provide a valuable ground as we move forward with an ethnographic examination of how clinicians draw on the CSD literature in their clinical decision making and reasoning about specific cases. We suspect that the dominance of thin representations focused on body structures and functions, representations that are quite abstracted from the particularities of individuals with ACCD and their life worlds, makes the work of clinicians to translate research evidence challenging. The general absence of attention to the life worlds of individuals with ACCD seems to be in tension with the ICF framework's biopsychosocial model and with ASHA's scope of practice, grounded in a commitment to optimize communication in order to improve quality of life. How do clinicians intervene in the lives of clients when the research literature is almost silent on those domains? However, it is the next phase of the research that will address this important question.
CSD, as an applied field, has long argued for the importance of highlighting the clinical significance of our research endeavors by linking findings to clinical practice (e.g., including sections on clinical implications), by seeking input from participants about the study procedures (e.g., including sections on social validity, particularly in single-subject research designs), and by conducting clinical research. Our research on translational practices aims to further this effort by examining how representations of people and their life worlds may impact the work of clinicians as they translate research evidence for clinical goals. Detailed analysis of the nature of the textual evidence is one key for reflecting on, and deepening our understandings of, the translational resources and practices in our field. The attention to thick description in anthropology, much like the emphasis on detailed clinical case studies in the work of Luria (1968, 1972)  and Sacks (1970, 1984), is grounded in the notion that there is a kind of generalizable knowledge about people and their lives that comes from thick description just as there is a kind of generalizable knowledge that comes from experimental and norm-based research. If that is the case, then evidence-based practice could benefit from attending more fully to issues of ecological validity and from more research that utilizes thick representations to support the process of clinical translation. In any case, we believe it is critical to carefully investigate the resources and processes that clinicians use in designing clinical interventions, optimizing communication, and improving quality of life for the individuals they serve.
Acknowledgments
This project was supported in part by University of Illinois Campus Research Board Grant 13201 (awarded to Julie A. Hengst). We are indebted to the student research assistants who helped complete the detailed data analysis for this project: Olivia Dolleton, Jennifer Gerry, Alex Karigan, Kathy Kastanes, Tara Marcoski, Amanda Rohde, Martha Sherrill, Carley Serena, and Allison Virgilio. Thanks also to Paul Prior for his advice on textual analysis and for providing responses to earlier versions of this article.
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Appendix
List of 56 ACCD Articles Profiled for Use of Thin/Thick Representations of People
Note. * indicates article was identified through categorical coding as displaying some evidence of thick representation; in addition, the type of representation profile identified through discourse analysis is identified as thin, thick, or mixed.
1940–1949
Anderson, J. (1942). The speech examination of aphasic patients. Journal of Speech and Hearing Disorders, 7, 361–366. [* mixed]
Huber, M. (1944). A phonetic approach to the problem of perception in a case of Wernicke's aphasia. Journal of Speech and Hearing Disorders, 9(3), 227–238. [* mixed]
Backus, O. (1945). The rehabilitation of aphasic veterans. Journal of Speech and Hearing Disorders, 10, 149–153. [* thin]
Peacher, W. G. (1945). Speech disorders in World War II: III. Dysarthria. Journal of Speech and Hearing Disorders, 10(4), 287–291. [thin]
1950–1959
Buck, M. (1950). Speech therapy in a psychiatric hospital: A report of two cases. Journal of Speech and Hearing Disorders, 15(4), 307–315. [* mixed]
Thurston, J. R. (1954). An empirical investigation of the loss of spelling ability in dysphasics. Journal of Speech and Hearing Disorders, 19(3), 344–349. [thin]
Wepman, J., Bock, R., Jones, L., & Van Pelt, D. (1956). Psycholinguistic study of aphasia: A review of the concept of anomia. Journal of Speech and Hearing Disorders, 21, 468–477. [* thin]
Street, B. S. (1957). Hearing loss in aphasia. Journal of Speech and Hearing Disorders, 22(1), 60–67. [* thin]
1960–1969
Tikofsky, R. S., & Reynolds, G. L. (1962). Preliminary study: Nonverbal learning and aphasia. Journal of Speech and Hearing Research, 5(2), 133–143. [* thin]
Filby, Y., Edwards, A. E., & Seacat, G. F. (1963). Word-length, frequency, and similarity in the discrimination behavior of aphasics. Journal of Speech and Hearing Research, 6(3), 255–261. [thin]
Sies, L., & Butler, R. (1963). A personal account of dysphasia. Journal of Speech and Hearing Disorders, 28, 261–266. [* thick]
Wepman, J., Morency, A. (1963). Filmstrips as an adjunct to language therapy for aphasia. Journal of Speech and Hearing Disorders, 28, 191–194. [* mixed]
Allan, C., Turner, J., & Gadea-Ciria, M. (1966). Investigations into speech disturbances following stereotaxic surgery for parkinsonism. British Journal of Disorders of Communication, 1(1), 55–59. [thin]
Sefer, J., & Schuell, H. (1969). A year of aphasia therapy: A case study. British Journal of Disorders of Communication, 4, 73–82. [* mixed]
1970–1979
Holland, A. L. (1970). Case studies in aphasia rehabilitation using programmed instruction. Journal of Speech and Hearing Disorders, 35(4), 377–390. [* mixed]
Johns, D. F., & Darley, F. L. (1970). Phonemic variability in apraxia of speech. Journal of Speech and Hearing Research, 13(3), 556–583. [thin]
Sheehan, J. G., Aseltine, S., & Edwards, A. E. (1973). Aphasic comprehension of timing spacing. Journal of Speech and Hearing Research, 16(4), 650–657. [thin]
Rochford, G. (1974). Are jargon dysphasics dysphasic? British Journal of Disorders of Communication, 9(1), 35–44. [thin]
Fredman, M. (1975). The effect of therapy given in Hebrew on the home language of the bilingual or polyglot adult aphasic in Israel. British Journal of Disorders of Communication,10(1), 61–69. [* mixed]
Helm, N. (1979). Management of palilalia with a pacing board. Journal of Speech and Hearing Disorders, 44, 350–353. [* mixed]
1980–1989
Kotten, A. (1982). Therapy of neologistic jargon aphasia: A case report. British Journal of Disorders of Communication, 17(2), 61–73. [thin]
Kent, R. D., & Rosenbek, J. C. (1983). Acoustic patterns of apraxia of speech. Journal of Speech and Hearing Research, 26, 231–249. [thin]
Pierce, R. S., & Beekman, L. A. (1985). Effects of linguistic and extralinguistic context on semantic and syntactic processing in aphasia. Journal of Speech and Hearing Research, 28(3), 250–254. [* thin]
Reinvang, I. (1987). Crossed aphasia and apraxia in an artist. Aphasiology, 1(5), 423–434. [* mixed]
Rice, B., Paull, A. & Muller, D. J. (1987). An evaluation of a social support group for spouses of aphasic partners. Aphasiology, 1(3), 247–256. [* mixed]
Berhman, M., & Lieberthal, T. (1989). Category-specific treatment of a lexical-semantic deficit: A single case study of global aphasia. British Journal of Disorders of Communication, 24(3), 281–299. [* thin]
Herrmann, M., & Wallesch, C. W. (1989). Psychosocial changes and psychosocial adjustment with chronic and severe nonfluent aphasia, Aphasiology, 3(6), 513–526. [* mixed]
Lomas, J., Pickard, L., Bester, S., Elbard, H., Finlayson, A., & Zoghaib, C. (1989). The communicative effectiveness index: Development and psychometric evaluation of a functional communication measure for adult aphasia. Journal of Speech and Hearing Disorders, 54, 113–124. [* thin]
Poeck, K., Huber, W., & Willmes, K. (1989). Outcome of intensive language treatment in aphasia. Journal of Speech and Hearing Disorders, 54, 471–479. [* thin]
1990–1999
Wallesch, C. W. (1990). An early detailed description of aphasia in a deaf-mute: Anton Leischner's “die ‘aphasie’ der taubstummen” (1943). Aphasiology, 4(5), 511–518. [* thin]
Marshall, R. C. (1993). Problem-focused group treatment for clients with mild aphasia. American Journal of Speech-Language Pathology, 2(2), 31–37. [* mixed]
Berthier, M. L., & Starkstein, S. E. (1994). Catastrophic reaction in crossed aphasia. Aphasiology, 8(1), 89–95. [* thin]
Seddoh, S. A. K., & Robin, D. A. (1996). Speech timing in apraxia of speech versus conduction aphasia. Journal of Speech, Language, and Hearing Research, 39(3), 590. [* thin]
Yiu, E. M. L., & Worrall, L. E. (1996). Agrammatic production: A cross-linguistic comparison of English and Cantonese. Aphasiology, 10(6), 623–647. [thin]
McClenahan, R., & Weinman, J. (1998). Determinants of career distress in nonacute stroke. International Journal of Language and Communication Disorders, 33(Supplement), 138–143. [* thin]
Robson, J., Pring, T., Marshall, J., Morrison, S. & Chiat, S. (1998). Written communication in undifferentiated jargon aphasia: A therapy study. International Journal of Language and Communication Disorders, 33(3), 305–328. [* mixed]
Katz, W. F., Bharadwaj, S. V., & Carstens, B. (1999). Electromagnetic articulography treatment for an adult with Broca's aphasia and apraxia of speech. Journal of Speech, Language, and Hearing Research, 42(6), 1355. [thin]
Simmons-Mackie, N., Damico, J., & Damico. H. (1999). A qualitative study of feedback in aphasia treatment. American Journal of Speech-Language Pathology, 8, 218–230. [* mixed]
2000–2009
Kennedy, M. (2000). Topic scenes in conversations with adults with right-hemisphere brain damage. American Journal of Speech-Language Pathology, 9, 72–86. [* thin]
Ripich, D. N., Carpenter, B. D., & Ziol, E. W. (2000). Conversational cohesion patterns in men and women with Alzheimer's disease: A longitudinal study. International Journal of Language and Communication Disorders, 35 (1), 49–64. [* thin]
Kagan, A., Black, S. E., Duchan, J. F., Simmons-Mackie, N., & Square, P. (2001). Training volunteers as conversation partners using “supported conversation for adults with aphasia” (SCA): A controlled trial. Journal of Speech, Language, and Hearing Research, 44(3), 624–638. [* thin]
Molrine, C. J., & Pierce, R. S. (2002). Black and white adults' expressive language performance on three tests of aphasia. American Journal of Speech-Language Pathology, 11(2), 139–150. [thin]
Beeson, P. M., Rising, K., & Volk, J. (2003). Writing treatment for severe aphasia: Who benefits? Journal of Speech, Language, and Hearing Research, 46(5), 1038–1060. [thin]
Togher, L., McDonald, S., Code, C., & Grant, S. (2004). Training communication partners of people with traumatic brain injury: A randomized controlled trial. Aphasiology, 18(4), 313–335. [* mixed]
Bruce, C., Parker, A., & Renfrew, L. (2006). “Helping or something”: perceptions of students with aphasia and tutors in further education. International Journal of Language and Communication Disorders, 41(2), 137–154. [* mixed]
Turner, S., & Whitworth, A. (2006). Clinicians' perceptions of candidacy for conversation partner training in aphasia: How do we select candidates for therapy and do we get it right? Aphasiology, 20(7), 616–643. [* mixed]
Hilari, K., & Byng, S. (2009). Health-related quality of life in people with severe aphasia. International Journal of Language and Communication Disorders, 44(2). 193–205. [* thin]
2010–2012
Ferguson, A., Duffield, G., & Worrall, L. (2010). Legal decision-making by people with aphasia: Critical incidents for speech pathologists. International Journal of Language and Communication Disorders, 45(2), 244–258. [* thin]
Hengst, J. A., Duff, M. C., & Dettmer, A. (2010). Rethinking repetition in therapy: Repeated engagement as the social ground of learning. Aphasiology, 24(6–8), 887–901. [* thick]
Jacks, A., Mathes, K. A., & Marquardt, T. P. (2010). Vowel acoustics in adults with apraxia of speech. Journal of Speech, Language, and Hearing Research, 53(1), 61–74. [thin]
Mckelvey, M., Hux, K., Dietz, A., Beukelman, D. (2010). Impact of personal relevance and contextualization on word-picture matching by people with aphasia. American Journal of Speech-Language Pathology, 19, 22–23. [* thin]
Purves, B. A., Logan, H., & Marcella, S. (2011). Intersections of literal and metaphorical voices in aphasia. Aphasiology, 25(6–7), 688–699. [* thick]
Sacchett, C., & Black, M. (2011). Drawing as a window to event conceptualization: Evidence from two people with aphasia, Aphasiology, 25(1), 3–26. [* mixed]
Simmons-Mackie, N., & Elman, R. J. (2011). Negotiation of identity in group therapy for aphasia: The Aphasia Café. International Journal of Language and Communication Disorders, 46(3), 312–323. [* mixed]
Croot, K., Ballard, K., Leyton, C. E., & Hodges, J. R. (2012). Apraxia of speech and phonological errors in the diagnosis of nonfluent/agrammatic and logopenic variants of primary progressive aphasia. Journal of Speech, Language, and Hearing Research, 55(5), S1562–S1572. [thin]
Kiran, S., Caplana, D., Sandberga, C., Levya, J., Berardinoa, A., Ascensoa, E., … Tripodisa, Y. (2012). Development of a theoretically based treatment for sentence comprehension deficits in individuals with aphasia. American Journal of Speech-Language Pathology, 21, S88–S102. [* thin]
Footnote
1 Cheryl Yepez, a clinical instructor in our program, created and printed this poster, drawing on the ASHA's Key Steps in the EBP Process: http://www.asha.org/members/ebp/steps/.
Cheryl Yepez, a clinical instructor in our program, created and printed this poster, drawing on the ASHA's Key Steps in the EBP Process: http://www.asha.org/members/ebp/steps/.×
Table 1. Sample set for categorical analysis of Communication Sciences and Disorders (CSD) literature. The total number of articles reviewed are listed by journal and decade. This sample is just over half of all articles published in these journals.
Sample set for categorical analysis of Communication Sciences and Disorders (CSD) literature. The total number of articles reviewed are listed by journal and decade. This sample is just over half of all articles published in these journals.×
Decade JSHD AJSLP JSHR/JSLHR BJDC/EJDC/IJLCD Aphasiology Totals
1930s 104 a 104
1940s 187 187
1950s 181 77 a 258
1960s 198 270 80 a 548
1970s 268 352 86 706
1980s 254 374 95 190 a 913
1990s 175 a 614 263 283 1,335
2000s 157 521 148 310 1,136
2010s 102 a 366 a 152 a 252 a 872
Totals 1,192 434 2,574 824 1,035 6,059
Note. JSHD = Journal of Speech and Hearing Disorders; AJSLP = American Journal of Speech-Language Pathology; JSHR/JSLHR = Journal of Speech and Hearing Research/Journal of Speech, Language, and Hearing Research; BJDC/EJDC/IJLCD = British Journal of Disorders of Communication/European Journal of Disorders of Communication/International Journal of Language and Communication Disorders.
Note. JSHD = Journal of Speech and Hearing Disorders; AJSLP = American Journal of Speech-Language Pathology; JSHR/JSLHR = Journal of Speech and Hearing Research/Journal of Speech, Language, and Hearing Research; BJDC/EJDC/IJLCD = British Journal of Disorders of Communication/European Journal of Disorders of Communication/International Journal of Language and Communication Disorders.×
a Partial decades.
Partial decades.×
Table 1. Sample set for categorical analysis of Communication Sciences and Disorders (CSD) literature. The total number of articles reviewed are listed by journal and decade. This sample is just over half of all articles published in these journals.
Sample set for categorical analysis of Communication Sciences and Disorders (CSD) literature. The total number of articles reviewed are listed by journal and decade. This sample is just over half of all articles published in these journals.×
Decade JSHD AJSLP JSHR/JSLHR BJDC/EJDC/IJLCD Aphasiology Totals
1930s 104 a 104
1940s 187 187
1950s 181 77 a 258
1960s 198 270 80 a 548
1970s 268 352 86 706
1980s 254 374 95 190 a 913
1990s 175 a 614 263 283 1,335
2000s 157 521 148 310 1,136
2010s 102 a 366 a 152 a 252 a 872
Totals 1,192 434 2,574 824 1,035 6,059
Note. JSHD = Journal of Speech and Hearing Disorders; AJSLP = American Journal of Speech-Language Pathology; JSHR/JSLHR = Journal of Speech and Hearing Research/Journal of Speech, Language, and Hearing Research; BJDC/EJDC/IJLCD = British Journal of Disorders of Communication/European Journal of Disorders of Communication/International Journal of Language and Communication Disorders.
Note. JSHD = Journal of Speech and Hearing Disorders; AJSLP = American Journal of Speech-Language Pathology; JSHR/JSLHR = Journal of Speech and Hearing Research/Journal of Speech, Language, and Hearing Research; BJDC/EJDC/IJLCD = British Journal of Disorders of Communication/European Journal of Disorders of Communication/International Journal of Language and Communication Disorders.×
a Partial decades.
Partial decades.×
×
Table 2. Descriptions of thin and thick representations of people and their life worlds, across four International Classification of Functioning, Disability and Health (ICF)-derived domains, used to guide discourse analysis of 56 core acquired cognitive-communication disorders (ACCD) research articles.
Descriptions of thin and thick representations of people and their life worlds, across four International Classification of Functioning, Disability and Health (ICF)-derived domains, used to guide discourse analysis of 56 core acquired cognitive-communication disorders (ACCD) research articles.×
Domain Thin representations Thick representations
(A) People/identities Labels on the basis of ability, demographic category, generic roles Personally meaningful labels (names, initials, pseudonyms) and social roles and relationships
(e.g., aphasic subjects; nonaphasic group; ID#) (e.g., Mary; her son)
(B) Body structures/functions Informal and formal assessments (medical, behavioral) of deficits and strengths using professional terminology People's accounts of their experiences and evaluations of their abilities, in personal terms
(e.g., left middle cerebral artery infarct; impaired auditory comprehension) (e.g., participant reports he can't remember names of places)
(C) Activities/participation Informal and formal assessments of target abilities, communication needs, and patterns of participation in specific activity domains People's accounts in their own experiences, abilities, communication needs, and patterns of participation in their everyday activities
(e.g., assessment of ADLs) (e.g., family's collaborative effort; “getting back to playing golf”; life story, ambitions)
(D) Internal/social contexts Informal and formal assessments and reports, in disciplinary terms, of people's internal states, and social barriers or supports People's accounts in personal terms of their internal states and social barriers or supports
(e.g., quantifying and measuring anxiety and depression; access to AAC device) (e.g., Mary uses her device at a coffee house every morning)
Note. ID = identification; ADL = activities of daily living; AAC = augmentative and alternative communication.
Note. ID = identification; ADL = activities of daily living; AAC = augmentative and alternative communication.×
Table 2. Descriptions of thin and thick representations of people and their life worlds, across four International Classification of Functioning, Disability and Health (ICF)-derived domains, used to guide discourse analysis of 56 core acquired cognitive-communication disorders (ACCD) research articles.
Descriptions of thin and thick representations of people and their life worlds, across four International Classification of Functioning, Disability and Health (ICF)-derived domains, used to guide discourse analysis of 56 core acquired cognitive-communication disorders (ACCD) research articles.×
Domain Thin representations Thick representations
(A) People/identities Labels on the basis of ability, demographic category, generic roles Personally meaningful labels (names, initials, pseudonyms) and social roles and relationships
(e.g., aphasic subjects; nonaphasic group; ID#) (e.g., Mary; her son)
(B) Body structures/functions Informal and formal assessments (medical, behavioral) of deficits and strengths using professional terminology People's accounts of their experiences and evaluations of their abilities, in personal terms
(e.g., left middle cerebral artery infarct; impaired auditory comprehension) (e.g., participant reports he can't remember names of places)
(C) Activities/participation Informal and formal assessments of target abilities, communication needs, and patterns of participation in specific activity domains People's accounts in their own experiences, abilities, communication needs, and patterns of participation in their everyday activities
(e.g., assessment of ADLs) (e.g., family's collaborative effort; “getting back to playing golf”; life story, ambitions)
(D) Internal/social contexts Informal and formal assessments and reports, in disciplinary terms, of people's internal states, and social barriers or supports People's accounts in personal terms of their internal states and social barriers or supports
(e.g., quantifying and measuring anxiety and depression; access to AAC device) (e.g., Mary uses her device at a coffee house every morning)
Note. ID = identification; ADL = activities of daily living; AAC = augmentative and alternative communication.
Note. ID = identification; ADL = activities of daily living; AAC = augmentative and alternative communication.×
×
Table 3. Total number of articles sampled across journals listed by decade, with the number and percent of total articles identified as research genre, as acquired cognitive-communication disorders (ACCD) focused, and as displaying any evidence of thick representations of people.
Total number of articles sampled across journals listed by decade, with the number and percent of total articles identified as research genre, as acquired cognitive-communication disorders (ACCD) focused, and as displaying any evidence of thick representations of people.×
Decade Total no. articles Research genre
ACCD focused
Thick representation
No. % No. % No. %
1930s 104 50 48 1 1 5 5
1940s 187 64 34 8 4 33 18
1950s 258 182 71 10 4 16 6
1960s 548 388 71 34 6 56 10
1970s 706 552 78 62 9 61 9
1980s 913 729 80 209 23 66 7
1990s 1,335 1,055 79 369 28 201 15
2000s 1,136 981 86 349 31 177 16
2010s 872 769 88 310 36 133 15
Totals 6,059 4,770 79 1,352 22 748 12
Table 3. Total number of articles sampled across journals listed by decade, with the number and percent of total articles identified as research genre, as acquired cognitive-communication disorders (ACCD) focused, and as displaying any evidence of thick representations of people.
Total number of articles sampled across journals listed by decade, with the number and percent of total articles identified as research genre, as acquired cognitive-communication disorders (ACCD) focused, and as displaying any evidence of thick representations of people.×
Decade Total no. articles Research genre
ACCD focused
Thick representation
No. % No. % No. %
1930s 104 50 48 1 1 5 5
1940s 187 64 34 8 4 33 18
1950s 258 182 71 10 4 16 6
1960s 548 388 71 34 6 56 10
1970s 706 552 78 62 9 61 9
1980s 913 729 80 209 23 66 7
1990s 1,335 1,055 79 369 28 201 15
2000s 1,136 981 86 349 31 177 16
2010s 872 769 88 310 36 133 15
Totals 6,059 4,770 79 1,352 22 748 12
×
Table 4. Total number of articles sampled listed by journal, with the number and percent of total articles identified as research genre, as acquired cognitive-communication disorders (ACCD) focused, and as displaying any evidence of thick representations of people.
Total number of articles sampled listed by journal, with the number and percent of total articles identified as research genre, as acquired cognitive-communication disorders (ACCD) focused, and as displaying any evidence of thick representations of people.×
Journal (years published) Articles sampled Research
ACCD
Thick representation
No. % No. % No. %
JSHD (1936–1990) 1,192 754 63 71 6 124 10
AJSLP (1991–present) 434 315 73 52 12 51 12
JSHR/JSLHR (1958–present) 2,574 2,401 93 138 5 159 6
BJDC/EJDC/IJLCD (1966–present) 824 557 68 141 17 126 15
Aphasiology (1987–present) 1,035 743 72 950 92 288 28
Totals 6,059 4,770 79 1,352 22 748 12
Note. JSHD = Journal of Speech and Hearing Disorders; AJSLP = American Journal of Speech-Language Pathology; JSHR/JSLHR = Journal of Speech and Hearing Research/Journal of Speech, Language, and Hearing Research; BJDC/EJDC/IJLCD = British Journal of Disorders of Communication/European Journal of Disorders of Communication/International Journal of Language and Communication Disorders.
Note. JSHD = Journal of Speech and Hearing Disorders; AJSLP = American Journal of Speech-Language Pathology; JSHR/JSLHR = Journal of Speech and Hearing Research/Journal of Speech, Language, and Hearing Research; BJDC/EJDC/IJLCD = British Journal of Disorders of Communication/European Journal of Disorders of Communication/International Journal of Language and Communication Disorders.×
Table 4. Total number of articles sampled listed by journal, with the number and percent of total articles identified as research genre, as acquired cognitive-communication disorders (ACCD) focused, and as displaying any evidence of thick representations of people.
Total number of articles sampled listed by journal, with the number and percent of total articles identified as research genre, as acquired cognitive-communication disorders (ACCD) focused, and as displaying any evidence of thick representations of people.×
Journal (years published) Articles sampled Research
ACCD
Thick representation
No. % No. % No. %
JSHD (1936–1990) 1,192 754 63 71 6 124 10
AJSLP (1991–present) 434 315 73 52 12 51 12
JSHR/JSLHR (1958–present) 2,574 2,401 93 138 5 159 6
BJDC/EJDC/IJLCD (1966–present) 824 557 68 141 17 126 15
Aphasiology (1987–present) 1,035 743 72 950 92 288 28
Totals 6,059 4,770 79 1,352 22 748 12
Note. JSHD = Journal of Speech and Hearing Disorders; AJSLP = American Journal of Speech-Language Pathology; JSHR/JSLHR = Journal of Speech and Hearing Research/Journal of Speech, Language, and Hearing Research; BJDC/EJDC/IJLCD = British Journal of Disorders of Communication/European Journal of Disorders of Communication/International Journal of Language and Communication Disorders.
Note. JSHD = Journal of Speech and Hearing Disorders; AJSLP = American Journal of Speech-Language Pathology; JSHR/JSLHR = Journal of Speech and Hearing Research/Journal of Speech, Language, and Hearing Research; BJDC/EJDC/IJLCD = British Journal of Disorders of Communication/European Journal of Disorders of Communication/International Journal of Language and Communication Disorders.×
×
Table 5. Total number of acquired cognitive-communication disorders (ACCD) articles across decades, with the number and percentages of these coded as research and as displaying any evidence of thick representations of people. The last column shows the number of ACCD research articles coded with any evidence of thick representation of people in relation to the total number or ACCD research articles, and the percentage.
Total number of acquired cognitive-communication disorders (ACCD) articles across decades, with the number and percentages of these coded as research and as displaying any evidence of thick representations of people. The last column shows the number of ACCD research articles coded with any evidence of thick representation of people in relation to the total number or ACCD research articles, and the percentage.×
Decade Total no. ACCD articles Research genre
Thick representation
Research articles + thick representation
No. % No. % No. %
1930s 1 1 100 1 100 (1/1) 100
1940s 8 3 38 8 100 (3/3) 100
1950s 10 7 70 6 60 (5/7) 71
1960s 34 15 44 17 50 (12/15) 80
1970s 62 33 53 10 16 (9/33) 27
1980s 209 115 55 21 10 (16/115) 14
1990s 369 226 61 129 35 (86/226) 38
2000s 349 297 85 102 29 (94/297) 32
2010s 310 239 77 109 35 (98/239) 41
Totals 1,352 936 69 403 30 (324/936) 35
Table 5. Total number of acquired cognitive-communication disorders (ACCD) articles across decades, with the number and percentages of these coded as research and as displaying any evidence of thick representations of people. The last column shows the number of ACCD research articles coded with any evidence of thick representation of people in relation to the total number or ACCD research articles, and the percentage.
Total number of acquired cognitive-communication disorders (ACCD) articles across decades, with the number and percentages of these coded as research and as displaying any evidence of thick representations of people. The last column shows the number of ACCD research articles coded with any evidence of thick representation of people in relation to the total number or ACCD research articles, and the percentage.×
Decade Total no. ACCD articles Research genre
Thick representation
Research articles + thick representation
No. % No. % No. %
1930s 1 1 100 1 100 (1/1) 100
1940s 8 3 38 8 100 (3/3) 100
1950s 10 7 70 6 60 (5/7) 71
1960s 34 15 44 17 50 (12/15) 80
1970s 62 33 53 10 16 (9/33) 27
1980s 209 115 55 21 10 (16/115) 14
1990s 369 226 61 129 35 (86/226) 38
2000s 349 297 85 102 29 (94/297) 32
2010s 310 239 77 109 35 (98/239) 41
Totals 1,352 936 69 403 30 (324/936) 35
×
Table 6. An example of an article profile with thin representation.
An example of an article profile with thin representation.×
Headings (page no.) Thin representations Thick representations
Abstract (p. 623) A. Cantonese-speaking agrammatic subjects; English-speaking agrammatic subjects A. N/A
B. N/A B. N/A
C. N/A C. N/A
D. N/A D. N/A
Introduction (pp. 623–627) A. Chinese-speaking agrammatic subjects A. N/A
B. Broca's/nonfluent type aphasia B. N/A
C. N/A C. N/A
D. N/A D. N/A
Method (pp. 627–630) A. Four subject groups (English or Cantonese agrammatic, fluent nonagrammatic, and nonaphasic groups) A. N/A
B. Mean WAB-AQ subtest scores for aphasic groups (Table 1); slow, halting speech; limited use of morphemes; fragmentary sentences B. N/A
C. Research Task—Elicited Narrative speech C. N/A
D. N/A D. N/A
Results (pp. 630–640) A. Subject groups; Cantonese subjects A. N/A
B. Fluent aphasia; results of linguistic measures (e.g., MLU) presented by groups (Tables 2, 3, & 4; Figures 1 & 2) B. N/A
C. N/A C. N/A
D. N/A D. N/A
Discussion (pp. 640–642) A. Cantonese aphasia subjects A. N/A
B. Shorter MLU; elliptical sentences B. N/A
C. N/A C. N/A
D. N/A D. N/A
Note. Examples of representations of people and their life worlds are listed by A = people/identities, B = body structures/functions, C = activities/participation, D = contexts, internal/external; see Table 2. N/A = not applicable; WAB-AQ = Western Aphasia Battery–Aphasia Quotient; MLU = mean length of utterance. Yiu, E. M., & Worrall, L. E. (1996) . Agrammatic production: A cross-linguistic comparison of English and Cantonese. Aphasiology, 10(6), 623–647.
Note. Examples of representations of people and their life worlds are listed by A = people/identities, B = body structures/functions, C = activities/participation, D = contexts, internal/external; see Table 2. N/A = not applicable; WAB-AQ = Western Aphasia Battery–Aphasia Quotient; MLU = mean length of utterance. Yiu, E. M., & Worrall, L. E. (1996) . Agrammatic production: A cross-linguistic comparison of English and Cantonese. Aphasiology, 10(6), 623–647.×
Table 6. An example of an article profile with thin representation.
An example of an article profile with thin representation.×
Headings (page no.) Thin representations Thick representations
Abstract (p. 623) A. Cantonese-speaking agrammatic subjects; English-speaking agrammatic subjects A. N/A
B. N/A B. N/A
C. N/A C. N/A
D. N/A D. N/A
Introduction (pp. 623–627) A. Chinese-speaking agrammatic subjects A. N/A
B. Broca's/nonfluent type aphasia B. N/A
C. N/A C. N/A
D. N/A D. N/A
Method (pp. 627–630) A. Four subject groups (English or Cantonese agrammatic, fluent nonagrammatic, and nonaphasic groups) A. N/A
B. Mean WAB-AQ subtest scores for aphasic groups (Table 1); slow, halting speech; limited use of morphemes; fragmentary sentences B. N/A
C. Research Task—Elicited Narrative speech C. N/A
D. N/A D. N/A
Results (pp. 630–640) A. Subject groups; Cantonese subjects A. N/A
B. Fluent aphasia; results of linguistic measures (e.g., MLU) presented by groups (Tables 2, 3, & 4; Figures 1 & 2) B. N/A
C. N/A C. N/A
D. N/A D. N/A
Discussion (pp. 640–642) A. Cantonese aphasia subjects A. N/A
B. Shorter MLU; elliptical sentences B. N/A
C. N/A C. N/A
D. N/A D. N/A
Note. Examples of representations of people and their life worlds are listed by A = people/identities, B = body structures/functions, C = activities/participation, D = contexts, internal/external; see Table 2. N/A = not applicable; WAB-AQ = Western Aphasia Battery–Aphasia Quotient; MLU = mean length of utterance. Yiu, E. M., & Worrall, L. E. (1996) . Agrammatic production: A cross-linguistic comparison of English and Cantonese. Aphasiology, 10(6), 623–647.
Note. Examples of representations of people and their life worlds are listed by A = people/identities, B = body structures/functions, C = activities/participation, D = contexts, internal/external; see Table 2. N/A = not applicable; WAB-AQ = Western Aphasia Battery–Aphasia Quotient; MLU = mean length of utterance. Yiu, E. M., & Worrall, L. E. (1996) . Agrammatic production: A cross-linguistic comparison of English and Cantonese. Aphasiology, 10(6), 623–647.×
×
Table 7. An example of an article profile with thick representation.
An example of an article profile with thick representation.×
Headings (page no.) Thin representations Thick representations
Abstract (p. 688) A. A man with nonfluent aphasia and apraxia A. N/A
B. N/A B. N/A
C. N/A C. The creativity with which a man with aphasia integrates components of a therapeutic process into a repertoire of tools to support communication
D. N/A D. N/A
Introduction (pp. 688–689) A. How persons with aphasia manage and negotiate their evolving identities A. N/A
B. N/A B. A familiar person's voice
C. N/A C. N/A
D. Their social worlds D. N/A
Background to the Case Study (p. 690) A. People with nonfluent aphasia A. Skip, third author; first author, Barbara; second author, Heidi
B. Nonfluent aphasia complicated by apraxia B. N/A
C. N/A C. That attracted Skip's attention when the first author (Barbara) invited him to try the program and think about ways he might like to use it
D. SentenceShaper program D. N/A
Methodology (pp. 690–691) A. The particular case A. N/A
B. N/A B. N/A
C. N/A C. Targeted events in the rehabilitation process
D. N/A D. N/A
Overview of Procedures (p. 691) A. Two participants A. Skip, Heidi, Barbara
B. N/A B. Skip's SentenceShaper recordings
C. N/A C. Heidi's interpretations of process in clinic; stories of Skip's speaking activities outside of clinic
D. N/A D. Skip as an expert in living with aphasia; embedded it firmly in the context of his own life
Participants (pp. 692–693) A. N/A A. Skip, Heidi, Barbara; Skip was a powerful public speaker
B. CVA from trauma to left carotid artery, 27 months post onset, WAB-AQ of 54; nonfluent aphasia B. His oral production; he often needs to make multiple attempts
C. Speech characterized by word-finding impairments, articulatory distortions, writes single words C. Acknowledged as a powerful public speaker, even if he can't actually speak very well; Heidi described her interpretation of her role…as that of a volunteer who could support Skip
D. N/A D. Skip draws on background running a printing/desktop publishing business to create written documents, cartoon drawings depicting life with aphasia
The Text (pp. 693–694) A. Group members A. Skip
B. The text contains 628 words, 46 sentences B. The reading Skip chose to record; Skip's person introduction to his recording—“As a result of a motorcycle accident in 2001, I have a speech impairment called aphasia.”
C. N/A C. N/A
D. N/A D. N/A
Findings (pp. 694–696) A. A second listener A. Skip, Heidi, Barbara
B. Melodic Intonation Therapy B. Used playback to self-prompt attempts
C. Mean number of words recorded was 2.95, 72.1% intelligibility; relied on Heidi for multiple repetitions C. Skip and Heidi reviewed the recording and re-recorded some segments; Skip recalled using Melodic Intonation Therapy in earlier therapy, experiences Heidi drew on to support Skip
D. N/A D. Re-recording some segments that…though intelligible to both listeners, did not satisfy Skip. Skip chose to leave some of these in his recording.
Discussion (pp. 696–697) A. A person with aphasia A. Skip, Heidi, Barbara
B. N/A B. Skip's “best” recording was self-determined
C. N/A C. Skip continues to refine his narrative
D. SentenceShaper; listeners D. Skip's commitment in time and effort
Conclusion (p. 698) A. People with aphasia A. N/A
B. N/A B. N/A
C. N/A C. N/A
D. Clinicians; to help people with aphasia achieve personal goals D. N/A
Note. Examples of representations of people and their life worlds are listed by A = people/identities, B = body structures/functions, C = activities/participation, D = contexts, internal/external, see Table 2. N/A = not applicable, CVA = cerebrovascular accident, WAB-AQ = Western Aphasia Battery–Aphasia Quotient. Purves, B. A., Logan, H., & Marcella, S. (2011) . Intersections of literal and metaphorical voices in aphasia. Aphasiology, 25(6–7), 688–699.
Note. Examples of representations of people and their life worlds are listed by A = people/identities, B = body structures/functions, C = activities/participation, D = contexts, internal/external, see Table 2. N/A = not applicable, CVA = cerebrovascular accident, WAB-AQ = Western Aphasia Battery–Aphasia Quotient. Purves, B. A., Logan, H., & Marcella, S. (2011) . Intersections of literal and metaphorical voices in aphasia. Aphasiology, 25(6–7), 688–699.×
Table 7. An example of an article profile with thick representation.
An example of an article profile with thick representation.×
Headings (page no.) Thin representations Thick representations
Abstract (p. 688) A. A man with nonfluent aphasia and apraxia A. N/A
B. N/A B. N/A
C. N/A C. The creativity with which a man with aphasia integrates components of a therapeutic process into a repertoire of tools to support communication
D. N/A D. N/A
Introduction (pp. 688–689) A. How persons with aphasia manage and negotiate their evolving identities A. N/A
B. N/A B. A familiar person's voice
C. N/A C. N/A
D. Their social worlds D. N/A
Background to the Case Study (p. 690) A. People with nonfluent aphasia A. Skip, third author; first author, Barbara; second author, Heidi
B. Nonfluent aphasia complicated by apraxia B. N/A
C. N/A C. That attracted Skip's attention when the first author (Barbara) invited him to try the program and think about ways he might like to use it
D. SentenceShaper program D. N/A
Methodology (pp. 690–691) A. The particular case A. N/A
B. N/A B. N/A
C. N/A C. Targeted events in the rehabilitation process
D. N/A D. N/A
Overview of Procedures (p. 691) A. Two participants A. Skip, Heidi, Barbara
B. N/A B. Skip's SentenceShaper recordings
C. N/A C. Heidi's interpretations of process in clinic; stories of Skip's speaking activities outside of clinic
D. N/A D. Skip as an expert in living with aphasia; embedded it firmly in the context of his own life
Participants (pp. 692–693) A. N/A A. Skip, Heidi, Barbara; Skip was a powerful public speaker
B. CVA from trauma to left carotid artery, 27 months post onset, WAB-AQ of 54; nonfluent aphasia B. His oral production; he often needs to make multiple attempts
C. Speech characterized by word-finding impairments, articulatory distortions, writes single words C. Acknowledged as a powerful public speaker, even if he can't actually speak very well; Heidi described her interpretation of her role…as that of a volunteer who could support Skip
D. N/A D. Skip draws on background running a printing/desktop publishing business to create written documents, cartoon drawings depicting life with aphasia
The Text (pp. 693–694) A. Group members A. Skip
B. The text contains 628 words, 46 sentences B. The reading Skip chose to record; Skip's person introduction to his recording—“As a result of a motorcycle accident in 2001, I have a speech impairment called aphasia.”
C. N/A C. N/A
D. N/A D. N/A
Findings (pp. 694–696) A. A second listener A. Skip, Heidi, Barbara
B. Melodic Intonation Therapy B. Used playback to self-prompt attempts
C. Mean number of words recorded was 2.95, 72.1% intelligibility; relied on Heidi for multiple repetitions C. Skip and Heidi reviewed the recording and re-recorded some segments; Skip recalled using Melodic Intonation Therapy in earlier therapy, experiences Heidi drew on to support Skip
D. N/A D. Re-recording some segments that…though intelligible to both listeners, did not satisfy Skip. Skip chose to leave some of these in his recording.
Discussion (pp. 696–697) A. A person with aphasia A. Skip, Heidi, Barbara
B. N/A B. Skip's “best” recording was self-determined
C. N/A C. Skip continues to refine his narrative
D. SentenceShaper; listeners D. Skip's commitment in time and effort
Conclusion (p. 698) A. People with aphasia A. N/A
B. N/A B. N/A
C. N/A C. N/A
D. Clinicians; to help people with aphasia achieve personal goals D. N/A
Note. Examples of representations of people and their life worlds are listed by A = people/identities, B = body structures/functions, C = activities/participation, D = contexts, internal/external, see Table 2. N/A = not applicable, CVA = cerebrovascular accident, WAB-AQ = Western Aphasia Battery–Aphasia Quotient. Purves, B. A., Logan, H., & Marcella, S. (2011) . Intersections of literal and metaphorical voices in aphasia. Aphasiology, 25(6–7), 688–699.
Note. Examples of representations of people and their life worlds are listed by A = people/identities, B = body structures/functions, C = activities/participation, D = contexts, internal/external, see Table 2. N/A = not applicable, CVA = cerebrovascular accident, WAB-AQ = Western Aphasia Battery–Aphasia Quotient. Purves, B. A., Logan, H., & Marcella, S. (2011) . Intersections of literal and metaphorical voices in aphasia. Aphasiology, 25(6–7), 688–699.×
×