Background: Many neurologic conditions, for example multiple sclerosis (MS), are associated with subtle communication and language difficulties. To detect such difficulties, there is a need for valid and reliable methods. While standard aphasia test batteries have been found insufficient, more complex language tasks are believed to be able to distinguish more subtle language difficulties from normal variation in communicative ability. Aims: The aim of this study was to: (1) explore the influence of demographic variables on the results of a novel complex oral semantic fluency task with multiple restrictions in non-braindamaged (NBD) adults, (2) investigate the construct validity and reliability of the method, and (3) compare the results of NBD individuals and individuals with MS. Method and procedure: One hundred and ten NBD individuals performed the complex task and three standard fluency tasks with single restrictions. Regression analyses were run to assess the influence of demographic factors. Furthermore, 16 individuals with MS and subjective anomia performed the complex task and the results were compared with those for a matched group of NBD individuals. Outcome and results: Age and education influenced the NBD individuals' scores on the complex task. The NBD individuals' results on the complex task correlated with those on the three standard fluency tasks. Furthermore, the subgroup of 16 pair-matched NBD individuals produced statistically significantly more adequate responses in the complex task than the group of individuals with MS. However, on an individual level some of the participants with MS performed at level with, or even better than the pair-matched NBD individuals. Provision of scoring guidelines yielded high interrater-reliability. Conclusions: The results illustrate the challenge in attempts to provide formal measures of subtle language disorders. Still, the complex task is a promising assessment tool which may be a complement to existing standard word fluency tasks, although future studies are required to establish the validity and ability to detect subtle language difficulties in different clinical groups.

It is known that Parkinson’s disease is often accompanied by a motor speech disorder, which results in impaired communication. However, people with Parkinson’s disease may also have impaired word retrieval (anomia) and other communicative problems, which have a negative impact on their ability to participate in conversations with family as well as healthcare staff. The aim of the present study was to explore effects of impaired speech and language on communication and how this is managed by people with Parkinson’s disease and their spouses. Using a qualitative method based on Conversation Analysis, in-depth analyses were performed on natural conversational interaction in five dyads including elderly men who were at different stages of Parkinson’s disease. The findings showed that the motor speech disorder in combination with word retrieval difficulties and adaptations, such as using communication strategies, may result in atypical utterances that are difficult for communication partners to understand. The coexistence of several communication problems compounds the difficulties faced in conversations and individuals with Parkinson’s disease are often dependent on cooperation with their communication partner to make themselves understood.