A Comparison of Coverbal Gesture Use in Oral Discourse Among Speakers With Fluent and Nonfluent Aphasia

Abstract

Purpose: Coverbal gesture use, which is affected by the presence and degree of aphasia, can be culturally specific. The purpose of this study was to compare gesture use among Cantonese-speaking individuals: 23 neurologically healthy speakers, 23 speakers with fluent aphasia, and 21 speakers with nonfluent aphasia. Method: Multimedia data of discourse samples from these speakers were extracted from the Cantonese AphasiaBank. Gestures were independently annotated on their forms and functions to determine how gesturing rate and distribution of gestures differed across speaker groups. A multiple regression was conducted to determine the most predictive variable(s) for gesture-to-word ratio.Results: Although speakers with nonfluent aphasia gestured most frequently, the rate of gesture use in counterparts with fluent aphasia did not differ significantly from controls. Different patterns of gesture functions in the 3 speaker groups revealed that gesture plays a minor role in lexical retrieval whereas its role in enhancing communication dominates among the speakers with aphasia. The percentages of complete sentences and dysfluency strongly predicted the gesturing rate in aphasia. Conclusions: The current results supported the sketch model of language-gesture association. The relationship between gesture production and linguistic abilities and clinical implications for gesture-based language intervention for speakers with aphasia are also discussed.G esture is the most common form of nonverbal behavior accompanying human communication. It is defined as spontaneous movements of hands and arms that flow simultaneously with speech (Kendon, 1980). A considerable number of studies have suggested that gestures are communicatively intended (e.g., de Ruiter, 2000;McNeill, 1992) and can enhance everyday social interaction. Moreover, coverbal gestures can supplement the semantic content of oral output (Kendon, 2000) through their representation of spatial/directional and dynamic aspects of language content. Beattie and Shovelton (1999) further supported the supplementary role gestures play in human conversation by arguing that listeners could obtain more semantic information when a conversational partner had used both language and gestures (as compared with the language-only condition) within a verbal exchange task.The view that gestures can assist lexical retrieval during oral production was illustrated in the lexical retrieval hypothesis (LRH) reported by Krauss and Hadar (1999). To be more specific, it was proposed that the spatial and dynamic features of a concept represented by gestures could activate word retrieval. Gillespie, James, Federmeier, and Watson (2014) further suggested that impaired language competency, such as speech dysfluency or word-finding difficulty, was a primary driving force for use of gestures. Additional evidence echoing the LRH was provided by Chawla and Krauss (1994), who demonstrated that unimpaired speakers used gestures more frequently during spontaneous speech as compared with rehearsed speech th...

Use of co-verbal gestures during word-finding difficulty among Cantonese speakers with fluent aphasia and unimpaired controls

“…To examine the relationship between co-verbal gesture use and lexical retrieval more rigorously among unimpaired speakers and PWA, the current study adopted a method different from Kong, Law, Wat, et al (2015) and Kong et al (2017). All instances of WFD in controls and PWA were first identified, before examining if each incident co-occurred with the speakers’ employment of a gesture.…”

“…It was observed that higher use of gestures in the PWA group was associated with improved lexical retrieval. A follow-up study by Kong, Law, and Chak (2017) compared co-verbal gesture employment among 23 fluent PWA, 21 non-fluent PWA, and 23 controls. The results revealed an association between improved WFD and use of non-content-carrying gestures among PWA (unlike the use of content-carrying gestures in controls during WFD).…”

“…As these two studies adopted an observational design to examine the co-occurrence of gesture and resolution of word retrieval, a causal relationship between the two could not be established. Moreover, the demonstration of a clear connection between the gestures employed and their corresponding function(s) was potentially limited by the methodology adopted in Kong, Law, Wat, et al (2015) and Kong et al (2017). Specifically, all instances of gestures were first identified, and the form and primary function of the identified gestures were subsequently coded based on the corresponding content of production.…”

The Role of Gesture in Communication and Cognition: Implications for Understanding and Treating Neurogenic Communication Disorders

“…Gesture production also seems to vary by type of aphasia and on the dimension of fluency; Cicone et al (1979) found that gesture form parallels verbal output where people with non-fluent aphasia produced fewer but clear and informative gestures, and people with fluent aphasia produced frequent but vague gestures. In contrast, other studies have found that people with non-fluent aphasia gesture at higher rates than those with fluent aphasia ( Kong et al, 2017 ). In a story retell task, people with non-fluent Broca’s aphasia produced almost twice as many gestures per 100 words as people with fluent Wernicke’s aphasia, and they also differed by gesture type; people with Broca’s aphasia were more likely to produce meaningful gestures such as iconic gestures whereas those with Wernicke’s aphasia produced more beat and metaphoric, or abstract, gestures ( Sekine et al, 2013 ).…”

Differential roles of gestures on spatial language in neurotypical elderly adults and individuals with focal brain injury

“…Supporting this view, studies report that people with aphasia (PWA) use gestures at a higher frequency than healthy adults (e.g., Feyereisen, 1983;LeMay, David, & Thomas, 1988). Although different patholinguistic profiles yielded differential patterns of gesture use by PWA (e.g., Hadar, Wenkert-Olenik, Krauss, & Soroker, 1998;Kronke, Kraft, Regenbrecht, & Obrig, 2013;Preisig et al, 2018;Rose, 2006), more severe forms of aphasia were generally associated with greater use of spontaneous co-speech gestures (Carlomagno & Cristilli, 2006;Kong, Law & Chak, 2017). However, many of these studies focused on general language use and investigated the integrity of gestures in speech by employing semi-structured interviews, free conversations, and narrating stories (e.g., Dipper, Cocks, Rowe, & Morgan, 2011;Lausberg, Davis, & Rothenhäuser, 2000;Rose & Douglas, 2003).…”