The use of standardised short-term and working memory tests in aphasia research: a systematic review

Abstract

Impairments of short-term and working memory (STM, WM), both verbal and non-verbal, are ubiquitous in aphasia. Increasing interest in assessing STM and WM in aphasia research and clinical practice as well as a growing evidence base of STM/WM treatments for aphasia warrant an understanding of the range of standardised STM/WM measures that have been utilised in aphasia. To date, however, no previous systematic review has focused on aphasia. Accordingly, the goals of this systematic review were: (1) to identify standardised tests of STM and WM utilised in the aphasia literature, (2) to evaluate critically the psychometric strength of these tests, and (3) to appraise critically the quality of the investigations utilising these tests. Results revealed that a very limited number of standardised tests, in the verbal and non-verbal domains, had robust psychometric properties. Standardisation samples to elicit normative data were often small, and most measures exhibited poor validity and reliability properties. Studies using these tests inconsistently documented demographic and aphasia variables essential to interpreting STM/WM test outcomes. In light of these findings, recommendations are provided to foster, in the future, consistency across aphasia studies and confidence in STM/WM tests as assessment and treatment outcome measures.

Conversation Therapy with People with Aphasia and Conversation Partners using Video Feedback: A Group and Case Series Investigation of Changes in Interaction

“…The stability, in spite of this, suggests the group were not within a phase of spontaneous recovery and that the intervention did not influence their short term memory/phonological processing. In this sense, it provided good experimental control, although future studies could employ multiple measures of short-term memory as advised by Murray et al (2016). …”

“…Second, assessment of digit span was carried out before and after therapy. This measure provided control for any generalized effect of intervention (for a review see Murray et al, 2016). If this was occurring, change would be predicted to occur on this sensitive task, which was not at floor or ceiling for any participant.…”

“…Historically, aphasia has been viewed as an impairment of memory and it is well established that there is a correlation between performance on verbal short term memory tasks such as digit span and performance on language tasks in PWA (Salis et al, 2015). While assessment of short term memory is not without issues, digit span is widely used in research and practice, with some tests of this showing strong construct validity and predictive and discriminant validity (Murray et al, 2016). A further consideration in task selection was that the participants would be likely to be neither consistently at floor or ceiling on the task, allowing scope for change.…”

Short-Term Memory and Aphasia: From Theory to Treatment

“…Classically, verbal STM has been experimentally and clinically tested by auditorily presenting a sequence of digits or words and having the participant or client repeat them immediately after their presentation (i.e., immediate serial recall), a method that continues to be the most widespread in the recent literature. 1 STM can be thought of as a subset of working memory, which encompasses both this fleeting information storage system and other attentional functions that allow longer maintenance of information in STM and more active manipulation of the stored information. 2,3 Verbal STM is almost ubiquitously found to be impaired in individuals with aphasia, 2 and thus, understanding the interaction between verbal STM and language processing is a theoretically and clinically important endeavor.…”

Working memory treatment in aphasia: A theoretical and quantitative review

“…A comprehensive WM test battery that would target the different WM components discussed here in a process-specific and integrated manner is still lacking. Although there have been some standardization efforts for a subset of the tasks and instruments presented here (e.g., Kalinyak-Fliszar et al, 2011;Majerus et al, 2015), standardized, psychometrically valid and theoretically-informed WM test batteries, particularly for use in severely impaired patients such as aphasic patients, remain scarce (Murray, Salis, Martin, & Dralle, 2016). By explicitly characterizing the storage versus processing requirements as well as the attentional and executive processes involved in all types of WM tasks, a theoretically-informed WM battery could also be a step toward the resolution of the debate around the distinction of 'working memory' versus 'short-term memory' tasks.…”