Production and comprehension in aphasia: gains and pitfalls in using macrostructure tasks in Aesop's fables

Macrostructures provide the global meaning of a text. Using Aesop's fables, the main goal of this study has been to identify the advantages and limitations in using the macrostructure tasks of retell, summary, lesson, and gist as clinical tools in understanding 16 patients with mild-to-moderate aphasia. Results suggest that all of the macrostructure tasks are important in determining the production skills of patients with aphasia. Comprehension, on the other hand, is best determined through the macrostructure tasks of retell and lesson. In addition to the language processing skills of patients with aphasia, macrostructures also provide a cognitive picture of how patients manipulate information from stories (i.e., reducing information, making inferences, and generalizing didactic information). Inherent limitations, however, are seen when interpreting possible reasons why patients with aphasia are unable to perform some of these tasks. Given that the potential gains of using macrostructure tasks outweigh the limitations, this study suggests that macrostructures may have clinical value as a diagnostic tool in understanding the cognitive-linguistic processes of patients with brain injury.