Silent pauses in aphasia

Pauses may be studied as an aspect of the temporal organization of speech, as well as an index of internal cognitive processes, such as word access, selection and retrieval, monitoring, articulatory planning, and memory. Several studies have demonstrated specific distributional patterns of pauses in typical speech. However, evidence from patients with language impairment is sparse and restricted to small-scale studies. The aim of the present study is to investigate empty pause distribution and associations between pause variables and linguistic elements in aphasia. Eighteen patients with chronic aphasia following a left hemisphere stroke were recruited. The control group consisted of 19 healthy adults matched for age, gender, and years of formal schooling. Speech samples from both groups were transcribed, and silent pauses were annotated using ELAN. Our results indicate that in both groups, pause duration distribution follows a log-normal bimodal model with significantly different thresholds between the two populations, yet specific enough for each distribution to justify classification into two distinct groups of pauses for each population: short and long. Moreover, we found differences between the patient and control group, prominently with regard to long pause duration and rate. Long pause indices were also associated with fundamental linguistics elements, such as mean length of utterance. Overall, we argue that post-stroke aphasia may induce quantitative but not qualitative alterations of pause patterns during speech, and further suggest that long pauses may serve as an index of internal cognitive processes supporting sentence planning. Our findings are discussed within the context of pause pattern quantification strategies as potential markers of cognitive changes in aphasia, further stressing the importance of such measures as an integral part of language assessment in clinical populations.