Audiovisual speech segmentation in post-stroke aphasia: a pilot study

Background: Stroke may cause sentence comprehension disorders. Speech segmentation, i.e. the ability to detect word boundaries while listening to continuous speech, is an initial step allowing the successful identification of words and the accurate understanding of meaning within sentences. It has received little attention in people with post-stroke aphasia (PWA).Objectives: Our goal was to study speech segmentation in PWA and examine the potential benefit of seeing the speakers' articulatory gestures while segmenting sentences.Methods: Fourteen PWA and twelve healthy controls participated in this pilot study. Performance was measured with a word-monitoring task. In the auditory-only modality, participants were presented with auditory-only stimuli while in the audiovisual modality, visual speech cues (i.e. speaker's articulatory gestures) accompanied the auditory input. The proportion of correct responses was calculated for each participant and each modality. Visual enhancement was then calculated in order to estimate the potential benefit of seeing the speaker's articulatory gestures.Results: Both in auditory-only and audiovisual modalities, PWA performed significantly less well than controls, who had 100% correct performance in both modalities. The performance of PWA was correlated with their phonological ability. Six PWA used the visual cues. Group level analysis performed on PWA did not show any reliable difference between the auditory-only and audiovisual modalities (median of visual enhancement = 7% [Q1 - Q3: -5 - 39]).Conclusion: Our findings show that speech segmentation disorder may exist in PWA. This points to the importance of assessing and training speech segmentation after stroke. Further studies should investigate the characteristics of PWA who use visual speech cues during sentence processing.