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Updated: Jul 10, 2026

Examining Gesture Production in the Presence of Communication Challenges
Published on: January 26, 2024
Cohesive gestures in discourse by Chinese-speaking individuals with aphasia
1School of Humanities and Foreign languages, Qingdao University of Technology, China; National Research Center for Language and Well-Being, Shanghai, China.
Objective:
This study investigated the use of cohesive gestures in narrative discourse by persons with aphasia (PWA) and healthy control (HC) participants, aiming to delineate the preserved, impaired, and compensatory aspects of gestural cohesion following linguistic impairment.
Methods:
Ten PWA with non-fluent aphasia and ten HC narrated a story based on a cartoon. Their co-speech gestures were coded into a taxonomy of 17 cohesive types, categorized into grammatical and lexical cohesion. Group comparisons were conducted for total gesture count, gesture-per-hundred-words ratio, gesture-speech semantic relations, and the frequency of each cohesive type.
Results:
While the total number of cohesive gestures did not differ between groups, the PWA group demonstrated a significantly higher gesture-per-hundred-words ratio. PWA relied heavily on complement gestures to serve as functional slot-fillers. Their gestural profile was characterized by preserved use of referential and substitutive gestures, with a marked compensatory increase in verb substitution. In contrast, the production of gestures encoding logical relations (causal, temporal) and abstract semantic packaging (general word) was reduced in PWA.
Conclusions:
The findings reveal a pattern of constrained multimodal compensation. The gestural system in aphasia is not globally impaired but undergoes adaptive reorganization. It amplifies concrete, lexical-level cohesive functions to maintain core narrative content, while higher-order, abstract cohesive functions remain vulnerable.
Significance:
This study supports a model of integrated but functionally differentiated speech-gesture systems. The results demonstrate the necessity of incorporating multimodal assessment in aphasia rehabilitation and highlight gesture's specific potential and its limits as a compensatory channel for discourse cohesion.
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