Electronic Thesis and Dissertation Repository

Degree

Master of Science

Program

Health and Rehabilitation Sciences

Supervisor

Dr. J. B. Orange

Abstract

Concurrent with the well-documented motor speech production impairments in amyotrophic lateral sclerosis (ALS), individuals with ALS exhibit language problems including confrontation and generative naming difficulties, single word auditory and reading comprehension problems, and decreased self-regulation based on fewer self-corrected utterances, among other language disruptions. Health related quality of life (HRQoL) measures specific to ALS often contain items related to its characteristic speech production problems that are thought to influence overall quality of life. However, the language problems in ALS are rarely if ever considered within the context of HRQoL. The current study aimed to identify the relationship between language problems (i.e., quality of communication) and HRQoL among individuals with ALS. Twenty-eight participants with ALS completed a general HRQoL (i.e., SF-36) and a quality of communication measure (i.e., ASHA QCL). Scores on these measures were compared with standardized language test scores and discourse measures including verbal fluency, the Boston Naming Test (BNT), and discourse measures obtained from a picture description task. Participants also completed a cognitive status and depression screening using the Montreal Cognitive Assessment (MoCA) and the Geriatric Depression Scale (GDS), respectively. The severity of ALS was measured using the ALS Functional Rating Scale. Results indicated that verbal fluency (animals), discourse output, and speech intelligibility are associated with quality of communication. Regression analyses revealed important predictors of quality of communication including the BNT, MoCA, GDS, and speech intelligibility. The only significant predictor for general HRQol (i.e., SF-36) was the GDS. Results suggest that poor performance on standardized language tests may not be indicative of poor quality of communication, however, findings show that poor efficiency on discourse tasks does affect quality of communication. Results also show that depression in individuals with ALS is associated with poor HRQoL. Overall physical functioning does not significantly contribute to quality of communication or overall HRQoL. An important implication of the findings is that clinicians should focus on optimizing communication in those individuals with ALS who have poor speech intelligibility in order to optimize discourse output, which, in turn, will enhance the quality of communication in individuals with ALS.

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