Development and Real‐Time Clinical Application of New Transcription‐Less Discourse Assessment Approaches for Arabic Speakers With Aphasia

What is already known on the subject Conversations between people rely heavily on producing relevant and informative spoken discourse. Thus, there has been increased interest in the application of discourse tasks in clinical practice to enable a comprehensive assessment of expressive language and functional communication. However, utilising discourse tasks in clinical settings is impractical because their administration and scoring are time-consuming, labour-heavy, and must be completed after the session has ended. Therefore, transcription-less, efficient, and accurate approaches to analyse discourse responses have been developed and validated in English. However, no study has investigated the application of these approaches in real-time clinical settings with people with aphasia (PWA). What this study adds To our knowledge, this is the first study to (i) develop and validate content word fluency (CWF) checklists and main concept (MC) lists in Arabic. These were created for three discourse tasks (composite picture description, storytelling narratives, and procedural discourse) using discourse responses from a neurotypical control group; and (ii) examine the application of these valid, transcription-less, efficient, and accurate approaches to assess CWF and informativeness of spoken discourse in PWA in real-time clinical settings. What are the potential or actual clinical implications of this work? The transcription-less, efficient, and accurate discourse assessment approaches that have been developed and validated in this study allow clinicians to objectively assess discourse responses produced by Arabic speakers with aphasia during clinical examinations while the person is speaking without the need for offline transcription, analyses, and scoring. The reliable application of these approaches in real-time clinical settings encourages clinicians to incorporate discourse tasks as part of their routine clinical examination with PWA to be used (i) for a comprehensive assessment of expressive language skills beyond words and sentences, (ii) to guide the development of personalised therapy goals and strategies to improve functional communication, and (iii) as outcome measurements to monitor spontaneous recovery and changes in response to interventions.