Optimizing the assessment of auditory attention in aphasia - ABSTRACT Aphasia is a disorder marked by impairments in language and cognition. There is substantial variability in how well people with aphasia (PWA) respond to treatment. This variability stems from aphasia treatment programs primarily focusing on language, which is problematic since experimental models indicate that treatment response in aphasia is predicted by pre-treatment language and cognitive measures. Aphasia treatment programs therefore need to address PWA’s cognitive deficits in addition to their language deficits. Attention is one aspect of cognition that is a prime target for aphasia treatment efforts because it is a foundational process that supports other cognitive functions. Attention is also an important prognostic indicator of recovery from aphasia. Yet, attention is rarely assessed in PWA due to a lack of appropriate assessment tools. The Attention Network Test (ANT) is one promising tool because it can measure three types of attention (alerting, orienting, executive control) using one task in 5-10 minutes. To date, the ANT has primarily been used to measure visuospatial attention. However, it is more critical to assess auditory attention than visual attention in PWA because the neural resources that support auditory attention are more left lateralized than visual attention, meaning the left hemisphere strokes which cause aphasia, likely cause greater deficits in auditory attention than visual attention. Auditory attention is also a stronger predictor of language abilities than visual attention. While auditory versions of the ANT exist, our preliminary work indicates that they are inappropriate to use with PWA and/or do not assess the aspects of auditory attention involved in language. In Aim 1, we will use the knowledge gained from our preliminary work to further develop the auditory ANT for use with PWA. We will optimize the auditory ANT by combining task relevant (information that needs to be consciously processed to complete the task) and irrelevant information (conscious processing is not needed for task completion) into a single stimulus. Our pilot data indicates that this approach is feasible, and that the proposed auditory ANT measures alerting, orienting, and executive control as we expect in controls. In Aim 2, we will establish the test-retest reliability, criterion validity, and internal consistency of the auditory ANT in PWA and controls. In Aim 3, we will predict PWA and controls’ language production and comprehension abilities from their alerting, orienting, and executive control abilities. This proposal will produce a psychometrically sound assessment of auditory attention for use with PWA. The results of this proposal also lay the foundation for future work that will use this auditory ANT to predict language recovery in post-stroke aphasia.
