Hostname: page-component-5c6d5d7d68-vt8vv Total loading time: 0.001 Render date: 2024-08-24T07:18:30.107Z Has data issue: false hasContentIssue false

Assessment of strategic processing during narrative comprehension in individuals with mild cognitive impairment

Published online by Cambridge University Press:  04 May 2010

MAUREEN SCHMITTER-EDGECOMBE*
Affiliation:
Department of Psychology, Washington State University, Pullman, Washington
SCOTT CREAMER
Affiliation:
Department of Psychology, Washington State University, Pullman, Washington
*
*Correspondence and reprint requests to: Maureen Schmitter-Edgecombe, Department of Psychology, Washington State University, Pullman, WA 99164-4820. E-mail: schmitter-e@wsu.edu.

Abstract

A think-aloud protocol was used to examine the strategies used by individuals with mild cognitive impairment (MCI) during text comprehension. Twenty-three participants with MCI and 23 cognitively healthy older adults (OA) read narratives, pausing to verbalize their thoughts after each sentence. The verbal protocol analysis developed by Trabasso and Magliano (1996) was then used to code participants’ utterances into inferential and non-inferential statements; inferential statements were further coded to identify the memory operation used in their generation. Compared with OA controls, the MCI participants showed poorer story comprehension and produced fewer inferences. The MCI participants were also less skilled at providing explanations of story events and in using prior text information to support inference generation. Poorer text comprehension was associated with poorer verbal memory abilities and poorer use of prior text events when producing inferential statements. The results suggest that the memory difficulties of the MCI group may be an important cognitive factor interfering with their ability to integrate narrative events through the use of inferences and to form a global coherence to support text comprehension. (JINS, 2010, 16, 661–671.)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Text revision. Washington, DC: American Psychiatric Press, Inc.Google Scholar
Bschor, T., Kuhl, K.P., & Reischies, F.M. (2001). Spontaneous speech of patients with dementia of the Alzheimer type and Mild Cognitive Impairment. International Psychogeriatrics, 13, 289298.CrossRefGoogle ScholarPubMed
Chapman, S.B., Zientz, J., Weiner, M., Rosenberg, R., Frawley, W., & Burns, M.H. (2002). Discourse changes in early Alzheimer disease, mild cognitive impairment, and normal aging. Alzheimer Disease and Associated Disorders, 16, 177186.CrossRefGoogle ScholarPubMed
Cote, N., & Goldman, S.R. (1999). Building representations of information text: Evidence from children’s think-aloud protocols. In van Oostendorp, H. & Goldman, S.R. (Eds.), The construction of mental representations during reading (pp. 169193). Mahwah, NJ: Erlbaum.Google Scholar
Creamer, S. & Schmitter-Edgecombe, M. (in press). Narrative comprehension in Alzheimer’s disease: Assessing inferences and memory operations with a think-aloud procedure. Neuropsychology.Google Scholar
Cromley, J.G., & Azvedo, R. (2007). Testing and refining the direct and inferential mediation model of reading comprehension. Journal of Educational Psychology, 99, 311325.CrossRefGoogle Scholar
Delis, D.C., Kaplan, E., & Kramer, J.H. (2001). Trail Making Test A & B. San Antonio, TX: The Psychological Corporation.Google Scholar
Ericsson, K.A., & Kintsch, W. (1995). Long-term working memory. Psychological Review, 102, 211245.CrossRefGoogle ScholarPubMed
Ericsson, K.A., & Simon, H.A. (1993). Protocol analysis: Verbal reports as data (Revised ed.). Cambridge, MA: The MIT Press.CrossRefGoogle Scholar
Fleming, V.B., & Harris, J.L. (2008). Complex discourse production in mild cognitive impairment: Detecting subtle changes. Aphasiology, 22, 729740.CrossRefGoogle Scholar
Fleming, V.B., & Harris, J.L. (2009). Test-retest discourse performance of individuals with mild cognitive impairment. Aphasiology, 23, 940950.CrossRefGoogle Scholar
Fonteyn, M.E., Kuipers, B., & Grobe, S.J. (1993). A description of think aloud method and protocol analysis. Qualitative Health Research, 3, 430441.CrossRefGoogle Scholar
Graesser, A.C., Singer, M., & Trabasso, T. (1994). Constructing inferences during narrative text comprehension. Psychological Review, 101, 371395.CrossRefGoogle ScholarPubMed
Hudon, C., Belleville, S., Souchay, C., Gély-Nargeot, M.C., Chertkow, H., & Gauthier, S. (2006). Memory for gist and detail information in Alzheimer’s disease and mild cognitive impairment. Neuropsychology, 20, 566577.CrossRefGoogle ScholarPubMed
Hughes, C.P., Berg, L., Danzinger, W.L., Coben, L.A., & Martin, R.L. (1982). A new clinical scale for the staging of dementia. British Journal of Psychiatry, 140, 566572.CrossRefGoogle ScholarPubMed
Kaplan, E.F., Goodglass, H., & Weintraub, S. (1983). The Boston naming test (2nd ed.). Philadelphia, PA: Lea & Febiger.Google Scholar
Kempler, D., Almor, A., & MacDonald, M.C. (1998). Teasing apart the contribution of memory and language impairments in Alzheimer’s disease: An online study of sentence comprehension. American Journal of Speech-Language Pathology, 7, 6167.CrossRefGoogle Scholar
Laing, S.P., & Kamhi, A.G. (2002). The use of think-aloud to compare inferencing abilities in average and below-average readers. Journal of Learning Disabilities, 35, 436447.CrossRefGoogle ScholarPubMed
Langston, M.C., Trabasso, T., & Magliano, J.P. (1999). Modeling online comprehension. In Ram, A. & Moorman, K. (Eds.), Computational models of reading and understanding (pp. 181226). Cambridge, MA: MIT Press.Google Scholar
Lezak, M.D. (1983). Neuropsychological assessment (2nd ed.). New York, NY: Oxford University Press.Google Scholar
Magliano, J.P., & Millis, K.K. (2003). Assessing reading skill with a think-aloud procedure. Cognition and Instruction, 21, 251283.CrossRefGoogle Scholar
Magliano, J.P., Trabasso, T., & Graesser, A.C. (1999). Strategic processing during comprehension. Journal of Educational Psychology, 91, 615629.CrossRefGoogle Scholar
McGinnis, D., Goss, R.J., Tessmer, C., & Zelinski, E.M. (2008). Inference generation in young, young-old and old-old adults: Evidence for semantic architecture stability. Applied Cognitive Psychology, 22, 171192.CrossRefGoogle Scholar
Measso, G., Cavarzeran, F., Zappalà, G., & Lebowitz, B.D. (1993). The mini-mental state examination: Normative study of an Italian random sample. Developmental Neuropsychology, 9, 7785.CrossRefGoogle Scholar
Morris, J.C. (1993). The Clinical Dementia Rating (CDR): Current version and scoring rules. Neurology, 43, 24122414.CrossRefGoogle ScholarPubMed
Morris, J.C., McKeel, D.W., & Storandt, M. (1991).Very mild Alzheimer’s disease: Informant-based clinical, psychometric, and pathologic distinction from normal aging. Neurology, 41, 469478.CrossRefGoogle ScholarPubMed
Myers, J.L., & Duffy, S.A. (1990). Causal inferences and text memory. In Graesser, A.C. & Bower, G.H. (Eds.), Inferences and text comprehension (pp. 159173). Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
Petersen, R.C., Doody, R., Kurz, A., Mohs, R.C., Morris, J.C., Rabins, P.V., et al. . (2001). Current concepts in mild cognitive impairment. Archives of Neurology, 58, 19851992.CrossRefGoogle ScholarPubMed
Pressley, M., & Afflerback, P. (1995). Verbal protocols of reading: The nature of constructively responsive reading. Hillsdale, NJ: Erlbaum.Google Scholar
Reitan, R.M. (1958). Validity of the Trail Making Test as an indicator of organic brain damage. Perceptual and Motor Skills, 8, 271276.CrossRefGoogle Scholar
Schmitter-Edgecombe, M., & Bales, J.W. (2005). Understanding text after severe closed-head injury: Assessing inferences and memory operations with a think-aloud procedure. Brain and Language, 94, 331346.CrossRefGoogle ScholarPubMed
Schmitter-Edgecombe, M., Woo, E., & Greeley, D. (2009). Characterizing multiple memory deficits and their relation to everyday functioning in individuals with mild cognitive impairment. Neuropsychology, 23, 168177.CrossRefGoogle ScholarPubMed
Smith, A. (1991). Symbol Digit Modalities Test. Los Angeles, CA: Western Psychological Services.Google Scholar
Trabasso, T., & Magliano, J.P. (1996a). Conscious understanding during comprehension. Discourse Processes, 2, 255287.CrossRefGoogle Scholar
Trabasso, T., & Magliano, J.P. (1996b). How do children understand what they read and what ca new do to help them? In Graves, M., van den Brock, P., & Taylor, B. (Eds.), The first R: Every child’s right to read. New York: Teacher’s College Press.Google Scholar
Trabasso, T., & Suh, S. (1993). Understanding text: Achieving explanatory coherence through on-line inferences and mental operations in working memory. Discourse Processes, 16, 334.CrossRefGoogle Scholar
van der linden, M., & Poncelet, M. (1998). The role of working memory in language and communication disorders. In Stemmer, B. & Whitaker, H.A. (Eds.), The handbook of neurolinguistics. San Diego, CA: Academic Press.Google Scholar
Wechsler, D. (1997). Letter-number sequencing. In Wechsler adult intelligence scale-third edition. San Antonio, TX: The Psychological Corporation.Google Scholar
Welsh, K.A., Breitner, J.C., & Magruder-Habib, K.M. (1993). Detection of dementia in the elderly using telephone screening of cognitive status. Neuropsychiatry, Neuropsychology, & Behavioral Neurology, 6, 103110.Google Scholar
Whitney, P., Ritchie, B.G., & Clark, M.B. (1991). Working-memory capacity and the use of elaborative inferences in text comprehension. Discourse Processes, 14, 133145.CrossRefGoogle Scholar
Yesavage, J.A., Brink, T.L., Rose, T.L., Lum, O., Huang, V., Adey, M.B., et al. . (1983). Development and validation of a geriatric depression rating scale: A preliminary report. Journal of Psychiatric Research, 17, 3749.CrossRefGoogle Scholar
Zachary, R.A. (1991). Shipley Institute of living scale revised manual. Los Angeles: Western Psychological Services.Google Scholar
Zwaan, R.A., & Brown, C.M. (1996). The influence of language proficiency and comprehension skill on situation-model construction. Discourse Processes, 21, 289328.CrossRefGoogle Scholar