Relationship between language impairment and pragmatic behavior in aphasic adults

We explored the relationship between language impairment and pragmatic performance in aphasic adults during the first 48 weeks postonset. Twenty patients, ten fluent and tell nonfluent, who had suffered a single left hemisphere stroke participated in the study. Half of the patients received 44 weeks of individual treatment and half received 44 weeks of group treatment. Language impairment-auditory comprehension, reading, oral-expressive language, and writing-was determined with the Porch Index of Communicative Ability at four weeks postonset, pretreatment, and at 15, 26, 37, and 48 weeks postonset. Pragmatic performance-verbal aspects, paralinguistic aspects, and nonverbal aspects-was assessed during conversation with a pragmatic protocol at the same points in time. The patients made significant improvement in both language impairment and pragmatic performance between 4 and 48 weeks postonset, and there were no significant differences in improvement between the fluent and nonfluent groups or between patients receiving individual or group treatment. In our fluent aphasic patients, language impairment and pragmatic performance were significantly related at four weeks postonset but not thereafter. Conversely, in our nonfluent aphasic patients, language impairment and pragmatic performance were not significantly related at four weeks postonset, but they were significantly related at 15, 26, 37, and 48 weeks postonset. The significance of the relationship between language impairment and pragmatic performance was sporadic over time in the individual and group treatment groups.