A person’s race can affect the question as much as their stroke history

A person's race affects the question as much as their stroke history

A new study shows that race is important to consider when evaluating stroke-related communication disorders. Credit: Erin Hull, Duke Health

A stroke that occurs on the right side of the brain can sometimes subtly impair social communication, which can be difficult for clinicians to assess.

But these impairments are less subtle for patients and their families, whose lives and livelihoods are often turned upside down, leading to significant life changes such as job loss and divorce.

Clinical researchers have developed several diagnostic tools for the right (right hemisphere) stroke survivorsbut the tools are mainly based on data from white patient.

That’s a problem, says Duke voice pathologist and assistant professor Jamila Minga, Ph.D., CCC-SLP, because some of the diagnostic tools available can favor those people. most affected by The hit. Black men and women are twice as likely to have a stroke as whites, and a person’s linguistic predisposition can vary according to their race and gender.

A new study from Duke and North Carolina Central University (NCCU) researchers, led by Minga, verifies the suspicion that race changes the way communication impairments manifest.

Minga has found that some stroke survivors ask fewer questions. But this new study also found that a person’s race—regardless of brain injury—affects their propensity to ask questions.

The study appears January 10 in the journal Journal of Speech, Language and Hearing Studies.

Although strokes are likely to occur on the left or right side of the brain, research into stroke-related communication deficits has primarily focused on survivors of left hemisphere stroke. .

“That’s largely due to the decline in communication after the stroke,” says Minga, who recently joined Duke as an assistant professor in the department of head and neck surgery & communication sciences. Strokes in the left hemisphere of the brain are becoming more and more obvious.

Instead, right hemisphere stroke survivors have what clinicians call pragmatism—difficulty understanding and creating language appropriate to contexts and situations. different situations. For example, Minga recalls a time when she visited the patient’s room to assess the voice and while his wife sat in the chair beside him, the patient asked Minga to lie on his hospital bed. He’s not joking or being mean.

“He can make language. He can totally understand. He structure of sentences, grammar and morphology are fine,” says Minga. “Conformity? Not much.”

It is the subtleties of speech and social conventions that make it difficult to identify communication impairment in right-hemisphere stroke survivors, says Minga, leaving many people unable to do so. diagnosed and no help.

Is different Minga’s school found that right hemisphere stroke participants asked fewer questions when getting to know someone new, inspiring her and others to measure the quantity and quality of questions as a potential diagnostic tool.

“Everybody recognizes the question, no matter what language you speak,” says Minga. “It’s easily quantifiable. And questions are used to initiate, maintain, and dissolve relationships. They’re the key to socializing.”

To address whether race affects stroke survivors’ questioning habits, Minga analyzed five-minute conversations from 32 women who had participated in a previous study and measure the number of questions they ask when getting to know a new person. The group of participants consists of an equal number of Black and white womanhalf of them had a stroke in the right hemisphere of the brain.

As previously discovered by Minga, participants with right hemisphere stroke asked fewer questions than those without a stroke regardless of their race in a conversation with a stranger (a female graduates of speech therapy).

However, when Minga and her team analyzed the results by race, they found that regardless of stroke status, Black women asked half as many questions as their counterparts. Caucasians, an average of about 20 questions.

“White participants without a stroke had the highest frequency of questioning, followed by white participants with a right hemisphere stroke,” Minga said. “Thereafter, the Black participants did not have a stroke, and the lowest numbers were seen in the Black participants who had had a stroke in the right hemisphere of the brain.”

The results highlight how communication impairment can be diagnosed right hemisphere stroke may need to be adjusted based on race.

The team is monitoring this study to see if pairing Black participants with a Black conversational partner changes the nature of questioning. (Most speech therapists are white; only 4% identify as Black).

Minga hopes this work motivates clinicians to consider giving more information to patients rather than assuming someone’s reticence is due to a lack of curiosity, especially for Black women.

Minga and her team write in their report: “For Black stroke survivors, the functional consequences of impaired communication are significant. “It can affect financial stability, parenting, and daily social interactions, all of which are important for health and well-being.”

More information:
Danai Kasambira Fannin et al., Crossroads of race and questioning in women after brain injury in the right hemisphere, Journal of Speech, Language and Hearing Studies (2023). DOI: 10.1044/2022_JSLHR-22-00327

Provided by
Duke University

quote: A person’s race can affect questioning as well as their stroke history (2023, Jan 10) retrieved Jan 10, 2023 from 2023-01-person-history.html

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