I am doing some research that to quantify the efficiency of a certain treatment upon various parameters related to production and comprehension of speech and language, in patients with aphasia.

However, between the various papers that report such measures (refs below), I am at a loss with regard to how to classify the various abilities, tested as they are by various tests, etc. I've had a go in this table, but it just seems those categories are not at all mutually exclusive, but instead overlapping in multiple ways.

Any tips in how I could make those categories more firm, perhaps from someone who deals in aphasia research, would be much appreciated!

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  • Hurkmans, J.; Bruijn, M. de; Boonstra, A. M.; Jonkers, R.; Bastiaanse, R.; Arendzen, H.; Reinders-Messelink, H. A. Music in the Treatment of Neurological Language and Speech Disorders: A Systematic Review. Aphasiology 2012, 26 (1), 1–19. https://doi.org/10.1080/02687038.2011.602514.

  • van der Meulen, I.; van de Sandt-Koenderman, M. E.; Ribbers, G. M. Melodic Intonation Therapy: Present Controversies and Future Opportunities. Archives of Physical Medicine and Rehabilitation 2012, 93 (1, Supplement), S46–S52. https://doi.org/10.1016/j.apmr.2011.05.029.

  • Zumbansen, A.; Peretz, I.; Hébert, S. Melodic Intonation Therapy: Back to Basics for Future Research. Front. Neurol. 2014, 5. https://doi.org/10.3389/fneur.2014.00007.

  • Zumbansen, A.; Tremblay, P. Music-Based Interventions for Aphasia Could Act through a Motor-Speech Mechanism: A Systematic Review and Case–Control Analysis of Published Individual Participant Data. Aphasiology 2018, 33 (4), 466–497. https://doi.org/10.1080/02687038.2018.1506089.

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    The question as is would be very hard to answer, and I say that without having a glimpse of an idea about the topic. At first sight, it seems that the different points are well distinguished. What is it exactly that you find had been confused? If specifying that would not fit into the frame of the question, it's likely that an answer doesn't either, and therefore the question would be formally off-topic, to be put on hold with the general advise "too broad". – vectory Apr 1 '19 at 20:27
  • You are completely right that the question is vague and difficult to answer. I'll try to clarify things for myself and then edit it. – z8080 Apr 2 '19 at 7:51

Not knowing much about aphasia, I'll give it a shot from a general perspective: Apparently you want to try some music treatment for patients who are affected in different ways and degrees by aphasia. For that, you collected a number of exercises(?) and tests from literature written by people who had similar ideas, to expand on their work.

To test efficiency, you need to first measure the different issues, then apply the treatment, then measure again, and so on. You get graphs which hopefully all go up.

So you should first separate into measurement and treatment. Both could be done involving music, some exercises could even be a mixture of both. Where both is done in one step, you should still write the measurements in one column (or row) separate from the notes about the treatment. So you get four columns - treatment/measurement/both, name, notes, results (only for measurements). How you quantify them is up to you - a percentage (of the ideal or healthy/normal results) should be possible to apply to any kind of measurement.

Next, you want to separate into what is being treated and measured - I'd start with the medical classifications of aphasia, and try to break them down into what part of the brain is actually affected - whereby the more severe forms would have more of those parts affected. Articulation. Speech center. Different memory abilities. Different mental abilities (grammar, abstraction, humor...). 'Comprehension' (also with different tests). And so on. However, the brain has many parts and you know better which parts could be affected and separated through methodical tests and treatments.

The different exercises/tests you have in your table should be possible to break up to fit into this classification system. However, each part will probably also affect many other parts - so I suggest to not bother too much with a perfect fit and to just choose the classification which fits best from your point of view (logically, most effect, literature...).

This way, you end up with a journal which you can directly use to write a spread sheet with your data and analysis, but also as classification system for your future publications.

On a side note, you might also want to try to track other information - like how much of your results is actual healing or relearning, how much is motivation and other such temporary effects, whether any abilities keep degrading from age or original causes of the aphasia, influence of any personal/environmental (temporary) issues, and so on.

My personal belief about what separates aphasia from other brain issues is that it affects the parts of the brain responsible for connecting the different parts. So things get messed up, even though the individual parts may not be affected. People know sounds, but they come out garbled. They know words but they mix them up. And so on. The main issue in healing or relearning is that learning/relearning/error correction will usually change the parts which are actually fine, as the brain doesn't know that the damage occured elsewhere. Which can cause a lot of issues, for instance when the brain repairs an actually damaged part, but by then other parts have already learned to work with the damage, and now don't work correctly with the repaired part anymore. Which leads to some back and forth. Eventually, the brain will find ways to work correctly with and without the repair in the right place, but it takes a lot of additional wiring until just one part of the brain functions normally again (whereby some parts may never heal completely). And stimulation (through Music) seems to be a good way to get there.

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