Aphasia in South Asian languages (ASAL) project: a protocol of connected speech tasks for investigating cross-linguistic grammatical profiles in aphasia for South Asian languages

Background: Languages vary in their syntactic (e.g. word order in sentences), lexical (e.g. presence of specific word classes), and morphological (e.g. inflectional or derivational forms of words) properties. This cross-linguistic variation in language typology influences the manifestation of agrammatic symptoms. However, most theoretical models of agrammatism are based on English and a few European languages, limiting their generalizability. This narrow focus neglects the rich syntactic, lexical and morphological variations available in languages globally. Clinically, the lack of language-specific characteristics of agrammatic impairments limits translational potential for precise and improved diagnosis. The Aphasia in South Asian Languages (ASAL) project addresses this gap by leveraging interdisciplinary expertise and advances in connected speech methodologies and analyses. It aims to identify cross-linguistic features of agrammatic production in post-stroke aphasia across under-researched languages from two major language families: Indo-Aryan (Hindi-Urdu, Bengali) and Dravidian (Tamil, Kannada, Malayalam). Aim: This paper presents the protocol developed as the part of the ASAL project for eliciting connected speech data to examine cross-linguistic grammatical profiles in aphasia. It outlines procedures for data collection across five connected speech genres and offers detailed guidelines for transcription, segmentation and data extraction. Additionally, it provides recommendations for linguistic analyses aimed at characterising agrammatism and grammatical deficits, while also accounting for cross-linguistic variation. Methods & Procedures: The protocol was designed for cross-sectional data acquisition from cohorts of people with post-stroke aphasia meeting the criteria of “agrammatic by clinical standard” and neurologically unimpaired speakers in each of the five languages. Data collection procedures are detailed for five connected speech genres–personal narrative, procedural task, image sequence, novel story narrative and picture description–with multiple exemplars in each. Additional data include demographics, aphasia type and severity, and cognitive assessments (e.g. verbal fluency, inhibition, memory span, shifting, cognitive screen). The protocol provides guidance for transcription, data extraction and recommendations for cross-linguistic analyses, along with results of preliminary analyses. Conclusion: The ASAL project is a pioneering initiative investigating agrammatism in linguistically diverse, under-studied South Asian clinical populations. This protocol enables researchers to conduct cross-linguistic studies and develop culturally and linguistically tailored clinical tools. Specifically, it supports: 1) the identification of agrammatic features in narrative speech across languages; 2) the development of clinical checklists for identifying grammatical impairments. This protocol is uniquely positioned to facilitate effective comparisons between universal and language-specific grammatical patterns across a broad spectrum of languages and language families, including multilingual populations and diverse clinical conditions.