Cookie theft renewal

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One piece of the "Boston diagnostic aphasia examination" is a picture description task, for which a standard stimulus is the line drawing shown below on the left:

For one example of how such descriptions can be used, see Naomi Nevler et al., "Automatic measurement of prosody in behavioral variant FTD", 2017. Because it's a standard part of a standard examination, there's been a good reason to continue to use this drawing — but I've often joked that if I were the examination subject, I'd probably spend half of my description time commenting about the picture's 1955-era vibe.

A few days ago, some researchers from JHU presented (and began validating) a more modern version of the picture, shown on the right above — Shauna Berube et al., "Stealing Cookies in the Twenty-First Century: Measures of Spoken Narrative in Healthy Versus Speakers With Aphasia", 2018.

Our goal was to evaluate an updated version of the “Cookie Theft” picture by obtaining norms based on picture descriptions by healthy controls for total content units (CUs), syllables per CU, and the ratio of left–right CUs. In addition, we aimed to compare these measures from healthy controls to picture descriptions obtained from individuals with poststroke aphasia and primary progressive aphasia (PPA) to assess whether these measures can capture impairments in content and efficiency of communication.

As well as being less culturally dated, the updated picture depicts a larger number of situations and visual details. This ought to make the subject's task easier — but it's hard to know whether that makes it a better diagnostic stimulus or not.



  1. Peter said,

    September 19, 2018 @ 9:37 am

    The lady mowing the lawn must have a really quiet lawn mower.

  2. J.W. Brewer said,

    September 19, 2018 @ 9:37 am

    The replacement picture itself seems rather dated in its implicit suggestion that the grass in the yard of a suburban house would be cut by one of the house's light-skinned owners (of either sex) rather than by a darker-skinned immigrant to whom the task had been outsourced.

  3. Ricky said,

    September 19, 2018 @ 9:51 am

    I'm guessing that part of the test must be finding inconsistencies, which would explain talking on the phone while mowing the lawn.

    But since it has been brought up, she's not mowing the lawn. She's mowing the flower bed, which is a) no, do not destroy flowers like that, and b) the earth is usually too soft in a flower bed to run a mower over it.

  4. Martha said,

    September 19, 2018 @ 10:00 am

    JW Brewer, I don't know anyone who doesn't mow their own lawn.

    I just don't understand why that lady is mowing the lawn in a pencil skirt (or how she can hear the call, as Peter mentioned). Also, is she mowing flowers, or dead leaves? I thought it was dead leaves.

  5. BobbieZ said,

    September 19, 2018 @ 10:03 am

    As a former speech pathologist, this kind of drawing was useful for testing aphasic patients. Many of them had moderate to severe expressive aphasia but still could point out several of the incongruities on the picture. In contrast, there were other patients with other kinds of brain damage who tended to focus on small details in the picture, and did not even mention the major incongruities. I often found this contrast in patient responses to be a good diagnostic indicator.

  6. outeast said,

    September 19, 2018 @ 10:29 am

    @Ricky, Martha – I think she's mowing the flowers because she's not paying attention as a consequence of being on the phone. Is the guy wiping the dish with a sponge or standing there playing on his phone, having forgotten he's still holding a plate? That would explain the overflowing sink, though nothing can explain the overflowing hair.

  7. Trogluddite said,

    September 19, 2018 @ 10:58 am

    Mark Liberman – "I've often joked that if I were the examination subject, I'd probably spend half of my description time commenting about the picture's 1955-era vibe."

    BobbieZ – "In contrast, there were other patients with other kinds of brain damage who tended to focus on small details in the picture, and did not even mention the major incongruities"

    Such focus on tangential aspects of the image, or fine details at the expense of major themes, would be common for autistic people. Very similar tests are often used as part of a clinical assessment for autism, so I was rather surprised not to see it mentioned in any of the links (though, I admit, I was rather skimming them!)

    My autism wasn't diagnosed until I was in my mid-forties, and such late (or even much later) diagnosis is relatively common given that e.g. Asperger's Syndrome was unknown during the childhood and youth of such people. I was struck a while ago by the similarity of my own temporary aphasia when overstimulated or extremely anxious and that of a friend who suffered a stroke. This led me to wonder how the conclusions drawn by such tests might be skewed for autistic patients, particularly where the autism is undiagnosed.

    Were I to have a stroke, for example, how would a clinician determine the extent to which the stroke had affected my language abilities, and how much was caused by the extreme stress of the medical emergency and the bewildering environment of a hospital bringing out the latent aphasia of my autism? (sadly, my experience of medical staff who do not specialise in autism is that they generally have a very poor understanding of issues such as this, even where the diagnosis is known.)

  8. djw said,

    September 19, 2018 @ 12:08 pm

    Peter, my battery-powered mower might be quiet enough to allow me to talk on my phone while I mow, but I'm not good at walking and chewing gum at the same time so, yes, Ricky, I might find myself mowing the flowers while I tried to do that. And yes, Martha, I've been cutting my own lawn for most of the time since the divorce more than 20 years ago; at first I couldn't afford even the cheap help, and then I decided that it's about the most exercise I get now that I'm retired (although the electric mower makes it less strenuous than the old gas ones did).

    I would just have to kill the guy doing the dishes while ignoring the kids on the unstable stool and the soapy water all over the place. I might mow over him on purpose.

  9. David L said,

    September 19, 2018 @ 12:17 pm

    In the new pic the boy is falling off the stool and seems appropriately alarmed, but in the first pic he seems quite unconcerned.

    Is that something you're supposed to notice in the test?

  10. Andrew (not the same one) said,

    September 19, 2018 @ 12:36 pm

    Two thoughts:

    a. If I were presented only with the picture on the right, I would suppose that the sink was overflowing because there was a man in charge of it, but the picture on the left shows that the same thing happened when a woman was in charge.

    b. In the picture on the right, the cookie jar is marked 'Cookies', while on the left it's marked 'Cookie Jar', I don't live in a place where cookies are a part of the ordinary fabric of life, but I do possess jars marked 'Sugar' etc., so 'Cookies' seems more natural to me. Are there really jars marked 'Cookie Jar', or is this to be read as a message to those outside the picture (as it would be if a table had 'Table' written on it, etc.).

  11. Jerry Packard said,

    September 19, 2018 @ 1:34 pm

    I've presented the BDAE 'cookie theft' picture to hundreds of Chinese patients with aphasia, and we had to also be concerned with the scores of cross-cultural problems inherent in such an exercise. Fortunately, the bar was low when it came to the standards for production (for the English-speaking patients as well), and we were generally happy to get any usable speech at all. I recall that later someone drew up a version that was more culturally-appropriate to China.

  12. Adam said,

    September 19, 2018 @ 2:34 pm

    Jerry, I'm curious – do you know what changes were made to create a picture more appropriate for Chinese patients?

  13. Gregory Kusnick said,

    September 19, 2018 @ 2:42 pm

    To me the most glaring anachronism is that this 21st-century suburban house apparently lacks a dishwasher.

  14. David Morris said,

    September 19, 2018 @ 4:13 pm

    There's a dishwasher. He's standing right there.

  15. Jerry Friedman said,

    September 19, 2018 @ 4:51 pm

    What the heck kind of right-node raising or related thing is "Stealing Cookies in the Twenty-First Century: Measures of Spoken Narrative in Healthy Versus Speakers With Aphasia"? Or did the authors just accidentally leave "Speakers" out of their title?

  16. Jerry Friedman said,

    September 19, 2018 @ 5:20 pm

    I think my problem with the title is with the word order. "Healthy Versus Speakers…" boggled me, though "Healthy Versus Aphasic Speakers" would give me no problems, whether it's right-node raising or not. I seem to need the items contrasted to be directly adjacent to "versus".

    By the way, I might have thought the woman was mowing colorful weeds such as dandelions and thistles, since that kind of suburban landscaping often puts barriers between the lawn and the flowerbed to avoid problems of exactly that kind.

    How soon will the new picture looks dated? It's got obviously binary gender roles, care has been taken to reverse one gender stereotype, and phones are handheld. And where can you find residential neighborhoods with lush green lawns and flat roofs? Phoenix, Las Vegas?

  17. Rebecca said,

    September 19, 2018 @ 6:55 pm

    If the lawnmower is quiet enough to not scare off the cat, it’s quiet enough for a phone conversation.

  18. Jerry Packard said,

    September 19, 2018 @ 7:44 pm

    Adam, about the only thing I remember is that the people were all Asian, and that the female dishwasher was washing chopsticks and rice bowls.

  19. Rick Rubenstein said,

    September 19, 2018 @ 8:01 pm

    Interesting that they chose to lessen a dated vibe by adding a pompadour. I'm sure this says something about something.

  20. JPL said,

    September 19, 2018 @ 8:02 pm

    Apart from the tap and the home-baked cookies, what mainly gives the first picture its 1955- era vibe is not so much the gender of the dishwasher, but her apron and frock.

  21. Christopher Barts said,

    September 19, 2018 @ 8:18 pm

    The picture on the right is still dated, only this time about twenty or twenty-five years out of date, not upwards of sixty. It's not only dated in terms of clothing style, but in general art style as well. It reminds me of advertisements from the 1990s, is what I'm saying here. Also, they're all wearing shoes, and she's mowing the lawn in a dress. Heck, she's wearing a dress! Also, buildings in the US generally aren't that colorful on the outside, and those are somewhat odd buildings to have in a residential zone where people have their own lawns, which they mow. Maybe that's down to art style.

  22. speedwell said,

    September 19, 2018 @ 9:55 pm

    Jerry, it's "person-first" language, said to be more respectful of the disabled–oops, people with disabilities–by emphasising their personhood first and their disabilities second. It should have been corrected to something like "people with typical speech patterns versus speakers with aphasia" to be consistent, but they only got halfway with it.

    Incidentally, the autistic community mostly rejects person-first language in favour of "autistic person" or "neurodivergent person". The reason I most commonly hear for this is that you don't hear constructions like "person with normality" or "person with intelligence" when you are describing someone with a positive quality; it's "normal person" or "intelligent person". Nobody claims that language diminishes the personhood of a neurotypical person. A few of my friends actually prefer to call themselves "autistics" or "Aspies" because, they reason, we call people "women" and "scientists", not "people with femaleness" or "people who work in science"–not even "female person" or "scientific-work person".

  23. Jason said,

    September 20, 2018 @ 12:34 am

    I agree with Christopher Barts: The "updated" picture has a 1990s vibe to it: Freddie Prinz Junior does the washing up while Cathy Dennis, wearing a retro-50s pencil skirt to mow the lawn, takes a call on her Nokia 5110.

  24. Trogluddite said,

    September 20, 2018 @ 1:52 am

    speedwell – "the autistic community mostly rejects person-first language in favour of "autistic person" or "neurodivergent person". The reason I most commonly hear for this is that you don't hear constructions like "person with normality" or "person with intelligence" when you are describing someone with a positive quality"

    Another common, and not mutually exclusive, objection is that "with" implies the possibility of "without"; i.e. presumption that the autism is separable from the person and/or that "without" is automatically preferable. This has several shades; for some people, simply that for a life-long condition, it is illogical. As autism is a developmental condition, every perception of the world and personal development is influenced by it to a degree, so some consider it an integral part of their identity. Others take the view that autism is only considered a disorder because society is too inflexible to accommodate autistic behaviours. From any of these viewpoints, the implied "without" could be seen to mean replacement by a non-autistic changeling. It's rare that a week goes by on an autism community forum where we don't debate a little bit of linguistics – it can get quite lively!

  25. James Wimberley said,

    September 20, 2018 @ 5:25 am

    It's a morality tale: phoning while doing household chores can lead to accidents and is presumptive child abuse by neglect.

  26. Rodger C said,

    September 20, 2018 @ 7:00 am

    What speedwell said. Specifically, I suspect careless editing from "aphasic speakers."

  27. bks said,

    September 20, 2018 @ 7:51 am

    The dog has no eyes, giving the picture a Twilight Zone vibe.

  28. philip said,

    September 20, 2018 @ 9:30 am

    Surely the woman is not mowing anything? She is standing still, with the mower turned off so she can hear the phone call. Otherwise she would be facing the other way and pushing the lawnmower, not dragging it behind her.

    The man, however, is multi-tasking in an eco-friendly way: using the same water to wash the dishes AND the floor.

  29. Jerry Friedman said,

    September 20, 2018 @ 9:32 am

    speedwell and Rodger C: Thanks, that seems reasonable. And thanks to speedwell and Trogluddite for the comments on usage in the autistic community.

    The disagreements on "person-first" terminology remind me of a time I inadvertently annoyed someone here by saying I saw no objection to "Jew" and was a little uncomfortable with "Jewish person". ("Person who is Jewish" as the preferred form would just be strange.) They felt frustrated by contradictory advice.

  30. philip said,

    September 20, 2018 @ 9:39 am

    Sorry about that! I have only now made the pic bigger and see that she is in fact moving – and mowing – in the right direction.

  31. Mick O said,

    September 20, 2018 @ 1:22 pm

    After reading the comments, I'm fairly certain that the true purpose of the drawing was to find out what Language Log commenters would notice.

  32. seriously said,

    September 20, 2018 @ 1:55 pm

    Do many of ;you have your sarcasm-detecting software disabled? I'm pretty confident that JW Brewer's observation was meant to be witty rather than serious.

  33. Jerry Packard said,

    September 20, 2018 @ 3:48 pm

    Yes, it was a conscious decision, as I was remembering that back in the day I had been discouraged from using the word 'aphasic' as a noun.

  34. Philip Taylor said,

    September 21, 2018 @ 11:10 am

    Jerry — Interesting. To the best of my belief, the analogous use of nominative "paraplegic" is not (yet ?) discouraged, although of course "spastic" is now almost totally unacceptable except in its most clinical usages.

  35. Ray said,

    September 22, 2018 @ 11:17 am

    haha I clicked on the link to the ajslp site and got a window that said: THIS SITE USES COOKIES.

  36. Emily said,

    September 23, 2018 @ 7:31 pm

    Those are some weird birds in the new picture. What are they, tiny flying penguins?

    Also, I think the woman is supposed to be actively mowing the flowers because there are petals flying up around her legs.

  37. Emily said,

    September 23, 2018 @ 7:36 pm

    My dog has no eyes.
    How does he see?

    …wait, that doesn't work.

  38. Jerry Friedman said,

    September 24, 2018 @ 9:36 am

    Emily: I think those are giant colorful flies. And try "How does he look?"

  39. Gwen Katz said,

    September 25, 2018 @ 5:21 pm

    The concept of "focus on tangential details at the expense of major themes" is interesting to me, because it seems like there's room for argument about what's a major theme and what's tangential, especially without any context. In the 50s, the fact that they chose to depict a woman doing the dishes would have obviously been beside the point, but now it jumps out at everyone.

    (To me, the most dated aspect of the picture is that a middle-class family with children owns a house.)

  40. Ray said,

    September 25, 2018 @ 8:22 pm

    I also like how the drawing itself (with its non-Western perspective used in depicting the cabinets) feels very much like an old japanese woodblock print. (which might explain why the guy's sponge matches his pants)

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