Handedness and performance on verbal fluency task in

adults: An empirical study

Abstract
Verbal fluency test is one of the most common test used to investigate the semantic
knowledge and lexical skills among the patients with neurological problems that lead to
language disorder. The study is conducted on the university’s graduate and post graduate
students who are adults. The sample size is taken as 158. The result shows that the
handedness is an important factor in deciding the score on letter fluency task, but not
important for semantic fluency task. Further, the left-handlers are more efficient than right-
handlers on verbal fluency test. Both the tests are significantly but poorly correlated. Hence,
the performance of respondents on each test should be seen independently. the findings are in
line of few past studies but also contradict some of them. The study explores the way of
similar research across the gender and age to have better insights on the study of semantic
knowledge and lexical skills of patients with different sociodemographic backgrounds.
Introduction
To measure the verbal functioning, the verbal fluency test is generally used that primarily
involves two major tasks – Semantic fluency and Letter fluency. Semantic fluency is also
called category fluency, where the respondents are asked to generate as many words as he can
in the given categories in the given time period. In the letter fluency, respondents are asked to
generate words starting with the given letters. In the standard procedure, the time is generally
given up to 1 minute and the respondent’s score is determined on the basis of number of
correct words he generates (Lezak et al. 2012).

Verbal fluency tasks are performed for various purposes in neuropsychological assessment. It
is used to support the diagnosis of hyperactivity/attention-deficit disorder (Andreou & Trott,
2013) and identification of neurodegenerative diseases that lead to cognitive impairments in a
person like Parkinson’s disease (Pettit et al. 2013) and Alzheimer disease (Zhao et al. 2013).
The verbal ability like lexical retrieval ability and lexical knowledge are also measured
among the non-clinical group through the Verbal fluency tasks (Cohen et al. 1999; Weckerly
et al. 2001). It is also used as a test of executive control activity (Fitzpatrick et al. 2013)

The verbal fluency task has been significantly validated in many studies to assess the verbal
ability, specifically the lexical access ability that shows the ability to generate words from the
mental lexicon (Levelt et al. 1999). So, a participant with small group of vocabularies is
expected to generate fewer words than the participant with large stock of vocabularies
(Sauzeon et al. 2011). Similarly, in case of language impairment or dyslexia, a child faces
difficulties in finding the words and hence, generate fewer words than a normal child who
doesn’t have such impairment (Bragrad et al., 2012).

Both the letter and Semantic fluency tasks are similar in nature, but significantly differ in the
context of the nature of task. In verbal fluency task, words are generated from phonemic
category which is rarely used in day-to-day life for speech production. In contrast, the
Semantic fluency tasks is similar to daily tasks like preparing the list of shopping, or
preparing the preparing the list of invitees etc. For a normal person, generally there is no
significant differences are observed between the two tasks. However, few studies have
confirmed a significant discrepancy between the two tasks among the persons with some
impairment. For example, Semantic fluency is found to be poor among the person with
Alzheimer’ s disease (Meijer et al. 2011) and patients with focal lesions (Jones et al. 2006).
In contrast, patient with amyotrophic lateral sclerosis are found to be impaired in letter
fluency task (Quinn et al. 2016).

Studies have also been conducted on the relationship between the handedness and the verbal
fluency performance. In the study of Agostini & Dellatolas (2001), right-handed boys are
found to be more fluent on Semantic fluency tasks than the left-handed boys. Similar result is
also found in the study of Andrea et al. (2016) who performed the study among the children
between the age of 5 and 6 in Brazil. However, in contrast of these studies, no significant
difference is found on verbal fluency test between the left-handed and right-handed person
(Ramier & Hecaen, 1977; Maeshima et al. 1992). So, overall mix of results are found on the
verbal fluency performance between the left-handed and tight-handed respondents.

Most of the previous studies have been conducted on the person or group of persons with
some kind of impairments like dyslexia or hearing impairment. Further, majority of studies
have also been conducted on children. Therefore, it would be interest to perform the test of
verbal fluency task on the adults. The objective of our study is to determine whether there is
any significant difference between the letter fluency and Semantic fluency among the adults
and is there any role of handedness in letter and Semantic fluency.

The research questions are as follows:

1. Is there any significant difference between letter and semantic fluency performance in
adults?
2. Is there any significant difference between right-handers and left-handers in verbal
fluency performance?
3. In right handers, is there a significant difference between letter and semantic fluency
performance?
4. In left handers, is there a significant difference between letter and semantic fluency
performance?
5. Is performance on the semantic fluency task significantly related to performance of
letter fluency task?

The study would help to investigate semantic knowledge and lexical skills among patients
with language disorder.
Methods
a. Participants
The participants of this study are undergraduate and postgraduate students attending
universities who are typically adults, with no history of language difficulties and don’t have
any hearing impairment. They are randomly selected and their participation are completely
based on their consent. A total of 158 students have participated in our study in which, there
are 57 males and 101 females. The range of their age is 19 to 47 years.

b. Materials
For letter and semantic fluency tests, a set of questions are verbally asked to each student and
ask them to respond with their answers on a sheet of paper.

c. Procedure
The standard time of 1 minute is given to each student to respond. The responses are
collected and organised, and then score on letter fluency and semantic fluency are calculated
for each student. Their handedness is observed during their writing.

Results
Hypotheses
To answer each of the research question, following hypotheses are formulated to test.

For research question 1

H0: There is no significant difference between letter and semantic fluency performance in
adults?

For research question 2

H0: There is no significant difference between right-handers and left-handers in verbal

fluency performance?

For research question 3

H0: In right handers, there is no significant difference between letter and semantic
fluency performance?

For research question 4

H0: In left handers, there is no significant difference between letter and semantic fluency
performance?
For research question 5

H0: The performance on the semantic fluency task is significantly related to performance
of letter fluency task?

Descriptive statistics
The descriptive statistic shows the data distribution and it is given in table 1 below.

Table 1: Descriptive statistics

N Minimum Maximum Mean Std. Deviation

Letter Fluency (Number Correct) 158 2.00 100.00 44.7532 20.45554
Semantic Fluencyv(Number Correct) 158 15.00 73.00 48.6582 12.14392
Age in Years 158 19.00 47.00 24.3987 3.88848
Valid N (listwise) 158

For letter fluency task, the min. and max. scores are found to be 2 and 100 respectively with
mean of 44.75 and Std. dev. is 20.45. In case of semantic fluency task, the min. and max.
scores are 15 and 73 respectively with mean of 48.66 and Std. dev od 12.14. The eman age of
respondent is 24.40 years with min. and max. ages are 19 and 47 years respectively.

frequency distribution of ‘Group’ and ‘Gender’ are given in table 2 and 3 respectively.

Table 2: frequency distribution of Group

Frequency Percent Valid Percent

RH 92 28.2 58.2
LH 66 20.2 41.8
Total 158 48.5 100

Table 3: frequency distribution of Gender

Frequency Percent Valid Percent

Male 57 17.5 36.1
Female 101 31.0 63.9
Total 158 48.5 100.0

Around 92 (58.2%) respondents are right-handed and 66 (41.8%) are left-handed. There are
57 males (36.1%) and 101 females (63.9%) in the sample.

Inferential statistics
For hypothesis 1, we run ‘paired sample t-test’ and we found difference of mean score at -
3.90 with Std. error of 1.88. The t-statistic is found to be -2.070 (df = 157) with p-value of
0.040. Hence, we reject the null hypothesis and conclude that there is a significant difference
between letter and semantic fluency performance in adults.

For hypothesis 2, we run ‘t-test for independent sample’ and we found that for letter fluency
task, the t-statistic for difference of handedness is -1.118 with p-value of 0.266. For semantic
fluency task, the t-statistic for difference of handedness is 4.305 with p-value of 0.000.
Hence, we conclude that for letter fluency task, there is a significant difference between left-
handler and right-handler, while for semantic fluency task, there is no significant difference
between them.

For hypotheses 3 and 4, we run ‘paired sample t-test’ and found that for right-handler, the t-
statistic for difference of mean score is found to be -3.797 (df = 91) with p-value of 0.000 and
hence, we reject the Null hypothesis and conclude that there is a significant difference
between letter and semantic fluency performance among right-handlers.

Similarly, for left-handlers, the t-statistic for difference of mean score is found to be 1.126 (df
= 65) with p-value of 0.264 and hence, we accept the Null hypothesis and conclude that there
is no significant difference between letter and semantic fluency performance among left-
handlers.

For hypothesis 5, we find the “Pearson correlation coefficient” and found it 0.007 with p-
value of 0.931. Hence, we accept the Null hypothesis and conclude that the performance on
semantic fluency task is significantly related to performance on letter fluency task

Discussion
The analyses suggest that the performance of adults on letter fluency task significantly differs
from performance on semantic fluency task. The handedness is significant factor for scores
on letter fluency task, but it is insignificant for score on semantic fluency task. Further, there
is a significant difference between letter and semantic fluency performance among right-
handlers, but there is no significant difference left-handlers. Finally, the performance on
semantic fluency task is significantly related to performance on letter fluency task.

Our findings answer the research questions that verbal fluency test differs among adults. The
handedness is an important factor in deciding the score on letter fluency task, but not
important for semantic fluency task. However, right-handler performs differently on letter
and semantic fluency task but left-handler performs equally on both tasks. There is a
significant correlation between performance on letter and semantic fluency tasks but such
correlation is very small.

Our findings are in line of findings of Ramier & Hecaen, (1977) and Maeshima et al. (1992)
who found no significant relationship between left-handler and right-handler on semantic
fluency task. However, our findings contradict the finding of Agostini & Dellatolas (2001)
who argued that the right-handed boys are found to be more fluent on Semantic fluency tasks
than the left-handed boys. So, the nature of test, whether it is letter fluency task or semantic
fluency task and the person’s handedness both decide his score on a particular task. Hence,
the selection of verbal fluency task and the handedness of a person are equally important for
such test.

Our study has certain limitations like we have taken small sample size; we have not
considered any type of psychological or cognitive barriers a respondent may have; we have
also not conducted the study across the gender; and also our study is based on the respondents
of a particular university. If we improve our sample by increasing its size, making it more
diversified and considering the psychological or cognitive barriers to respondents, our result
will be more accurate.

Further research can be carried on by taking the samples from different universities and
background of respondents and conducting the study across the age and gender. Such study
will give more insights on investigating semantic knowledge and lexical skills among patients
with language disorder.

Overall, it is concluded that there is a relation between handedness and verbal fluency test but
such relation depends upon the nature of test carried on. Both tests are significantly, but
poorly correlated. The result finds that the handedness is an important factor in deciding the
score on letter fluency task, but not important for semantic fluency task. Further, the left-
handlers are more efficient than right-handlers on verbal fluency test.
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