This paper examines psycho-phonological impairments in pronunciation of monosyllabic and bi-syllabic words in stroke patients of Federal Teaching Hospitals Lokoja and Abuja as it focuses on a glaring gap in the application of context to clinical linguistics studies. The study is anchored on the Optimality Theory (OT) and looks at the effect of stroke-related neurological limitations on phonological production which violates the principles of Segmental Faithfulness (MAX-IO, DEP-IO) and Syllable Integrity. With the help of a mixed-methods design, the data were gathered through semi-structured interviews and structured speech tests of 10 purposively sampled patients, whose articulatory products were phonetically transcribed in IPA. An OT-based analysis revealed systematic error patterns among patients, including omission of final consonants in all cases (100%), vowel shortening in 73% of patients, and reduction of unstressed syllables in 87%, which aligns with existing cross-linguistic literature. More importantly, socio-cultural issues, such as the lack of diagnostic tools and linguistic diversity, intensified the treatment results, contravening the ideas of the Western-centric literature. The major findings reaffirm that the place of the lesion determines the level of impairment, but they also reveal that there are special health barriers to access in Nigeria. The research suggests the introduction of culturally tailored speech therapy interventions with an initial emphasis on constraint-based intervention and contextually available tools, to tackle clinical and socio-structural care infrastructure deficits in the stroke care provision in Nigeria.
Fakoya et al. (Sat,) studied this question.