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PubMed2004

Semantic feature analysis treatment for anomia in two fluent aphasia syndromes.

The effect of semantic feature analysis (SFA) treatment on confrontation naming and discourse production was examined in 2 persons, 1 with anomic aphasia and 1 with Wernicke's aphasia. Results indicated that confrontation naming of treated nouns improved and generalized to untreated nouns for both participants, who appeared to have different lexical access impairments. Both participants demonstrated improvement in some aspects of discourse production associated with the confrontation naming SFA treatment. However, there was no change in most manifestations of lexical retrieval difficulty during discourse for either participant. These findings support previous work regarding improved and generalized naming associated with SFA treatment and indicate a need to examine effects of improved confrontation naming on more natural speaking situations.

Aged↗
PubMed2005

Comparison of alternatives to multidimensional scoring in the assessment of language comprehension in aphasia.

PURPOSE: Multidimensional scoring methods yield valuable information about communication abilities. However, issues of training demands for valid and reliable scoring, especially in current service delivery contexts, may preclude common usage. Alternatives to multidimensional scoring were investigated in a sample of adults with aphasia. METHOD: One alternative method involved modified multidimensional scoring; the others incorporated correct/incorrect scoring. The scores for the 3 alternative methods were derived from the scores obtained using the traditional multidimensional method. Revised Token Test scores obtained using the traditional multidimensional method were collected from 10 participants with aphasia. These scores were manipulated to yield 3 additional sets of scores corresponding to the alternative methods. RESULTS: There were no significant differences between the traditional multidimensional method and 1 of the correct/incorrect methods. Significant differences were found between traditional multidimensional scoring and each of the other 2 methods. CONCLUSIONS: The study findings suggest that simpler scoring systems might yield similar data to traditional multidimensional scoring. If simpler alternative methods yield similar results, using alternative scoring methods with published tests based on multidimensional scoring will help expand their use in everyday clinical practice.

Adult↗
PubMed2003

The role of semantic complexity in treatment of naming deficits: training semantic categories in fluent aphasia by controlling exemplar typicality.

The effect of typicality of category exemplars on naming was investigated using a single subject experimental design across participants and behaviors in 4 patients with fluent aphasia. Participants received a semantic feature treatment to improve naming of either typical or atypical items within semantic categories, while generalization was tested to untrained items of the category. The order of typicality and category trained was counterbalanced across participants. Results indicated that patients trained on naming of atypical exemplars demonstrated generalization to naming of intermediate and typical items. However, patients trained on typical items demonstrated no generalized naming effect to intermediate or atypical examples. Furthermore, analysis of errors indicated an evolution of errors throughout training, from those with no apparent relationship to the target to primarily semantic and phonemic paraphasias. Performance on standardized language tests also showed changes as a function of treatment. Theoretical and clinical implications regarding the impact of considering semantic complexity on rehabilitation of naming deficits in aphasia are discussed.

Aged↗
PubMed2003

The role of semantic complexity in treatment of naming deficits: training semantic categories in fluent aphasia by controlling exemplar typicality.

The effect of typicality of category exemplars on naming was investigated using a single subject experimental design across participants and behaviors in 4 patients with fluent aphasia. Participants received a semantic feature treatment to improve naming of either typical or atypical items within semantic categories, while generalization was tested to untrained items of the category. The order of typicality and category trained was counterbalanced across participants. Results indicated that patients trained on naming of atypical exemplars demonstrated generalization to naming of intermediate and typical items. However, patients trained on typical items demonstrated no generalized naming effect to intermediate or atypical examples. Furthermore, analysis of errors indicated an evolution of errors throughout training, from those with no apparent relationship to the target to primarily semantic and phonemic paraphasias. Performance on standardized language tests also showed changes as a function of treatment. Theoretical and clinical implications regarding the impact of considering semantic complexity on rehabilitation of naming deficits in aphasia are discussed.

Aged↗
PubMed2003

Collaborative referencing between individuals with aphasia and routine communication partners.

H. H. Clark (1992) argues that successful referencing depends on speakers and listeners working together to establish shared perspectives on target objects. In his collaborative referencing model, he identifies 3 phases in the referencing process: initiation, refashioning, and acceptance. For referencing tasks, successful collaboration can be seen in the streamlining of referencing expressions and in the decrease of overt collaborative effort across trials. Although previous studies have shown that speakers with aphasia can be successful on referencing tasks, they have not examined how that success is achieved through the collaborative work of the partners. Using a referencing task adapted from H. H. Clark and D. Wilkes-Gibbs (1986), this study examined how 4 adults with moderate-to-severe aphasia collaborated with routine communication partners (spouses or children). Overall, these pairs completed the referencing task trials with 96% accuracy and displayed referencing processes that generally conformed to Clark's collaborative referencing model. Close analysis of the discourse of these interactions revealed patterns of collaboration that went beyond Clark's model-the pairs used diverse verbal and nonverbal resources, actively negotiated the task across trials, and layered their own personal goals and perspectives onto these interactions. This study highlights the plasticity of functional communication (the diversity of ways the pairs worked together to complete the same task) and points to the importance of understanding processes of tacit learning that take place in social interactions.

Adolescent↗
PubMed2003

Writing treatment for severe aphasia: who benefits?

Writing treatment that involved repeated copying and recall of target words was implemented with 8 individuals with severe aphasia in order to discern the best candidates for the treatment. Four of the 8 participants had strong positive responses to the copy and recall treatment (CART), relearning spellings for 15 targeted words during 10 to 12 weeks of treatment and up to 5 additional words during a month-long homework-based program. Of the 4 other participants, 3 learned the spellings of some target words but failed to reach criterion, and 1 had a poor treatment outcome. Insights regarding possible factors that limited success were gained by examination of individual responses to treatment as well as performance on the pretreatment assessments of semantic, phonological, and orthographic processes. Among the factors associated with success were (a) consistent, accurate completion of daily homework, (b) a relatively preserved semantic system, (c) the ability to discern words from nonwords, and (d) adequately preserved nonverbal visual problem-solving skills. Aphasia severity and minimal pretreatment spelling abilities did not necessarily limit the response to treatment. Participants with positive treatment outcomes demonstrated improved spelling of target words following repeated copying within a single treatment session, and accurately completed daily writing homework. Thus, pretreatment assessment and stimulability within initial treatment sessions provided indications of likely outcome.

Aged↗
PubMed1977

The efficacy of cueing techniques in Broca's aphasia.

Twenty Broca's aphasia patients were stimulated with four cues in a picture-naming task. Among the severe aphasics in the group, presentation of a word to be imitated was the most effective cue and presentation of the initial syllable of the word ranked second. Sentence completion and printed word cues were equally effective and ranked third. Mild aphasic patients responded equally well to all four classes of cues. Reliability measures indicated that the order of potency of cues for the severe group was stable over time. Oral apraxia did not appear to contribute significantly to the severity of Broca's aphasia in any of these subjects. Possible explanations are presented for the effectiveness of cues studied.

Aphasia↗
PubMed1980

Reliability and validity characteristics of the Western Aphasia Battery (WAB).

The reliability and validity characteristics of the Western Aphasia Battery (WAB) are described. High internal consistency measures and high test-retest reliability argue for stability of the test both because its parts contribute to the composite index and because of its temporal reliability. Inter- and intrajudge reliability are both very high, suggesting consistent scoring within and between scorers. The WAB satisfies face- and content-validity criteria. Results from the WAB and the Neurosensory Center Comprehensive Examination for Aphasia (NCCEA) highly correlate, indicating good construct validity. WAB AQ scores and Raven's Coloured Progressive Matrices scores significantly correlate, suggesting that the language portions of the WAB are not totally independent from nonverbal functioning. WAB AQ scores reliably differentiate between aphasic and control groups, with only a small overlap for high functioning anomic aphasic subjects.

Adolescent↗
PubMed1982

Measurement of reading comprehension in aphasia with the RCBA.

Information is presented regarding the Reading Comprehension Battery for Aphasia (RCBA). The results of reliability and validity measures show the test to be psychometrically adequate. Multidimensional and plus-minus methods of scoring the test are equally effective, but plus-minus scoring appears to be more efficient. Order of subtest difficulty is consistent for the entire subject group and does not vary significantly for fluent and nonfluent aphasics. Finally, both auditory comprehension and overall severity of aphasia correlate significantly with reading comprehension.

Adult↗
PubMed1976

Divergent semantic behavior in aphasia.

The purpose of the present study was to examine the divergent semantic behaviors of 30 persons with aphasia in comparison to these same behaviors in a group of 30 normal individuals. Specifically, this study examined fluency or the number of ideas produced, flexibility or the variety of ideas produced, and communality within each subject group and between the two groups. Results support the existence of the divergent mental operation and indicate that persons with aphasia are impaired in their ability to generate semantic responses under this operation. Therefore, speech pathologists may wish to include divergent tasks in their evaluation procedures and plan therapy directed toward the retrieval of divergent responses.

Aged↗
PubMed1977

Short-term memory scan in normal individuals and individuals with aphasia.

Ten matched pairs of normal adults and adults with aphasia participated in a short-term memory, visual recognition paradigm wherein each determined whether or not a probe digit appeared in a subset of digits previously presented. Reaction times, measured in milliseconds from onset of probe digits until completion of visual-motor responses, were analyzed as a function of increasing subset size (two, four, and six digits) and the positive versus the negative response condition. Reaction times were significantly slower for the subjects with aphasia. Both groups of subjects demonstrated linear increases in reaction time across levels of subset size. For both groups, increases in reaction time were similar in the positive vs the negative-response conditions. Resulting parallel slopes suggested that both groups of subjects used a serial exhaustive scan of short-time memory. Results from this study did not support results obtained by others in previous studies which may have been confounded by group differences in visual retention spans.

Adult↗
PubMed1994

A measure of the contribution of a gesture to the perception of speech in listeners with aphasia.

The contribution of a visual source of contextual information to speech perception was measured in 12 listeners with aphasia. The three experimental conditions were: Visual-Only (referential gesture), Auditory-Only (computer-edited speech), and Audio-Visual. In a two-alternative, forced-choice task, subjects indicated which picture had been requested. The stimuli were first validated with listeners without brain damage. The listeners with aphasia were subgrouped as having high or low language comprehension based on standardized test scores. Results showed a significantly larger contribution of gestural information to the responses of the lower-comprehension subgroup. The contribution of gesture was significantly correlated with the amount of ambiguity experienced with the auditory-only information. These results show that as the auditory information becomes more ambiguous, individuals with impaired language comprehension deficits make greater use of the visual information. The results support clinical observations that speech information received without visual context is perceived differently than when received with visual context.

Adult↗
PubMed1999

The efficacy of group communication treatment in adults with chronic aphasia.

We examined the effects of group communication treatment on linguistic and communicative performance in adults with chronic aphasia. Participants were randomly assigned to two treatment and two deferred treatment groups. Groups were balanced for age, education level, and initial aphasia severity. Twenty-four participants completed the 4-month treatment trial. While in the treatment condition, all participants received 5 hours of group communication treatment weekly, provided by a speech-language pathologist. The focus of treatment included increasing initiation of conversation and exchanging information using whatever communicative means possible. While awaiting group communication treatment, participants in the deferred treatment groups engaged in such activities as support, performance, or movement groups in order to control for the effects of social contact. Linguistic and communicative measures were administered to all participants at entry, after 2 and 4 months of treatment, and following 4 to 6 weeks of no treatment. In addition, participants in the deferred treatment groups received an additional administration of all measures just before their treatment trial. Results revealed that participants receiving group communication treatment had significantly higher scores on communicative and linguistic measures than participants not receiving treatment. In addition, significant increases were revealed after 2 months of treatment and after 4 months of treatment. No significant decline in performance occurred at time of follow-up.

Adult↗
PubMed1999

Model-based semantic treatment for naming deficits in aphasia.

An interactive activation model for picture naming was used to guide treatment of a semantic-level deficit in 4 individuals with aphasia and severe picture-naming problems. Participants exhibited a profile consistent with Broca's aphasia with severe naming deficits, part of which was attributable to a semantic impairment based on testing of the lexical system. A semantic-based treatment was used to train naming of nouns in two semantic categories using a single-participant multiple baseline across behaviors and participants. Additional treatment, which included orthographic and phonological information about target words, then was applied. Treatment responses and error patterns demonstrated that semantic treatment resulted in improved naming of both trained and untrained items for 2 of 4 participants. Two participants did not show improved naming until treatment emphasizing the phonological form of the word was provided. This study demonstrates the utility of using an interactive activation model to plan treatment based on levels of disruption in the lexical processing system.

Aphasia, Broca↗
PubMed1999

Electromagnetic articulography treatment for an adult with Broca's aphasia and apraxia of speech.

Electromagnetic articulography (EMA) was explored as a means of remediating [s]/[symbol in text] articulation deficits in the speech of an adult with Broca's aphasia and apraxia of speech. Over a 1-month period, the subject was provided with 2 different treatments in a counterbalanced procedure: (1) visually guided biofeedback concerning tongue-tip position and (2) a foil treatment in which a computer program delivered voicing-contrast stimuli for simple repetition. Kinematic and perceptual data suggest improvement resulting from visually guided biofeedback, both for nonspeech oral and, to a lesser extent, speech motor tasks. In contrast, the phonetic contrast treated in the foil condition showed only marginal improvement during the therapy session, with performance dropping back to baseline 10 weeks post-treatment. Although preliminary, the findings suggest that visual biofeedback concerning tongue-tip position can be used to treat nonspeech oral and (to a lesser extent) speech motor behavior in adults with Broca's aphasia and apraxia of speech.

Aphasia, Broca↗
PubMed2000

Communicating with people with stroke and aphasia: understanding through sensation without words.

To illuminate the phenomena of 'communicating with people with stroke and aphasia without words', 10 care providers particularly successful at communicating with stroke and aphasia patients who were working at a stroke rehabilitation ward narrated their experiences of communicating with such patients. A phenomenological hermeneutic approach, inspired by Ricoeur's philosophy, was used in the analysis. Two main themes were found: facilitating openness and being in wordless communication. The care providers sensed the feelings of the patients and experienced similar feelings themselves, thus, the communication is guided by the shared feelings between the care provider and the patient, i.e. communion. For this 'communication through sensation' to take place, the following factors were found to be necessary: creative closeness in combination with protective distance; striving for satisfaction and against exhaustion and desperation; meeting the patient halfway to gain understanding; exhibiting attention and accessibility to the patient; and trust and confidence for both care providers and patients. The findings were interpreted and discussed in the light of works by Levinas, Lögstrup and Stern.

Adult↗
PubMed2002

Understanding between care providers and patients with stroke and aphasia: a phenomenological hermeneutic inquiry.

Understanding between care providers and patients with stroke and aphasia: a phenomenological hermeneutic inquiry The present study illuminates the understanding in communication between formal care providers and patients with stroke and aphasia. Five care providers and three such patients participated in the study. Video recordings were made during conversations about pictures (n = 15), and the care providers were also interviewed (n = 15) after the video-recorded conversations. A phenomenological hermeneutic method of interpretation of the interview text was used. The findings showed that a range of conditions for 'understanding and being understood' in the communication on the part of the care providers exists. These different conditions are: lacking both knowledge and understanding; having knowledge but not necessarily accompanied by understanding; and being in understanding. Within the condition 'being in understanding', the care providers create a feeling of at-homeness in a relaxed atmosphere and thus have the opportunity to be in 'understanding and being understood' together with the patient. The condition 'being in understanding' appears in connection with the care providers' creating of a 'calm liturgy of caring' by mediating humility and calm vitality affects to the patients, and further, when needed, being present on the level of mystery, i.e. caring communion.

Adult↗
PubMed1999

Primary progressive aphasia: a case report.

We report a 69-year-old male patient whose motor aphasia started at the age of 61. The language disability remained isolated and progressed over a period of eight years without any additional cognitive deficits. Computed tomography (CT) and magnetic resonance imaging (MRI) showed moderate cortical atrophy with frontal dominance. Single photon emission tomography (SPECT) showed hypoperfusion in the frontotemporoparietal region, positron emission tomography (PET) demonstrated a global cortical reduction of glucose utilization with a lesser decrement in the occipital lobes. The clinical symptoms and the neuropsychological findings fit the diagnosis of primary progressive aphasia.

Aged↗