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Multi-modality aphasia therapy is as efficacious as constraint induced aphasia therapy for chronic aphasia: A phase 1 study
No full textConstraint-induced aphasia therapy (CIAT; Pulvermüller et al., 2001) has been shown to be efficacious in promoting positive changes in formal tests of language function and client perceptions of everyday communication for many individuals with chronic aphasia. Since the publication of the CIAT studies, questions have arisen concerning the appropriateness of utilizing well-established multi-modality treatments in aphasia rehabilitation (Rose, in press). Multi-modal treatments exploit the often-preserved drawing, gesture, reading and writing abilities of individuals with aphasia, either as compensation techniques when spoken communication fails to be restored, or as direct cross-modal facilitation techniques to reestablish language and speech. Multi-Modality Aphasia Treatment (M-MAT; Attard, Rose & Lanyon, 2013) is one such treatment. What remains unclear is the relative efficacy of these two intensive but fundamentally different treatment types (CIAT and M-MAT). Such information is necessary to minimize unnecessary health care spending
Supported Reading Comprehension for People with Aphasia: Photographic and Linguistic Supports
Get PDFPeople with aphasia generally experience better reading comprehension of material formatted in aphasia-friendly manners (e.g., Rose Worrall, & McKenna, 2003) than material formatted in other ways. Aphasia-friendly principles include linguistic-based text modifications (i.e., increased white space, simplified syntax and vocabulary) and visual supports (i.e., relevant images) (Howe, Worrall, & Hickson, 2004). However, conflicting reports exist in the literature regarding the helpfulness of pairing visual supports with text (Brennan, Worrall, & McKenna, 2005; Dietz, Hux, McKelvey, & Beukelman, 2009; Rose, Worrall, Hickson, & Hoffman, 2011). Also, linguistically-based supports may bolster the reading comprehension of people with aphasia in the same way these supports help children understand written materials. Linguistic supports include the use of topic setters (e.g., organizational headings) and keywords alerting a reader to the topic and activating prior knowledge. To date, investigators have performed only preliminary explorations about the effects of linguistic and visual supports on the reading comprehension of people with aphasia. Therefore, the purpose of this study was to compare the individual and combined effect of linguistic and photographic supports on the reading comprehension of narratives by people with aphasia
The Effect of Cognitive Load on Discourse Fluency in Women with TBI
No full textEach year, approximately 125,000 individuals in the United States sustain a traumatic brain injury (TBI) from which they are expected to have life-long disability (Selassie et al., 2008). Social communication deficits are common (Coelho, 1995) in individuals with TBI, and contribute to negative social outcomes (Galski, Tompkins, & Johnston, 1998; Struchen et al., 2008). Though social communication deficits after TBI are well characterized (Coelho, 1995), the underlying neurpsychological mechanisms of these deficits remain unclear. One neuropsychological deficit that has been linked to social communication impairments in the TBI literature is executive dysfunction (Channon & Watts, 2003; Coelho, Liles, & Duffy, 1995; Douglas, 2010), yet it is unclear whether this relationship is correlational (e.g., brain injury affects both social communication and executive functioning) or causal (e.g. executive dysfunction causes poor social communication). To address this knowledge gap, the aim of this study was to characterize the relationship of executive dysfunction to social communication by manipulating the executive function (EF) demands of a discourse task and investigating the effects of this manipulation on discourse performance. Participants were women with and without TBI. Women were chosen for this investigation because they are frequently under-represented in TBI research, in part to their lower risk for TBI (Faul, Xu, Wald, & Coronado) and also because there is evidence of sex-based differences in social communication outcomes following TBI (Dahlberg et al., 2006; Turkstra). The study focused on one aspect of discourse performance that might be affected by EF demand, discourse fluency
Therapeutic effect of an intensive, comprehensive aphasia program: Aphasia LIFT
No full textThe development of intensive, comprehensive aphasia programs (ICAPs) is increasing due to evidence in favour of greater treatment intensity (Cherney, Patterson, Raymer, Frymark, & Schooling, 2008), the adoption of a broad, holistic, biopsychosocial approach in aphasia rehabilitation (Byng & Duchan, 2005; Kagan et al., 2008; Martin, Thompson, & Worrall, 2008; Simmons-Mackie & Kagan, 2007), and the desire to meet the needs of people with aphasia and their family members in therapy (Howe et al., 2012; Worrall et al., 2012). ICAPs comprise a range of therapy approaches (individual therapy, group therapy, patient/family education, technology), delivered at high intensity (minimum of three hours per day over at least two weeks), to a defined group of participants within a specified amount of time (Cherney, Worrall, & Rose, 2012). Aphasia LIFT (Language Impairment and Functioning Therapy) is a research-based ICAP that uses evidence-based therapy approaches to target language and functioning across the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) domains (WHO, 2001). The aim of this study was to determine the therapeutic effect of Aphasia LIFT on language impairment, functional communication, and communication-related quality of life (QOL)
Tracking social connection versus isolation in aphasia
Get PDFThe World Health Organization’s assertion that “health is more than the absence of disease” (WHO, 2001) is relevant to clinicians serving persons with aphasia (PWA). In the framework proposed by the WHO’S International Classification of Functioning, Health and Disability (ICF) (WHO, 2001) contextual and personal factors are presented as key parts of a model that describes functioning in the context of life with some type of disability. For PWA, life with reduced access to spontaneous and effortless use of language skills represents a daily challenge, but the impact is more far reaching than reductions in language use.
Social networks reduce after aphasia, thus narrowing the field of communication opportunities and possibly leading to social isolation (Hilari & Northcott, 2006; Vickers, 2010). This reduction may be a critical clinical factor because social networks are tied to health, well-being and longevity. Further, post stroke depression is a compounding factor, especially when aphasia is present(Thomas & Lincoln, 2008). A variety of national and international policies support the clinical investigation of social networks. First, evidence based practice calls for clinicians to consider client perspectives and values (ASHA, 2005) . Also, the international Commission on Accreditation of Rehabilitation Facilities (CARF, 2012) sets standards for a variety of program areas, including medical rehabilitation. CARF mandates that qualifying rehabilitation programs offer services uniquely designed for stroke survivors that result in the improvement of the quality of life, increase of life participation, and reduction of activity limitations. Therefore, having a brief and easily accessible instrument to investigate the PWA’s sense of social connection versus social isolation could encourage more frequent attention to this aspect of functioning during the rehabilitation process. Such a tool may also provide aphasia group leaders and program directors or specialists with a valuable and quick way to track outcomes related to PWA’s participation in programming designed to meet their needs, thus providing support for ongoing programming and development of programs
Cognitive control in bilingual aphasia
No full textThe ability to suppress irrelevant information requires cognitive control. This process plays a key role when bilinguals are required to speak one language and inhibit the non-target language. Previous research evaluating linguistic and non-linguistic inhibition in bilingual and monolingual healthy adults has revealed a bilingual advantage on non-linguistic tasks (Bialystok, 2001; Costa et al., 2008; Luk et al., 2010). However, a case study comparing healthy bilinguals, monolinguals, and bilingual aphasic patients contradicts the aforementioned studies (Green et al., 2010), suggesting that linguistic cognitive tasks may require different processing demands than non-linguistic cognitive tasks. No study has yet systematically examined cognitive control in bilingual aphasia to determine whether deficits in language inhibition are specific to the language domain or are a more general cognitive deficit. The current study investigates the degree to which language general cognitive control in bilingual aphasia is based in the cognitive domain or language domain. We predict that the language inhibition deficits noted in bilingual patients is language domain specific rather than cognitive domain general
Comparing Semantic and Syntactic Expectation between Verbs and Thematic Roles: Evidence from Eyetracking
No full textIt has been shown with priming paradigms at the single word level (e.g., Edmonds & Mizrahi, 2011; Ferretti, McRae, & Hatherell, 2001) and eyetracking methods at the sentence level (e.g., Altmann & Kamide, 1999; Kamide, Scheepers, & Altmann, 2003) that a verb generates semantic expectations about an upcoming noun (McRae, Ferretti, & Amyote, 1997). In addition to semantic relationships, syntactic constraint is also involved in the expectation process (e.g., Friederici, Steinhauer, & Frisch, 1999; Gunter, Friederici, & Schriefers, 2000). Therefore, both semantic and syntactic constraints are important for fast and accurate language comprehension. However, previous studies have investigated the importance of each constraint independently and have not compared the two constraint effects. Therefore, the purpose of this study is to investigate the effects of semantic and syntactic constraint to evaluate whether one constraint plays a more important role in expectancy generation.
We presented pictures of objects representing the thematic roles of patient (a receiver of the action) and instrument (an object used to do the action) with simultaneous auditory presentation of verbs. With respect to syntax, the patient (bathtub) would be required after a 2-place verb (scrubbing), but the related instrument (sponge) would be optional and not syntactically required. To evaluate semantic expectation, we manipulated the degree of the semantic relationship (see Materials) of the patients and instruments as they related to the presented verb. Using eyetracking, we hypothesized that if participants looked at the patient picture regardless of how strongly the patient was semantically related to the verb, it would indicate that syntactic expectation overrides semantic expectation. Alternatively, if participants looked at the highly-related picture regardless of whether it was a patient or instrument, it would indicate that semantic expectation overrides syntactic expectation
Differential patterns of noun-verb naming and the verb argument complexity in persons with aphasia and normal elderly adults
No full textThe purpose of the study was to investigate 1) whether persons with aphasia (PWA) showed differential patterns between noun and verb naming tasks compared to normal elderly individuals (NEI) and 2) whether the two groups showed differential effects of verb argument complexity on a Korean-verb naming task. Results revealed that PWA showed differentially greater difficulties in verbs than nouns compared to NEI. PWA presented worse performance on unaccusative and 3-place verbs than unergative verbs. However, these patterns were not observed in NEA. Dissociated patterns of verb argument complexity were discussed with respect to Korean-specific verb argument structures
Effects of auditory masking on speech fluency in aphasia and apraxia of speech: Immediate and delayed responses
Get PDFThe purpose of the present study is to characterize the fluency response to auditory masking in ten adults with aphasia, using a time series methodology to account for non-independence of repeated data points and allow for a more fine-grained characterization of individual response patterns
Exploring the Relationship Between Ease of Articulation and Treatment for AOS
Get PDFInvestigators continue to search for effective treatments for acquired apraxia of speech (AOS). One difficulty for investigators interested in developing treatment approaches is that the mechanisms underlying AOS are still not completely understood (e.g., Ziegler, 2002). Locke (1972) performed a study to examine the ease of articulation of English speech phonemes by having adults rate phonemes according to how easy or difficult they were to produce. He found that rated ease of articulation had a strong correlation with the order of phoneme acquisition in children. Phonemes that adults perceived to be easier to produce were acquired earlier by children, and those they perceived to be more difficult to produce were acquired later by children. Moreover, he found that children tended to substitute phonemes that adults rated as easier for those they rated as more difficult. AOS is considered to be a motor speech disorder, so perhaps ease of articulation may play a role in the nature of the problems individuals with AOS demonstrate. The purpose of this study was to determine whether there is a relationship between the phonemes that are selected for treatment or are reported to be in error in persons with AOS and the phonemes that are rated as more difficult to produce by normal speakers