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Cataphora processing in agrammatic aphasia: Eye movement evidence for integration deficits
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Exploring the Relationship between Attention Allocation and Working Memory Processes in Persons with and without Aphasia
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AphasiaBank: 7-Year Interest Rate Index and Yield
Full text linkAt the 2008 Clinical Aphasiology Conference, Holland et al. (2008) presented a general introduction to the AphasiaBank project that had recently been funded by NIH. That report covered: AphasiaBank’s goals, rationale, and discourse samples; the demographic and test data being collected; and brief descriptions of the coding and analysis systems that had been modified from the very well established Child Language Data Exchange (CHILDES, MacWhinney, 2000) for use with persons with aphasia (PWA). The goal was both to explain the project to the CAC audience and to encourage their participation as researchers and educators.
Now entering its 8th year of funding, the database has grown to contain 302 transcribed discourse samples from PWA and 161 transcribed discourse samples from non-aphasic comparison participants. AphasiaBank is currently the largest shared database of multi-media interactions for the study of communication in aphasia. The standardized protocol guarantees maximal comparability across the database. Some participants have been retested a second and third time at intervals of a year or more. Transcriptions of the discourse samples are linked to digitized audio/video, all of which are password protected at the website and can be downloaded by AphasiaBank members. Additionally, other data sets at the website include media files of the Famous People Protocol (Holland, Fromm, Forbes & MacWhinney 2013), transcripts and media for several aphasia script treatment protocols, media for aphasia group treatment sessions, a variety of non-standardized transcripts linked to media contributed by other aphasia researchers, plus media and transcripts from aphasia participants whose native language is French, Spanish, Greek, and Mandarin.
The purpose of this paper is to present an updated summary of the following:
1) current demographic and test data on PWA who have completed the standardized protocol;
2) professional membership in the database;
3) published clinical research using the database; and
4) educational applications of the database.
In addition, performance on the Western Aphasia Battery (WAB, Kertesz, revised, 2007) by the AphasiaBank sample will be compared with that of the norming sample published for the WAB. The larger AphasiaBank WAB data set comprises a different participant pool in that it represents people with chronic aphasia who seek continued support services
Judging Communicative Competence: Investigating Age-Related Stereotypes in Speech-Language Pathology Students
No full textThe proportion of the US population over age 65 is projected to reach almost 80 million by the year 2040, doubling the numbers from 2000 (Administration on Aging, 2012). With the aging of the population, the incidence of age-related diseases and disorders like stroke and dementia is expected to increase, adding to the caseloads of speech-language pathologists (SLPs). Most SLPs, by contrast, are younger adults; over a quarter of SLPs in the US are under age 35 (ASHA, 2012). Thus, as the elderly population grows, more intergenerational communication encounters will occur between SLPs and their aging clients, increasing demands for cultural competence, specifically with regard to ageism. However, the field of speech-language pathology has seen little research into the impact of age-related stereotypes on service delivery (Armstrong & McKechnie, 2003).
One’s interactions with people are implicitly shaped by stereotypes, widely held unconscious representations of groups of people (Devine, 1989). According to the Age Stereotypes in Interaction model (Hummert, 2012), there are three main factors that trigger stereotypes: the perceiver’s self-system, the context of the interaction, and physical traits. ‘Self-system’ refers to one’s beliefs and attitudes, which are themselves determined by one’s age, cognitive complexity, and past experiences (Hummert, 2012; Ryan, 2007). Stereotypes can be reinforced by the context in which intergenerational encounters occur. To illustrate, Hummert and colleagues (1998) found that younger adults used different language when speaking to older adults in the hospital vs an apartment. Aspects of physical appearance (e.g. grey hair, stooped posture) create an immediate impression of the older individual (Adams et al., 2012). Using photographs, Hummert and colleagues (1997) found that adults perceived to be older were stereotyped more negatively than younger-looking adults. Negative stereotypes may, in turn, affect older adult’s responses, resulting in a cycle of reinforced stereotypes and negative interactions (Ryan, 2007). Williams and colleagues (2009) found that nurses who used ‘elderspeak’ met with more resistance to care in their patients with dementia. To prevent such negative interactions, SLPs must become aware of the potential impact of implicit age-related stereotypes. The purpose of this study was to determine whether SLP students are influenced by age-related stereotypes when judging the communication of older adults
Garden-Path Effects and Recovery in Aphasia
No full textHow people resolve and recover from syntactic ambiguity has been a central research topic in the psycholinguistic literature on sentence comprehension. It has attracted less attention in the literature on communicative impairments. However, there is increasing evidence that brain damage can affect how adults understand syntactically ambiguous sentences, both for right-hemisphere brain damage (e.g., Schneiderman & Saddy, 1988) and left-hemisphere damage (e.g., Novick, Trueswell & Thompson-Schill, 2005). Understanding how persons with aphasia (PWA) comprehend syntactically ambiguous sentences is therefore important to evaluating their communicative function, specifically their sentence comprehension ability.
Syntactically ambiguous sentences are often referred to as garden-path sentences (Bever, 1970). These sentences lead comprehenders “down the garden path”: they cause readers or listeners to briefly misinterpret an ambiguous word or phrase, initially misanalyzing its syntactic role in the sentence. Subsequent information then indicates that this initial interpretation was incorrect, forcing comprehenders to reinterpret the sentence. This garden-path effect has been consistently found in healthy young and older adults (Christianson, et al., 2001, 2006; Ferreira & Henderson, 1991; Frazier & Rayner, 1982).
Syntactic ambiguity resolution may be particularly strongly affected by reduced cognitive function such as reduced working memory (WM), common in healthy aging (e.g., Christianson, et al., 2006; Kemper et al., 2004). Kemper and colleagues (2004) found that older adults showed larger garden-path effects than younger adults, spending longer reading and re-reading garden-path sentences, and that these age-related differences were mediated by WM. This finding provides evidence of the importance of WM in resolving syntactic ambiguities. Christianson, et al. (2006) found that older adults’ comprehension question accuracy for garden-path sentences was correlated with their WM span. This finding provides evidence of the role of WM in successful recovery from a garden path.
However, there has been little research on whether PWA also exhibit garden-path effects in their real-time comprehension of syntactically ambiguous sentences, or how successfully they recover from such garden paths. PWA have also been argued to have reduced WM capacity which contributes to their sentence comprehension deficits (e.g., Miyake, Carpenter & Just, 1994). WM is likely involved in the reanalysis of garden-path sentences (Kemper, et al., 2004), since reanalysis requires performing operations on structures held in memory. This study therefore examined the comprehension of garden-path sentences in PWA, and tested how their on-line garden-path effects and their off-line garden-path recovery were predicted by WM and short-term memory (STM)
Intensive Multimodal Communication Intervention for People with Chronic Aphasia
No full textThe purpose of this study was to examine an intensive multimodal intervention for chronic aphasia. The intervention aimed to increase successful initial use of nonverbal communication modalities to prevent communication breakdowns and to improve switching among communication modalities to repair communication breakdowns. Two people with chronic aphasia completed 10 three-hour intervention sessions across a two-week period. Participant one demonstrated increased successful initial nonverbal modality use across three words lists and increased switching to repair breakdowns. Participant two showed limited success using nonverbal modalities initially or as a repair attempt. Clinical implications and future research directions will be discussed
Cortical and structural connectivity damage correlated with impaired syntactic processing
No full textProblems with sentence processing and production are not exclusive to speakers with agrammatic aphasia. Besides peripheral problems with auditory processing or articulatory control, lexical retrieval, attention and short-term memory deficits may all underlie difficulties with organizing words into sentences, applying inflectional morphology and correctly accessing and processing verb argument structure. Lesions that result in sentence processing problems are therefore not homogeneously limited to a small region. However, sentence processing and production can be broken up into components, in order to investigate the brain-behavior relationship in greater detail. The Northwestern Assessment of Verbs and Sentences (NAVS) allows for such investigations, as it consists of several tasks that tap into different components of syntactic processing (Cho-Reyes & Thompson, 2012). In particular, the NAVS focuses on the pivotal role of verbs and verb argument structure in sentence (de)construction.
With respect to structural syntactic features that affect sentence processing, it is of interest to investigate deficits that are characterized by greater problems with noncanonical sentence structures, compared to canonical structures. Patients with such a pattern of impairment may be considered to have a specific deficit in complex syntactic processing. Brain-behavior investigations that focus on such patterns may yield greater insight into regions and/or networks that serve a particular role in the syntactic computations that underlie the relation between canonical and noncanonical sentences (Magnusdottir et al., 2013).
As part of a larger study into correlations between brain damage and functional deficits, we submitted participants to an MRI scanning protocol that included anatomical scans, diffusion tensor imaging, resting state functional imaging, and perfusion imaging. Such a combination of methods reduces the chance of underestimating the extent of stroke-induced brain damage and its effect on patient symptoms. We investigated correlations with performance on NAVS subtests, as well as with the ratio of performance on canonical versus noncanonical sentence structures
Sound Production Treatment: Synthesis and Quantification of Outcomes
No full textTreatment for acquired apraxia of speech (AOS) has taken numerous forms, with positive outcomes reported for most treatments. Following a critical evaluation and synthesis of the AOS treatment literature, AOS treatment guideline developers concluded that “taken as a whole, the AOS treatment literature indicates that individuals with AOS may be expected to make improvements in speech production as a result of treatment, even when AOS is chronic….and the strongest evidence for this conclusion exists for treatments designed to improve articulatory kinematic aspects of speech production” (Wambaugh, Duffy, McNeil, Robin, & Rogers, 2006; p.lxii ). This conclusion was based upon general criteria concerning the overall quantity and quality of the evidence-base. Strom (2008) subsequently confirmed the positive effects of articulatory-kinematic AOS treatment approaches using meta-analysis.
The AOS guidelines developers grouped treatment studies by general focus (e.g., articulatory-kinematic, rate/rhythm, intersystemic reorganization, and alternative/augmentative); at the time of the guidelines report, no one treatment had a sufficient database to warrant individual consideration (Wambaugh et al., 2006). Over the past decade, additional AOS treatment evidence has accumulated with investigations moving toward comparisons of treatment approaches (Wambaugh, Mauszycki, & Ballard, 2013).
Sound Production Treatment (SPT; Wambaugh, Kalinyak-Fliszar, West, & Doyle, 1998) is an articulatory-kinematic AOS treatment that has received relatively systematic study over the past 15 years. There are now sufficient reports of SPT to support its evaluation as a specific approach rather than as part of the general category of articulatory-kinematic approaches. A synthesis and quantification of the effects of SPT is needed to permit comparison to other treatments, to allow evaluation of different applications of SPT, and to facilitate examination of generalization effects of treatment. The purpose of the current investigation was to quantify the effects of SPT in terms of the magnitude of change (i.e., effect size) associated with treatment and follow-up phases of efficacy studies
Improving auditory access to low imageabilty words by embedding them in imageable semantic-syntactic contexts in a case of deep phonological dysphasia
No full textDeep dysphasia is a relatively rare subcategory of aphasia, characterized by word repetition impairment and profound auditory-verbal short-term memory (AVSTM) limitation. Accuracy of word repetition is better for words than nonwords (lexicality effect) and better for high-image than low-image words (imageability effect). The cardinal feature of deep dysphasia is the occurrence of semantic errors in single word repetition (Howard & Franklin, 1988). Phonological dysphasia shares all of these features except that semantic errors in repetition appear in repetition of multiple words and sentences. Thus, it has been proposed that these two ‘syndromes’ are not distinct, but actually are based on an impairment of auditory-verbal STM that can vary by severity, leading to deep dysphasia when severe and phonological dysphasia when mild (Martin, Saffran & Dell, 1996; Ablinger, Ablel & Huber, 2008).
First, we report a single case treatment study of a person whose pattern of word repetition performance was consistent with the continuum of phonological-deep dysphasia: poor repetition of nonwords, imageability effects in repetition of single and multiple words and semantic errors in repetition of multiple word utterances. Differences in processing abstract (i.e., low imageability) versus concrete (i.e., high image) have been considered recently in aphasic treatment protocols (Kiran, Sandberg & Abbott, 2009). Here we test the effects of a theoretically motivated treatment that manipulates the semantic cohesiveness of low imageability (i.e., abstract)-low frequency (LI-LF)words to improve access to and short-term retention of LI words in deep-phonological dysphasia.
Following presentation of the treatment case study, we describe an experimental protocol to determine if this approach of increasing imageability of abstract words through syntactic and semantic contexts can be extended to other individuals who present along the deep--phonological dysphasia continuum
Evolution of language symptoms in narrative production: A single-case study of Broca's aphasia
Full text linkIn producing an oral narrative such as a fairy tale, the content can be expressed in numerous forms. The lexical items depicting the agents, the objects, and the activities which make up the story, the syntactic structures, and the type of speech produced can vary. Narratives produced by persons with aphasia (PWA) reveal features that are intact and others that are indicative of impaired language processing. Thus, long-term analysis of narratives produced by PWAs provides a unique opportunity to examine the evolution of the predominant symptoms affecting narrative production. Initially due to the severity of language impairment, symptoms may overlap and mask specific deficits which are initially difficult to separate from one another and/or required features may be omitted and substituted.
The aim of this single case study is to characterize the changes in the use of direct and reported speech in the (re-)telling of the fairy tale ‘Cinderella’ over time in the context of the overall language recovery process. The main question addressed is to what extent the availability of specific structures influences narrative production: Is there a tendency for direct speech to be correctly, differentially used by TH in his production of the fairy tale ‘Cinderella’ at various stages of language recovery in contrast to describing the succession of events not using direct speech