Stories, Attention, Memory and Aphasia

Persons with aphasia have language deficits that affect their ability to communicate at the discourse level. These linguistic impairments may be related to impaired cognitive functions. The study purpose was to determine the relationship among cognitive processes and story comprehension and production ability in PWA. Participants included 11 PWA and 20 control participants. Tasks included attention and memory measures and a story task. Participants told stories depicted in wordless picture books then answered questions about the stories. Preliminary results indicate that aphasia severity is a better predictor of performance on the story tasks than performance on the cognitive measures

Reliability of Main Event Measurement in the Discourse of Individuals with Aphasia

The purpose of this study was to: (a) compare the performance of healthy adults and adults with aphasia on ability to convey main events in pictured stimuli and (b) establish session-to-session reliability of the authors’ main event measure. The main event measure was designed to quantify participants’ abilities to convey an understanding of the central relationships between concepts depicted in pictured stimuli. Participants were older adults with and without brain damage. Results indicated that healthy adults told a significantly higher proportion of main events than adults with aphasia and that for both groups, the main events measure was stable across sessions

The Impact of Stimulus on Narrative Discourse Production

To quantify narrative discourse ability, clinicians frequently ask individuals to describe pictures and then analyze the resulting language samples for within and/or between sentence processes. For this study, we wanted to determine if color line drawings versus black and white line drawings impacted the quality and quantity of narrative discourse samples. Eighteen healthy adults aged 42.1 to 58.8 described single and sequential pictures in two sessions: a color session and black and white session, randomized and counterbalanced. Both word count and percentage main events relayed were affected by the color condition. Detailed results and clinical implications will be discussed

Productive Vocabulary across Discourse Types

One of the most illuminative predictors of oral performance, lexical diversity (LD), is often neglected or, when used, it is often estimated incorrectly. In this study, we used dedicated software that combines an algebraic transformation model and curve fitting to explore whether there are differences in LD among four types of discourse (procedural discourse, single picture descriptions, story telling, and recounts) and to assess to what extent age influences LD when using each of the aforementioned types of discourse. A LD hierarchy was found with discourse. However, age influenced LD for specific types of discourse. Clinical implications will be discussed

Training Information Components to Improve Narrative Discourse Performance

Most communication interactions are carried out at the discourse level. Clinically, it is important and ecologically valid to develop treatment protocols aimed at improving discourse ability in adults with aphasia. The purpose of this study was to investigate the effectiveness of scripting information components for narratives, one type of discourse ability, in adults with aphasia. This multiple probe design across participants and behaviors included two participants with Broca’s aphasia and one with conduction aphasia. Data analyses indicated that the protocol was effective in increasing the amount of information relayed in response to picture stimuli

The Efficacy of Semantic Feature Analysis for the Treatment of Aphasia: A Systematic Review

Semantic feature analysis (SFA) is a common treatment for improving naming ability in persons with aphasia (PWA). To examine the effectiveness of SFA in improving naming abilities, we conducted an evidence-based systematic review. Seven studies met the inclusion criteria, were assigned appropriate levels of evidence, and were examined for methodological quality using the Single-Case Experimental Design (SCED) scale. Inter-rater reliability was established using Cohen’s weighted kappa statistic. To determine the clinical significance of SFA, effect sizes, or percent of non-overlapping data (PND), were calculated. Results of this study indicate that SFA may be most effective for persons with fluent aphasias

Comparison of Upper Extremity Function in Women With and Women Without a History of Breast Cancer

Design: This was an observational cross-sectional study. Methods: Women who were diagnosed with breast cancer and had a mean post–surgical treatment time of 51 months (range = 12–336 months) were compared with women who did not have breast cancer (CTRL group). Self-reported upper extremity function using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and shoulder range of motion, strength, and muscular endurance were measured. Participants were divided into 3 groups: breast cancer involving the nondominant limb (BC-ND), breast cancer involving the dominant limb (BC-DOM), and CTRL. Results: A total of 59 women in the CTRL group, 23 women in the BC-ND group, and 28 women in the BC-DOM group completed measures. Mean DASH scores in women with breast cancer were higher than those of women in the CTRL group, regardless of the limb on which cancer occurred (Cohen d = 1.13; 95% CI = 2.20 to 16.21) Range of motion for the BC-ND group was significantly less for flexion (Cohen d = 1.19, 95% CI = −13.08 to −0.11) and external rotation (Cohen d = 1.11, 95% CI = −18.62 to −1.98) compared with the CTRL group. Strength in the BC-ND group was 23% to 25% lower in the CTRL group for external (Cohen’s d = 0.89, 95% CI = 0.09 to 0.12) and internal rotation (Cohen d = 0.92, 95% CI = 0.10 to 0.13). Endurance was not significantly different in the 3 groups. Limitations: Some participants had rehabilitation, which may have skewed results. The range of post–surgical treatment times was broad, making it difficult to determine when function returned. Muscular endurance measures demonstrated a ceiling effect and large variance, limiting the ability to distinguish differences among participants. These results may not be generalizable to the subset of women who were treated with lumpectomy, sentinel node biopsy, or chest wall radiation alone or who underwent a contralateral prophylactic mastectomy. Conclusion: In the long term, women with breast cancer have lower self-reported shoulder function than women without breast cancer. Motion and strength are lower among women who have experienced cancer on the nondominant limb

Linguistic Performance across Different Narrative Types

The purpose of this study was to: (1) investigate the impact of directive task instructions on the ability to convey main events in pictured stimuli with healthy, older adults and (2) to establish session-to-session reliability of the main event measure using different task instructions. The main event measure was designed to quantify participants’ abilities to express the relations and causal links depicted in the pictured stimuli. Stimuli included Nicholas and Brookshire’s (1993) two single pictures and two picture sequences. Statistical analyses revealed that manipulating task instructions significantly affected the proportion of main events produced by healthy older adults

Impact of Manipulating Task Instructions on Narrative Discourse Performance

Quantitative measures of structured discourse skills of adults with aphasia can be valuable in documenting evidenced-based practice. A number of researchers have shown that measures such as Yorkston and Beukelman’s (1980) content unit analysis and Nicholas and Brookshire’s (1993) correct information unit (CIU) analysis are helpful in monitoring changes in the connected speech of individuals with aphasia (Craig et al., 1993; Nicholas & Brookshire, 1993; Yorkston & Beukelman, 1980). Moreover, researchers suggest that any comprehensive assessment of structured discourse should also include a measure of the ability to relay main events (Capilouto, Wright & Cranfill, 2003; Nicholas & Brookshire, 1995). van Dijk and Kintsch (1983) have suggested that one way speakers establish main ideas in conversation is by communicating the relations and causal links among units of information. Wright, Capilouto, Wagovich, Cranfill, and Davis (2005) developed a main event measure designed to focus on an individual’s ability to convey the relationships and causal connections between ideas in narrative discourse. Results of previous investigations have demonstrated that individuals without aphasia conveyed a higher proportion of main events than adults with aphasia (Capilouto, Wright, & Wagovich, 2005a). Further, findings indicated that participants, regardless of age or presence of aphasia, communicated a greater proportion of relationships between characters, actions, and ideas in response to sequential versus single pictures, but neurologically intact participants did not perform at or near ceiling level on the measure (Capilouto, Wright, & Wagovich, in press, 2005; Wright et al., 2005). Task instructions in the previous investigations requested participants to “tell what was going on in the picture(s)”. Olness (2005) suggested that instructions specifically requesting a beginning, middle, and end might yield qualitatively and quantitatively different narratives. The purpose of the present investigation, then, is two-fold. First, we compared the performance of two groups of healthy older adults on the ability to convey main events in pictured stimuli when two different task instructions were provided. Healthy older adults were used in this initial investigation to determine the impact of altered directions on discourse samples of speakers without specific language deficits. In doing so, the intent is to provide normative data on a measure of discourse, with different task instructions, that can then be used as a reference for evaluating the discourse abilities of adult clinical populations. Second, we established session-to-session reliability of the main event measure using the different task instructions

Abnormal Nutritive Sucking as an Indicator of Neonatal Brain Injury

A term neonate is born with the ability to suck; this neuronal network is already formed and functional by 28 weeks gestational age and continues to evolve into adulthood. Because of the necessity of acquiring nutrition, the complexity of the neuronal network needed to suck, and neuroplasticity in infancy, the skill of sucking has the unique ability to give insight into areas of the brain that may be damaged either during or before birth. Interpretation of the behaviors during sucking shows promise in guiding therapies and how to potentially repair the damage early in life, when neuroplasticity is high. Sucking requires coordinated suck-swallow-breathe actions and is classified into two basic types, nutritive and non-nutritive. Each type of suck has particular characteristics that can be measured and used to learn about the infant\u27s neuronal circuitry. Basic sucking and swallowing are present in embryos and further develop to incorporate breathing ex utero. Due to the rhythmic nature of the suck-swallow-breathe process, these motor functions are controlled by central pattern generators. The coordination of swallowing, breathing, and sucking is an enormously complex sensorimotor process. Because of this complexity, brain injury before birth can have an effect on these sucking patterns. Clinical assessments allow evaluators to score the oral-motor pattern, however, they remain ultimately subjective. Thus, clinicians are in need of objective measures to identify the specific area of deficit in the sucking pattern of each infant to tailor therapies to their specific needs. Therapeutic approaches involve pacifiers, cheek/chin support, tactile, oral kinesthetic, auditory, vestibular, and/or visual sensorimotor inputs. These therapies are performed to train the infant to suck appropriately using these subjective assessments along with the experience of the therapist (usually a speech therapist), but newer, more objective measures are coming along. Recent studies have correlated pathological sucking patterns with neuroimaging data to get a map of the affected brain regions to better inform therapies. The purpose of this review is to provide a broad scope synopsis of the research field of infant nutritive and non-nutritive feeding, their underlying neurophysiology, and relationship of abnormal activity with brain injury in preterm and term infants