Magnetoencephalographic evidence of neural plasticity following aphasia therapy

This study used magnetoencephalography (MEG) to investigate changes in the spatio-temporal patterns of neural activity following language treatment in 6 individuals with chronic aphasia. All participants demonstrated agrammatic production profile with morphosyntactic deficits and responded positively to language treatment targeting verb morphology. MEG responses to an online morphological processing task were measure twice before initiation of treatment and once after cessation of treatment. All six participants demonstrated quantitative and qualitative changes in neural activity following aphasia therapy, and the spatiotemporal patterns were similar to those found in neurologically unimpaired participants. The results demonstrate that, in this study, neurophysiological changes following language therapy were specific to the linguistic process that was targeted, and not the result of general cognitive or compensatory mechanisms

Treatments for verb inflection impairment in agrammatism: an investigation of treatment type and stimulus type

What is the best way to treat the verb inflection deficit that is so pervasive in agrammatic aphasia? We addressed this question in two treatment efficacy studies. Study 1, which was based on current theoretical perspectives and empirical data on agrammatism, compared the relative efficacy of two treatment types: one focused on extensive practice with morpho-phonological aspects while the other emphasized on training semantic features such as tense marking. Sentence production outcomes were significantly more superior with tense training. Study 2 investigated differences in acquisition and generalization patterns as a factor of verb type (training regular versus irregular verbs). Current psycholinguistic perspectives on the lexical representation of verbs coupled with the complexity account of treatment efficacy (CATE) predicts more favorable outcomes from training irregular verbs compared to regular verbs

KISSING SLOWS LICKING: AN INVESTIGATION OF BODY PART OVERLAP IN VERB PRIMING

There is growing evidence that speakers mentally simulate the action portrayed by a verb and action simulation is an inherent part of language comprehension. This study examined if processing action words facilitates processing of other somatotopically (bodypart) related action words and if there are differences between normal and verb-impaired aphasic participants. Visual lexical priming of arm/hand and face/mouth verbs revealed that somatotopic relatedness interfered with processing of the ensuing verb in both groups and this interference effect was larger for aphasic participants. This suggests that semantic feature activation is robust and maybe an unlikely source of verb deficits in aphasia

Can verb morphology be primed in agrammatic aphasia?

In order to investigate the underlying source of verb inflection errors in agrammatic aphasia, we used a morphological priming paradigm to elicit picture descriptions from nine Broca’s aphasic individuals. The primes were either identical to the target verb form, inflectionally congruent (sang-skipped, walked-skipped) or inflectionally incongruent (walks-skipped). A significant facilitation was found only with primes that were congruent for tense, irrespective of morphological overlap (sang-skipped). A disadvantage was found for incongruent primes. The results suggest that the most likely source of the verb inflection deficit in agrammatism is insufficient activation of the appropriate tense information

Evidence Based Systematic Review of Aphasia Therapy for bilingual individuals

Relatively little is known about the best practices for language therapy in bilingual aphasia. This systematic review examined three crucial questions faced by speech-language pathologists during clinical decision making: outcomes when language therapy is provided in the secondary language (L2), extent of cross-language transfer (CLT) and variables that influence CLT, and outcomes when language therapy is mediated by a language broker. Data from 14 studies (N=45 aphasic individuals) indicate that treatment in L2 leads to positive outcomes (akin to L1 treatment); CLT occurred in about half of the studies, especially when L1 was the language of treatment

Discourse measures of Prefrontal dysfunction: a pilot study

This study piloted a set of quantitative and qualitative measures designed to capture the discourse impairments of patients with prefrontal cortex damage (PFCD). We compared the immediate and delayed narratives of PFCD patients and matched controls on measures of lexical efficiency, story content, thematic units, story grammar features, and discourse errors. Several measures, including lexical efficiency and various word and phrase level discourse errors, differentiated between groups. Subsequent to refinement, replication, and normative data collection, the tools created here will assist in the diagnosis of PFCD patients, provide a basis for therapeutic intervention, and track changes in discourse over time

Interpreting MMSE Performance in Highly Proficient Bilingual Spanish-English and Asian Indian-English Speakers: Demographic Adjustments, Item Analyses, and Supplemental Measures

Purpose: Performance on the Mini-Mental State Examination (MMSE), among the most widely used global screens of adult cognitive status, is affected by demographic variables including age, education, and ethnicity. This study extends prior research by examining the specific effects of bilingualism on MMSE performance. Method: Sixty independent community-dwelling monolingual and bilingual adults were recruited from Eastern and Western regions of the United States in this cross-sectional group study. Independent sample t-tests were used to compare two bilingual groups (Spanish-English and Asian Indian-English) with matched monolingual speakers on the MMSE, demographically adjusted MMSE scores, MMSE item scores, and a nonverbal cognitive measure. Regression analyses were also performed to determine whether language proficiency predicted MMSE performance in both groups of bilingual speakers. Results: Group differences were evident on the MMSE, on demographically adjusted MMSE scores, and on a small subset of individual MMSE items. Scores on a standardized screen of language proficiency predicted a significant proportion of the variance in the MMSE scores of both bilingual groups. Conclusions: Bilingual speakers demonstrated distinct performance profiles on the MMSE. Results suggest that supplementing the MMSE with a language screen, administering a nonverbal measure, and/or evaluating item-based patterns of performance may assist with test interpretation for this population

Interpreting MMSE Performance in Highly Proficient Bilingual Spanish-English and Asian Indian-English Speakers: Demographic Adjustments, Item Analyses, and Supplemental Measures

Purpose: Performance on the Mini-Mental State Examination (MMSE), among the most widely used global screens of adult cognitive status, is affected by demographic variables including age, education, and ethnicity. This study extends prior research by examining the specific effects of bilingualism on MMSE performance. Method: Sixty independent community-dwelling monolingual and bilingual adults were recruited from Eastern and Western regions of the United States in this cross-sectional group study. Independent sample t-tests were used to compare two bilingual groups (Spanish-English and Asian Indian-English) with matched monolingual speakers on the MMSE, demographically adjusted MMSE scores, MMSE item scores, and a nonverbal cognitive measure. Regression analyses were also performed to determine whether language proficiency predicted MMSE performance in both groups of bilingual speakers. Results: Group differences were evident on the MMSE, on demographically adjusted MMSE scores, and on a small subset of individual MMSE items. Scores on a standardized screen of language proficiency predicted a significant proportion of the variance in the MMSE scores of both bilingual groups. Conclusions: Bilingual speakers demonstrated distinct performance profiles on the MMSE. Results suggest that supplementing the MMSE with a language screen, administering a nonverbal measure, and/or evaluating item-based patterns of performance may assist with test interpretation for this population

Treatment integrity of elaborated semantic feature analysis aphasia therapydelivered in individual and group settings

Background & Aims This study ran within the framework of the Thales Aphasia Project that investigated the efficacy of elaborated semantic feature analysis (ESFA). We evaluated the treatment integrity (TI) of ESFA, i.e., the degree to which therapists implemented treatment as intended by the treatment protocol, in two different formats: individual and group therapy. Methods & Procedures Based on the ESFA manual, observation of therapy videos and TI literature, we developed two ESFA integrity checklists, for individual and group therapy, and used them to rate 15 videos of therapy sessions, delivered by three speech–language therapists (SLTs). Thirteen people with aphasia (PwA) were involved in this study. Reliability of the checklists was checked using Kappa statistics. Each session's TI was calculated. Differences in TI scores between the two therapy approaches were calculated using independent sample t-tests. Treating SLTs’ views on what facilitates TI were also explored through a survey. Outcomes & Results Inter- and intra-rater reliability were excellent (.75 ≤ κ ≤ 1.00) for all but one video (κ = .63). Overall, a high TI level (91.4%) was achieved. Although both approaches’ TI was high, TI for individual therapy sessions was significantly higher than for group sessions (94.6% and 86.7% respectively), t(13) = 2.68, p = .019. SLTs found training, use of the treatment manual, supervision and peer support useful in implementing ESFA therapy accurately. Conclusions & Implications ESFA therapy as delivered in Thales is well described and therapists can implement it as intended. The high TI scores found enhance the internal validity of the main research project and facilitate its replication. The need for more emphasis on the methodological quality of TI studies is discussed