Effects of Gesture and Semantic-Phonologic Treatments for Verb Retrieval

Evidence for verb retrieval treatment effects in aphasia is limited. In a within subject design, we compared effects of two verb retrieval treatments, semantic-phonologic training versus gesture training, in four individuals with verb retrieval impairments ranging from moderate to severe. Verb picture naming improved for trained verbs in three of four participants during semantic-phonologic training. Verb picture naming improved for trained verbs in only one of four participants during gesture training. No improvements were evident in untrained words during either training phase. Though verbs and gestures have closer neural correlates, there was greater advantage for semantic-phonologic training for verbs

Anomia Treatment Platform as Behavioral Engine for Use in Research on Physiological Adjuvants to Neurorehabilitation

The purpose of this study was to create a behavioral treatment engine for future use in research on physiological adjuvants in aphasia rehabilitation. We chose the behavioral target anomia, which is a feature displayed by many persons who have aphasia. Further, we wished to saturate the treatment approach with many strategies and cues that have been empirically reported to have a positive influence on aphasia outcome, with the goal being to optimize the potential for positive response in most participants. A single-subject multiple baseline design with replication across eight participants was employed. Four men and four women, with an average age of 62 yr and an average of 63.13 mo poststroke onset, served as participants. Word-retrieval treatment was administered 3 d/wk, 1 h/d for a total of 20 treatment hours (6-7 wk). Positive acquisition effects were evident in all eight participants (d effect size [ES] = 5.40). Treatment effects were maintained 3 mo after treatment termination for five participants (d ES = 2.94). Within and across semantic category, generalization was minimal (d ES = 0.43 within and 1.09 across). This study demonstrates that this behavioral treatment engine provides a solid platform on which to base future studies whereby various treatment conditions are manipulated and pharmacologic support is added

Item Response Theory Analysis of the Western Aphasia Battery

The purpose of this investigation was to improve the validity of the Western Aphasia Battery for measuring aphasia severity and change over time by examining its fit to an item response theory (IRT) measurement model. The advantages of IRT include interval scaling, potential for equating scores across aphasia tests, and more veridical reporting of score reliability. Despite reasonable overall fit to the model, a small number of WAB items demonstrated substantial misfit, suggesting that they do not productively contribute to the measurement of aphasia severity. Potential explanations for this misfit, and implications of IRT for aphasia testing will be discussed

The Effects of Feature Type on Semantic Priming of Picture Naming in Normal Speakers

The aim of this study was to investigate the roles of features on conceptual activation.  A picture naming paradigm was employed to measure speech reaction time (SRT) during feature-to-concept activation.  Forty-seven older adults completed the priming task twice with an ISI of 200msec and 600msec. Results indicate that regardless of semantic category, distinctive feature primes resulted in the fastest SRT compared to shared features, combined distinctive and shared features, and neutral primes.  The results indicate that as stated in the Conceptual Structure Account (Tyler & Moss, 2001; Taylor et al., 2007) distinctive features have a privileged role in concept activation

Multi-modal Treatment of Phonological Alexia: Behavioral and Pilot fMRI Outcomes

Post-stroke phonological alexia is characterized by impaired reading of pseudowords, with relatively intact reading or orthographically irregular words. We conducted a single-subject repeated-probe research study of a multi-modal treatment of phonological processing and reading skills in five adults with phonological alexia. Based on the phonological deficit hypothesis, treatment tasks involved training written and verbal phonological skills. Visual inspection of repeated-probe graphs and standardized test scores provided evidence of improved phonological processing and real word reading skills for only some participants. One participant’s Pilot fMRI of overt pseudoword reading and pseudoword repeating exhibited perilesional and right-hemisphere neural reorganization

Phonologic Rehabilitation of Anomia in Aphasia

The single most common feature of aphasia is impairment in ability to name, whether it involves naming seen objects, or producing nouns, verbs and other words conveying meaning in spontaneous language. The traditional treatment approach to this problem is to explicitly train aphasic patients in naming. Controlled studies have shown that this approach may be quite effective. However, typically generalization is very limited, that is, the knowledge gained by the patient tends to be limited to the words actually trained, and there is at best very modest improvement in performance with untrained words (limited mainly to those that are semantically related to the trained words). Because generalization is can be limited with this approach, there currently exists no viable means of training patients on the full corpus of words (perhaps several thousand) they are likely to need in daily life. Two approaches might be taken to solving this problem: 1) develop cost effective means for providing training on several thousand words; and 2) develop alternative training methods, e.g., phonological therapy, that potentially could intrinsically generalize widely. The focus of this proposal is the second of these two approaches. Thus, the primary purpose of this Phase II clinical rehabilitation study was to examine the effect of a phonologic based treatment on confrontation naming by individuals with anomic aphasia. We used a single-subject ABA design replicated across ten participants. The primary research question asked if phonologic treatment would improve confrontation naming. Secondary research questions addressed the impact of treatment on 1) generalization to untrained behaviors such as discourse production; 2) retention effects at 3-months; 3) phonologic production and 4) nonword repetition (potential evidence of phoneme sequence knowledge acquisition)

Neural Signatures of Semantic and Phonemic Fluency in Young and Old Adults

As we age, our ability to select and produce words changes, yet we know little about the underlying neural substrate of word-finding difficulties in old adults. The present study was designed to elucidate changes in specific frontally mediated retrieval processes involved in word-finding difficulties associated with advanced age. We implemented two overt verbal (semantic and phonemic) fluency tasks during functional magnetic resonance imaging and compared brain activity patterns of old and young adults. Performance during the phonemic task was comparable for both age-groups and mirrored by strongly left lateralized (frontal) activity patterns. On the other hand, a significant drop of performance during the semantic task in the older goup was accompanied by additional right (inferior and middle) frontal activity, which was negatively correlated with performance. Moreover, the younger group recruited different subportions of the left inferior frontal gyrus for both fluency tasks, while the older participants failed to show this distinction. Thus, functional integrity and efficient recruitment of left frontal language areas seems to be critical for successful word-retrieval in old age

Dosing of a cued picture naming treatment for anomia

Constrain Induced Language Therapy (CILT) has spurred discussion of treatment “intensity” in aphasia research, as clinicians and researchers began asking about the important features of CILT, and whether the principle of massed practice was in fact the driving force behind the treatment technique. However, as studies began addressing intensity of treatment, the need for consistent terms with regard to dosage in aphasia treatment research became apparent. Cherney, Patterson & Raymer (2011) reviewed the literature on CILT and highlight the importance of considering different aspects of dosage with regard to specific therapy approaches. Warren, Fey & Yoder (2007) identified these dosage parameters as dose form, dose, dose frequency, total intervention duration, and cumulative intervention intensity. The purpose of the present study was to identify dosing effects of a cued picture naming treatment, using the terminology proposed by Warren et al. (2007), on word finding abilities in individuals with anomia

Measurement Properties of the Functional Outcomes Questionnaire for Aphasia

Aphasia often results in negative social, emotional, and financial consequences endorsing rehabilitation efforts that influence communication beyond the level of impairment. The FOQ-A assesses the impact of aphasia treatment on functional communication, extending measurement into activity and participation. The purpose of this study is to evaluate the measurement properties of the FOQ-A in a sample of 127 individuals with moderate to severe aphasia subsequent to stroke. Results of Rasch analysis indicate that the FOQ-A is unidimensional, has good internal consistency, and contains adequate person separation for measuring change after rehabilitation; however, revisions to the scale may improve its usefulness

The Development of a Standardized Assessment of Phonology in Aphasia

The long-term goal of this research is to develop a valid and reliable impairment level measure of phonology in aphasia. The short-term goal, and focus of this abstract, is to present data collected from individuals with aphasia for 3 domains (or subtests) of this assessment: reading, repetition and perception. From the perspective of Item response theory (IRT), procedures will be presented on the development of the item bank. Results pertaining to the psychometric properties of the items when tested on individuals with aphasia show a reasonable fit to the Rasch model. Further research will validate and refine existing items