Evaluation of Demographic and Language Predictors of Main Concept Production in Spanish/English Bilingual Discourse Using Nicolas and Brookshire Stimuli

Hispanics are the fastest growing minority group in the US, and stroke incidence for Hispanics is higher than that of non-Hispanic caucasians (Dong et al., 2012). Since stroke is the leading cause of aphasia, and the majority of Hispanics are bilingual Spanish/English speakers, there is a growing need for appropriate assessment methods for bilingual aphasia. One challenge in assessing bilinguals is their diverse language backgrounds, including differences in proficiency and use across languages. Previous studies have reported correlations between variables such as frequency of use and self-rated proficiency and performance in language tasks such as picture-naming accuracy (Edmonds & Donovan, 2012; Gollan et al. 2007), verbal fluency (Muñoz & Marquardt, 2008, Langdon et al., 2005; Elgamal et al., 2011), and discourse informativeness (Edmonds, 2013). In a study investigating discourse in 83 English/ Spanish bilingual adults, Edmonds (2013) reported varied patters of correlations for informativeness and efficiency measures (WPM, %CIUs, CIUs/min ) in English and Spanish. Naming accuracy and overall proficiency were significantly correlated with all measures of informativeness regardless of language; whereas, percent usage and age of exposure varied across languages (Edmonds, 2013). The metric of %CIU is often used to evaluate informativeness in discourse, but %CIU does not address the completeness of the discourse. I.e., one can achieve high %CIUs by providing correct information on half the picture, thus, targeting only half of the main concepts (MC). Alternatively, many MCs can be discussed with lower %CIU due to repetitions, circumlocutions and reformulations. In order to understand this dynamic better in bilinguals with varying degrees of proficiency across langauges, we adapted Nicholas and Brookshire’s (1993, 1995) MC analysis to this population. Our research questions were: 1) Is there a relationship (correlation) between %CIUs and MCs? 2) What self-reported participant variables (e.g., proficiency ratings, usage) and tested language variables (discourse variables, confrontation naming) correlate to English and Spanish MCs? 3) Of the significantly correlated variables, which contribute most to regression models of MCs in English and Spanish

Comparing Semantic and Syntactic Expectation between Verbs and Thematic Roles: Evidence from Eyetracking

It 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

The Effect of Computerized Verb Network Strengthening Treatment on Lexical Retrieval in Aphasia

Most treatment for people with chronic aphasia relies on face-to-face treatment in a clinical setting. However, some people with aphasia may not have access to outpatient centers or transportation. As computers become more prevalent, their usefulness as a therapy tool also increases. Effective computerized telerehabilitation removes transportation concerns while improving the patient’s computer skills, which are vital for modern communication. Many computerized treatments have been developed for chronic aphasia (Adrian, Gonzalez, Buiza & Sage, 2011; Katz, 2010), including some with promising results, but few have been used via telerehabilitation, so participants must still travel to receive treatment. The purpose of the current study was to adapt Verb Network Strengthening Treatment (VNeST) (Edmonds & Babb, 2011; Edmonds, Nadeau, & Kiran, 2009), a treatment to aid lexical retrieval in sentence context, for computer use. This Computerized VNeST program (VNeST-C) was used to adminster VNeST via the Internet, allowing the participant to receive treatment without transportation concerns. This study also allowed us to integrate typing of responses into the treatment, thereby potentially improving lexical retrieval in spoken and typing modalities. Specifically, this study sought to answer three research questions: Will treatment result in improvement in pre- to post-treatment changes in 1) sentence description of pictures containing trained and untrained semantically related verbs in both typed and spoken modalities, 2) confrontation naming of nouns and verbs in typed and spoken modalities, 3) sections of the Western Aphasia Battery - Revised

The effects of Verb Network Strengthening Treatment on a group of persons with aphasia: Replication and extension of previous findings

The current study aims to replicate and extend previous findings with a larger number of participants. Specifically, we asked whether training a set of verbs generalizes to production of 1) sentences containing trained verbs (The carpenter measures the lumber.), 2) sentence containing untrained semantically related verbs (The farmer weighs the apples.), 3) sentences unrelated to treatment (The dog watches the cat.), and 4) single word naming of nouns and verbs. Changes to Western Aphasia Battery-Revised (WAB-R) scores and responses to the CETI completed by communication partners (e.g., spouses of participants) were also evaluated

Delivering word retrieval therapies for people with aphasia in a virtual communication environment

Background: Delivering therapy remotely, via digital technology, can enhance provision for people with aphasia. EVA Park is a multi-user virtual island that can be used for such delivery. The first EVA Park study showed that daily language stimulation delivered via the platform improved functional communication and was positively received by users (Marshall et al, 2016; Amaya et al, 2018). This paper reports two single case studies, evaluating its capacity to deliver targeted language interventions. The first employed therapy for noun retrieval, using cued picture naming and modified Sematic Feature Analysis. The second employed modified Verb Network Strengthening Treatment (VNeST). Aims: This study aimed to determine if treatment delivery was feasible in EVA Park, as assessed by participant compliance, treatment fidelity and participants’ views. It explored the impact of the therapies on treated and untreated word production, connected speech and functional communication. Methods & Procedures: Two participants with aphasia each received 20 sessions of individual therapy in EVA Park, delivered over 5 weeks. Feasibility was assessed by measuring compliance with the therapy regime, recording and checking the fidelity of 20% of treatment sessions, and using post therapy interviews to explore participant views. Treatment outcomes were evaluated via repeated measures single case designs, in which assessments were administered twice before therapy, immediately post therapy and five weeks later. Outcome measures included Object Picture Naming (study 1), Sentence Elicitation Pictures (study 2), Naming 84 items from the Object and Action Naming Battery (study 2), Narrative Production (Study 2), the Northwestern Assessment of Verb and Sentences: Argument Structure Production Test (Study 2) and Communication Activities of Daily Living – 2 (Study 1 & 2). Outcomes & Results: Feasibility results were excellent. Both participants were fully compliant with the therapy regime. There was at least 90% fidelity with the treatment protocols and participant views were positive. Outcomes varied across the studies. The noun therapy significantly improved the naming of treated words, with good maintenance. Lexical gains were less evident on the Sentence Elicitation Pictures used in the VNeST study. Neither study demonstrated generalisation to untreated words, connected speech or functional communication. Conclusions: Two treatment approaches, designed for face to face delivery, could be delivered remotely in EVA Park. Outcomes for the noun treatment were comparable to previous evaluations. Comparisons with previous research were more challenging for VNeST, owing to differences in methodology. Further evaluations of other treatment approaches are warranted

Impact of Health Insurance, ADAP, and Income on HIV Viral Suppression Among US Women in the Womenʼs Interagency HIV Study, 2006–2009

Implementation of the Affordable Care Act motivates assessment of health insurance and supplementary programs, such as the AIDS Drug Assistance Program (ADAP) on health outcomes of HIV-infected people in the United States. We assessed the effects of health insurance, ADAP, and income on HIV viral load suppression

Reduced Regional Cerebral Blood Flow Relates to Poorer Cognition in Older Adults With Type 2 Diabetes

Type 2 diabetes mellitus (T2DM) increases risk for dementia, including Alzheimer’s disease (AD). Many previous studies of brain changes underlying cognitive impairment in T2DM have applied conventional structural magnetic resonance imaging (MRI) to detect macrostructural changes associated with cerebrovascular disease such as white matter hyperintensities or infarcts. However, such pathology likely reflects end-stage manifestations of chronic decrements in cerebral blood flow (CBF). MRI techniques that measure CBF may (1) elucidate mechanisms that precede irreversible parenchymal damage and (2) serve as a marker of risk for cognitive decline. CBF measured with arterial spin labeling (ASL) MRI may be a useful marker of perfusion deficits in T2DM and related conditions. We examined associations among T2DM, CBF, and cognition in a sample of 49 well-characterized nondemented older adults. Along with a standard T1-weighted scan, a pseudocontinuous ASL sequence optimized for older adults (by increasing post-labeling delays to allow more time for the blood to reach brain tissue) was obtained on a 3T GE scanner to measure regional CBF in FreeSurfer derived regions of interest. Participants also completed a neuropsychological assessment. Results showed no significant differences between individuals with and without T2DM in terms of cortical thickness or regional brain volume. However, adjusting for age, sex, comorbid vascular risk factors, and reference CBF (postcentral gyrus) older adults with T2DM demonstrated reduced CBF in the hippocampus, and inferior temporal, inferior parietal, and frontal cortices. Lower CBF was associated with poorer memory and executive function/processing speed. When adjusting for diabetes, the significant associations between lower regional CBF and poorer executive function/processing speed remained. Results demonstrate that CBF is reduced in older adults with T2DM, and suggest that CBF alterations likely precede volumetric changes. Notably, relative to nondiabetic control participants, those with T2DM showed lower CBF in predilection sites for AD pathology (medial temporal lobe and inferior parietal regions). Findings augment recent research suggesting that perfusion deficits may underlie cognitive decrements frequently observed among older adults with T2DM. Results also suggest that CBF measured with ASL MRI may reflect an early and important marker of risk of cognitive impairment in T2DM and related conditions