Noun and verb processing in aphasia and healthy aging: Online behavioural and ERP investigations

Nouns, verbs and function words are reported to be differentially impaired in individuals with aphasia. However, the behavioural evidence of selective word class impairments relies heavily on observations from single word production or offline comprehension studies. This thesis applied online measures to probe noun and verb input processing in individuals with aphasia and in healthy aging. Experiments 1, 2 and 3 employed an online reaction time task (word-monitoring) to investigate differential processing of noun (NP) and verb phrases (VP) in three different conditions, 1) phrase structure violations (much/*many milk), 2) premodification (Tom kicked vs Tom should have kicked) and 3) phrase frequency (high: asked for directions; low: looked for directions). Experiment 1 was conducted with neurotypical younger and older adults to explore age effects in language processing using a word-monitoring task (WMT), and to establish normative performance. The results showed that both groups were equally sensitive to NP and VP manipulations, although older adults were more disrupted by phrase structure violations. Experiment 2 employed the WMT with a group of individuals with aphasia, while Experiment 3 followed up on the group findings by examining single case evidence for NP/VP dissociations in two individuals with severe impairments, two agrammatic and one anomic individual. Together, the findings from the group and individual case analyses indicated that noun/verb dissociations are absent in input processing, while also showing residual sensitivity to function words in the form of verb premodifiers. However, there is some evidence at the individual level, that more severely impaired individuals have greater difficulties processing nouns relative to verbs. In the final experiment with neurotypical younger and older adults, event-related potentials (ERPs) were recorded in responses to verbs in facilitatory contexts and ungrammatical sentences. The findings revealed no age-related changes in electrophysiological responses to verbs in both contexts

Which blueberries are better value? The development and validation of the functional numeracy assessment for adults with aphasia

BACKGROUND: People with aphasia (PWA) can experience functional numeracy difficulties, that is, problems understanding or using numbers in everyday life, which can have numerous negative impacts on their daily lives. There is growing interest in designing functional numeracy interventions for PWA; however, there are limited suitable assessments available to monitor the impact of these interventions. Existing functional numeracy assessments lack breadth and are not designed to be accessible for PWA, potentially confounding their performance. Additionally, they do not include real-life demands, such as time pressure, which may affect their ecological validity. Thus, there is a crucial need for a new assessment to facilitate further research of PWA's functional numeracy. AIMS: To develop, validate and pilot a wide-ranging, aphasia-friendly functional numeracy assessment to investigate how functional numeracy is impacted by aphasia severity and time pressure demands, and to explore predictors of PWA's functional numeracy. METHODS & PROCEDURES: To develop the Functional Numeracy Assessment (FNA), 38 items inspired by the General Health Numeracy Test (GHNT) and Excellence Gateway were adapted for suitability for PWA and entered in a computerized psychometric-style test. The final 23 items (FNA23) were selected based on 213 neurotypical controls' performance, and controlled for difficulty, response modality and required numeracy skills. Aphasia-friendly adaptations of the GHNT and Subjective Numeracy Scale were used to examine the FNA23's concurrent validity. Internal consistency reliability and interrater reliability (for spoken responses) were also examined. A novel Time Pressure Task was created by slight adaptation of seven FNA23 questions to explore the effects of time pressure on functional numeracy performance. A total of 20 PWA and 102 controls completed all measures on an online testing platform. OUTCOMES & RESULTS: The FNA23 demonstrated acceptable internal consistency reliability (KR-20 = 0.81) and perfect interrater reliability (for spoken responses). FNA23 and GHNT scores were positively associated, suggesting satisfactory concurrent validity. PWA demonstrated poorer functional numeracy than controls and took longer to complete assessments, indicating that aphasia impacts functional numeracy. Time pressure did not significantly impact performance. PWA demonstrated a wide range of functional numeracy abilities, with some performing similarly to controls. CONCLUSIONS & IMPLICATIONS: The FNA23 is a wide-ranging, valid and reliable assessment which, with further development, will be a useful tool to identify and monitor PWA's functional numeracy difficulties in research and clinical practice. Considering PWA's widespread functional numeracy difficulties evidenced by this study, all PWA would likely benefit from routine evaluation for functional numeracy difficulties as part of their neurorehabilitation journeys. WHAT THIS PAPER ADDS: What is already known on this subject Few studies have investigated functional numeracy difficulties in PWA. No published functional numeracy assessments exist that have been specifically designed to be accessible for PWA. What this paper adds to existing knowledge The newly developed FNA23 is a valid and reliable tool to extensively assess PWA's functional numeracy. This study confirmed previous findings of widespread functional numeracy difficulties in PWA that are related to their aphasia severity. What are the potential or actual clinical implications of this work? The FNA23 can be used to assess PWA's functional numeracy to inform areas of strengths and difficulties to target in intervention, and to monitor progress towards achieving intervention objectives. All PWA should be routinely evaluated for functional numeracy difficulties

Phonetics for Word Monitoring Manual

Unpublished manual providing a short overview of the basics of acoustics that people might need to know when trying to create stimuli for Word Monitoring Tasks, but when they are unfamiliar with acoustic phonetics

A three-minute test of implicit language processing for large sample sizes: Proof-of-concept application in a public science event

Research into human language processing is challenged by its implicit nature of processes, the short time-window in which they take place, and heterogeneity within the population. We used a word monitoring task to measure implicit sensitivity to grammar, semantics, and the strength of word collocations, when listening to natural spoken sentences. We report substantial and novel adjustments to the paradigm, which allowed a participant to be tested in about three minutes, and data from a proof-of-concept study for which we recruited 125 visitors of different backgrounds to a science event. Linear mixed-effects models suggest that participants’ response time to target words was 45ms slower when words were less predictable in their grammatical, semantic, or collocational context (p = .034). There was no significant difference between language conditions. However, in non-native speakers, grammatical manipulation was less effective than manipulations of semantics and word collocations (p < .08), which is consistent with theories of shallow language processing in non-native speakers. There was no significant effect of age on language sensitivity. Effects generally replicated findings based on standard word-monitoring methods, suggesting that the novel adjustments can be applied in situations where participants’ time is limited, e.g. at events, in schools or online

The SWAN game-based approach to re-building numeracy skills in aphasia: a consecutive controlled case series

SWAN (Sequences in Words and Numbers) is a game-based approach to learning (or re-learning) basic numeracy skills: the number sequence and the relation between spoken numbers and Arabic numerals. The phone or tablet-based game has been designed specifically for children and adults with communication difficulties