The Big Sky Aphasia Program: Patient and Student Training Outcomes

Intensive comprehensive aphasia programs (ICAPs) are a relatively new service delivery model for stroke rehabilitation (Rose, Cherney, & Worrall, 2013). The Big Sky Aphasia Program at the University of Montana meets the criteria for an ICAP and has been intentionally designed with clearly defined intensity parameters, a concern for client, caregiver, and clinician perspectives, and a focus on comprehensive therapy that addresses multiple modalities using strategies and recreational opportunities individualized to the patient

Patient Perspectives & Patient Reported Outcomes of an Intensive Comprehensive Aphasia Program

The purpose of this project was to explore patient perspectives and PROMs for stroke survivors with aphasia who participate in an intensive comprehensive aphasia program (ICAP) that was developed by the PI and is delivered at the University of Montana (Off, et al., 2015; 2017). Patient perspectives and PROMs were used to complement traditionally administered psychometric measures to document patient speech, language, cognition, and psychosocial outcomes following the ICAP. To date, no researchers have documented patient perspectives of their outcomes in the context of an ICAP

Subcortical Lesions and Language: A Conversational Discourse Analysis

The present study investigated the nature of conversational discourse data at the point of breakdown in specific neurologically compromised patients. Data were obtained during the observation and video recording of informal conversational situations (i.e., clinical settings or the patient’s natural environment). Three adult patients who had suffered neurological damage, at the site of the basal ganglia were assessed. Due to the inappropriateness of two of the patients, a case study was conducted on the remaining patient. In lieu of formal assessment via standardized instruments and test batteries, conversational discourse, in natural, non-artificial settings, were descriptively analyzed at the point of communication breakdown (e.g., decreased topic maintenance, lack of referents, etc.). Analysis of the patient’s conversational language abilities and deficits revealed short-term memory, referent, and coherence difficulties. The use of this descriptive conversational analysis of the patient’s language abilities and deficits sought to provide a more detailed and complete assessment of the patient’s communicative abilities for future remediation and treatment strategies

Repetition Priming and Anomia: An Investigation of Stimulus Dosage

In a recent review of anomia management, Maher & Raymer reported that 30% of aphasia intervention research from 1946 to 2001 focused on naming; however, despite this proliferation of case reports and small group studies, there is still no clear agreement on how best to manage these deficits (Maher & Raymer, 2004, p. 13). The inconsistency of acquisition, maintenance, and generalization effects observed across participants and types of treatment protocols is likely to stem from an inadequate knowledge base about how subject and treatment variables influence learning. One treatment variable that has received increasing attention over the past two or three years is treatment intensity. Principles of neurobiological learning across both animal and human research suggest that the intensity of treatment is a significant factor for learning. Additional research exploring experience-dependent neural plasticity involved in memory and learning indicates that a large number of trials per session are required to elicit behavioral and/or neural change. Despite a considerable amount of literature examining overall treatment intensity, data are not available regarding the frequency (i.e., stimulus dosage) of treatment at which individuals with aphasia will maximally benefit. A single-subject A-B design with replication across four individuals with aphasia and one healthy non-brain injured gender-matched control participant was used to assess the influence of repeated attempts at picture-naming, coupled with repeated exposure to hearing and reading target words, on the acquisition and maintenance of trained stimuli, and generalization to untrained stimuli. Individuals with chronic aphasia participated in a multi-week repetition priming protocol designed to investigate the influence of stimulus dosage on naming accuracy and latency. Results revealed positive repetition priming effects for trained items across both acquisition and maintenance phases; such positive effects were not observed for untrained stimuli or alternate exemplars. Stimulus dosage manipulations did not consistently influence naming performance for individuals with aphasia