Efficacy of Elaborated Semantic Features Analysis in Aphasia: a quasi-randomised controlled trial

Background: Word finding difficulty is one of the most common features of aphasia. Semantic Features Analysis (SFA) directly aims to improve word finding in people with aphasia. Evidence from systematic reviews suggests that SFA leads to positive outcomes, yet the evidence comprises single case studies and case series. There is a need to evaluate the efficacy of SFA in controlled group studies/trials. Aims: To evaluate the efficacy of Elaborated Semantic Feature Analysis (ESFA) for word finding in people with aphasia. We investigated: (a) the efficacy of ESFA versus a delayed therapy/control, (b) the efficacy of two therapy approaches– individual versus a combination of individual and group therapy. Methods and procedures: We ran a multi-centre, quasi-randomised controlled trial, nested in a larger study (Thales-Aphasia). Participants were recruited from community settings. They had to be people with aphasia due to stroke at least four months post-onset. Participants were randomized to individual vs combination vs delayed therapy/control groups. Both therapy groups had three hours of ESFA per week for 12 weeks. Delayed therapy/control group had no intervention for 12 weeks and were then randomized to either individual or combination therapy. The primary outcome was confrontation naming. Secondary outcomes were the Boston Naming Test, Discourse, the Functional Assessment of Communication Skills for adults (ASHA–FACS), the Stroke and Aphasia Quality of Life scale (SAQOL-39g), the General Health Questionnaire-12 item, and the EQ-5D. Outcomes and Results: Of the 72 participants of the Thales-Aphasia project, 58 met eligibility criteria for speech-language therapy and 39 were allocated to ESFA. The critical p-value was adjusted for multiple comparisons (.005). For the therapy versus control comparison, there was a significant main effect of time on the primary outcome (p<.001, η2p=.42) and a significant interaction effect (p=.003, η2p=.21). An interaction effect for the SAQOL-39g (p=.015, η2p=.11) and its psychosocial domain (p=.013, η2p=.12) did not remain significant after Bonferroni adjustment. For the individual versus combination ESFA comparison, there were significant main effects of time on the primary outcome (p<.001, η2p=.49), the BNT (p<.001, η2p=.29) and the ASHA-FACS (p=.001, η2p=.18). Interaction and group effects were not significant. Conclusion: Though underpowered, this study provides evidence on the efficacy of ESFA to improve word finding in aphasia, with gains similar in the two therapy approaches. Trial registration: ISRCTN71455409, https://doi.org/10.1186/ISRCTN7145540

Elaborated Semantic Feature Analysis Treatment: Lexicality and Generalization effects in case with anoamic aphasia

Semantic Feature Analysis (SFA) is a treatment technique designed to improve the naming abilities by increasing the level of activation within a semantic network and subsequently enable the individual to have easier lexical retrieval. This technique was first described by Boyle and Coelho (1995), where it was applied in a case with mild non-fluent aphasia, resulting in improved confrontation naming of trained and untrained items but not generalization to connected speech. In reduplication study by Coelho et al (2000), SFA was used in a case with moderate fluent aphasia. where gains were made in both trained and untrained items during a confrontation naming task, as well as in connected speech. The authors suggested that the improvement in the connected speech it might be influenced by not only the differences in severity but also type of aphasia. Furthermore, they suggest that the effect of SFA intervention is reflected in an increase in communicative efficiency. Boyle (2004) investigated further the efficacy of SFA treatement in another two cases with fluent aphasia, one with anomic aphasia and one with Wernicke’s aphasia. In this study, she reported improvement in both cases in trained and untrained items, but no generalization effects on connected speech on the measures of mean words per minute, mean correct information units per minute or the percentage of all words that were correct information units. Conley and Coelho (2003) described a treatment approach in a case with chronic Broca’s aphasia, where they combined SFA with Response Elaboration Training (RET). In this case, they reported that the combined approached resulted in improvement the individual’s ability to retrieve noun words but it was unclear which approach contributed to the final outcome. However, they reported lexicality effects, as features of high familiarity words were more easily named than those of low familiarity words. The present study describes an Elaborated Semantic Feature Analysis (ESFA) treatment approach which was applied to improved word retrieval of object nouns in a case with non fluent anomic aphasia. The approach was based on the SFA approach (Boyle and Coelho, 1995; Coelho et al, 2000; Boyle, 2004), but also allowed the individual to elaborate the features described to a sentence. The purpose of this approach was to enable the individual to transfer the naming abilities to connected speech

THE VALIDATION OF THE APHASIA SCREENING TEST IN GREEK SPEAKING POPULATION

The need for an aphasia screening tool validated in Greek speaking population is long overdue. Until now, clinicians are relied on informal assessment and observation. The aim of this paper is to present the process of adaptation and validation of the Aphasia Screening Test (Whurr, 1996) in Greek speaking population. This test was used mainly due to its use widely across different countries and languages

Debatable results of surgery for lung cancer in a patient with long existing pulmonary metastases from differentiated thyroid carcinoma

Introduction: The appropriate following treatment in a patient with a new presented non-small cell lung cancer (NSCLC) and history of chronic lung metastases of thyroid origin has never been reported. In such cases, the presence of long­standing thyroid metastatic disease with proven “limited malignant potential” could be considered as a minor treatment problem justifying one’s the decision to focus on the primary lung carcinoma as the only serious threat for the patient’s life.Case report: We report the surgical treatment of a new presented NSCLC in a patient with chronic lung metastases of thyroid origin and we present all the diagnostic, staging and treatment problems.Conclusion: The therapeutic results of our surgical approach were not encouraging. This could be owed to our staging prob­lems of NSCLC and the well documented limited immunological response of such patients with multiple neoplasms

COMMUNICATION AND COGNITIVE IMPAIRMENT AMONG NURSING HOMES RESIDENTS IN GREECE

In Greece, the percentage of elderly living in nursing homes is relatively small compared to other European countries. The reason behind this is mainly due to the social structure and the role of the family, which plays an important role in the care of the elderly. Until now it has not been a systematic investigation of the communication and cognitive impairments of the population living in nursing home. This is the first epidemiological study, aimed to assess the presence of such impairments and also the degree of the severity in order to address the need for speech & language therapy intervention

THE PSYCHOMETRIC PROPERTIES OF THE SNODGRASS AND VANDERWART PICTURES IN GREEK NORMAL AND APHASIC POPULATION

The standardised set of pictures by Snodgrass and Vanderwart (1980) has been used extensively in literature investigated difference and similarities in the processing of pictures. Until now there have not been data for these pictures from native Greek speaking population. The aims of this study were: a. to investigate the psychometric properties of these pictures in the native Greek speaking normal elderly population in terms of name agreement, image agreement, familiarity and visual complexity, and b. to demonstrate how variables of picture processing effect the performance of aphasic Greek speaking population during verbal and written naming

International Comparisons of the Public Awareness of Aphasia: Greece, Argentina and Norway

Awareness of aphasia was surveyed in shoppers in Greece, Argentina and Norway (N=1851) using translations of the questionnaire used by Simmons-Mackie et al, 2002. Between 57.4% (Norway) and 20% (Argentina) had heard of aphasia (37.1% overall), but those who had basic knowledge ranged from 13.9% (Norway) to 6.25% (Argentina) (combined 9.2%). We found significant variability in knowledge of aphasia between the countries surveyed and previous surveys. As with previous studies, this appears to provide further evidence of differences in levels of awareness of aphasia in different cultures, which will be discussed. Such information is vital for targeting awareness raising

A Systematic Review of Semantic Feature Analysis Therapy Studies for Aphasia

Purpose : The purpose of this study was to review treatment studies of semantic feature analysis (SFA) for persons with aphasia . The review documents how SFA is used, appraises the quality of the included studies and evaluates the efficacy of SFA. Methods : The following electronic databases were systematically searched (last search February 2017) : Academic Search Complete; CINAHL Plus; E -journals; Health Policy Reference Centre; MEDLINE; PsycART ICLES; PsycINFO; and SocINDEX. The quality of the included studies was rated. Clinical efficacy was determined by calculating effect sizes ( Cohen’s d ) or percent of non-overlapping data when d could not be calculated. Results: Twenty -one studies were reviewed reporting on 55 persons with aphasia. SFA was used in six different types of studies: confrontation naming of nouns, of verbs , connected speech /discourse, group, multilingual and studies where SFA was compared with other approaches . The quality of included studies was high [ Single Case Experimental Design Scale (SCED S) average (range) =9.55 ( 8.0- 11 )]. Naming of trained items improved for 45 participants ( 81.82%). Effect sizes indicated there was a small treatment effect. Conclusions: SFA leads to p ositive outcomes despite the variability of treatment procedures, dosage, duration and variations to the traditional SFA protocol. Further research is warranted to examine the efficacy of SFA and generalization effects in larger controlled studies

Quality of life after stroke: Evaluation of the Greek SAQOL-39g

Background/Aims: Stroke and aphasia rehabilitation aims to improve people’s quality of life. Yet, scales for measuring health-related quality of life in stroke typically exclude people with aphasia. They are also primarily available in English. An exception is the Stroke and Aphasia Quality of Life scale (SAQOL-39g). This scale has been tested with people with aphasia; it has been adapted for use in many countries including Greece. The aim of this study was to examine the psychometric properties of the Greek SAQOL-39g. Methods: An interview-based psychometric study was carried out. Participants completed: receptive sub-tests of Frenchay Aphasia Screening Test, Greek SAQOL-39g, General Health Questionnaire-12, Frenchay Activities Index, Montreal Cognitive Assessment and Barthel Index. Results: 86 people took part; 26 provided test-retest reliability data. The Greek SAQOL-39g demonstrated excellent acceptability (minimal missing data; no floor/ceiling effects), test-retest reliability (ICC= 0.96 scale, 0.83-0.99 domains) and internal consistency (Cronbach’s alpha 0.96 scale, 0.92-0.96 domains). There was strong evidence for convergent (r=0.53-0.80 scale; 0.54-0.89 domains) and discriminant validity (r=0.52 scale; 0.04-0.48 domains). Conclusion: The Greek SAQOL-39g is a valid and reliable scale. It is a promising measure for use in stroke and aphasia treatment prioritization, outcome measurement and service evaluation