Uusien sanojen oppiminen afasiassa

Peer reviewe

Efficacy of a multicomponent singing intervention on communication and psychosocial functioning in chronic aphasia: A randomized controlled crossover trial

The ability to produce words through singing can be preserved in severe aphasia, but the benefits of group-based singing rehabilitation in aphasia are largely unknown. Our aim was to determine the efficacy of a multicomponent singing intervention on communication and speech production, emotional-social functioning and caregiver well-being in aphasia. Fifty-four patients with acquired brain injury and chronic aphasia and their family caregivers (n = 43) were recruited. Using a crossover randomized controlled trial design, participants were randomized to two groups who received a 4-month singing intervention either during the first or second half of the study in addition to standard care. The intervention comprised weekly group-based training (including choir singing and group-level melodic intonation therapy) and tablet-assisted singing training at home. At baseline, 5- and 9-month stages, patients were assessed with tests and questionnaires on communication and speech production, mood, social functioning, and quality of life and family caregivers with questionnaires on caregiver burden. All participants who participated in the baseline measurement (n = 50) were included in linear mixed model analyses. Compared with standard care, the singing intervention improved everyday communication and responsive speech production from baseline to 5-month stage, and these changes were sustained also longitudinally (baseline to 9-month stage). Additionally, the intervention enhanced patients’ social participation and reduced caregiver burden. This study provides novel evidence that group-based multicomponent singing training can enhance communication and spoken language production in chronic aphasia as well as improve psychosocial wellbeing in patients and caregivers.Peer reviewe

Speech segmentation in aphasia

Background: Speech segmentation is one of the initial and mandatory phases of language learning. Although some people with aphasia have shown a preserved ability to learn novel words, their speech segmentation abilities have not been explored. Aims: We examined the ability of individuals with chronic aphasia to segment words from running speech via statistical learning. We also explored the relationships between speech segmentation and aphasia severity, and short-term memory capacity. We further examined the role of lesion location in speech segmentation and short-term memory performance. Methods & Procedures: The experimental task was first validated with a group of young adults (n = 120). Participants with chronic aphasia (n = 14) were exposed to an artificial language and were evaluated in their ability to segment words using a speech segmentation test. Their performance was contrasted against chance level and compared to that of a group of elderly matched controls (n = 14) using group and case-by-case analyses. Outcomes & Results: As a group, participants with aphasia were significantly above chance level in their ability to segment words from the novel language and did not significantly differ from the group of elderly controls. Speech segmentation ability in the aphasic participants was not associated with aphasia severity although it significantly correlated with word pointing span, a measure of verbal short-term memory. Case-by-case analyses identified four individuals with aphasia who performed above chance level on the speech segmentation task, all with predominantly posterior lesions and mild fluent aphasia. Their short-term memory capacity was also better preserved than in the rest of the group. Conclusions: Our findings indicate that speech segmentation via statistical learning can remain functional in people with chronic aphasia and suggest that this initial language learning mechanism is associated with the functionality of the verbal short-term memory system and the integrity of the left inferior frontal region

Novel word acquisition in aphasia: Facing the word-referent ambiguity of natural language learning contexts

Recent research suggests that some people with aphasia preserve some ability to learn novel words and to retain them in the long-term. However, this novel word learning ability has been studied only in the context of single word-picture pairings. We examined the ability of people with chronic aphasia to learn novel words using a paradigm that presents new word forms together with a limited set of different possible visual referents and requires the identification of the correct word-object associations on the basis of online feedback. We also studied the relationship between word learning ability and aphasia severity, word processing abilities, and verbal short-term memory. We further examined the influence of gross lesion location on new word learning. The word learning task was first validated with a group of forty-five young adults. Fourteen participants with chronic aphasia were administered the task and underwent tests of immediate and long-term recognition memory at 1 week. Their performance was compared to that of a group of fourteen matched controls using growth curve analysis. The learning curve and recognition performance of the aphasia group was significantly below the matched control group, although above-chance recognition performance and case-by-case analyses indicated that some participants with aphasia had learned the correct word-referent mappings. Verbal short-term memory but not word processing abilities predicted word learning ability after controlling for aphasia severity. Importantly, participants with lesions in the left frontal cortex performed significantly worse than participants with lesions that spared the left frontal region both during word learning and on the recognition tests. Our findings indicate that some people with aphasia can preserve the ability to learn a small novel lexicon in an ambiguous word-referent context. This learning and recognition memory ability was associated with verbal short-term memory capacity, aphasia severity and the integrity of the left inferior frontal region

Novel word learning ability in chronic post-stroke aphasia : variability and modality effects

Novel word learning has been rarely studied in people with aphasia (PWA), although it can provide a relatively pure measure of their learning potential, and thereby contribute to the development of effective aphasia treatment methods. The main aim of the present thesis was to explore the capacity of PWA for associative learning of word–referent pairings and cognitive-linguistic factors related to it. More specifically, the thesis examined learning and long-term maintenance of the learned pairings, the role of lexical-semantic abilities in learning as well as acquisition of phonological versus semantic information in associative novel word learning. Furthermore, the effect of modality on associative novel word learning and the neural underpinnings of successful learning were explored. The learning experiments utilized the Ancient Farming Equipment (AFE) paradigm that employs drawings of unfamiliar referents and their unfamiliar names. Case studies of Finnishand English-speaking people with chronic aphasia (n = 6) were conducted in the investigation. The learning results of PWA were compared to those of healthy control participants, and active production of the novel words and their semantic definitions was used as learning outcome measures. PWA learned novel word–novel referent pairings, but the variation between individuals was very wide, from more modest outcomes (Studies I–II) up to levels on a par with healthy individuals (Studies III–IV). In incidental learning of semantic definitions, none of the PWA reached the performance level of the healthy control participants. Some PWA maintained part of the learning outcomes up to months post-training, and one individual showed full maintenance of the novel words at six months post-training (Study IV). Intact lexical-semantic processing skills promoted learning in PWA (Studies I–II) but poor phonological short-term memory capacities did not rule out novel word learning. In two PWA with successful learning and long-term maintenance of novel word–novel referent pairings, learning relied on orthographic input while auditory input led to significantly inferior learning outcomes (Studies III–IV). In one of these individuals, this previously undetected modalityspecific learning ability was successfully translated into training with familiar but inaccessible everyday words (Study IV). Functional magnetic resonance imaging revealed that this individual had a disconnected dorsal speech processing pathway in the left hemisphere, but a right-hemispheric neural network mediated successful novel word learning via reading. Finally, the results of Study III suggested that the cognitive-linguistic profile may not always predict the optimal learning channel for an individual with aphasia. Small-scale learning probes seem therefore useful in revealing functional learning channels in post-stroke aphasia

Speech segmentation in aphasia

Background: Speech segmentation is one of the initial and mandatory phases of language learning. Although some people with aphasia have shown a preserved ability to learn novel words, their speech segmentation abilities have not been explored. Aims: We examined the ability of individuals with chronic aphasia to segment words from running speech via statistical learning. We also explored the relationships between speech segmentation and aphasia severity, and short-term memory capacity. We further examined the role of lesion location in speech segmentation and short-term memory performance. Methods & Procedures: The experimental task was first validated with a group of young adults (n = 120). Participants with chronic aphasia (n = 14) were exposed to an artificial language and were evaluated in their ability to segment words using a speech segmentation test. Their performance was contrasted against chance level and compared to that of a group of elderly matched controls (n = 14) using group and case-by-case analyses. Outcomes & Results: As a group, participants with aphasia were significantly above chance level in their ability to segment words from the novel language and did not significantly differ from the group of elderly controls. Speech segmentation ability in the aphasic participants was not associated with aphasia severity although it significantly correlated with word pointing span, a measure of verbal short-term memory. Case-by-case analyses identified four individuals with aphasia who performed above chance level on the speech segmentation task, all with predominantly posterior lesions and mild fluent aphasia. Their short-term memory capacity was also better preserved than in the rest of the group. Conclusions: Our findings indicate that speech segmentation via statistical learning can remain functional in people with chronic aphasia and suggest that this initial language learning mechanism is associated with the functionality of the verbal short-term memory system and the integrity of the left inferior frontal region