Effects of Individual and Group Therapies on Verb Production in Aphasia

Language interventions are frequently classified along a continuum (Paul & Cascella, 2007). At one end of the continuum are impairment-based approaches that aim to remediate a particular language skill. Successful treatments often utilize models of cognitive-linguistic processing and have been shown to improve language performance in individuals with aphasia (Thompson & Shapiro, 2005; Whitworth, Webster, & Howard, 2005, Wertz et al 1981). At the other end of the continuum is the participant-centered approach. These types of interventions place the client at the center of the intervention. Group treatment is a socially oriented intervention and an example of a participant-centered approach. Studies support the use of conversation group treatments to improve language performance in individuals with aphasia (Wertz et al., 1981, Elman & Bernstein-Ellis, 1999b). Considerable evidence exists in the literature to support both these types of interventions and both interventions seek to improve communication in the individual with aphasia (Martin, Thompson & Worrall, 2008). However, there have been no studies that compare the effects of these two approaches. This study compared the effect of these two approaches on remediation of verb production in aphasia. The goals were 1) to determine if performance on verbs trained in an impairment-based approach, a participant-centered approach, or an integrated context that used both approaches improved to a greater extent, and 2) to determine whether combining these training approaches led to improvements in related language functions and in verbal communication

C/O Abundance Ratios and Dust Features in Galactic Planetary Nebulae

The iron depletion factors found in Galactic planetary nebulae (PNe) span over two orders of magnitude, suggesting that there are differences in the grain formation and destruction processes from object to object. We explore here the relation between the iron depletions, the infrared dust features, and the C/O abundance ratios in a sample of Galactic PNe. We find that those objects with C/O < 1 show a trend of increasing depletions for higher values of C/O, whereas PNe with C/O > 1 break the trend and cover all the range of depletions. Most of the PNe with C/O < 1 show silicate features, but several PNe with C-rich features have C/O < 1, probably reflecting the uncertainties associated with the derivation of C/O. PAHs are distributed over the entire range of iron depletions and C/O values.Comment: 2 pages, 1 figure, to appear in the conference proceedings of "Planetary Nebulae: An Eye to the Future" IAU Symp. 283, A. Manchado, L. Stanghellini & D. Schoenberner, ed

Nursing students' nonverbal reactions to malodor in wound care simulation

Background: wound care is an essential competency which nursing students are expected to acquire. To foster students' competency, nurse educators use high fidelity simulation to expose nursing students to various wound characteristics. Problem: little is known about how nursing students react to simulated wound characteristics. Malodor is a wound characteristic which can be particularly difficult for nursing students to manage. To facilitate students' developing skills in managing malodor, nurse educators have designed high fidelity simulations including olfactory realism. However, there is a gap in nursing knowledge about nursing students' reactions to malodor in simulation. Aim of the study: the aim of this project was to describe how nursing students reacted to malodor in video recordings of wound care simulation. Methodology: the project was an observational study using qualitative descriptive methodology to describe nursing students' nonverbal reactions to malodor in simulation. A coding scheme using the Facial Action Coding System (FACS) was drawn from the literature and revised with nonverbal behavior codes which emerged during data analysis. Based on feedback from two expert observers/raters, three coding schemes were developed and tested using NVivo software. Findings: content analysis of participants' nonverbal reactions to malodor revealed three themes of reactions: noticing, confirming, and focusing. Additionally, nonverbal reactions embedded in the three themes seemed to cluster into two patterns of behaviors: physical reactions and psychosocial reactions. Two of the coding schemes exhibited inter-rater agreement values of 82%.Ph.D

An Intensive, Interdisciplinary Treatment Program for Persons with Aphasia

Traditionally, much of individual aphasia therapy has been focused on attempts to remediate underlying linguistic deficits. While many treatments have been shown to improve discrete language functions (Robey et al, 1998), those newly learned skills do not always transfer readily to non-trained environments. Over the past two decades, a growing number of aphasiologists have begun to focus their attention on social approaches to aphasia assessment and treatment (Elman, 2007). One such approach, group treatment, serves as a natural and dynamic vehicle to improve social communication, which has been shown to improve discrete language skills in persons with aphasia (pwa), (Elman & Bernstein-Ellis, 1999). Group treatment frequently co-occurs with individual therapy, but is rarely used as a formal mechanism to train generalization. Another area of broad discussion in aphasia rehabilitation is the concept of treatment intensity. Basso (2005) reported that pwa who received a higher number of therapy sessions improved more than those who received a lower number of therapy sessions. Bhogal et al (2003) found that treatment provided on a more intense level (>8.8 hours/week) for a shorter period of time resulted in stronger improvements compared to treatment provided on a less intense level over a longer period of time. A final issue is that individuals with stroke-induced aphasia often present with concomitant motor, cognitive and dietary/cardiac issues. Thus it seems that an interdisciplinary approach incorporating physical, occupational and nutritional therapy would also be beneficial. This paper explores the speech-language effects of a treatment program, which attempts to incorporate evidenced-based treatment, in an intensive, interdisciplinary format. Pilot data from an initial cohort completed June 2011 as well as multiple-baseline data from a second cohort completed June 2012 is presented

Typicality-based Differences in Treatment of Naming Deficits

Two anomic patients completed feature-based naming treatment using typical and atypical words in two different categories. One patient learned typical words but not atypical words; the other patient showed the opposite pattern of learning. No generalization to untrained words within the same category occurred. These findings argue against the use of atypical words in anomia treatment (Kiran & Thompson, 2003). Both patients demonstrated normal typicality effects during online category verification. Typicality-based differences in treatment outcomes are explained in terms of increased semantic interference for typical words, and decreased controlled selection in anterior aphasics

Effects of prosody and transitivity biases in auditory syntactic ambiguity resolution

Studies of written sentence processing have found that, in the absence of commas, lexical information such as verb subcategorization biases and plausibility influence the interpretation of sentences with early closure (EC) ambiguities. In auditory sentence processing, prosody functions similarly to punctuation. The present study used self-paced listening to investigate whether prosody interacted with lexical factors to produce garden path effects similar to those observed in reading studies in a group of twenty-one college students. The results suggested that prosody interacts with transitivity during resolution of EC ambiguities, and that prosodic cues function similarly to commas in disambiguation of this structure

Effects of Syntactic Complexity in Discourse Comprehension

This study aimed to evaluate the effects of syntactic complexity in discourse comprehension in persons with aphasia (pwa) and age-matched controls.  Data suggest that syntactic complexity does influence processing at the discourse level and that heuristic processing alone is not enought to compensate for syntactic processing demands in disourcse.  Results also showed that the Test of Syntacitc Effects in Discourse Comprehension (Levy et al, 2010) is sensitive to syntactic complexity in a way that the Discourse Comprehension Test-Revised (Brookshire and Nicholas, 2008) is not

Sentence Comprehension in Aphasia: Stability of Performance

This study investigated the stability of 42 aphasic patients’ performance in measures of sentence comprehension. Accuracy data from 11 sentences types in each of 5 tasks were analyzed. Split-half reliability was generally high, and correlations for identical sentence types across tasks were slightly higher than those for different sentences across tasks. Analysis of individual patient data revealed only one patient with the same syntactic deficit on two tasks, and it may have been a speed/accuracy trade-off. These data suggest that performance on all sentence types combined is stable across tasks, but that task effects do influence performance

Rasch Models of Aphasic Deficits of Syntactic Comprehension

Responses of forty-two patients with aphasia secondary to left hemisphere strokes to eleven sentence types in enactment and sentence-picture matching tasks were modeled using Rasch models that varied in the inclusion of the factors of task, sentence type grouping, and patient clustering. The best fitting models required the factors of task and patient group but not sentence type grouping. The simulation suggests that aphasic syntactic comprehension is best accounted for by models that include different estimates of resource availability for different tasks and different resource availability in different groups of patients, but not deficits affecting specific syntactic structures