American Journal of Speech-Language Pathology current issue

Specific Language Impairment and Executive Functioning: Parent and Teacher Ratings of Behavior [Research Article]

Wittke, K., Spaulding, T. J., Schechtman, C. J. — 2013-05-21T06:16:21-07:00

Purpose

The current study used the Behavior Rating Inventory of Executive Function—Preschool Version (BRIEF–P; Gioia, Espy, & Isquith, 2003), a rating scale designed to investigate executive behaviors in everyday activities, to examine the executive functioning of preschool children with specific language impairment (SLI) relative to their typically developing (TD) peers.

Method

Nineteen preschool children with SLI were age- and gender-matched to 19 TD peers. Both parents and teachers of the participants completed the BRIEF–P.

Results

The executive functioning of children with SLI were rated significantly worse than those of controls by both parents and teachers. Adults' perceptions of the children's executive functioning significantly correlated with the children's language abilities.

Conclusion

Parent and teacher perceptions of executive functioning in children with SLI align with prior findings of executive deficits that have been documented on neuropsychological assessments and experimental tasks. Furthermore, the results provide additional supporting evidence of the relationship between language abilities and executive functioning in early child development.

Preschool Speech Error Patterns Predict Articulation and Phonological Awareness Outcomes in Children With Histories of Speech Sound Disorders [Research Article]

Preston, J. L., Hull, M., Edwards, M. L. — 2013-05-21T06:16:21-07:00

Purpose

To determine if speech error patterns in preschoolers with speech sound disorders (SSDs) predict articulation and phonological awareness (PA) outcomes almost 4 years later.

Method

Twenty-five children with histories of preschool SSDs (and normal receptive language) were tested at an average age of 4;6 (years;months) and were followed up at age 8;3. The frequency of occurrence of preschool distortion errors, typical substitution and syllable structure errors, and atypical substitution and syllable structure errors was used to predict later speech sound production, PA, and literacy outcomes.

Results

Group averages revealed below-average school-age articulation scores and low-average PA but age-appropriate reading and spelling. Preschool speech error patterns were related to school-age outcomes. Children for whom >10% of their speech sound errors were atypical had lower PA and literacy scores at school age than children who produced <10% atypical errors. Preschoolers who produced more distortion errors were likely to have lower school-age articulation scores than preschoolers who produced fewer distortion errors.

Conclusion

Different preschool speech error patterns predict different school-age clinical outcomes. Many atypical speech sound errors in preschoolers may be indicative of weak phonological representations, leading to long-term PA weaknesses. Preschoolers' distortions may be resistant to change over time, leading to persisting speech sound production problems.

A Comparison of Computerized and Paper-Based Language Tests With Adults With Aphasia [Research Article]

Newton, C., Acres, K., Bruce, C. — 2013-05-21T06:16:21-07:00

Purpose

This study investigated whether computers are a useful tool in the assessment of people with aphasia (PWA). Computerized and traditionally administered versions of tasks were compared to determine whether (a) the scores were equivalent, (b) the administration was comparable, (c) variables such as age affected performance, and (d) the participants' perceptions of the computerized and traditionally administered versions of the tasks were similar.

Method

Fifteen PWA were assessed on 2 language tasks—sentence-picture matching and grammaticality judgment—in 3 conditions: computer only, computer with the clinician present, and traditional. The participants also completed questionnaires rating aspects of each condition.

Results

Scores from the traditionally administered tasks were highly correlated with those from the computerized tasks, but scores from the computerized tasks were significantly lower. There was no significant difference in the time taken between the conditions. Whereas some individuals felt comfortable with the computer, overall, participants preferred the traditional assessment method or when another person was in the room. No factors were identified that predicted participants' relative performance in the computer condition.

Conclusion

The results suggest that PWA can be assessed using computerized versions of tasks, but that caution should be exercised when comparing scores to those collected using traditional methods, including norms. The variation in participants' opinions regarding computerized tasks suggests that this method might be more suitable for some participants than others.

Pragmatic Language Assessment in Williams Syndrome: A Comparison of the Test of Pragmatic Language--2 and the Children's Communication Checklist--2 [Research Note]

Hoffmann, A., Martens, M. A., Fox, R., Rabidoux, P., Andridge, R. — 2013-05-21T06:16:21-07:00

Purpose

Individuals with Williams syndrome (WS) are recognized as having a strong desire for social relationships, yet many of them have difficulty forming and maintaining peer relationships. One cause may be impairments in pragmatic language. The current study compared the assessment of pragmatic language skills in individuals with WS using the Test of Pragmatic Language—Second Edition (TOPL–2; Phelps-Terasaki & Phelps-Gunn, 2007) and the Children's Communication Checklist—Second Edition (CCC–2; Bishop, 2003).

Method

Twenty children and adolescents diagnosed with WS were given the TOPL–2, and their parents completed the CCC–2.

Results

The TOPL–2 identified 8 of the 14 older children (ages 8–16 years) as having pragmatic language impairment and all of the 6 younger children (ages 6–7 years) as having such. In comparison, the CCC–2 identified 6 of the 14 older children and 2 of the 6 younger children as having pragmatic language impairment. The older group also had a higher composite score than the younger group on the CCC–2.

Conclusion

The TOPL–2 identified significantly more participants as having pragmatic language impairment than did the CCC–2. The TOPL–2 may be more useful in assessing pragmatic language in older children than younger children. The results offer important preliminary clinical implications of language measures that may be beneficial in the assessment of individuals with WS.

Acoustic Characteristics of Simulated Respiratory-Induced Vocal Tremor [Research Note]

Lester, R. A., Story, B. H. — 2013-05-21T06:16:21-07:00

Purpose

The purpose of this study was to investigate the relation of respiratory forced oscillation to the acoustic characteristics of vocal tremor.

Method

Acoustical analyses were performed to determine the characteristics of the intensity and fundamental frequency (F₀) for speech samples obtained by Farinella, Hixon, Hoit, Story, and Jones (2006) using a respiratory forced oscillation paradigm with 5 healthy adult males to simulate vocal tremor involving respiratory pressure modulation. The analyzed conditions were sustained productions of /a/ with amplitudes of applied pressure of 0, 1, 2, and 4 cmH₂O and a rate of 5 Hz.

Results

Forced oscillation of the respiratory system produced modulation of the intensity and F₀ for all participants. Variability was observed between participants and conditions in the change in intensity and F₀ per unit of pressure change, as well as in the mean intensity and F₀. However, the extent of modulation of intensity and F₀ generally increased as the applied pressure increased, as would be expected.

Conclusion

These findings suggest that individuals develop idiosyncratic adaptations to pressure modulations, which are important to understanding aspects of variability in vocal tremor, and highlight the need to assess all components of the speech mechanism that may be directly or indirectly affected by tremor.

Evidence-Based Clinical Voice Assessment: A Systematic Review [Review]

2013-05-21T06:16:21-07:00

Purpose

To determine what research evidence exists to support the use of voice measures in the clinical assessment of patients with voice disorders.

Method

The American Speech-Language-Hearing Association (ASHA) National Center for Evidence-Based Practice in Communication Disorders staff searched 29 databases for peer-reviewed English-language articles between January 1930 and April 2009 that included key words pertaining to objective and subjective voice measures, voice disorders, and diagnostic accuracy. The identified articles were systematically assessed by an ASHA-appointed committee employing a modification of the critical appraisal of diagnostic evidence rating system.

Results

One hundred articles met the search criteria. The majority of studies investigated acoustic measures (60%) and focused on how well a test method identified the presence or absence of a voice disorder (78%). Only 17 of the 100 articles were judged to contain adequate evidence for the measures studied to be formally considered for inclusion in clinical voice assessment.

Conclusion

Results provide evidence for selected acoustic, laryngeal imaging–based, auditory–perceptual, functional, and aerodynamic measures to be used as effective components in a clinical voice evaluation. However, there is clearly a pressing need for further high-quality research to produce sufficient evidence on which to recommend a comprehensive set of methods for a standard clinical voice evaluation.

Releasing the Constraints on Aphasia Therapy: The Positive Impact of Gesture and Multimodality Treatments [Select Papers From the 42nd Clinical Aphasiology Conference]

Rose, M. L. — 2013-05-21T06:16:21-07:00

Purpose

There is a 40-year history of interest in the use of arm and hand gestures in treatments that target the reduction of aphasic linguistic impairment and compensatory methods of communication (Rose, 2006). Arguments for constraining aphasia treatment to the verbal modality have arisen from proponents of constraint-induced aphasia therapy (Pulvermüller et al., 2001). Confusion exists concerning the role of nonverbal treatments in treating people with aphasia. The central argument of this paper is that given the state of the empirical evidence and the strong theoretical accounts of modality interactions in human communication, gesture-based and multimodality aphasia treatments are at least as legitimate an option as constraint-based aphasia treatment.

Method

Theoretical accounts of modality interactions in human communication and the gesture production abilities of individuals with aphasia that are harnessed in treatments are reviewed. The negative effects on word retrieval of restricting gesture production are also reviewed, and an overview of the neurological architecture subserving language processing is provided as rationale for multimodality treatments. The evidence for constrained and unconstrained treatments is critically reviewed.

Conclusion

Together, these data suggest that constraint treatments and multimodality treatments are equally efficacious, and there is limited support for constraining client responses to the spoken modality.

An Analysis of Aphasic Naming Errors as an Indicator of Improved Linguistic Processing Following Phonomotor Treatment [Select Papers From the 42nd Clinical Aphasiology Conference]

Kendall, D. L., Pompon, R. H., Brookshire, C. E., Minkina, I., Bislick, L. — 2013-05-21T06:16:21-07:00

Purpose

The aim of this study was to investigate the influence of phonomotor treatment on the types of errors produced during a confrontation naming task for people with aphasia (PWA).

Method

Ten PWA received 60 hr of phonomotor treatment across 6 weeks. Confrontation naming abilities were measured before and after treatment, and responses were coded as correct or incorrect. Incorrect responses were coded for error type. Paired t tests comparing pre-, post- and 3 months posttreatment naming accuracy and error type were performed.

Results

Group data showed that naming accuracy on trained items improved significantly immediately post treatment, and gains were maintained 3 months later. Naming accuracy on untrained items did not show significant improvement immediately post treatment or 3 months later. Results of error type analysis were not significant. However, a decrease in omission errors and an increase in mixed errors were noted immediately post treatment for naming of untrained items.

Conclusion

Results suggest that intensive phonomotor treatment improved lexical-retrieval abilities and may have triggered a shift in linguistic processing, as indicated by a decrease in omission errors on trained items and an increase in mixed errors on untrained items.

Treatment of Proper Name Retrieval Deficits in an Individual With Temporal Lobe Epilepsy [Select Papers From the 42nd Clinical Aphasiology Conference]

2013-05-21T06:16:21-07:00

Purpose

Studies investigating language deficits in individuals with left temporal–lobe epilepsy have consistently demonstrated impairments in proper name retrieval. The aim of this Phase I rehabilitation study was to investigate the effects of a linguistically distributed word retrieval treatment on proper name retrieval in an individual with left temporal–lobe epilepsy.

Method

A 61-year old right-handed male with left temporal–lobe epilepsy (clinical onset at the age of 50) and a deficit in proper name retrieval participated in this study. A single-subject, repeated-probe ABAA design with testing before, immediately after, and 3 months after treatment completion was employed. Proper name retrieval treatment was administered 2 hr per day for 5 days.

Results

Results demonstrated improved naming on trained items and maintenance of trained items 3 months after treatment completion.

Conclusion

Treatment, which took advantage of the individual's undamaged linguistic networks, promoted the reorganization of networks supporting proper naming, leading to improved proper name retrieval. Further research replicating these findings in individuals with varying degrees of proper name retrieval impairment is warranted. Additionally, the mechanism behind the observed improvements in proper name retrieval needs to be investigated further using functional neuroimaging.

Suppression and Narrative Time Shifts in Adults With Right-Hemisphere Brain Damage [Select Papers From the 42nd Clinical Aphasiology Conference]

Scharp, V. L., Tompkins, C. A. — 2013-05-21T06:16:21-07:00

Purpose

This study examined the functioning of a central comprehension mechanism, suppression, in adults with right-hemisphere damage (RHD) while they processed narratives that cued a shift in time frame. In normal language comprehension, mental activation of concepts from a prior time frame is suppressed. The (re)activation of information following a time frame shift was also assessed.

Method

Twenty adults (12 RHD; 8 non brain–damaged) completed a speeded word recognition task while listening to narratives in 2 conditions: shift ("an hour later") and no shift ("a moment later").

Results

There was no group difference in suppression for response time proportion data (shift/no shift), but cluster analyses identified a suppression deficit in 8 of the adults with RHD. There was overlap in suppression function at the narrative and lexical levels. The group with RHD was significantly delayed in mentally (re)activating new information after a time shift cue.

Conclusion

Results underscore the generality of suppression functioning in adults with RHD. As such, treatment for a suppression deficit at one level may generalize to another level. An apparent independence of suppression and activation deficits suggests that each may need separate treatment. A better understanding of the nature and boundary conditions of suppression and activation deficits should better inform clinical decisions.

Mild Aphasia: Is This the Place for an Argument? [Select Papers From the 42nd Clinical Aphasiology Conference]

Armstrong, E., Fox, S., Wilkinson, R. — 2013-05-21T06:16:21-07:00

Purpose

Individuals with mild aphasia often report significant disruption to their communication despite seemingly minor impairment. This study explored this phenomenon through examining conversations of a person with mild aphasia engaging in argumentation—a skill she felt had significantly deteriorated after her stroke.

Method

A person with mild aphasia and her husband recorded 4 conversations involving topical issues. The discourse dynamics and lexical-grammatical content were analyzed using systemic functional linguistic (Halliday & Matthiessen, 2004) and conversation analysis (Sacks, Schegloff, & Jefferson, 1974) frameworks.

Results

The couple demonstrated similarities in the types of conversational moves, but the language of the person with aphasia was more nonspecific and simplified, manifesting in difficulties developing a logical argument and responding to the partner's line of argument. In addition, the nonaphasic speaker recurrently overlapped the aphasic speaker in order to request clarification of particular points, highlighting the types of behaviors that can occur in this form of higher level language activity.

Conclusion

The complex argument task and the multilevel and multi-approach analysis are useful tools for examining persons with mild aphasia, revealing aspects that are often overlooked in standard tests. Treatment could incorporate more complex notions such as evaluative language and the role of overlap in complex conversations.

Treatment Fidelity: Its Importance and Reported Frequency in Aphasia Treatment Studies [Select Papers From the 42nd Clinical Aphasiology Conference]

Hinckley, J. J., Douglas, N. F. — 2013-05-21T06:16:21-07:00

Purpose

Treatment fidelity is a measure of the reliability of the administration of an intervention in a treatment study. It is an important aspect of the validity of a research study, and it has implications for the ultimate implementation of evidence-supported interventions in typical clinical settings.

Method

Aphasia treatment studies published in the last 10 years in 3 journals were reviewed using coding techniques that were adapted from Gresham, Gansle, Noell, Cohen, and Rosenblum (1993). The following items were noted: identifying information, study design, description of both the dependent and independent variables, and whether a measure of treatment fidelity was explicitly included.

Results

Of the aphasia treatment studies published in the last 10 years, 14% explicitly reported treatment fidelity. Most studies reporting treatment fidelity used checking of videotaped sessions by independent raters. Of the reviewed studies, 45% provided sufficient treatment description to support replication.

Conclusion

Treatment fidelity is widely acknowledged as being critical to research validity and is a foundation for the implementation of evidence-based practices, but only a small percentage of aphasia treatment studies published in the last 10 years explicitly reported treatment fidelity. Recommendations for research practices include increased attention to matters of treatment fidelity in the peer review process and explicit incorporation of 3 levels of treatment fidelity in treatment research.

The Cognitive Basis for Sentence Planning Difficulties in Discourse After Traumatic Brain Injury [Select Papers From the 42nd Clinical Aphasiology Conference]

Peach, R. K. — 2013-05-21T06:16:21-07:00

Purpose

Analyses of language production of individuals with traumatic brain injury (TBI) place increasing emphasis on microlinguistic (i.e., within-sentence) patterns. It is unknown whether the observed problems involve implementation of well-formed sentence frames or represent a fundamental linguistic disturbance in computing sentence structure. This study investigated the cognitive basis for microlinguistic deficits in individuals with TBI.

Method

Fifteen nonaphasic individuals with severe TBI and 6 age- and education-matched non brain–injured adults participated in this study. Monologic discourse samples were analyzed for pausing patterns, mazes, errors, and abandoned utterances. Measures of cognitive abilities were correlated with the sentence measures.

Results

The speakers with TBI produced more pauses between clauses (but not within clauses) as well as more mazes than did the non brain–injured speakers. Significant regression models were built. Raven's Coloured Progressive Matrices (Raven, 1965), a measure associated with working memory, predicted pause behavior, and Likenesses–Differences (Baker & Leland, 1967), a measure of executive function, predicted maze behavior.

Conclusions

Sentence planning impairments following TBI are associated with deficient organization and monitoring of language representations in working memory. These findings suggest that the deficits are due to problems in the recruitment and control of attention for sentence planning. These findings bear on sentence processing models that emphasize the activation, organization, and maintenance of language representations for accurate sentence production.

Rehabilitation in Bilingual Aphasia: Evidence for Within- and Between-Language Generalization [Select Papers From the 42nd Clinical Aphasiology Conference]

Kiran, S., Sandberg, C., Gray, T., Ascenso, E., Kester, E. — 2013-05-21T06:16:21-07:00

Purpose

The goal of this study was to examine if there was a principled way to understand the nature of rehabilitation in bilingual aphasia such that patterns of acquisition and generalization are predictable and logical.

Method

Seventeen Spanish–English bilingual individuals with aphasia participated in the experiment. For each participant, three sets of stimuli were developed for each language: (a) English Set 1, (b) English Set 2 (semantically related to each item in English Set 1), (c) English Set 3 (unrelated control items), (d) Spanish Set 1 (translations of English Set 1), (e) Spanish Set 2 (translations of English Set 2; semantically related to each item in Spanish Set 1), and (f) Spanish Set 3 (translations of English Set 3; unrelated control items). A single-subject experimental multiple baseline design across participants was implemented. Treatment was conducted in 1 language, but generalization to within- and between-language untrained items was examined.

Results

Treatment for naming on Set 1 items resulted in significant improvement (i.e., effect size >4.0) on the trained items in 14/17 participants. Of the 14 participants who showed improvement, within-language generalization to semantically related items was observed in 10 participants. Between-language generalization to the translations of trained items was observed in 5 participants, and between-language generalization to the translations of the untrained semantically related items was observed in 6 participants.

Conclusion

The results of this study demonstrated within- and between-language patterns that were variable across participants. These differences are indicative of the interplay between facilitation (generalization) and inhibition.

What People Living With Aphasia Think About the Availability of Aphasia Resources [Select Papers From the 42nd Clinical Aphasiology Conference]

Hinckley, J. J., Hasselkus, A., Ganzfried, E. — 2013-05-21T06:16:21-07:00

Purpose

Obtaining health information and resources can influence an individual's (a) access to services, (b) interactions with health care providers, and (c) ability to manage one's own health needs. The purpose of this study was to gather the perceptions of consumers living with aphasia about resource availability and information needs.

Method

An online survey of consumers in the United States was conducted about the availability of aphasia resources. Analysis of survey responses and comments formed the basis for focus group questions. Four focus groups consisting of persons with aphasia and their caregivers were conducted to explore the survey response themes more deeply.

Results

Survey respondents (N = 302) rated aphasia resources as "somewhat difficult to find." Topics ranked as most important by these respondents were (a) how to keep improving, (b) communication strategies, (c) aphasia treatment techniques, (d) coping strategies, and (e) strategies for caregivers. Survey comments and focus group themes suggested that accessing information is difficult, health care providers are not perceived to know about aphasia resources, and there is a lack of public awareness of aphasia that is a barrier to finding information and resources.

Conclusion

Understanding how people living with aphasia seek information may allow us to better tailor access to resources in the future.

Evaluation of Attention Training and Metacognitive Facilitation to Improve Reading Comprehension in Aphasia [Select Papers From the 42nd Clinical Aphasiology Conference]

Lee, J. B., Sohlberg, M. M. — 2013-05-21T06:16:21-07:00

Purpose

This pilot study investigated the impact of direct attention training combined with metacognitive facilitation on reading comprehension in individuals with aphasia.

Method

A single-subject, multiple baseline design was employed across 4 participants to evaluate potential changes in reading comprehension resulting from an 8-week intervention using Attention Process Training—3 (APT–3). The primary outcome measure was a maze reading task. Pre- and posttesting included attention and reading comprehension measures. Visual inspection of graphed performance data across conditions was used as the primary method of analysis. Treatment effect sizes were calculated for changes in reading comprehension probes from baseline to maintenance phases.

Results

Two of the study's 4 participants demonstrated improvements in maze reading, with corresponding effect sizes that were small in magnitude according to benchmarks for aphasia treatment research. All 4 participants made improvements on select standardized measures of attention.

Conclusion

Interventions that include a metacognitive component with direct attention training may elicit improvements in participants' attention and allocation of resources. Maze passage reading is a repeated measure that appears sensitive to treatment-related changes in reading comprehension. Issues for future research related to measurement, candidacy, and clinical delivery are discussed.

Semantic Feature Analysis: Incorporating Typicality Treatment and Mediating Strategy Training to Promote Generalization [Select Papers From the 42nd Clinical Aphasiology Conference]

Wambaugh, J. L., Mauszycki, S., Cameron, R., Wright, S., Nessler, C. — 2013-05-21T06:16:21-07:00

Purpose

This investigation was designed to examine the generalization effects of semantic treatment for word retrieval deficits in people with aphasia. Semantic feature analysis (SFA; Boyle & Coelho, 1995), typicality treatment (Kiran & Thompson, 2003), and mediating strategy training were combined to maximize potential generalization effects.

Method

Treatment, which included SFA and a semantic feature judgment task, was conducted with 9 participants with chronic aphasia in the context of multiple baseline designs across behaviors. Typical and atypical exemplars were trained across animate and inanimate categories. Treatment was sequentially modified to overtly train the use of SFA as a mediating strategy.

Results

Eight of the 9 participants demonstrated improvements in naming of trained stimuli. Positive generalization effects were limited overall; possible response generalization was evident for 5 participants. Instruction in the use of a mediating strategy resulted in improved naming of treated words for all participants; however, generalization to untreated words did not occur.

Conclusion

Treatment using SFA resulted in improved naming of treated typical and atypical exemplars in both animate and inanimate categories for 8 of 9 participants. Training in a mediating strategy also resulted in improved retrieval of experimental words. Regardless of intervention approach, generalization to untreated items was limited.

An Aphasia Mentoring Program: Perspectives of Speech-Language Pathology Students and of Mentors With Aphasia [Select Papers From the 42nd Clinical Aphasiology Conference]

Purves, B. A., Petersen, J., Puurveen, G. — 2013-05-21T06:16:21-07:00

Purpose

In contrast to clinician-as-expert models, social models of clinical practice typically acknowledge people with aphasia as equal partners in intervention. Given this, there may be a place within speech-language pathology education for programs situating people with aphasia as experts. This paper describes an aphasia mentoring program that was implemented as part of a speech-language pathology graduate program.

Method

Qualitative research methods with thematic analysis of interviews, focus groups, questionnaires, and participant observation were used to develop a description of the mentoring program, including the experiences and perspectives of the participants—both mentors (people with chronic aphasia) and students.

Results

Five themes, including getting better, aphasia advocacy, group as versus for therapy, we're a team, and focus on mentoring, emerged from the mentors' data. Five themes, including shifting the power dynamic, getting to know the person, seeing members as mentors, making classroom learning real, and connecting with a community, emerged from the students' data. There were significant overlaps and intersections between the 2 data sets.

Conclusion

Findings revealed how an aphasia mentoring program that positions people with aphasia as experts can make a significant contribution to student education while supporting mentors' own goals, with implications for improved quality of life.

Speech Motor Programming in Apraxia of Speech: Evidence From a Delayed Picture-Word Interference Task [Select Papers From the 42nd Clinical Aphasiology Conference]

Mailend, M.-L., Maas, E. — 2013-05-21T06:16:21-07:00

Purpose

Apraxia of speech (AOS) is considered a speech motor programming impairment, but the specific nature of the impairment remains a matter of debate. This study investigated 2 hypotheses about the underlying impairment in AOS framed within the Directions Into Velocities of Articulators (DIVA; Guenther, Ghosh, & Tourville, 2006) model: The retrieval hypothesis states that access to the motor programs is impaired, and the damaged programs hypothesis states that the motor programs themselves are damaged.

Method

The experiment used a delayed picture-word interference paradigm in which participants prepare their response and auditory distracters are presented with the go signal. The overlap between target and distracter words was manipulated (i.e., shared sounds or no shared sounds), and participants' reaction times (RTs) were measured. Participants included 5 speakers with AOS (4 with concomitant aphasia), 2 speakers with aphasia without AOS, and 9 age-matched control speakers.

Results

The control speakers showed no effects of distracter type or presence. The speakers with AOS had longer RTs in the distracter condition compared to the no-distracter condition. The speakers with aphasia without AOS were comparable to the control group in their overall RTs and RT pattern.

Conclusion

Results provide preliminary support for the retrieval hypothesis, suggesting that access to motor programs may be impaired in speakers with AOS. However, the possibility that the motor programs may also be damaged cannot be ruled out.

Measuring Lexical Diversity in Narrative Discourse of People With Aphasia [Select Papers From the 42nd Clinical Aphasiology Conference]

Fergadiotis, G., Wright, H. H., West, T. M. — 2013-05-21T06:16:21-07:00

Purpose

A microlinguistic content analysis for assessing lexical semantics in people with aphasia (PWA) is lexical diversity (LD). Sophisticated techniques have been developed to measure LD. However, validity evidence for these methodologies when applied to the discourse of PWA is lacking. The purpose of this study was to evaluate four measures of LD to determine how effective they were at measuring LD in PWA.

Method

Four measures of LD were applied to short discourse samples produced by 101 PWA: (a) the Measure of Textual Lexical Diversity (MTLD; McCarthy, 2005), (b) the Moving-Average Type-Token Ratio (MATTR; Covington, 2007), (c) D (McKee, Malvern, & Richards, 2000), and (d) the Hypergeometric Distribution (HD-D; McCarthy & Jarvis, 2007). LD was estimated using each method, and the scores were subjected to a series of analyses (e.g., curve-fitting, analysis of variance, confirmatory factor analysis).

Results

Results from the confirmatory factor analysis suggested that MTLD and MATTR reflect LD and little of anything else. Further, two indices (HD-D and D) were found to be equivalent, suggesting that either one can be used when samples are >50 tokens.

Conclusion

MTLD and MATTR yielded the strongest evidence for producing unbiased LD scores, suggesting that they may be the best measures for capturing LD in PWA.

Modified Response Elaboration Training: Application to Procedural Discourse and Personal Recounts [Select Papers From the 42nd Clinical Aphasiology Conference]

Wambaugh, J. L., Nessler, C., Wright, S. — 2013-05-21T06:16:21-07:00

Purpose

This investigation was designed to examine the effects of a modification of response elaboration training (RET; Kearns, 1985) with speakers with mild to mild–moderate aphasia. The modification entailed application of RET to procedural discourse and personal recounts rather than to narrative discourse.

Method

Three participants with chronic aphasia received modified RET (M–RET) applied sequentially in the context of multiple baseline designs to the conditions of personal recounts and procedural discourse. Production of correct information units (CIUs; Nicholas & Brookshire, 1993) served as the primary dependent variable.

Results

Participants 2 and 3 demonstrated increases in the production of CIUs in response to treatment of procedures. M–RET applied to the personal recount condition was not associated with increased production of CIUs in personal recounts in probes. However, Participant 1 demonstrated increased CIU production for previously treated procedures when treatment was applied to personal recounts. Small effect sizes were obtained for procedural sets for Participant 1, and large effect sizes were obtained for procedural sets for Participants 2 and 3. Maintenance of gains at 3 and 6 weeks post treatment was strong.

Conclusion

Application of M–RET to procedural discourse appears to be a viable treatment option for participants with mild to mild–moderate aphasia.

Nonlinguistic Learning in Individuals With Aphasia: Effects of Training Method and Stimulus Characteristics [Select Papers From the 42nd Clinical Aphasiology Conference]

Vallila-Rohter, S., Kiran, S. — 2013-05-21T06:16:21-07:00

Purpose

The purpose of the current study was to explore nonlinguistic learning ability in individuals with aphasia, examining the impact of stimulus typicality and feedback on success with learning.

Method

Eighteen individuals with aphasia and 8 nonaphasic controls participated in this study. All participants completed 4 computerized, nonlinguistic category-learning tasks. Learning ability was probed under 2 methods of instruction: feedback-based (FB) and paired-associate (PA). The impact of task complexity on learning ability was also examined, comparing 2 stimulus conditions: typical and atypical. Performance was compared between groups and across conditions.

Results

The controls were able to successfully learn categories under all conditions. For the individuals with aphasia, 2 patterns of performance arose: One subgroup of individuals was able to maintain learning across task manipulations and conditions; the other subgroup demonstrated a sensitivity to task complexity, learning successfully only in the typical training conditions.

Conclusion

Results support the hypothesis that impairments of general learning are present in individuals with aphasia. Some individuals demonstrated the ability to extract category information under complex training conditions; others learned only under conditions that were simplified and that emphasized salient category features. Overall, the typical training condition facilitated learning for all of the participants. Findings have implications for treatment, which are discussed.

Characterizing Discourse Deficits Following Penetrating Head Injury: A Preliminary Model [Select Papers From the 42nd Clinical Aphasiology Conference]

2013-05-21T06:16:21-07:00

Purpose

Discourse analyses have demonstrated utility for delineating subtle communication deficits following closed head injuries (CHIs). The present investigation examined the discourse performance of a large group of individuals with penetrating head injury (PHI). Performance was also compared across 6 subgroups of PHI based on lesion locale. A preliminary model of discourse production following PHI was proposed and tested.

Method

Story narratives were elicited from 2 groups of participants, 167 with PHI and 46 non brain–injured (NBI). Micro- and macrostructural components of each story were analyzed. Measures of memory, executive functions, and intelligence were also administered. All measures were compared across groups and PHI subgroups. The proposed model of discourse production was tested with a structural equation modeling procedure.

Results

No differences for the discourse measures were noted across the six PHI subgroups. Three measures distinguished the PHI and NBI groups: narrative length, story grammar, and completeness. The proposed model of discourse production had an adequate-to-good fit with the cognitive and discourse data.

Conclusion

In spite of differing mechanisms of injury, the PHI group's discourse performance was consistent with what has been reported for individuals with CHI. The model tested represents a preliminary step toward understanding discourse production following traumatic brain injury.