Showing papers in "Aphasiology in 1997"

Agrammatic and non-brain-damaged subjects' verb and verb argument structure production

Abstract: This study examined verb and verb argument structure production in 10 agrammatic aphasic and 10 non-brain-damaged subjects. Production of six types of verbs was examined in two conditions-a confrontation and an elicited condition; and production of verb arguments was examined in a sentence condition in which each target verb was elicited with all possible argument structure arrangements. Results showed statistically significant differences between the aphasic and non-brain-damaged subjects in all conditions, but no significant differences were found between confrontation and elicited labelling conditions for either subject group. The aphasic subjects, however, produced obligatory one-place verbs correctly significantly more often than three-place or complement verbs in the elicited condition and a consistent hierarchy of verb difficulty was found in both the confrontation and elicited conditions, For both subject groups sentence production was influenced by the number of arguments or participant roles and by the type of arguments required by the verb. In addition, the complexity of the verb (i.e. the number of possible argument structure arrangements) influenced sentence production with simple verbs produced correctly with their arguments more often than complex ones. Finally, obligatory arguments were produced correctly more often than optional ones, even when production of the optional arguments was requested. These data indicate that the argument structure properties of verbs are important dimensions of lexical organization that influence both verb retrieval and sentence production in agrammatic aphasic subjects.

Communication partners: Enhancing participation in life and communication for adults with aphasia in natural settings

Abstract: Communication partners is a novel aphasia treatment plan whose aim is to restore a sense of purpose, direction, and control to daily life for both patient and caregiver. Treatment involves the participation of a community volunteer who, once paired with an aphasic adult, acts as a liaison in bridging clinical and real-life pursuits. Initially, treatment pairs are taught how to interact freely and effectively. Once comfortable in each other's company these partners embark on activities of the patient's choosing at home or in the community. Results from 10 treated pairs failed to yield significant differences on the Boston Diagnostic Aphasia Exmamination, Communication Abilities in Daily Living, or the Affect Balance Scale. However, all participants, i.e. patients, caregivers, and communication partners, noted statistically significant gains in the aphasic adult's well-being and communication on two investigator-constructed questionnaires. Other informal measures also supported the use of this trea...

Visual analogue mood scales to measure internal mood state in neurologically impaired patients: Description and initial validity evidence

Abstract: This report describes the development of seven visual analogue mood scales (VAMS), using vertical 100 mm lines and simple, schematic faces representing the following mood states: sad, afraid, angry, tired, energetic, happy, and confused. Two studies are described in which 311 normal volunteers completed the VAMS, as well as the Profile of Mood States (in both studies) and the Beck Depression Inventory (in one study). Using the multitrait—multimethod technique, the VAMS were found to have excellent discriminant and convergent validity. In one study a separate set of VAMS, in which all words were removed from the scales, was also used. Participants' ratings on these No-Word VAMS were highly correlated with their ratings on the VAMS with corresponding words, indicating that the VAMS have content validity and would be accurately completed by patients with impaired language comprehension. These brief mood scales may prove useful in both clinical and research settings in which valid assessment of inter...

Patterns of language decline in non-fluent primary progressive aphasia

Abstract: Language samples collected yearly for up to 11 years post-onset of symptoms from four subjects presenting with non-fluent primary progressive aphasia (PPA) were analyzed and compared with samples collected from both non-brain-damaged subjects and those with agrammatic Broca's aphasia resulting from a single left-hemisphere stroke. Extensive analysis of lexical and morphosyntactic variables in these samples revealed two patterns of expressive language decline in the PPA subjects - one resembling that seen in our agrammatic aphasic subjects - i.e. impaired production of closed-class elements and loss of sentential structures governed by these elements-and the other characterized by advancing word-retrieval difficulties. These data are relevant for patient-management purposes and, in addition, they provide information relevant to language representation and organization.

Reformulating the definition of compensatory strategies in aphasia

Abstract: Based on authentic data from an ethnographic study of compensatory strategies in adults with aphasia, an operational definition of compensatory strategies has been formulated. By employing seven characteristics derived from the data, this definition provides a perspective on compensation that is different from previous definitions and examples. Several assessment and treatment implications are discussed.

Quality of life in aphasia in the first post-stroke year

Abstract: The term quality of life (QOL) is used by both scientists and lay persons and is defined in many different ways. One of the major challenges in measuring QOL results from the fact that it is a latent trait not subject to direct observation or countable phenomena. Specific attention to QOL in the stroke survivor has been rare. This paper reviews the literature, identifies some of the issues, and reports a study of QOL in 59 consecutively admitted post-stroke aphasic patients who were treated in a comprehensive rehabilitation medicine programme and followed from three to twelve months post onset. The results suggest that improved QOL in aphasic persons of all types in the first poststroke year relates to the intensity and duration of aphasia rehabilitation services which addresses language, communication strategies, copying skills, and psychosocial issues.

Improvement in psychological well-being of people with aphasia and their families: Evaluation of a community-based programme

Abstract: The York-Durham Aphasia Centre comprises a community-based programme for people with aphasia and their families. It offers long-term support and service at any time post-stroke or head injury. This evaluation focused on improvement in psychosocial well-being in the clients and their family members as a measure of programme effectiveness. Trained programme volunteers administered Ryff's Psychological Well-being Scale to 35 clients twice, at 6 months apart. Twelve family members also self-administered the scale twice. Voluuteers handled the administration well, and aphasic clients were able to complete the scale with little difficulty. Both clients and family members showed positive change in five of six dimensions of psychological well-being. This improvement in both groups may be related to the direct attention the programmes give to psychosocial well-being and communication, the overall environment of the centre, and the test administration itself. The positive change in these aphasic clients of...

Performance of subjects with multiple sclerosis on tests of high-level language

Abstract: The present study describes the high-level language (HLL) abilities of a group of 60 subjects with multiple sclerosis (MS) based on their performance on the Test of Language Competence (TLC) and The Word Test (TWT). Comparative performance of the MS group with matched control subjects revealed that the MS subjects presented with difficulties understanding ambiguous sentences and metaphoric expressions, making inferences, and re-creating sentences, and exhibited relatively poor performance on vocabulary and semantic tasks. Subjects with both a chronic progressive (CP) (n = 32) and relapsing remitting (RR) (n = 28) course of MS had significant HLL problems, thereby suggesting that the presence of language deficits is not determined by disease course, as proposed by some authors. However, it was noted that the CP group had more severe language problems than the RR group, as indicated by lower scores on tasks requiring the subjects to re-create sentences, understand ambiguous sentences, make associat...

Production of affective and linguistic prosody by brain-damaged patients

Abstract: To test a number of hypotheses concerning the functional lateralization of speech prosody, the ability of unilaterally right-hemisphere-damaged (RHD), unilaterally left-hemisphere-damaged (LHD), and age-matched control subjects (NC) to produce linguistic and affective prosodic contrasts at the sentence level was assessed via acoustic analysis. Multiple aspects of suprasegmental processing were explored, including a manipulation of the type of elicitation task employed (repetition vs reading) and the amount of linguistic structure provided in experimental stimuli (stimuli were either speech-filtered, nonsensical, or semantically well formed). In general, the results demonstrated that both RHD and LHD patients were able to appropriately utilize the acoustic parameters examined (duration, fundamental frequency (F 0), amplitude) to differentiate both linguistic and affective sentence types in a manner comparable to NC speakers. Some irregularities in the global modulation of F 0 and amplitude by RHD ...

Grammaticality judgements of mildly aphasic individuals under dual-task conditions

Abstract: This study examined the grammaticality judgements of mildly aphasic individuals under dual-task conditions in order to examine the relationship between syntactic processing and resource capacity and allocation in aphasia. Individuals with aphasia and age-matched control subjects performed a listening task that required grammaticality judgements under isolation, focused attention, and divided attention conditions. Subjects were also required to rate task difficulty following completion of each listening condition. Although grammatical sensitivity was similar between groups during the isolation condition, introduction of a secondary, competing task resulted in significantly greater dual-task interference for the aphasic than for the control subjects. Despite these group differences in dual-task performance, aphasic and control subjects' perceptions of task difficulty failed to differ significantly. These findings provide further support for a resource limitation model of syntactic processing defici...

Emotional, psychological and psychosocial problems of aphasic patients: An introduction

Abstract: Emotional and psychosocial problems greatly influence the quality of life and the outcome of rehabilitation in aphasic patients. However, owing to the complexity of the problem and to the poverty of research tools enabling investigators to explore it effectively, they have usually received a limited amount of research. Since methodological and conceptual advancements have been made only in recent years in this field, this special issue of Aphasiology will try to give a sketchy account of this changing situation. The present article aims to provide an introductory survey of the whole field, by taking into account separately the three main factors (neurological, psychological and psychosocial) which usually interact in the life of aphasic patients. Neurological factors directly stem from disruption of specific neural mechanisms underlying the representation and control of emotional and social behaviour. Psychological factors consist of a variety of attitudes towards illness and disability which res...

A double-blind, placebo-controlled study of pharmacological and behavioural treatment of lexical-semantic deficits in aphasia

Abstract: This investigation replicated and extended an earlier study of naming disorders (McNeil. et al. 1995) by administering a placebo and pharmacological agents (d-amphetamine and selegiline) in the presence and absence of a behavioural intervention termed lexical-semantic activation inhibition therapy (L-SAIT) to examine their effects on naming performance in two adults with stroke-induced aphasia. Results revealed acquisition and maintenance effects of L-SAIT on targeted lexical items, no effects of placebo or active pharmacological agents in the absence of L-SAIT, and no differential effects between placebo + L-SAIT and pharmacological agents + L-SAIT. Thus, positive treatment effects were attributed to L-SAIT. Generalization to untrained items within and across form class was not observed, nor was generalization to measures of informativeness of connected speech. Subject 1 evidenced improvement on the Rapid Automatized Naming Test (Denckla and Rudel 1976).

An impairment in processing verbs' thematic roles: A therapy study

Abstract: This paper describes a subject with a selective verb disorder. Verb retrieval was impaired both in spontaneous speech and naming. When verbs were accessed a striking dissociation emerged. Subcategorization was surprisingly intact, while the assignment of verbs' thematic roles was poor. Verb comprehension was also impaired, particularly when tasks demanded an appreciation of thematic information. A remediation programme was administered which aimed to improve insight into the role structures and mapping requirements of three argument verbs. Evaluation showed gains in the production of this type of verb, which generalized to untreated items. However, there was no generalization to verbs of a different type. Progress was also suggested by a second evaluative procedure, in which observers were asked to judge the intelligibility of the subject's output, before and after therapy. The theoretical implications of the findings are discussed.

Accuracy monitoring and task demand evaluation in aphasia

Abstract: This study investigated possible underlying sources of resource allocation deficits in aphasia. The ability to rate one's own accuracy, as well as to evaluate task difficulty, were examined in aphasic individuals and normal, control subjects as they performed a lexical decision listening task alone and in competition with two distractor tasks. The aphasic subjects were as precise as control subjects in monitoring the accuracy of their lexical decisions. Despite greater error rates and slower reaction times, aphasic individuals' perceptions of task difficulty did not differ significantly from those of the control subjects. Therefore, resource allocation deficits in aphasia may reflect inadequate evaluation of task demands rather than poor self-monitoring of accuracy.

Suppression and discourse comprehension in right brain-damaged adults: A preliminary report

Abstract: Eighteen right-hemisphere-damaged (RHD) and 15 control subjects listened to sentences that ended in lexical ambiguities. The sentence verbs biased ambiguity interpretation. Probe words, representing unbiased meanings of the ambiguities, were presented for rapid judgements of their fit with the sentences. In rejecting probe words, both groups showed interference from unbiased meanings of the ambiguities at a short (175 ms) probe interval. Only RHD adults demonstrated interference 1000 ms after sentence offset, indicating that they suppressed contextually inappropriate meanings less effectively than control subjects. Discourse comprehension performance in RHD adults was also correlated with suppression. Theoretical and clinical implications are considered.

Measuring service encounters with the traumatic brain injury population

Abstract: Functional therapy tasks are frequently cited as being important for the successful carry-over of treatment objectives. Service encounters, such as shopping or enquiring for information on the telephone, are typical community integration activities used with the traumatically brain injured (TBI) population. This paper explores the use of systemic functional linguistics in the measurement of performance in service encounters using Generic Structure Potential (GSP) analysis. Results are presented for GSP analysis of service encounters on the telephone to a bus timetable information service, and the police, for five TBI individuals and five matched controls. Service encounters differed according to the complexity of information requested and the interpersonal, or tenor relationships between participants. Differences were evident between TBI and control interactions in the use of generic structural elements. Variation in generic structure was demonstrated across the two types of service encounter. The potential of GSP to measure the dynamic linguistic patterns in everyday TBT interactions is discussed.

Procedural discourse following traumatic brain injury

Abstract: Procedural discourse is a monologue discourse task concerned with explaining to a listener how a particular activity is carried out The study reported here is part of a series of investigations into discourse abilities following severe traumatic brain injury (TBI) The aim of this study was to compare the procedural discourse skills of a group of 26 TBI speakers, with those of two demographically distinct control groups The first control group comprised 26 non-TBI orthopaedic patients, and the second control group comprised 26 university students These control groups were selected because of the hypothesis that premorbid demographic factors could influence sociolinguistic skills, and hence performance on a procedural discourse task The TBI group was systematically compared with the control groups on content, productivity, and pragmatic measures They were not significantly different from orthopaedic patients on measures relating to content and productivity; however, they did differ significan

Proverb interpretation in fluent aphasia and Alzheimer's disease: Implications beyond abstract thinking

Abstract: This study compared proverb processing across three groups, i.e. patients with fluent aphasia (APH), patients with Alzheimer's Disease (AD), and normal control subjects (NC). Proverb stimuli were used to examine the effects of group membership and proverb familiarity in two presentation formats (i.e. spontaneous versus multiple-choice) on performance. The sensitivity of cognitive measures as predictors of ability to interpret proverbs was also investigated. In relation to NC subjects, patients with fluent APH exhibited significant difficulty formulating responses for familiar and unfamiliar spontaneous proverbs, whereas patients with AD demonstrated lower performance only on the unfamiliar proverbs. On the multiple-choice paradigm, however, patients with APH exhibited minimal difficulty. Conversely, the patients with AD manifested significant problems selecting the correct abstract response for familiar proverbs. With regard to predictors, language was relevant to familiar proverb interpretations and to proverbs presented in the spontaneous format. Cognition was a sensitive predictor for unfamiliar proverb interpretations and to the multiple-choice format. Deficits on the proverb tasks are discussed with reference to the potential breakdown of underlying linguistic and cognitive processes. The present data support the diagnostic value of proverbs in elucidating brain- behaviour relationships.

An analysis of the word-finding difficulties and of the content of the content of the discourse of recent and chronic aphasic speakers

Abstract: This study examined the changes in the discourse produced by recent and chronic aphasic speakers while describing the bank robbery picture from the Montreal-Toulouse protocol (Nespoulous et al. 1986) at two different assessments, on average 6 weeks apart. The manifestations of word-finding difficulties, content unit production and several efficacy of communication indices were analysed. No statistical improvement of word-finding difficulties or of content unit production was found in the discourse in the recent aphasic group. Overall, both groups were more efficient on the second assessment on the index of number of open-class words per unit of time. Significant correlations were observed between aphasia severity and content unit production, as well as with the efficacy of communication indices.

Deep dyslexia and right hemisphere reading - a regional cerebral blood flow study

Abstract: Deep dyslexia is an acquired reading disorder that is characterized by the production of semantic reading errors, greater success when reading aloud concrete and highly imageable words, frequent visual and visual-semantic errors, morphological errors and very poor reading of nonwords. The right hemisphere hypothesis proposes that in deep dylsexia the patient is not reading with an impaired version of the normal left hemisphere reading system, and cannot use that system for reading at all. Instead, a different reading system, located in the right hemisphere is used. The right hemisphere hypothesis was examined in this study by investigating the amount of cortical activation in the left and right cerebral hemispheres of a deep dyslexic patient (L.H.) during visual word recognition. Three experimental tasks were devised to isolate a Visual Word Recognition process and a Spoken Word Production process and these tasks were administered to the deep dyslexic patient as well as another patient with left-...

Naming famous people: An examination of tip-of-the-tongue phenomena in aphasia and Alzheimer's disease

Abstract: Confrontation naming of famous faces was studied in 33 individuals with aphasia (anemic, Broca's, and conduction) and 27 individuals with mild or moderate Alzheimer's disease (AD) Naming failures were examined for evidence of tip-of-the-tongue (TOT) state by probing semantic and word-form knowledge (initial letter and word shape) Basic semantic information was provided for many of the recognized faces by all subject groups Conduction and Broca's groups showed strongest evidence of TOT, performing above chance on initial letter identification There was little evidence of word-form knowledge in anemic and AD groups

The effects on verbal communication skills of right hemishere stroke in middle age

Abstract: Eighty-one right-handed middle-aged subjects (64 non-brain-damaged and 17 right hemisphere stroke) were assessed on a series of verbal comprehension and spoken discourse tasks. Educational level was found to affect the performance of the non-brain-damaged subjects who represented three standards of education. Comparison of the stroke subjects with the appropriate educational controls showed the stroke group to be weaker in several aspects of spoken language comprehension, particularly metaphor and inference. In picture description the non-brain-damaged groups used more words, spoke for longer and produced more information. In conversation, limited facial expression and eye contact and monotonous intonational pattern were characteristic of the stroke subjects, but other discourse parameters such as verbosity and topic maintenance did not distinguish these right-brain-damaged and non-brain-damaged groups. The results highlight first the requirement for language task control data to be education ref...

Principled syllabic dissolution in a primary progressive aphasia case

Abstract: In this longitudinal study, the syllabic paraphasias (here defined as insertions or deletions of a phoneme) produced by a Primary Progressive Aphasia case to syllabic adaptations of loanwords were compared. It is shown that paraphasias are phonologically principled and thus highly predictable. More specifically, it it shown that the repair strategies applied by the patient are very similar to those applied by normal speakers when they adapt borrowings. The rate of segment preservation as opposed to segment deletions is very high in borrowings and in the syllabic errors produced by the patient. However, the type of repair strategy applied by the patient changes with the progression of thephonological deficit, segment deletions being more frequent than segment insertions in the late stages of the illness. The evolution of the syllabic error pattern is accounted for by the effect of two principles: the Preservation and the Threshold Principles. The combined effects of these two principles entail tha...

Studying psychosocial problems in aphasia: Some conceptual and methodological considerations

Abstract: This paper describes problems of studies and research focusing on psychosocial and emotional sequelae in aphasic patients and their relatives. Based on a model of different components of the construct ‘psychosocial status’ and their interactions conceptual, methodological, and statistical problems are outlined. Furthermore, some specific aspects of evaluation, treatment, and outcome in aphasia rehabilitation are discussed.

Living with cognitive-communicative difficulties following traumatic brain injury: Using a model of interpersonal communication to characterize the subjective experience

Abstract: This study was undertaken to better understand the subjective experience of long-term cognitive-communicative impairments following severe cerebral insult. An additional aim was to explore the utility of a model of interpersonal communication in elucidating how such difficulties affect communicative interactions. Participants in the study were five dyads in which one member had sustained a severe traumatic brain injury (TBI). Data collection and analysis utilized both qualitative and quantitative methodology. It was found that individuals with long-term TBI continue to experience significant communication difficulties, which in combination with problems of memory, fatigue and irritability commonly generate unsatisfactory interpersonal communication experiences. The model of interpersonal communication provided a useful framework for considering why these interactions are ineffective or unsatisfactory. It is felt that the methodology outlined in this paper may offer a useful means of investigating...

An on-line study of grammaticality judgements in normal and aphasic speakers of Italian

Abstract: It has been widely argued that Broca's aphasics suffer from a loss of grammatical knowledge, accounting for the co-occurrence of expressive agrammatism (i.e. reduced, telegraphic speech with few inflections and function words) and specific problems with grammatical elements in sentence comprehensive. This idea is challenged by cross-linguistic studies showing that agrammatic patients retain detailed structural properties of their native language in comprehension and production, and by studies showing that these patients can make judgements of grammaticality that would be difficult to explain if they had lost grammatical knowledge. The present study compares sensitivity to errors of subject-verb and noun-adjective agreement in Italian, in agrammatic Broca's aphasics, fluent Wernicke's and anomic aphasics, college students and elderly controls. Stimuli vary in amount of grammatical context (i.e. the number of cues available to signal an agreement contrast), and in degree of violation (i.e. violatio...

Long-term effectiveness of PROMPT treatment in a severely apractic-aphasic speaker

Abstract: This study examined the acquisition and long-term maintenance of a functional core vocabulary by a severely apractic-aphasic speaker following the application of Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT) treatment. The subject was a 24-year-old male who had suffered a single left- hemisphere thrombotic CVA approximately 2 years prior to the beginning of this investigation. Treatment and maintenance were monitored over a 41-week period. The results showed that the 30 target words and phrases were produced accurately during the treatment phases of the study and after treatment was discontinued.

Participation of the Insula in Language

Abstract: Since the beginning of aphasia history, it has been known that the insula has a crucial role in language. The interest in the insula somehow decreased during the twentieth century, because it has not directly included in the perisylvian language area proposed by Dejerine. During the late twentieth century, it was proposed that the insula plays a crucial role on speech praxis. Since Wernicke, it has been observed that insula damage is frequently associated with aphasia; different types of aphasia have been reported in cases of insula damage: motor planning and organization of speech in Broca’s aphasia, repetition defects associated with conduction aphasia, and the word-deafness component of Wernicke’s aphasia. Mutism and oral apraxia have also been reported to be associated with left insula pathology. Neuroimaging studies have corroborated that the insula has extensive brain connection, including not only the frontal motor language area but also posterior language areas. Anatomical connections of the insula point also to an important viscero-limbic role, and it may accordingly be suggested that the insula is involved in verbal motivation.

Resource allocation in auditory processing of emphatically stressed stimuli in aphasia

Abstract: Kimelman and McNeil (1987) suggested that improved auditory comprehension for emphatically stressed information might be attributed to recruitment of additional processing resources. This study investigated effects of emphatic stress when it was applied to target words during a semantic judgement task on the auditory processing of non-stressed targets for a lexical decision task. Response time and accuracy were analysed for this dual-task experiment. It was first established that the stimuli contained appropriately placed stressed lexical items and that all subjects benefited from the emphatic stress. Next it was established that all subjects were able to voluntarily trade processing resources in the dual task under investigation, and were able to generate a performance operating curve (POC). Normal subjects showed the predicted performance decrement on the non-stressed word in the context of the preceding stressed word; subjects with aphasia did not. Results are discussed relative to resource allocation theory with normal subjects, and a working memory explanation for aphasic subjects' performance.