Showing papers on "Aphasia published in 1999"
TL;DR: PET was used to measure regional cerebral activity during tasks requiring reading of concrete and abstract nouns and verbs for lexical decision and indicated that abstract word processing was associated with selective activations, which is compatible with the view that lexical-semantic processing of words is mediated by an extensive, predominantly left hemispheric network of brain structures.
Abstract: The hypothesis that categorical information, distinguishing among word classes, such as nouns, verbs, etc., is an organizational principle of lexical knowledge in the brain, is supported by the observation of aphasic subjects who are selectively impaired in the processing of nouns and verbs. The study of lesion location in these patients has suggested that the left temporal lobe plays a crucial role in processing nouns, while the left frontal lobe is necessary for verbs. To delineate the brain areas involved in the processing of different word classes, we used PET to measure regional cerebral activity during tasks requiring reading of concrete and abstract nouns and verbs for lexical decision. These tasks activated an extensive network of brain areas, mostly in the left frontal and temporal cortex, which represents the neural correlate of single word processing. Some left hemispheric areas, including the dorsolateral frontal and lateral temporal cortex, were activated only by verbs, while there were no brain areas more active in response to nouns. Furthermore, the comparison of abstract and concrete words indicated that abstract word processing was associated with selective activations (right temporal pole and amygdala, bilateral inferior frontal cortex), while no brain areas were more active in response to concrete words. There were no significant interaction effects between word class and concreteness. Taken together, these findings are compatible with the view that lexical-semantic processing of words is mediated by an extensive, predominantly left hemispheric network of brain structures. Additional brain activations appear to be related to specific semantic content, or, in the case of verbs, may be associated with the automatic access of syntactic information.
468 citations
TL;DR: Differential activation patterns suggest a hierarchy within the language‐related network regarding effectiveness for improvement of aphasia; ie, right hemispheric areas contribute, if left hemispherical regions are destroyed.
Abstract: As previous functional neuroimaging studies could not settle the controversy regarding the contribution of dominant and subdominant hemisphere to recovery from poststroke aphasia, language performance was related to H215O-positron emission tomographic activation patterns in 23 right-handed aphasic patients 2 and 8 weeks after stroke. In patients classified according to the site of lesion (frontal, n = 7; subcortical, n = 9; temporal, n = 7) and in 11 control subjects, flow changes caused by a word repetition task were calculated in 14 regions representing eloquent and contralateral homotopic areas. These areas were defined on coregistered magnetic resonance imaging scans and tested for significance (Bonferroni corrected t test, α = 0.0036). At baseline, differences in test performance were only found between the subcortical and temporal group. The extent of recovery, however, differed and was reflected in the activation. The subcortical and frontal groups improved substantially; they activated the right inferior frontal gyrus and the right superior temporal gyrus (STG) at baseline and regained left STG activation at follow-up. The temporal group improved only in word comprehension; it activated the left Broca area and supplementary motor areas at baseline and the precentral gyrus bilaterally as well as the right STG at follow-up, but could not reactivate the left STG. These differential activation patterns suggest a hierarchy within the language-related network regarding effectiveness for improvement of aphasia; ie, right hemispheric areas contribute, if left hemispheric regions are destroyed. Efficient restoration of language is usually only achieved if left temporal areas are preserved and can be reintegrated into the functional network. Ann Neurol 1999;45:430–438
418 citations
TL;DR: This study supports the role of the right hemisphere in recovery from aphasia and demonstrates that the improvement in auditory comprehension induced by specific training is associated with functional brain reorganization.
Abstract: It has long been a matter of debate whether recovery from aphasia after left perisylvian lesions is mediated by the preserved left hemispheric language zones or by the homologous right hemisphere regions. Using PET, we investigated the short-term changes in the cortical network involved in language comprehension during recovery from aphasia. In 12 consecutive measurements of regional cerebral blood flow (rCBF), four patients with Wernicke's aphasia, caused by a posterior left middle cerebral artery infarction, were tested with a language comprehension task. Comprehension was estimated directly after each scan with a modified version of the Token Test. In the interval between the scans, the patients participated in brief, intense language comprehension training. A significant improvement in performance was observed in all patients. We correlated changes in blood flow measured during the language comprehension task with the scores achieved in the Token Test. The regions which best correlated with the training-induced improvement in verbal comprehension were the posterior part of the right superior temporal gyrus and the left precuneus. This study supports the role of the right hemisphere in recovery from aphasia and demonstrates that the improvement in auditory comprehension induced by specific training is associated with functional brain reorganization.
393 citations
TL;DR: Recovery of aphasia in adults can occur rapidly and is concomitant with an activation pattern that changes from left to a homologous right hemispheric pattern, even when the stroke evolves to completion.
Abstract: Background and Purpose—This study was undertaken to correlate functional recovery from aphasia after acute stroke with the temporal evolution of the anatomic, physiological, and functional changes as measured by MRI. Methods—Blood oxygenation level–dependent contrast and echo-planar MRI were used to map language comprehension in 6 normal adults and in 2 adult patients during recovery from acute stroke presenting with aphasia. Perfusion, diffusion, sodium, and conventional anatomic MRI were used to follow physiological and structural changes. Results—The normal activation pattern for language comprehension showed activation predominately in left-sided Wernicke’s and Broca’s areas, with laterality ratios of 0.8 and 0.3, respectively. Recovery of the patient confirmed as having a completed stroke affecting Broca’s area occurred rapidly with a shift of activation to the homologous region in the right hemisphere within 3 days, with continued rightward lateralization over 6 months. In the second patient, in who...
364 citations
TL;DR: The results provide indirect evidence that even limited salvage of peri-infarct tissue with acute stroke treatments will have an important impact on the rehabilitation of cognitive functions.
Abstract: OBJECTIVES Language functions comprise a distributed neural system, largely lateralised to the left cerebral hemisphere. Late recovery from aphasia after a focal lesion, other than by behavioural strategies, has been attributed to one of two changes at a systems level: a laterality shift, with mirror region cortex in the contralateral cortex assuming the function(s) of the damaged region; or a partial lesion effect, with recovery of perilesional tissue to support impaired language functions. Functional neuroimaging with PET allows direct observations of brain functions at systems level. This study used PET to compare regional brain activations in response to a word retrieval task in normal subjects and in aphasic patients who had shown at least some recovery and were able to attempt the task. Emphasis has been placed on single subject analysis of the results as there is no reason to assume that the mechanisms of recovery are necessarily uniform among aphasic patients. METHODS Six right handed aphasic patients, each with a left cerebral hemispheric lesion (five strokes and one glioma), were studied. Criteria for inclusion were symptomatic or formal test evidence of at least some recovery and an ability to attempt word retrieval in response to heard word cues. Each patient underwent 12 PET scans using oxygen-15 labelled water (H 2 15 O) as tracer to index regional cerebral blood flow (rCBF). The task, repeated six times, required the patient to think of verbs appropriate to different lists of heard noun cues. The six scans obtained during word retrieval were contrasted with six made while the subject was “at rest”. The patients’ individual results were compared with those of nine right handed normal volunteers undergoing the same activation study. The data were analysed using statistical parametric mapping (SPM96, Wellcome Department of Cognitive Neurology, London, UK). RESULTS Perception of the noun cues would be expected to result in bilateral dorsolateral temporal cortical activations, but as the rate of presentation was only four per minute the auditory perceptual activations were not evident in all people. Anterior cingulate, medial premotor (supplementary speech area) and dorsolateral frontal activations were evident in all normal subjects and patients. There were limited right dorsolateral frontal activations in three of the six patients, but a similar pattern was also found in four of the nine normal subjects. In the left inferolateral temporal cortex, activation was found for the normal subjects and five of the six patients, including two of the three subjects with lesions involving the left temporal lobe. The only patient who showed subthreshold activation in the left inferolateral temporal activation had a very high error rate when performing the verb retrieval task. CONCLUSIONS The normal subjects showed a left lateralised inferolateral temporal activation, reflecting retrieval of words appropriate in meaning to the cue from the semantic system. Lateralisation of frontal activations to the left was only relative, with right prefrontal involvement in half of the normal subjects. Frontal activations are associated with parallel psychological processes involved in word retrieval, including task initiation, short term (working) memory for the cue and responses, and prearticulatory processes (even though no overt articulation was required). There was little evidence of a laterality shift of word retrieval functions to the right temporal lobe after a left hemispheric lesion. In particular, left inferolateral temporal activation was seen in all patients except one, and he proved to be very inefficient at the task. The results provide indirect evidence that even limited salvage of peri-infarct tissue with acute stroke treatments will have an important impact on the rehabilitation of cognitive functions.
338 citations
TL;DR: The results indicate that the restoration of left-hemisphere language networks is associated with better recovery and inversely related to activity in the compensated or recruited areas of the right hemisphere.
Abstract: Background and Purpose—Two mechanisms for recovery from aphasia, repair of damaged language networks and activation of compensatory areas, have been proposed. In this study, we investigated whether both mechanisms or one instead of the other take place in the brain of recovered aphasic patients . Methods—Using blood oxygenation level–dependent functional MRI (fMRI), we studied cortical language networks during lexical-semantic processing tasks in 7 right-handed aphasic patients at least 5 months after the onset of left-hemisphere stroke and had regained substantial language functions since then. Results—We found that in the recovered aphasic patient group, functional language activity significantly increased in the right hemisphere and nonsignificantly decreased in the left hemisphere compared with that in the normal group. Bilateral language networks resulted from partial restitution of damaged functions in the left hemisphere and activation of compensated (or recruited) areas in the right hemisphere. Fa...
304 citations
TL;DR: Results revealed that participants receiving group communication treatment had significantly higher scores on communicative and linguistic measures than participants not receiving treatment.
Abstract: We examined the effects of group communication treatment on linguistic and communicative performance in adults with chronic aphasia. Participants were randomly assigned to two treatment and two def...
285 citations
TL;DR: Language dominance is more closely associated with the laterality of temporal and spatial movement representations (i.e., ideomotor praxis dominance) than is hand preference.
Abstract: Objective: To determine the relationship of language lateralization and hand preference to praxis performance following left and right hemispheric amobarbital-induced inactivations Background: Patients who are aphasic from left cerebral dysfunction also frequently exhibit ideomotor apraxia in which they make temporal, spatial, and postural errors of learned skilled movements However, hemispheric lateralization of the systems mediating ideomotor praxis in patients with atypical cerebral language dominance (ie, bilateral or right hemispheric language function) remains uncertain Methods: Subjects included 90 patients with intractable seizures who were undergoing the intracarotid amobarbital procedure (IAP) as part of their preoperative evaluation for epilepsy surgery Hand preference was determined by the Benton Handedness Questionnaire Praxis was assessed by the subject’s performance when pantomiming the use of four pictured tools Results: During left IAP, patients with typical language dominance made more ideomotor apraxic errors than did patients with atypical language dominance During right IAP, patients with atypical language dominance made more ideomotor apraxic errors than did patients with typical language dominance Overall, patients with atypical language dominance made fewer ideomotor apraxic errors than did patients with typical language dominance These relationships were present irrespective of hand preference Conclusions: Language dominance is more closely associated with the laterality of temporal and spatial movement representations (ie, ideomotor praxis dominance) than is hand preference Patients with atypical language dominance exhibit more bilateral cerebral distribution of both language and praxis function
228 citations
TL;DR: An epileptic patient who, during cortical stimulation of her posterior superior temporal gyrus, demonstrated frequent phonemic paraphasias, decreased repetition of words, and yet had intact semantic knowledge, suggest that cortical dysfunction alone may induce conduction aphasia.
186 citations
TL;DR: Impairment was most severe after left hemisphere damage, and apraxia was a strong correlate of increased dexterity errors, whereas reduced ipsilateral grip strength correlated with slowing, while dexterity errors appeared to be due to visuospatial problems.
Abstract: Background and Purpose—Previous research has reported impaired hand function on the “unaffected” side after stroke, but its incidence, origins, and impact on rehabilitation remain unclear. This study investigated whether impairment of ipsilateral dexterity is common early after middle cerebral artery stroke and explored the relationship to cognitive deficit. Methods—Thirty patients within 1 month of an infarct involving the parietal or posterior frontal lobe (15 left and 15 right hemisphere) used the ipsilateral hand in tests that simulated everyday hand functions. Performance was compared with that of healthy age-matched controls using the same hand. Standardized tests were used to assess apraxia, visuospatial ability, and aphasia. Results—All patients were able to complete the dexterity tests, but video analysis showed that performance was slow and clumsy compared with that of controls (P<0.001). Impairment was most severe after left hemisphere damage, and apraxia was a strong correlate of increased dex...
154 citations
TL;DR: In this paper, the authors discuss the growing literature which documents that not only may adults with aphasia present with attention deficits, but also that their attention deficits may negatively affect both language comprehension and production skills.
Abstract: Over the past decade, there has been increasing interest in the integrity of attention in adults with aphasia. This review paper examines this issue by first introducing attention theory and associated terminology. Next, the paper summarizes the growing literature which documents that not only may adults with aphasia present with attention deficits, but also that their attention deficits may negatively a ect both their language comprehension and production skills. Lastly, the clinical implications of adopting an attentional model of aphasia are considered with respect to strategies for both the assessment and treatment of adults with aphasia.
TL;DR: The utility of using an interactive activation model to plan treatment based on levels of disruption in the lexical processing system is demonstrated and semantic treatment resulted in improved naming of both trained and untrained items.
Abstract: An interactive activation model for picture naming was used to guide treatment of a semantic-level deficit in 4 individuals with aphasia and severe picture-naming problems. Participants exhibited a profile consistent with Broca's aphasia with severe naming deficits, part of which was attributable to a semantic impairment based on testing of the lexical system. A semantic-based treatment was used to train naming of nouns in two semantic categories using a single-participant multiple baseline across behaviors and participants. Additional treatment, which included orthographic and phonological information about target words, then was applied. Treatment responses and error patterns demonstrated that semantic treatment resulted in improved naming of both trained and untrained items for 2 of 4 participants. Two participants did not show improved naming until treatment emphasizing the phonological form of the word was provided. This study demonstrates the utility of using an interactive activation model to plan treatment based on levels of disruption in the lexical processing system.
TL;DR: Over 15 months of longitudinal assessment, a patient with semantic dementia, D.M., improved on tests of naming and category fluency for a specific set of items (Experiment 1), and the authors attribute this to his home drill with the names of these concepts plus pictures and descriptions of them.
Abstract: Over 15 months of longitudinal assessment, a patient with semantic dementia, D.M., improved on tests of naming and category fluency for a specific set of items (Experiment 1). The authors attribute this to his home drill with the names of these concepts plus pictures and descriptions of them. In Experiment 2, D.M. produced significantly more exemplars on category fluency for semantic categories that he had been practicing at home than for nonpracticed categories, an effect that cannot be attributed to an inherent difference between the 2 sets because the fluency performance of control participants revealed no significant difference between the 2 sets. In Experiment 3, D.M. rehearsed some of his previously nonpracticed categories daily for a period of 2 weeks: His fluency scores on the experimental categories improved substantially, but they declined once he ceased the daily drill. The results are discussed with respect to current views of long-term memory, particularly new word learning and forgetting, and to current techniques for facilitating word finding in aphasia.
Book•
16 Dec 1999
TL;DR: Aphasia and aphasia therapy - a framework for therapy interventions, and instrumentation in the assessment and therapy of motor speech disorders - a survey of techniques and case studies.
Abstract: Part 1 Background principles: the basic rationale determining objectives and hypotheses under what circumstances should the survey be undertaken? researching the problem. Part 2 The general survey design: an overview of the design choosing between postal and interview surveys obtaining the right size and type of sample. Part 3 survey and questionnaire formats: generating the items writing the survey. Part 4 Evaluating the items: the pilot study. Part 5 Analyzing the results: analyzing data from surveys. Part 6 The report: presenting the survey results evaluating reports evaluating reports together with introductory critiques. #REEC01426016Part 1 Aphasia and aphasia therapy: aphasia therapy - a clinical framework, Robert Wertz recovery of function in aphasia, Ilias Papathanasiou and Renata Whurr living with aphasia - a framework for therapy interventions, Sally Byng et al cognitive neuropsychology and aphasia therapy - the case of word retrieval, Dvaid Howard. Part 2 Motor speech disorders: dysarthria - clinical features, neuroanatomical framework and assessment, Bruce E. Murdoch et al dysarthria - an overview of treatment, Kathryn Yorkston and David Beukelman changing ideas in apraxia of speech, Nicholas Miller instrumentation in the assessment and therapy of motor speech disorders - a survey of techniques and case studies with EPG, Sara Wood and Bill Hardcastle.
TL;DR: It is concluded that multiple subpial transection may be useful in allowing for a restoration of speech and language abilities in children diagnosed with Landau-Kleffner syndrome.
Abstract: Landau-Kleffner syndrome is an acquired epileptic aphasia occurring in normal children who lose previously acquired speech and language abilities. Although some children recover some of these abilities, many children with Landau-Kleffner syndrome have significant language impairments that persist. Multiple subpial transection is a surgical technique that has been proposed as an appropriate treatment for Landau-Kleffner syndrome in that it is designed to eliminate the capacity of cortical tissue to generate seizures or subclinical epileptiform activity, while preserving the cortical functions subserved by that tissue. We report on the speech and language outcome of 14 children who underwent multiple subpial transection for treatment of Landau-Kleffner syndrome. Eleven children demonstrated significant postoperative improvement on measures of receptive or expressive vocabulary. Results indicate that early diagnosis and treatment optimize outcome, and that gains in language function are most likely to be seen years, rather than months, after surgery. Since an appropriate control group was not available, and that the best predictor of postoperative improvements in language function was that of length of time since surgery, these data might best be used as a benchmark against other Landau-Kleffner syndrome outcome studies. We conclude that multiple subpial transection may be useful in allowing for a restoration of speech and language abilities in children diagnosed with Landau-Kleffner syndrome.
TL;DR: Results of a picture naming test show that cognate pictures were more often correctly named in both languages than were non-cognates, and some error types and self-correction strategies appear to be unique to bilingual speakers.
TL;DR: In this paper, the authors provide information on the rationale, design characteristics, strengths and weaknesses of this research paradigm and its usefulness in clinical aphasiology and provide background information on various research paradigms not widely used in the field.
Abstract: As clinical aphasiologists seek different ways to understand the complexity of aphasia within naturalistic and social contexts, there is an increasing need to provide background information on various research paradigms not widely used in the field. Consistent with recent calls for qualitative research in clinical aphasiology, this article provides information on the rationale, design characteristics, strengths and weaknesses of this research paradigm and its usefulness in clinical aphasiology.
TL;DR: Using a qualitative interview approach, participants with aphasia and their relatives/caregivers reported many positive psychosocial changes following treatment, suggesting that group communication treatment had an impact on participants' home and community lives without direct treatment in those settings.
Abstract: This article discusses preliminary psychosocial data from an efficacy study on the effects of group communication treatment in adults with chronic aphasia. Using a qualitative interview approach, participants with aphasia and their relatives/caregivers reported many positive psychosocial changes following treatment. The results suggest that group communication treatment had an impact on participants' home and community lives without direct treatment in those settings. Results are discussed in the context of managed care, group theory, and positive health.
TL;DR: In this paper, ten nonaphasic volunteers and 10 individuals with aphasia were assigned to dyads and videotaped in conversation and judged each volunteer in the videotaped conversations from 'best' to 'worst' communication partner.
Abstract: Ten nonaphasic volunteers and 10 individuals with aphasia were assigned to dyads and videotaped in conversation. Judges ranked each volunteer in the videotaped conversations from 'best' to 'worst' communication partner. The two best and two worst interactions were submitted to detailed analysis using Conversation Analysis (CA) methodology. Discourse devices and resources employed by speaking partners in the dyads were identified. Results abstracted from the CA were compared to contrast discourse characteristics between the high ranked and low ranked partners. Specific strategies identified and implications for aphasia intervention are discussed.
TL;DR: This article examined the use of conversation analysis (CA) to guide individualized advice to the brother of a man with aphasia and provided a mechanism to evaluate the effect of the interaction.
Abstract: Recent research findings have suggested that there is a need for an individualized approach to the development of facilitation strategies which takes into account the unique effects of aphasia. The aim of this paper is to examine the use of conversation analysis (CA) to guide individualized advice to the brother (RB) of a man with aphasia (JB) and to provide a mechanism to evaluate the effect of the interaction. RB attended a weekly communication skills training group which ran once a week for six consecutive weeks. Prior to his inclusion in the group a qualitative analysis of a conversation between him and his brother provided detailed information on collaborative repair management. An assessment of his perception of the linguistic and pragmatic manifestations of his brother s aphasia was performed using the Conversation Analysis Profile for People with Aphasia (CAPPA). The detailed insights provided by the analyses guided the issues covered during the group. Following the intervention, the assessments w...
TL;DR: Several aspects of recovery from aphasia, namely its time course, the influence of biographical, gender, education, handedness, language, language components, and lesion factors and the potential impact of speech therapy and pharmacotherapy on spontaneous recovery will be discussed.
Abstract: About one third of acute stroke patients are aphasic [1]. Aphasia has an adverse influence on functional outcome [2], mood [3], quality of life [4, 5] and ability to return to work. Most studies on the natural recovery of language deficits after stroke were carried out in the 70 and 80ies [5– 18]. More recently, evidence from transcranial Doppler (TCD), SPECT and PET was instrumental to improve our understanding of the intraand interhemispheric mechanisms underlying recovery. We will briefly review several aspects of recovery from aphasia, namely its time course, the influence of biographical (age, gender, education, handedness), language (aphasia type and language components) and lesion factors (aetiology, location, size). The potential impact of speech therapy and pharmacotherapy on spontaneous recovery will be discussed.
TL;DR: In this article, a writing treatment protocol was designed for a 75 year-old man with severe Wernicke's aphasia, and four treatment phases were implemented: a multiple baseline design that documented improvement in single-word writing for targeted words, a clinician-directed home program that increased the corpus of correctly-spelled single words, another multiple baseline series that documented acquisition of additional written words, as well as pragmatic training in the use of singleword writing to support conversational communication; and a selfdirected home treatment to further expand written vocabulary.
Abstract: A writing treatment protocol was designed for a 75 year-old man with severe Wernicke's aphasia. Four treatment phases were implemented: (1) a multiple baseline design that documented improvement in single-word writing for targeted words; (2) a clinician-directed home program that increased the corpus of correctly-spelled single words; (3) another multiple baseline series that documented acquisition of additional written words, as well as pragmatic training in the use of single-word writing to support conversational communication; and (4) a self-directed home treatment to further expand written vocabulary. The patient's acquisition of targeted words suggested an item-specific treatment effect that strengthened weakened graphemic representations. The patient's continued acquisition of correctly spelled words during the self-directed home treatment supported the use of this approach to supplement more traditional clinician-directed treatment.
TL;DR: In this article, the authors provide an overview of a well-established analytic framework to investigate conversation in authentic settings, which is described according to its development and primary principles and several examples of its application to clinical aphasiology are provided.
Abstract: The conversational behaviours of individuals with aphasia are becoming a more important consideration in clinical aphasiology. This is due to the increased focus on conversational dyads and conversational partners via supported conversation for adults with aphasia. This article provides an overview of a well-established analytic framework to investigate conversation in authentic settings. This framework, conversation analysis, is described according to its development and primary principles. Several examples of its application to clinical aphasiology are provided.
TL;DR: The term Pick complex is suggested to indicate that these clinical and pathological variations are related and they were first described by Pick as clinical manifestations of fronotemporal atrophy.
Abstract: A substantive overlap between the clinical syndromes of frontal lobe dementia (FLD), frontotemporal dementia (FTD), or primary progressive aphasia (PPA), and corticobasal degeneration syndrome (CBDS)
TL;DR: Some redundancy was observed among measures in the ability to determine severity and measure change, but the results do not support one measure as an adequate replacement for another.
Abstract: The relationship between impairment and disability measures was examined for assessing initial severity of, and change in, aphasia. Twenty two aphasic adults were administered three aphasia tests at two points in time. Videotaped speech samples were collected and scored using Correct Information Unit and Main Concept analyses. Ten normal listeners viewed randomized, paired pre and post samples to provide a social judgement of change. Most impairment measures were significantly related, and most predicted disability scores. Change on most impairment measures was not related, and change on only one impairment measure predicted change in disability. Three of the connected speech measures predicted listener judgements. Thus, some redundancy was observed among measures in the ability to determine severity and measure change, but the results do not support one measure as an adequate replacement for another. Moreover, the relationship between change on the standardized impairment and disability measures and list...
TL;DR: Improvements in measures of both language impairment and functional communication can be broadly, positively, and significantly influenced by therapy services that are delivered to persons with aphasia in these community-based programs.
Abstract: Background and Purpose—Studies have yet to document that community-based aphasia treatment programs routinely produce results comparable or superior to published research protocols. We explore this issue here in an outcome study of individuals with aphasia enrolled in 2 community-based, comparably managed and equipped therapy programs, which use a specially designed computer-based tool that is employed therapeutically in adherence to an extensive, detailed, and formally trained patient care algorithm. Methods—Patients (n=60) were assessed before and after treatment with standardized instruments at both the impairment and the disability levels. Pretreatment and posttreatment means were calculated and compared, with statistical significance of differences established with the use of 1-tailed matched t tests. One-way ANOVAs were used to analyze the comparability of patient performance changes among various subgroups, eg, patients in acute versus chronic stages of aphasia, patients by aphasia diagnostic type ...
TL;DR: Auditory temporal-order judgement was investigated in patients suffering from unilateral focal brain lesions and results indicate that fine temporal resolution for auditory stimuli is predominantly associated with posterior regions of the LH.
TL;DR: In this article, the temporal reliability of analyses of collaborative repair in dyadic conversations recorded on four different occasions between eight people with aphasia and their relatives was investigated through comparison of quantitative and qualitative analyses.
Abstract: This paper describes an investigation of the temporal reliability of analyses of collaborative repair in aphasic conversation. Whilst it has been proposed that conversation analysis has a useful contribution to make to the assessment of aphasia, assessment methods which use natural interaction as a basis for analysis have been assumed to lack reliability because of variability in conversation in contrast to the standardization across assessments possible with formal assessments. This issue was addressed through comparison of quantitative and qualitative analyses of collaborative repair in dyadic conversations recorded on four different occasions between eight people with aphasia and their relatives. Quantitative results revealed significant within-participant variation in the quantity of collaborative repair occurring in the conversations but between-participant variation was of much greater magnitude. The findings of the qualitative analysis indicated reliability in the interactional challenges experienc...
TL;DR: The results suggested that focusing on individualized advice and targeting conversation management in the group setting was a useful way of providing advice to carers and the CAPPA and a quantitative/qualitative analysis of repair management seem to have the potential for motivating the individualized Advice and measuring the effectiveness of an intervention.
Abstract: This study describes a communication skills group programme for four carers of adults with aphasia that ran once a week for 6 consecutive weeks. The content of the group was based on an approach previously not described in the literature in any detail. Conversation analysis (CA) was used to guide individualized advice that was incorporated into the group by the use of written advice sheets. Intervention was motivated by the results of a newly developed assessment tool--the Conversation Analysis Profile for People with Aphasia (CAPPA)--and a quantitative and qualitative analysis of collaborative repair. The CAPPA utilizes the methodology of conversation analysis (CA) as a means of both characterizing and comparing the relationship between the carers' perception of the aphasia and what is occurring in natural conversation. During the group, accurate perceptions and strategies that minimized the disruption to the conversation were reinforced, while inaccurate perceptions and strategies that appeared to impede interaction were discouraged. The use of the CAPPA results and a quantitative/qualitative analysis of repair management to measure change pre- and post-group was explored. The post-intervention analyses examined three questions in particular: (1) did the carers demonstrate more accurate perceptions of their relatives' aphasia?; (2) did the carers report a decrease in the problem severity of the aphasia?; and (3) was there a change in the time taken to repair a trouble source and was this attributable to a change in the management of repair by the carer? The study was essentially an investigation of whether this type of approach was beneficial to the carers involved. The results suggested that focusing on individualized advice and targeting conversation management in the group setting was a useful way of providing advice to carers. Furthermore, the CAPPA and a quantitative/qualitative analysis of repair management seem to have the potential for motivating the individualized advice and measuring the effectiveness of an intervention.
01 Oct 1999
TL;DR: In this article, the authors present a survey of 40 years of language-elicitation studies focusing on children's verbal imitation and their language development in the context of parent-child Discourse.
Abstract: Contents: NB Ratner, L Menn, In the Beginning Was the Wug: Forty Years of Language-Elicitation Studies Part I:Eliciting Knowledge of Language EF Masur, Infants' Verbal Imitation and Their Language Development: Controversies, Techniques, and Consequences L Gerken, Examining Young Children's Morphosyntactic Development Through Elicited Production EV Clark, Coining New Words: Old and New Word Forms for New Meanings RA Berman, Children's Innovative Verbs Versus Nouns: Structured Elicitations and Spontaneous Coinages J Gropen, Methods for Studying the Production of Argument Structure in Children and Adults KE Nelson, Methods for Stimulating and Measuring Lexical and Syntactic Advances: Why Fiffins and Lobsters Can Tag Along With Other Recast Friends C Doughty, MH Long, Eliciting Second Language Speech Data Part II:Gathering Production Data in Naturalistic Settings CE Johnson, What You See Is What You Get: The Importance of Transcription for Interpreting Children's Morphosyntactic Development BA Pan, RY Perlmann, CE Snow, Food for Thought: Dinner Table as a Context for Observing Parent-Child Discourse E Andersen, Exploring Register Knowledge: The Value of "Controlled Improvisation" R Ely, A Wolf, A McCabe, G Melzi, The Story Behind the Story: Gathering Narrative Data From Children S Ervin-Tripp, Studying Conversation: How to Get Natural Peer Interaction Part III:Developmental Disorders NB Ratner, Elicited Imitation and Other Methods for the Analysis of Trade-Offs Between Speech and Language Skills in Children H Tager-Flusberg, The Challenge of Studying Language Development in Children With Autism LB Leonard, Understanding Grammatical Deficits in Children With Specific Language Impairment: The Evaluation of Productivity ML Donahue, Influences of School-Age Children's Beliefs and Goals on Their Elicited Pragmatic Performance: Lessons Learned From Kissing the Blarney Stone Part IV:Adult Disorders H Goodglass, Jean Berko Gleason's Contributions to Aphasia Research: Pioneering Elicitation Techniques L Menn, Studying the Pragmatic Microstructure of Aphasic and Normal Speech: An Experimental Approach LK Obler, S De Santi, Eliciting Language From Patients With Alzheimer's Disease