Handwritten and Typed Discourse in People With Aphasia: Reference Data for Sequential Picture Description and Comparison of Performance Across Modality.

PURPOSE: Writing can be completed by hand or by typing. Increasingly, functional and social activities are completed in the virtual domain, which often requires discourse level writing. Yet, there is a shortage of research on discourse writing in aphasia. The purpose of this study was to provide preliminary reference data for a sequential picture description task in writing by hand and typing for people with aphasia. Additionally, we examined individual modality differences when comparing handwritten and typed discourse. METHOD: Fifteen people with mild-moderate aphasia participated in this study. They completed a sequential picture description task in handwriting and in typing. Discourse samples were coded for Correct Information Units (CIUs) and Complete Utterances. Measures of productivity were also evaluated (e.g., Total Words, Total Utterances). Participants completed a computer use questionnaire regarding their current and premorbid typing and computer use. RESULTS: Preliminary reference data are reported. No significant differences were found at the group level for the measures evaluated. At the individual level, there was evidence of a modality effect for seven participants who demonstrated differences in the proportion of CIUs. CONCLUSIONS: Although preliminary, these findings suggest that, at the group level, the handwritten and typed discourse produced by people with mild-moderate aphasia is similar. However, at the individual level, there is potential for modality differences. Consistent patterns of premorbid computer use, difficulty ratings, and individual differences in writing modes were not identified for the participants who demonstrated a modality effect. However, there was preliminary evidence that poststroke handedness may contribute to modality differences exhibited by some participants, which should be explored in future research. Additionally, these reference data are preliminary and further research is required from a more heterogeneous group of people with aphasia and to better establish assessment practices for discourse writing.

Two-Year Longitudinal Evaluation of Community Aphasia Center Participation on Linguistic, Functional Communication, and Quality of Life Measures Across People With a Range of Aphasia Presentations.

PURPOSE: The purpose of this study was to evaluate potential changes on a hierarchy of language tasks and measures of functional communication and quality of life in a group of people with aphasia (PWA) who attended a community aphasia center for 2 years. A secondary purpose was to determine whether there were any predictors of change. METHOD: Twenty-seven PWA who attended Brooks Rehabilitation Aphasia Center (BRAC) were evaluated on an aphasia battery, confrontation naming, and structured discourse in addition to completing self-reported measures of functional communication and quality of life at three time points: before attending BRAC and after 1 (N = 27) and 2 (N = 20) years of BRAC participation. Twenty-six communication partners who communicated regularly with the PWA completed a questionnaire about their functional communication at the same time points. A mixed linear model was conducted for all dependent variables to determine change over time. Tau-b correlations were conducted between demographic and aphasia-related variables and difference scores for outcome measures that exhibited significant improvements. RESULTS: At 1-year testing, significant improvements were observed on the aphasia battery, object and action naming, and all self- and communication partner-reported measures. At 2-year testing, all improvements were maintained except for the self-reported measure of functional communication. Structured discourse showed increases in average number of words, percentage of meaningful words and utterances, and efficiency of meaningful word production after 2 years. No significant correlations were observed between predictor variables and difference scores. CONCLUSIONS: Participation in aphasia centers can result in significant changes in language, functional communication, and quality of life in people with chronic aphasia. These findings support the importance of aphasia centers in the continuum of care for PWA. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21313689.

Dosing of a cued picture-naming treatment for anomia.

PURPOSE: Recent investigations into effects of intensity or distribution of aphasia therapy have provided moderate evidence supporting intensive therapy schedules on aphasia treatment response. The purpose of the present study was to investigate the feasibility of creating an intensive therapy session without extending the amount of daily time a person spends in treatment. METHOD: Individuals who presented with chronic anomia poststroke (N = 8) participated in 2 weeks of a computerized, therapist-delivered, cued, picture-naming treatment. Dosing parameters for each session were 8 presentations of 50 pictures, totaling 400 teaching episodes per session. RESULTS: Of the 8 participants, 6 achieved significant increases from baseline on trained items after 400 teaching episodes (i.e., 1 treatment hr), and the remaining 2 participants achieved significant increases from baseline after 1200 teaching episodes (i.e., 3 treatment hr). Maintenance data from 7 of the participants indicated that 6 participants maintained significant improvement from baseline on trained items. CONCLUSIONS: Given an intensive and saturated context, anomic individuals were surprisingly quick at relearning to produce problematic words successfully. Most participants demonstrated retention of the gains 2 months after treatment ended. The high density of teaching episodes within the treatment session (i.e., the intensive treatment schedule) may have contributed to the behavioral gains.