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1.
Am J Speech Lang Pathol ; 32(5): 1979-2020, 2023 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-37433115

RESUMO

PURPOSE: This study tested the effectiveness of a modified semantic feature analysis (SFA) treatment protocol that incorporated metacognitive strategy training (MST). Regarding its restitutive component, SFA most reliably results in improved word retrieval for treated items and untreated, semantically related items, but evidence of response generalization is often small/inconsistent. Regarding its substitutive component, SFA is thought to facilitate successful communication via habituation of the SFA circumlocution strategy. However, repeated practice with SFA's strategy in the absence of direct MST may not result in independent strategy use and/or generalization. Furthermore, people with aphasia's independent use of the SFA strategy in moments of anomia is presently underreported. To address these limitations, we incorporated MST into SFA and directly measured substitutive outcomes. METHOD: Four people with aphasia participated in 24 treatment sessions of SFA + MST in a single-subject, A-B experimental design with repeated measurements. We measured word retrieval accuracy, strategy use, and explicit strategy knowledge. We calculated effect sizes to measure changes in word retrieval accuracy and strategy use and used visual inspection to assess gains in explicit strategy knowledge from pre- to posttreatment and retention. RESULTS: Participants achieved marginally small to medium effects in word retrieval accuracy for treated; untreated, semantically related; and untreated, semantically unrelated items and marginally small to large effects in independent strategy use. Explicit strategy knowledge was variable. CONCLUSIONS: Across participants, SFA + MST yielded positive changes in word retrieval accuracy or strategy use, or both. Positive changes in word retrieval accuracy were comparable to other SFA studies. Positive changes in strategy use demonstrate preliminary evidence of this treatment's ability to yield restitutive and substitutive gains. Overall, this study offers preliminary evidence of SFA + MST's effectiveness and highlights the importance of directly measuring SFA's substitutive outcomes, which showed that people with aphasia can respond to this treatment in multiple successful ways-not just improved target word production.


Assuntos
Afasia , Semântica , Humanos , Terapia da Linguagem/métodos , Afasia/terapia , Afasia/psicologia , Anomia/diagnóstico , Anomia/terapia , Anomia/psicologia , Generalização Psicológica
2.
Am J Speech Lang Pathol ; 31(1): 3-11, 2022 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-34310203

RESUMO

PURPOSE: Anomia, or difficulty with naming and word finding, is a pervasive deficit among individuals with aphasia. There is an extensive literature on the mechanisms underlying anomia and on approaches to treatment, but very little is known about the subjective experience of anomia during day-to-day life. METHOD: As part of a larger testing battery, 53 adults with poststroke aphasia took part in a novel, structured interview that included an open-ended question about the general experience of anomia: "Do you ever know what you want to say, but you can't say it out loud? Please describe that feeling." Video-recorded interview responses were transcribed and analyzed using thematic analysis, an iterative, data-driven process that categorizes interview data into common themes. RESULTS: Five main themes emerged among the data from 37 participants who produced adequate responses for use in thematic analysis: strategies to cope with or compensate for anomia, comments on awareness of the level of breakdown (e.g., "I have an idea, but can't get the right words"), negative emotions, impact on relationships, and changes in frequency over time. CONCLUSIONS: Participants showed strong awareness of anomia and its implications, demonstrating an ability to describe their language breakdown, identify relevant strategies to compensate and/or cope, and acknowledge the impact of anomia on their emotions and social interactions. This patient perspective may serve as a valuable supplement to information typically gained via objective language assessments. Clinicians and researchers may wish to consider incorporating similar subjective measures during assessment and treatment planning. Supplemental Material https://doi.org/10.23641/asha.15032643.


Assuntos
Afasia , Adulto , Anomia/diagnóstico , Anomia/etiologia , Anomia/psicologia , Afasia/diagnóstico , Afasia/etiologia , Afasia/psicologia , Humanos , Idioma , Terapia da Linguagem
3.
J Alzheimers Dis ; 81(4): 1763-1779, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33998546

RESUMO

BACKGROUND: Auditory naming tests are superior to visual confrontation naming tests in revealing word-finding difficulties in many neuropathological conditions. OBJECTIVE: To delineate characteristics of auditory naming most likely to reveal anomia in patients with dementia, and possibly improve diagnostic utility, we evaluated a large sample of patients referred with memory impairment complaints. METHODS: Patients with dementia (N = 733) or other cognitive impairments and normal individuals (N = 69) were evaluated for frequency of impairment on variables of the Auditory Naming Test (ANT) of Hamberger & Seidel versus the Boston Naming Test (BNT). RESULTS: Naming impairment occurred more frequently using the ANT total score (φ= 0.41) or ANT tip-of-the tongue score (TOT; φ= 0.19) but not ANT mean response time compared to the BNT in patients with dementia (p < 0.001). Significantly more patients were impaired on ANT variables than on the BNT in Alzheimer's disease (AD), vascular dementia (VaD), mixed AD/VaD, and multiple domain mild cognitive impairment (mMCI) but not in other dementias or amnestic MCI (aMCI). This differential performance of patients on auditory versus visual naming tasks was most pronounced in older, well-educated, male patients with the least cognitive impairment. Impaired verbal comprehension was not contributory. Inclusion of an ANT index score increased sensitivity in the dementia sample (92%). Poor specificity (41%) may be secondary to the inherent limitation of using the BNT as a control variable. CONCLUSION: The ANT index score adds diagnostic utility to the assessment of naming difficulties in patients with suspected dementia.


Assuntos
Anomia/diagnóstico , Disfunção Cognitiva/complicações , Demência/complicações , Idoso , Idoso de 80 Anos ou mais , Anomia/complicações , Anomia/psicologia , Disfunção Cognitiva/psicologia , Demência/psicologia , Feminino , Humanos , Testes de Linguagem , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos
4.
J Stroke Cerebrovasc Dis ; 29(10): 105161, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32912538

RESUMO

Gerstmann syndrome is defined as a tetrad including agraphia, acalculia, finger agnosia, and right-left disorientation. In the case studies presented in the literature, it has been reported that Gerstmann syndrome usually appears as an incomplete tetrad of symptoms or accompanied by cognitive deficits including aphasia, alexia, apraxia and some perceptual disorders. Here, we present of the patient with left angular and supramarginal gyrus infarction affecting the parietal lobe. In addition to the symptoms mentioned above, the patient had alexia and anomic aphasia as well. We discussed the clinic appearance and reviewed the current literature.


Assuntos
Agrafia/etiologia , Anomia/etiologia , Infarto Cerebral/complicações , Discalculia/etiologia , Dislexia/etiologia , Síndrome de Gerstmann/etiologia , Lobo Parietal/irrigação sanguínea , Agrafia/diagnóstico , Agrafia/psicologia , Anomia/diagnóstico , Anomia/psicologia , Infarto Cerebral/diagnóstico , Infarto Cerebral/psicologia , Discalculia/diagnóstico , Discalculia/psicologia , Dislexia/diagnóstico , Dislexia/psicologia , Síndrome de Gerstmann/diagnóstico , Síndrome de Gerstmann/psicologia , Humanos , Masculino , Pessoa de Meia-Idade
5.
J Speech Lang Hear Res ; 63(2): 599-614, 2020 02 26.
Artigo em Inglês | MEDLINE | ID: mdl-32073336

RESUMO

Purpose Aphasia is a language disorder caused by acquired brain injury, which generally involves difficulty naming objects. Naming ability is assessed by measuring picture naming, and models of naming performance have mostly focused on accuracy and excluded valuable response time (RT) information. Previous approaches have therefore ignored the issue of processing efficiency, defined here in terms of optimal RT cutoff, that is, the shortest deadline at which individual people with aphasia produce their best possible naming accuracy performance. The goals of this study were therefore to (a) develop a novel model of aphasia picture naming that could accurately account for RT distributions across response types; (b) use this model to estimate the optimal RT cutoff for individual people with aphasia; and (c) explore the relationships between optimal RT cutoff, accuracy, naming ability, and aphasia severity. Method A total of 4,021 naming trials across 10 people with aphasia were scored for accuracy and RT onset. Data were fit using a novel ex-Gaussian multinomial RT model, which was then used to characterize individual optimal RT cutoffs. Results Overall, the model fitted the empirical data well and provided reliable individual estimates of optimal RT cutoff in picture naming. Optimal cutoffs ranged between approximately 5 and 10 s, which has important implications for assessment and treatment. There was no direct relationship between aphasia severity, naming RT, and optimal RT cutoff. Conclusion The multinomial ex-Gaussian modeling approach appears to be a promising and straightforward way to estimate optimal RT cutoffs in picture naming in aphasia. Limitations and future directions are discussed.


Assuntos
Afasia/psicologia , Testes de Linguagem/normas , Modelos Estatísticos , Tempo de Reação , Idoso , Anomia/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição Normal , Padrões de Referência
6.
J Speech Lang Hear Res ; 62(12): 4464-4482, 2019 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-31805247

RESUMO

Purpose The ultimate goal of anomia treatment should be to achieve gains in exemplars trained in the therapy session, as well as generalization to untrained exemplars and contexts. The purpose of this study was to test the efficacy of phonomotor treatment, a treatment focusing on enhancement of phonological sequence knowledge, against semantic feature analysis (SFA), a lexical-semantic therapy that focuses on enhancement of semantic knowledge and is well known and commonly used to treat anomia in aphasia. Method In a between-groups randomized controlled trial, 58 persons with aphasia characterized by anomia and phonological dysfunction were randomized to receive 56-60 hr of intensively delivered treatment over 6 weeks with testing pretreatment, posttreatment, and 3 months posttreatment termination. Results There was no significant between-groups difference on the primary outcome measure (untrained nouns phonologically and semantically unrelated to each treatment) at 3 months posttreatment. Significant within-group immediately posttreatment acquisition effects for confrontation naming and response latency were observed for both groups. Treatment-specific generalization effects for confrontation naming were observed for both groups immediately and 3 months posttreatment; a significant decrease in response latency was observed at both time points for the SFA group only. Finally, significant within-group differences on the Comprehensive Aphasia Test-Disability Questionnaire (Swinburn, Porter, & Howard, 2004) were observed both immediately and 3 months posttreatment for the SFA group, and significant within-group differences on the Functional Outcome Questionnaire (Glueckauf et al., 2003) were found for both treatment groups 3 months posttreatment. Discussion Our results are consistent with those of prior studies that have shown that SFA treatment and phonomotor treatment generalize to untrained words that share features (semantic or phonological sequence, respectively) with the training set. However, they show that there is no significant generalization to untrained words that do not share semantic features or phonological sequence features.


Assuntos
Anomia/terapia , Afasia/psicologia , Generalização Psicológica , Terapia da Linguagem/métodos , Semântica , Idoso , Anomia/psicologia , Afasia/complicações , Feminino , Humanos , Testes de Linguagem , Masculino , Pessoa de Meia-Idade , Fonética , Desempenho Psicomotor , Resultado do Tratamento
7.
Cortex ; 120: 201-211, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31325799

RESUMO

To track neural correlates of naming performance with disease progression, we estimated key areas affected in nonfluent/agrammatic (nfvPPA) and logopenic (lvPPA) primary progressive aphasia variants over time and changes in naming correlates over time. Twenty-nine non-semantic PPA participants (17 nfvPPA and 12 lvPPA) were selected based upon current diagnostic criteria and PiB-PET status and conducted a confrontation-naming task and a structural MRI. Linear mixed-effect models implemented in FreeSurfer were used for tracking cortical thickness and epicenters of atrophy over time. Using averaged cortical thickness of epicenters and naming performance as variables of interest, two sets of multivariate analyses were conducted to compare atrophy progression and naming correlates across groups. While all PPA participants demonstrated naming deterioration and progressive cortical thinning in the left temporal lobe and the left inferior frontal gyrus, the lvPPA cohort showed greater naming deterioration and thinning in the left posterior inferior parietal cortex over time than it did the nfvPPA cohort. The multivariate analyses confirmed a widespread cortical thinning in lvPPA over time, but a more rapid thinning in the right superior frontal gyrus of nfvPPA participants. Impaired naming correlated with common cortical regions in both groups. These regions included the left anterior superior temporal gyrus and the posterior middle temporal gyrus, which was primarily affected in lvPPA. Non-semantic PPA variants initially present with separate epicenters of atrophy and different spatial-temporal patterns of neurodegeneration over time, but the common involvement in key cortical regions of the left temporal lobe accounts for naming deterioration in both groups.


Assuntos
Anomia/psicologia , Afasia Primária Progressiva/psicologia , Idoso , Anomia/diagnóstico por imagem , Afasia Primária Progressiva/diagnóstico por imagem , Afasia Primária Progressiva/patologia , Atrofia , Mapeamento Encefálico , Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/patologia , Cognição , Progressão da Doença , Feminino , Lobo Frontal/diagnóstico por imagem , Lobo Frontal/patologia , Humanos , Modelos Lineares , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Lobo Parietal/diagnóstico por imagem , Lobo Parietal/patologia , Semântica , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/patologia
8.
Am J Speech Lang Pathol ; 28(3): 1039-1052, 2019 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-31112652

RESUMO

Purpose A significant relationship between verbal short-term memory (STM) and language performance in people with aphasia has been found across studies. However, very few studies have examined the predictive value of verbal STM in treatment outcomes. This study aims to determine if verbal STM can be used as a predictor of treatment success. Method Retrospective data from 25 people with aphasia in a larger randomized controlled trial of phonomotor treatment were analyzed. Digit and word spans from immediately pretreatment were run in multiple linear regression models to determine whether they predict magnitude of change from pre- to posttreatment and follow-up naming accuracy. Pretreatment, immediately posttreatment, and 3 months posttreatment digit and word span scores were compared to determine if they changed following a novel treatment approach. Results Verbal STM, as measured by digit and word spans, did not predict magnitude of change in naming accuracy from pre- to posttreatment nor from pretreatment to 3 months posttreatment. Furthermore, digit and word spans did not change from pre- to posttreatment or from pretreatment to 3 months posttreatment in the overall analysis. A post hoc analysis revealed that only the less impaired group showed significant changes in word span scores from pretreatment to 3 months posttreatment. Discussion The results suggest that digit and word spans do not predict treatment gains. In a less severe subsample of participants, digit and word span scores can change following phonomotor treatment; however, the overall results suggest that span scores may not change significantly. The implications of these findings are discussed within the broader purview of theoretical and empirical associations between aphasic language and verbal STM processing.


Assuntos
Anomia/terapia , Terapia da Linguagem , Memória de Curto Prazo/fisiologia , Idoso , Anomia/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Prognóstico , Estudos Retrospectivos , Fala , Resultado do Tratamento
9.
Clin Linguist Phon ; 33(10-11): 1009-1030, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31017031

RESUMO

The study investigates code-switching by multilingual persons with dementia in two different speech contexts, picture naming tests and spontaneous conversation. It combines a psycholinguistic perspective on cognitive and linguistic skills with a qualitative conversation analytic approach to understanding the functions and appropriateness of code-switching in social interaction. The analysis shows that code-switching is used as a resource for compensating for word-retrieval problems in both the naming tests and in word search sequences in conversation. Furthermore, it serves to demarcate meta-communicative parentheses in which the participants comment on their process of word retrieval or express frustration about processing problems. Code-switching is generally treated as appropriate and relevant by the participants. In most instances, the speakers switch to a language known by the interlocutor. Only a few instances are treated as inappropriate by not being understandable to the interlocutor or by not adapting to the established language of the conversation. The patterns of code-switching are discussed considering typical symptoms of cognitive decline associated with dementia. Only very few instances may be interpreted as caused by a lack of awareness of the interlocutor's language background (associated with reduced episodic memory) or a lack of inhibition. Code-switching thereby presents itself primarily as a communicative resource for handling and overcoming another dementia-related symptom, namely anomia.


Assuntos
Anomia/psicologia , Demência/psicologia , Relações Interpessoais , Multilinguismo , Psicolinguística , Inteligibilidade da Fala , Idoso , Idoso de 80 Anos ou mais , Escalas de Graduação Psiquiátrica Breve , Compreensão , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Noruega , Análise e Desempenho de Tarefas
10.
J Clin Exp Neuropsychol ; 41(4): 353-363, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30608030

RESUMO

INTRODUCTION: Anomia is an impairment of naming: the retrieval of specific lexical items from the mental lexicon. Theoretically, whether anomia reflects a failure of selection at the preverbal "idea" level or at the subsequent linguistic formulation stage remains a topic of debate. We investigated the preverbal mechanism of idea selection for sentence generation, which requires the selection of a proposition from among competing alternatives during message formulation, in patients with severe anomia. METHOD: Patients with lesions to the left temporal lobe (N = 12), presenting with clinically defined anomia, and matched healthy controls (N = 24) completed sentence-level tasks that required the oral generation of a sentence or single word when presented with a word, a word pair, or a sentence. Selection demands were manipulated so that the stimuli activated many competing response options (low constraint) or one dominant or few response options (high constraint). RESULTS: There was no effect of stimuli constraint in the patient group that differed from that in the healthy control group on any of the generation tasks, suggesting that idea-level selection is intact in the patient group. CONCLUSIONS: These findings have implications for theoretical models of spoken language production and for clinical treatments of anomia.


Assuntos
Anomia/psicologia , Idioma , Lobo Temporal/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anomia/etiologia , Anomia/patologia , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/patologia , Feminino , Humanos , Testes de Linguagem , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/patologia
11.
J Speech Lang Hear Res ; 61(7): 1700-1717, 2018 07 13.
Artigo em Inglês | MEDLINE | ID: mdl-29946697

RESUMO

Purpose: The purpose of this study was to determine how 2 methods known to improve naming impairment in aphasia (i.e., retrieval practice and errorless learning) affect lexical access. We hypothesized that instances of naming during retrieval practice use and strengthen item-specific connections in each of 2 stages of lexical access: Stage 1, meaning-to-word connections, and Stage 2, word-to-phonology connections. In contrast, errorless learning prioritizes opportunities for repeating words, which we expect to primarily strengthen item-specific connections in Stage 2 because repetition circumvents the need for semantically driven word retrieval. Method: We tested the outcomes of retrieval practice versus errorless learning training for items that were selected because the naming errors they elicited suggested weakened connections at Stage 1 or at Stage 2 of lexical access for each of 10 individuals with chronic aphasia. Each participant's Stage 1 items and Stage 2 items were divided evenly between the 2 training conditions. Naming tests were administered 1 day and 1 week after training to assess retention of training gains. We also examined whether the participants' pretraining naming error profiles were associated with the relative efficacy of retrieval practice versus errorless learning. Results: The posttraining naming tests showed an advantage of retrieval practice over errorless learning for Stage 1 items and an advantage of errorless learning over retrieval practice for Stage 2 items. In addition, greater percentages of phonological error naming responses prior to training were associated with greater posttraining accuracy in the errorless learning condition relative to the retrieval practice condition. Conclusions: The findings suggest that the advantage of retrieval practice for naming impairment in aphasia largely results from greater strengthening of practiced semantic-lexical connections compared with errorless learning, which prioritizes repetition and, therefore, mainly confers strengthening of practiced lexical-phonological connections. Understanding how specific training conditions improve naming can help predict the relative efficacy of each method for individuals with aphasia.


Assuntos
Anomia/reabilitação , Afasia/reabilitação , Terapia da Linguagem/métodos , Aprendizagem , Rememoração Mental , Idoso , Anomia/psicologia , Afasia/psicologia , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Semântica , Resultado do Tratamento
12.
Am J Speech Lang Pathol ; 27(1S): 379-391, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29497750

RESUMO

Purpose: This study explored the relationship between anomia and verbal short-term memory (STM) in the context of an interactive activation language processing model. Method: Twenty-four individuals with aphasia and reduced STM spans (i.e., impaired immediate serial recall of words) completed a picture-naming task and a word pair repetition task (a measure of verbal STM). Correlations between verbal STM and word retrieval errors made on the picture-naming task were examined. Results: A significant positive correlation between naming accuracy and verbal span length was found. More intricate verbal STM analyses examined the relationship between picture-naming error types (i.e., semantic vs. phonological) and 2 measures of verbal STM: (a) location of errors on the word pair repetition task and (b) imageability and frequency effects on the word pair repetition task. Results indicated that, as phonological word retrieval errors (relative to semantic) increase, bias toward correct repetition of high-imageability words increases. Conclusions: Results suggest that word retrieval and verbal STM tasks likely rely on a partially shared temporary linguistic activation process.


Assuntos
Anomia/psicologia , Memória de Curto Prazo , Fonética , Semântica , Comportamento Verbal , Idoso , Anomia/diagnóstico , Compreensão , Feminino , Humanos , Testes de Linguagem , Masculino , Pessoa de Meia-Idade
13.
Am J Speech Lang Pathol ; 27(1S): 406-422, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29497752

RESUMO

Purpose: The purpose of this study was to examine the relationship between picture naming performance and the ability to communicate the gist, or essential elements, of a story. We also sought to determine if this relationship varied according to Western Aphasia Battery-Revised (WAB-R; Kertesz, 2007) aphasia subtype. Method: Demographic information, test scores, and transcripts of 258 individuals with aphasia completing 3 narrative tasks were retrieved from the AphasiaBank database. Narratives were subjected to a main concept analysis to determine gist production. A correlation analysis was used to investigate the relationship between naming scores and main concept production for the whole group of persons with aphasia and for WAB-R subtypes separately. Results: We found strong correlations between naming test scores and narrative gist production for the large sample of persons with aphasia. However, the strength of the correlations varied by WAB-R subtype. Conclusions: Picture naming may accurately predict gist production for individuals with Broca's and Wernicke's aphasia, but not for other WAB-R subtypes. Given the current reprioritization of outcome measurement, picture naming may not be an appropriate surrogate measure for functional communication for all persons with aphasia. Supplemental Materials: https://doi.org/10.23641/asha.5851848.


Assuntos
Anomia/psicologia , Afasia de Broca/psicologia , Afasia de Condução/psicologia , Afasia de Wernicke/psicologia , Compreensão , Idioma , Idoso , Idoso de 80 Anos ou mais , Anomia/diagnóstico , Afasia de Broca/diagnóstico , Afasia de Condução/diagnóstico , Afasia de Wernicke/diagnóstico , Bases de Dados Factuais , Feminino , Humanos , Testes de Linguagem , Masculino , Pessoa de Meia-Idade , Estimulação Luminosa , Índice de Gravidade de Doença
14.
Am J Speech Lang Pathol ; 27(1S): 464-476, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29497756

RESUMO

Purpose: Social models of aphasia rehabilitation emphasize the importance of supporting identity renegotiation, which can be accomplished in part through personal narrative construction. The purpose of this study was to examine the experiences of persons who had engaged in a project to coconstruct personal narratives about life with aphasia. Method: Qualitative interviews were conducted with 3 participants with aphasia who completed a 4-week personal narrative coconstruction project, which included preadministration and postadministration of the Communication Confidence Rating Scale for Aphasia (Cherney & Babbitt, 2011). Results were analyzed using interpretative phenomenological analysis. Results: Three themes were revealed: (a) More than a story: It changed my life validated the idea that the narrative coconstruction process supported a positive view of identity; (b) A positive experience captured the participants' enjoyment in coconstructing and sharing their story; (c) Hope engendered by the coconstruction experience empowered participants with new levels of confidence not only in their communication skills but also in themselves. Conclusions: This study provided insight into the experience of coconstructing personal narratives using a structured protocol. Participants experienced the project as a positive, meaningful opportunity to actively contemplate their life and look forward. The study has implications for clinicians considering support of identity renegotiation in aphasia rehabilitation.


Assuntos
Anomia/reabilitação , Afasia de Broca/reabilitação , Idioma , Terapia Narrativa/métodos , Qualidade de Vida , Idoso , Anomia/diagnóstico , Anomia/psicologia , Afasia de Broca/diagnóstico , Afasia de Broca/psicologia , Efeitos Psicossociais da Doença , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Narração , Poder Psicológico , Pesquisa Qualitativa , Recuperação de Função Fisiológica , Autoimagem , Comportamento Social , Fatores de Tempo , Resultado do Tratamento
15.
Am J Speech Lang Pathol ; 27(1S): 454-463, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29497755

RESUMO

Purpose: Current computer technologies permit independent practice for people with cognitive-communicative disorders. Previous research has investigated compliance rates and outcome changes but not treatment fidelity per se during practice. Our aim was to examine adherence to procedures (treatment fidelity) and accuracy while persons with aphasia independently practiced word production using interactive, multimodal, user-controlled, word-level icons on computers. Method: Four persons with aphasia independently practiced single-word production after stimulation via user-initiated interactions in 3 conditions: (I) auditory stimulus with static representational drawing; (II) auditory stimulus with synchronized articulation video; and (III) users' choice between the 2 prior conditions. Sessions were video-recorded for subsequent analysis, which established emergently refined behavioral taxonomies using an iterative, mixed-methods approach. Results: In independent practice, users only sometimes adhere to modeled behaviors, other times improvising novel behaviors. The latter sometimes co-occurred with successful productions. Differences in success rates were noted between Conditions I and II across behaviors with Condition II generally favored. In Condition III, participants tended to choose the stimulus that resulted in highest success rates. Conclusions: During independent practice with technology, persons with aphasia do not necessarily comply with clinicians' practice instructions, and treatment fidelity does not determine success. Autonomy and choice in practice may reveal unanticipated dimensions for computerized aphasia treatment.


Assuntos
Anomia/reabilitação , Afasia de Broca/reabilitação , Afasia de Wernicke/reabilitação , Terapia da Linguagem/métodos , Cooperação do Paciente , Autonomia Pessoal , Fala , Terapia Assistida por Computador/métodos , Estimulação Acústica , Idoso , Anomia/diagnóstico , Anomia/psicologia , Afasia de Broca/diagnóstico , Afasia de Broca/psicologia , Afasia de Wernicke/diagnóstico , Afasia de Wernicke/psicologia , Percepção Auditiva , Comportamento de Escolha , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estimulação Luminosa , Projetos Piloto , Análise e Desempenho de Tarefas , Resultado do Tratamento , Gravação em Vídeo , Percepção Visual
16.
Am J Speech Lang Pathol ; 27(1S): 477-484, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29497757

RESUMO

Purpose: The effect of repeated naming on both object and action picture naming in individuals with anomic aphasia is explored. We asked whether repeatedly naming the same items leads to improved accuracy and reduced response latency. Method: Ten individuals with anomic aphasia and 6 healthy adults, 3 young and 3 old, named a set of 27 object pictures and a set of 27 action pictures presented 1 at a time on a computer screen. We examined accuracy and response times (RTs) across the 2 blocks of 10 repeated trials. Results: Results demonstrated higher accuracy and faster RTs for object than for action naming for all participants, with lower accuracy rates and slower RTs for the people with aphasia (PWA) compared with the healthy individuals, and diverging patterns of change across trials. Unlike the healthy participants, whose RTs decreased across trials, PWA continued to demonstrate variability in response latencies across the trials. Conclusions: Our preliminary results suggest that measuring RT may be useful in characterizing retrieval difficulty in anomic aphasia and that the retrieval processes in PWA, even in those who experience mild anomia, may be less efficient or different from those processes in neurologically healthy individuals.


Assuntos
Anomia/terapia , Terapia da Linguagem/métodos , Idioma , Tempo de Reação , Adulto , Idoso , Anomia/diagnóstico , Anomia/psicologia , Estudos de Casos e Controles , Feminino , Humanos , Testes de Linguagem , Masculino , Pessoa de Meia-Idade , Estimulação Luminosa , Dados Preliminares , Recuperação de Função Fisiológica , Fatores de Tempo , Resultado do Tratamento , Percepção Visual , Adulto Jovem
17.
Am J Speech Lang Pathol ; 26(4): 1092-1104, 2017 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-28832881

RESUMO

PURPOSE: Although phonomotor treatment shows promise as an effective intervention for anomia in people with aphasia, responses to this treatment are not consistent across individuals. To better understand this variability, we examined the influence of 5 participant characteristics-age, time postonset, aphasia severity, naming impairment, and error profile-on generalization and maintenance of confrontation naming and discourse abilities following phonomotor treatment. METHOD: Using retrospective data from 26 participants with aphasia who completed a 6-week phonomotor treatment program, we examined the relationships between participant characteristics of interest and change scores on confrontation naming and discourse tasks, measured pretreatment, immediately following treatment, and 3 months following treatment. RESULTS: Although the participant characteristics of aphasia severity and error profile appeared to predict generalization to improved confrontation naming of untrained items and discourse performance, a post hoc analysis revealed that no one characteristic predicted generalization across participants at 3 months posttreatment. CONCLUSIONS: Response to phonomotor treatment does not appear to be influenced by aphasia and anomia severity level, error profile, participant age, or time postonset. Other factors, however, may influence response to intensive aphasia treatment and are worthy of continued exploration.


Assuntos
Anomia/reabilitação , Afasia/reabilitação , Generalização Psicológica , Terapia da Linguagem/métodos , Atividade Motora , Fonética , Patologia da Fala e Linguagem/métodos , Fala , Adulto , Fatores Etários , Idoso , Anomia/diagnóstico , Anomia/fisiopatologia , Anomia/psicologia , Afasia/diagnóstico , Afasia/fisiopatologia , Afasia/psicologia , Feminino , Humanos , Testes de Linguagem , Masculino , Pessoa de Meia-Idade , Destreza Motora , Recuperação de Função Fisiológica , Estudos Retrospectivos , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento
18.
Am J Speech Lang Pathol ; 26(3): 762-768, 2017 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-28505222

RESUMO

PURPOSE: This study examined discourse characteristics of individuals with aphasia who scored at or above the 93.8 cutoff on the Aphasia Quotient subtests of the Western Aphasia Battery-Revised (WAB-R; Kertesz, 2007). They were compared with participants without aphasia and those with anomic aphasia. METHOD: Participants were from the AphasiaBank database and included 28 participants who were not aphasic by WAB-R score (NABW), 92 participants with anomic aphasia, and 177 controls. Cinderella narratives were analyzed using the Computerized Language Analysis programs (MacWhinney, 2000). Outcome measures were words per minute, percent word errors, lexical diversity using the moving average type-token ratio (Covington, 2007b), main concept production, number of utterances, mean length of utterance, and proposition density. RESULTS: Results showed that the NABW group was significantly different from the controls on all measures except MLU and proposition density. These individuals were compared to participants without aphasia and those with anomic aphasia. CONCLUSION: Individuals with aphasia who score above the WAB-R Aphasia Quotient cutoff demonstrate discourse impairments that warrant both treatment and special attention in the research literature.


Assuntos
Anomia/diagnóstico , Afasia/diagnóstico , Testes de Linguagem , Medida da Produção da Fala/métodos , Patologia da Fala e Linguagem/métodos , Fala , Qualidade da Voz , Anomia/fisiopatologia , Anomia/psicologia , Anomia/reabilitação , Afasia/fisiopatologia , Afasia/psicologia , Afasia/reabilitação , Estudos de Casos e Controles , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fonética , Valor Preditivo dos Testes , Semântica
19.
Am J Speech Lang Pathol ; 26(2): 428-442, 2017 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-28475661

RESUMO

PURPOSE: The purpose of this investigation was to measure the effect of message type (i.e., action, naming) on the visual attention patterns of individuals with and without traumatic brain injury (TBI) when viewing grids composed of 3 types of images (i.e., icons, decontextualized photographs, and contextualized photographs). METHOD: Fourteen adults with TBI and 14 without TBI-assigned either to an action or naming message condition-viewed grids composed of 3 different image types. Participants' task was to select/sustain visual fixation on the image they felt best represented a stated message (i.e., action or naming). RESULTS: With final fixation location serving as a proxy for selection, participants in the naming message condition selected decontextualized photographs significantly more often than the other 2 image types. Participants in the action message condition selected contextualized photographs significantly more frequently than the other 2 image types. Minimal differences were noted between participant groups. CONCLUSIONS: This investigation provides preliminary evidence of the relationship between image and message type. Clinicians involved in the selection of images used for message representation should consider the message being represented when designing supports for people with TBI. Further research is necessary to fully understand the relationship between images and message type.


Assuntos
Atenção , Lesões Encefálicas Traumáticas/psicologia , Reconhecimento Visual de Modelos , Adulto , Anomia/psicologia , Anomia/reabilitação , Aprendizagem por Associação , Lesões Encefálicas Traumáticas/reabilitação , Auxiliares de Comunicação para Pessoas com Deficiência , Feminino , Fixação Ocular , Humanos , Individualidade , Masculino , Pessoa de Meia-Idade , Adulto Jovem
20.
J Speech Lang Hear Res ; 60(2): 406-421, 2017 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-28199471

RESUMO

Purpose: The relationship between cognitive abilities and aphasia rehabilitation outcomes is complex and remains poorly understood. This study investigated the influence of language and cognitive abilities on anomia therapy outcomes in adults with aphasia. Method: Thirty-four adults with chronic aphasia participated in Aphasia Language Impairment and Functioning Therapy. A language and cognitive assessment battery, including 3 baseline naming probes, was administered prior to therapy. Naming accuracy for 30 treated and 30 untreated items was collected at posttherapy and 1-month follow-up. Multiple regression models were computed to evaluate the relationship between language and cognitive abilities at baseline and anomia therapy outcomes. Results: Both language and cognitive variables significantly influenced anomia therapy gains. Verbal short-term memory ability significantly predicted naming gains for treated items at posttherapy (ß = -.551, p = .002) and for untreated items at posttherapy (ß = .456, p = .014) and 1-month follow-up (ß = .455, p = .021). Furthermore, lexical-semantic processing significantly predicted naming gains for treated items at posttherapy (ß = -.496, p = .004) and 1-month follow-up (ß = .545, p = .012). Conclusions: Our findings suggest that individuals' cognitive ability, specifically verbal short-term memory, affects anomia treatment success. Further research into the relationship between cognitive ability and anomia therapy outcomes may help to optimize treatment techniques.


Assuntos
Anomia/psicologia , Anomia/reabilitação , Afasia/reabilitação , Cognição , Terapia da Linguagem , Acidente Vascular Cerebral/complicações , Anomia/etiologia , Afasia/etiologia , Afasia/psicologia , Atenção , Doença Crônica , Função Executiva , Feminino , Seguimentos , Humanos , Idioma , Masculino , Memória de Curto Prazo , Pessoa de Meia-Idade , Reconhecimento Fisiológico de Modelo , Análise de Regressão , Percepção da Fala , Acidente Vascular Cerebral/psicologia , Reabilitação do Acidente Vascular Cerebral , Resultado do Tratamento , Percepção Visual
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