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Effect of Verb Network Strengthening Treatment (VNeST) in Persons With Aphasia: Extension and Replication of Previous Findings

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Purpose: Verb Network Strengthening Treatment (VNeST) is an aphasia treatment that targets verbs (e.g., measure) and their related thematic roles (e.g., carpenter-lumber). Previous studies reported encouraging results in a number of participants using single-subject design with improvements observed on naming, sentence production, and discourse. The purpose of the current study was to conduct a group analysis evaluating the effect of VNeST on similar outcomes. Method: A multiple baseline design across participants was conducted with 11 persons with aphasia due to stroke. Wilcoxon signed-ranks tests were used to evaluate potential improvement from pre- to posttreatment and maintenance. Individual effect sizes were also calculated to evaluate magnitude of change within and across participants. Results: Results showed significant improvement at posttreatment and maintenance on trained and untrained sentence probes and object and action naming. Improvement in the production of sentences not targeted in treatment was nonsignificant at posttreatment assessment but significant at maintenance. Moderate increases in percentage of complete utterances and overall informativeness were observed on discourse. Conclusion: The results of this study replicate previous findings and provide evidence that VNeST may promote specific and generalized lexical retrieval abilities and affect basic syntax production in both constrained and discourse production tasks.
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... As poststroke aphasia treatments are readily available and potentially directly applicable to PPA, many PPA treatment studies aim to test the efficacy of poststroke aphasia treatment protocols as a means for increasing treatment options for people with PPA. One treatment that has been found to be particularly effective in improving naming in poststroke aphasia is Verb Network Strengthening Treatment (VNeST; Edmonds, 2016;Edmonds et al., 2009Edmonds et al., , 2014. VNeST centers on producing sentences around target verbs (e.g., read) and related arguments (e.g., the author [agent], the book [patient]). ...
... VNeST centers on producing sentences around target verbs (e.g., read) and related arguments (e.g., the author [agent], the book [patient]). VNeST is designed to strengthen semantic relationships between verbs and their thematic roles, such as the agent and the patient (Edmonds et al., 2014). The VNeST design was theoretically motivated by past research showing that thematic roles prime or facilitate activation of associated verbs (Edmonds & Mizrahi, 2011;McRae et al., 2005), and the opposite relationship-that verbs prime activation of related agents and patients (Edmonds & Mizrahi, 2011;Ferretti et al., 2001)-is also true. ...
... The VNeST design was theoretically motivated by past research showing that thematic roles prime or facilitate activation of associated verbs (Edmonds & Mizrahi, 2011;McRae et al., 2005), and the opposite relationship-that verbs prime activation of related agents and patients (Edmonds & Mizrahi, 2011;Ferretti et al., 2001)-is also true. In poststroke aphasia, this treatment has been found to not only improve naming of trained verbs, but also to promote generalization to naming of untrained verbs and nouns, and to promote sentence production (Edmonds, 2016;Edmonds et al., 2009Edmonds et al., , 2014. Furthermore, for some patients, the benefits of VNeST extend to sentence comprehension (Edmonds, 2016;Edmonds et al., 2014). ...
Article
Purpose There are few evidence-based treatments for language deficits in primary progressive aphasia (PPA). PPA treatments are often adopted from the poststroke aphasia literature. The poststroke aphasia literature has shown promising results using Verb Network Strengthening Treatment (VNeST), a behavioral therapy that focuses on improving naming by producing verbs and their arguments in phrases and sentences. Emerging research in poststroke aphasia and PPA has shown promising results pairing behavioral language therapy with transcranial direct current stimulation (tDCS). Method This study used a double-blind, within-subjects, sham-controlled crossover design to study the effect of anodal tDCS applied to left inferior frontal gyrus (IFG) plus VNeST versus VNeST plus sham stimulation in two individuals with nonfluent variant PPA and one individual with logopenic variant PPA. Participants received two phases of treatment, each with 15 1-hr sessions of VNeST. One phase paired VNeST with tDCS stimulation, and one with sham. For each phase, language testing was conducted at baseline, and at 1 week and 8 weeks posttreatment conclusion. For each participant, treatment efficacy was evaluated for each treatment phase by comparing the mean change in accuracy between baseline and the follow-up time points for naming trained verbs (primary outcome measure), untrained verbs, and nouns on the Object and Action Naming Battery. Mean change from baseline was also directly compared between tDCS and sham phases at each time point. Results Results revealed a different pattern of outcomes for each of the participants. A tDCS advantage was not found for trained verbs for any participant. Two participants with nonfluent variant PPA had a tDCS advantage for generalization to naming of untrained verbs, which was apparent at 1 week and 8 weeks posttreatment. One participant with nonfluent variant also showed evidence of generalization to sentence production in the tDCS phase. Conclusion VNeST plus anodal tDCS stimulation of left IFG shows promising results for improving naming in PPA.
... Olgunun spontane konuşması mevcuttur, ancak üretimleri ağırlıklı olarak parafazi, neoloji ve jargonlardan oluştuğu için konuşma anlaşılırlığı oldukça düşüktür. Örneğin "ne iş yaparsınız" sorusuna bir önceki soruya verdiği "hayır" yanıtını vererek persevaratif üretim, sonrasında da sırasıyla "tamam, Allah Allah" sözcükleri "hakbe", "gebil" gibi anlamsız üretimler ve "tamam" "tamam" "tamam" sözcüklerinin üretimi VNeST çalışmaları ile tutarlıdır (Edmonds, 2009;Edmonds, 2016;Edmonds & Babb, 2011;Edmonds & Mammino, 2014;Edmonds ve ark., 2015;Kwag ve ark., 2014). ...
... başvurmak yerine hatasını düzeltmeye odaklanması da görülen diğer olumlu gelişmelerdendir.Bu iyileşmeler literatürdeki çalışmalarda bildirilen sonuçlar tutarlı bir bulgu olarak karşımıza çıkmaktadır ile(Edmonds, 2009;Edmonds & Babb, 2011;Edmonds & Mammino, 2014; Edmonds ve ark., 2015;Furnas & Edmonds, 2014).VNeST'in etkililiğini araştıran bir çalışmada(Edmonds, 2009), tutuk afazi olgularında spontane konuşmada; akıcı afazi olgularında ise tekrarlama ve işitsel anlama yetilerinde belirgin artış olduğu bildirilmektedir. Çalışmamızda akıcı afazi tipleri arasında yer alan transkortikal sensöriyel afazi tipi bulguları gösteren olgunun VNeST terapi yöntemi sonrası ADD testi puanları göz önüne alındığında tekrarlama ve işitsel anlamadaki puan artışının yanı sıra spontane konuşma puanında artışının gerçekleştiği görülmüştür. ...
... Step 1 of Verb Network Strengthening treatment (VNeST) -see Edmonds, 2014;Edmonds et al. 2015), with some studies pointing to the need for verb exercises to raise metalinguistic awareness of verbs prior to sentence treatment (e.g., Carragher et al., 2015). Thus, Phase 1 of the SPT comprised verb exercises and Phase 2 sentence exercises. ...
... Treatments with the best evidence (reported in Table 2 in both Hickin et al., 2020 and were incorporated into the SPT. Thus, for example, semantic feature analysis was included in verb treatment exercises based on the evidence from a series of studies by Wambaugh and colleagues (e.g., Wambaugh & Ferguson, 2007;Wambaugh et al., 2014); whilst VNeST was included in sentence exercises based on the work of Edmonds and colleagues (e.g., Edmonds, 2014;Edmonds et al., 2015). Photographs of PR verbs were used as stimuli in all three phases of treatment. ...
Article
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Background There is increasing evidence that face-to-face treatments for verb and sentence production deficits in aphasia can be effective. However, very few studies have investigated supplementing such treatments with self-managed computer-based home practice. Given the increasing importance of computer-based aphasia treatment, it is imperative that the feasibility of this mode of delivering verb and sentence treatments is explored. Aims This study explored the feasibility and preliminary effectiveness of a novel computer-based treatment for sentence production deficits in aphasia, delivered by a combination of face-to-face and self-managed treatment sessions. The effect of treatment on verb and sentence production, discourse and functional communication was assessed. Methods & Procedures The study used a pre-post design with six single cases: three males and three females aged 49 – 81 years. The Sentence Production Treatment (SPT) was developed based on the evidence from systematic reviews of verb-in-isolation and sentence treatments respectively. The SPT was low dose (8 hours) and clinician delivered, supplemented by a minimum set level (16 hours) of self-managed computer-based treatment. The feasibility of the SPT was investigated by: monitoring recruitment and retention of participants; logging any technical issues; assessing the fidelity of face-to-face treatment delivery using checklists; and monitoring compliance with self-delivered treatment. Outcomes & Results The SPT was found to be feasible and acceptable to the six participants. Treatment effects were noted on trained verb production and sentence production for five participants each. Generalisation to untrained verb and sentence targets and discourse was more limited, however four participants perceived functional communication improvements. Conclusions The study represents the first preliminary evidence that a computer-based sentence level treatment for sentence production deficits in aphasia, which included a self-managed component, is feasible and can be effective. Given these overall positive findings of feasibility and benefit, further feasibility testing is warranted, exploring intervention refinement and candidacy.
... NAP scores reflect amount of overlap between pre-and posttreatment phases, but they do not indicate the size of the difference between the phasesthis information is captured by Cohen's d. A benchmark of (+/-) 1.2 (small effect size) or above, as suggested by Edmonds et al. (2014) for untrained stimuli, in conjunction with a NAP score of (+/-) .32 (medium NAP score) or above (Parker & Vannest, 2009) was used as an indication of change due to treatment. ...
... Alternatively, his outlying results may be related to his aphasia diagnosis (Wernicke's aphasia). Although VNeST has been shown to be a potentially successful treatment option for people with Wernicke's aphasia (e.g., Edmonds et al., 2014), for the measures reported in this study it appears that VNeST was not successful for EH05 (but see Lerman et al., 2020 for other ways of measuring EH05's language changes). This trend could be attributed to his severe auditory comprehension and poor phonological skills which are known to negatively affect treatment efficacy (Robson et al., 2019). ...
Article
Background Treatment dose in aphasia therapy is typically measured by the overall number of treatment hours together with the distribution of treatment sessions over time. However, in order to provide accurate information on treatment dose, it is also necessary to identify and report the active components of any given intervention (Baker, 2012b; Cherney, 2012). Aims In this study, the relationship between treatment hours (overall and average per week), post-stroke language abilities, and treatment dose was examined in multilingual people with aphasia. The effect of treatment dose of a targeted linguistic process (relevant SVO sentence production) on treatment outcomes related to that linguistic process was also analysed. Methods and procedures Four multilingual people with aphasia received Verb Network Strengthening Treatment in either their L1, or both their L1 and a later-acquired language. The number of times the VNeST protocol was completed (i.e., number of verb cycles) per treatment block was compared to (a) treatment hours and post-stroke language abilities, and (b) treatment outcomes of tasks related to relevant SVO sentence production. Outcomes and results With a relatively similar number of treatment hours, a measure of post-stroke language abilities was a good predictor of the number of verb cycles completed during treatment. Furthermore, a higher number of verb cycles completed during treatment indicated more potential for within-language generalisation of relevant SVO sentence production. Conclusions Identifying the active component(s) of a given treatment and reporting this information together with post-stroke language abilities and treatment hours will provide more accurate information regarding treatment dose than is currently standardly reported. This information is crucial to a better understanding of the mechanisms of aphasia recovery.
... In the verbal description condition, each item was trained by presenting a short verbal description prompt in both written and auditory formats. This was intended to increase stimuli variability by providing a prompt without relying on trained pictures (Edmonds et al., 2014;Edmonds et al., 2009), which also increased the overall complexity of the stimulus-response mapping. ...
Article
Introduction : There is a pressing need to improve computer-based treatments for aphasia to increase access to long-term effective evidence-based interventions. The current single case design incorporated two learning principles, adaptive distributed practice and stimuli variability, to promote acquisition, retention, and generalization of words in a self-managed computer-based anomia treatment. Methods : Two participants with post-stroke aphasia completed a 12-week adaptive distributed practice naming intervention in a single-case experimental design. Stimuli variability was manipulated in three experimental conditions: high exemplar variability, low exemplar variability, and verbal description prompt balanced across 120 trained words. Outcomes were assessed at 1-week, 1-month, and 3-months post-treatment. Statistical comparisons and effect sizes measured in the number of words acquired, generalized, and retained were estimated using Bayesian generalized mixed-effect models. Results : Participants showed large and robust acquisition, generalization, and retention effects. Out of 120 trained words, participant 1 acquired ∼77 words (trained picture exemplars) and ∼63 generalization words (untrained picture exemplars of treated words). Similarly, participant 2 acquired ∼57 trained words and ∼48 generalization words. There was no reliable change in untrained control words for either participant. Stimuli variability did not show practically meaningful effects. Conclusions : These case studies suggest that adaptive distributed practice is an effective method for re-training more words than typically targeted in anomia treatment research (∼47 words on average per Snell et al., 2010). Generalization across experimental conditions provided evidence for improved lexical access beyond what could be attributed to simple stimulus-response mapping. These effects were obtained using free, open-source flashcard software in a clinically feasible, asynchronous format, thereby minimizing clinical implementation barriers. Larger-scale clinical trials are required to replicate and extend these effects.
... Verb network strengthening treatment (VNeST) is another aphasia treatment program that directs attention to the semantic aspects of target words by focusing on verbs and their thematic roles (Edmonds, Nadeau, et al., 2009). For example, the verb 'drive' is associated with 'car ', 'truck', 'limo', etc. Outcomes of this treatment have been promising with improved naming of trained and untrained objects as well as for relevant use of targets in discourse (Edmonds et al., 2014). ...
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Background Word retrieval deficits are common concerns for persons with aphasia (PWA). Treatment approaches can be divided into two processes, namely phonological and semantic, based on models suggesting that word activation consists of activating the semantic representation and phonological form of the target word. The role of syntax, however, has received less attention in models of retrieval and in the treatment of word retrieval deficits. Aims This study investigated whether a fixed noun phrase can support word finding in a PWA. Chinese is a classifier language where a classifier is obligatory in the quantitative noun phrase. The language uses two types of prenominal classifiers: sortal (serves to count individual nouns) and mensural (serves to count the units of nouns) classifiers. Methods & Procedures A Cantonese Chinese speaking PWA (LCH) with marked word retrieval deficits participated in this 15 bi-weekly, 90-minute treatment sessions, which focused on use of classifier cues to aid naming on confrontation naming. Twelve classifiers (6 sortal and 6 mensural) were selected to train target nouns. Target nouns were selected to pair with selected classifiers. Responses to cues were collected during each treatment session, documenting changes over time. Outcomes & Results Leveraging the relationship between target nouns and obligatory prenominal classifiers resulted in the participant’s improved picture naming for trained nouns as well as generalization to select untrained nouns. We report significant differences in the efficacy of sortal versus mensural classifiers to serve as primes for word retrieval. Sortal classifiers were significantly more effective than mensural classifiers, for both cueing trained and untrained target nouns. Conclusions For this speaker of a classifier language, use of classifiers served as viable cues for word retrieval and that sortal classifiers were more effective than mensural classifiers. Though word order does not distinguish between these two types of classifiers, their relative priming efficiency can be observed at the deep structure level. Findings suggest that a morphosyntactic approach to address word retrieval in a Chinese speaker may be beneficial but that great care must be taken in the creation of treatment materials. These factors must be further explored with additional participants and with a wider range of classifiers.
... The VNeST protocol has been reported in detail in previous studies (e.g. Edmonds, 2014;Edmonds et al., 2014Edmonds et al., , 2009) and we followed all its steps, with one modification. We added a written component to the original VNeST protocol, because EH02ʹs writing abilities in English were relatively spared, and his contact with Hebrew for the last 14 years had been predominantly in the written modality. ...
Article
Language difficulties can arise from reduced exposure to any given language (e.g. attrition) or after brain damage (e.g. aphasia). The manifestations of attrition and aphasia are often similar so differentiating between their effects on language loss and recovery is challenging. We investigated treatment effects for an English-Hebrew bilingual person with stroke-induced aphasia who had minimal contact with his Hebrew for over 14 years. We asked whether his attrited language could be rehabilitated, how effects of attrition and aphasia can be dissociated, and how such dissociation aids our understanding of the mechanisms involved in language recovery in aphasia. We administered a verb-based semantic treatment in Hebrew three times a week for six weeks (totalling 29 hours of therapy) and assessed changes in both Hebrew and English comprehension and production abilities across a variety of language tasks. Quantitative analyses demonstrated improvement in Hebrew production across language tasks, including those involving lexical retrieval processes that were trained during treatment. Improvement to English occurred in these same lexical retrieval tasks only. We interpret these results as indicating that the participant's attrited language (Hebrew) could be rehabilitated with both specific treatment and general exposure to Hebrew contributing to improvement. Furthermore, treatment effects transferred to the untreated English. Qualitative analyses indicated that an interaction among aphasia, incomplete mastery of Hebrew pre-stroke, and attrition contributed to the participant's language difficulties post-stroke. We conclude that partially shared underlying mechanisms of attrition and aphasia drive language processing and changes to it with treatment.
Article
Purpose A critical review was completed to evaluate replication of aphasia treatments that have been vetted and accepted on the American Speech-Language-Hearing Association Practice Portal. Method The electronic databases Academic Search Premier, ProQuest Central, CINAHL Complete, and ERIC were searched for relevant articles using treatment names as keywords. Coders compared stimuli, material, design, and statistical analysis to pilot treatment approaches. Each study was coded as direct, conceptual, failed, or no replication. Results Eighteen treatment approaches were selected for this review. A total of 188 articles met the inclusion criteria. Results revealed that 14 out of 18 treatment approaches were somehow replicated. Direct replications as the most valuable replication type for affirming previously found results were represented in only 1.5% of all studies (3/188). Failed direct replication were at 2% overall (4/188). Conceptual replications were more common across treatment approaches, but also represented at a low level with 22.8% (43/188). The majority of studies were coded as no replication attempt with 73.4%. Discussion A critical factor in developing an evidence-based practice is the existence of replicated results for treatment. Replication evaluates the reproducibility of an author's or authors' research methodology and resulting outcomes and helps to ensure that observed treatment effects are reproducible. For an evidence-based treatment to be implemented or used in any clinical setting, it must be one that can be replicated. Direct and conceptual replications of aphasia treatment approaches were found to be alarmingly low considering the importance of replication in our field. It is recommended that replication should become more valued and mainstreamed in aphasia research. A replication database that compiles and maintains treatment manuals for replication purposes can increase the accessibility and acceptability of replications for researchers.
Article
Objectives: Verb Network Strengthening Treatment (VNeST) is a semantic treatment that aims to improve lexical retrieval across a hierarchy of linguistic contexts, including sentences and discourse. So, the purpose of this study was to investigate the effects of VNeST using telepractice on Korean individuals with moderate to severe non-fluent aphasia and examine the advantages of telepractice treatment. Methods: Three Korean individuals with aphasia caused by a single lesion in the left hemisphere participated in this study. They received VNeST via ZOOM in real time at their home. VNeST protocol consisted of 6 steps: step 1, generate three agents and themes for the target verb; step 2, read each scenario aloud; step 3, choose the appropriate case marker and answer three wh-questions about agent-theme pairs; step 4, judge semantic plausibility of sentences; step 5, confront naming on animation target verb task; step 6, repeat the prompts of Step 1 without cues. Multiple-baseline design across behaviors was employed, and effect sizes of the treatment were obtained. Results: The results of this study are as follows: 1) all participants showes large effect sizes, 2) all participants showed a generalization effect, 3) the CIU rate of all participants improved, 4) all participants showed increased score or performance on language assessment task, 5) all participants and their careers responded that they were very satisfied with the telepractice treatment. Conclusion: The current study suggest that VNeST via telepractice is effective as off-line treatment in promoting generalization from single word naming in person with moderate to severe non-fluent aphasia.
Article
Background Language treatment for bilinguals with aphasia has been shown to result in gains in both the treated language and the untreated language (i.e., cross-language generalization). However, cross-language generalization is not consistently found. This inconsistency may be due to several factors, such as the age of acquisition of, and proficiency in, each language. One often-overlooked factor that may influence whether cross-language generalization occurs is the manner in which bilinguals learned their second language (L2): in a formal educational context (explicitly) or naturalistically through exposure to the language (implicitly). Prior research suggests that implicit L2 learning results in greater overlap in the representation of the first language (L1) and L2 in the brain, particularly for grammar, compared to explicit learning. In contrast, lexical processing in L1 and L2 is proposed to rely more on shared brain regions regardless of the manner of L2 acquisition. Greater overlap should provide a greater likelihood of cross-language generalization effects from treatment. Aims The goal of this study was to determine how the manner of acquisition of L2 may affect cross-language generalization following treatment in L2 separately targeting the lexicon (object naming) and grammar (sentence construction). Methods & Procedures Two Spanish-English bilinguals with aphasia each completed two treatment phases in English of 2-4 weeks each, in succession, with one week between them: semantic feature analysis (SFA) targeting object naming, and Verb Network Strengthening Treatment (VNeST) targeting verb retrieval and sentence construction. Pre- and post-treatment assessments and weekly probes were completed for each phase. Participant P1 learned English explicitly in an educational setting, while participant P2 learned English implicitly. Outcomes & Results As predicted, P2 showed cross-language generalization after verb/grammar treatment (VNeST) whereas P1 did not. However, contrary to the prediction that both participants should show cross-language generalization after noun treatment (SFA), only P1 showed cross-language generalization of object naming. Conclusions Cross-language generalization was observed for both participants but for different aspects of language. The findings suggest that naturalistic second language learning may lead to stronger links between languages in the grammatical system, whereas formal second language learning may lead to stronger links between languages in the lexical-semantic system. Future research should further explore the effects of manner of acquisition as a predictor of language co-activation and cross-language treatment generalization in bilinguals with aphasia.
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The effect of typicality of category exemplars on naming was investigated using a single subject experimental design across participants and behaviors in 4 patients with fluent aphasia. Participants received a semantic feature treatment to improve naming of either typical or atypical items within semantic categories, while generalization was tested to untrained items of the category. The order of typicality and category trained was counterbalanced across participants. Results indicated that patients trained on naming of atypical exemplars demonstrated generalization to naming of intermediate and typical items. However, patients trained on typical items demonstrated no generalized naming effect to intermediate or atypical examples. Furthermore, analysis of errors indicated an evolution of errors throughout training, from those with no apparent relationship to the target to primarily semantic and phonemic paraphasias. Performance on standardized language tests also showed changes as a function of treatment. Theoretical and clinical implications regarding the impact of considering semantic complexity on rehabilitation of naming deficits in aphasia are discussed.
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Background: A number of computerised treatments have been developed for aphasia, but few have remediated typing, an important functional task, and/or been implemented over the Internet via teletherapy, which can increase access to therapeutic services. The current study created a computerised version of Verb Network Strengthening Treatment (VNeST) and administered it via telerehabilitation over the Internet. VNeST is a semantic treatment which seeks to improve lexical retrieval of words through the conceptual connection between verbs and thematic roles. Previous iterations of VNeST have shown improvement in both spoken and written lexical retrieval for people with moderate and moderate-to-severe aphasia.
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Dissociations between the processing of nouns and verbs are well recognised in a number of neurological diseases. Anatomically, deficits in verb processing have been linked to the anterior (frontal), those of noun processing to the posterior (temporal) cortical regions of the dominant hemisphere. It remains, however, unclear whether this difference is due to linguistic (verbs versus nouns) or conceptual (actions versus objects) properties. To address this issue, we designed a novel test (the kissing and dancing test, KDT) consisting of 52 triplets of pictures depicting actions and 52 word triplets consisting of verbs, which was directly comparable with the 52 triplets of objects and nouns of the pyramids and palmtrees test (PPT). The two tests were validated in conjunction first on a normal control group, followed by assessments of 10 patients with the frontal variant frontotemporal dementia (fvFTD) and 14 patients with semantic dementia (SD). The patients with fvFTD were consistently more impaired on the KDT, those with SD on the PPT. Although the difference was found for both pictures and words, it was significant only for pictures in fvFTD and for words in SD. The results suggest that both linguistic and conceptual aspects play a role in the observed dissociation, but that their impact in frontal and temporal variants of FTD might be different. q
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Naming is a fundamental aspect of language. Word-finding deficit, anomia, is the most common symptom of language dysfunction occurring after brain damage. Besides its practical importance, anomia gives a fascinating view on the inner workings of language in the brain. There has been significant progress in the study of anomia in recent years, including advances in neuroimaging research and in psycholinguistic modelling. Written by two internationally known researchers in the field, this book provides a broad, integrated overview of current research on anomia. Beginning with an overview of psycholinguistic research on normal word retrieval as well as the influential cognitive models of naming, the book goes on to review the major forms of anomia. Neuroanatomical aspects, clinical assessment, and therapeutic approaches are reviewed and evaluated.
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Background: Despite advances in the development and testing of therapies for verb retrieval impairments in aphasia, generalisation effects of treatment remain a challenge. Semantic Feature Analysis (SFA) is a word retrieval treatment that has been reported to result in generalised responding to untrained object names with persons with aphasia. The theorised therapeutic mechanisms of SFA appeared to be appropriate for facilitating retrieval of trained and untrained action names.Aims: This investigation was designed to extend pilot research in which SFA was applied to verb retrieval. The primary purpose of the current study was to examine the acquisition and response generalisation effects of SFA applied to action naming with four persons with chronic aphasia. Additional purposes were to examine changes in production of content in discourse and to explore the correspondence of accuracy of naming during treatment to probe performance.Methods & Procedures: SFA was modified slightly to be appropriate for application to action naming as opposed to object naming; several feature categories were changed, but all other procedures were retained. Treatment was applied sequentially to two sets of action names in the context of multiple baseline designs across behaviours and participants. Accuracy of naming of trained and untrained actions in probes was measured repeatedly throughout all phases of the design. Production of correct information units (CIUs) in discourse was measured prior to and following treatment. The relationship of probe-naming performance to naming performance during treatment sessions was examined using correlational analyses.Outcomes & Results: Increased accuracy of naming of trained action names was associated with treatment for three of the four participants. The remaining participant did not demonstrate improvement in naming on probes, despite some gains during treatment. Generalisation to untrained action names did not occur for any of the participants. Increases in CIU production were observed for only one of the participants. For the participants with positive naming outcomes, probe performance correlated well with naming performance during treatment. For the participant who demonstrated some improvements in treatment, but did not show gains in naming on probes, weak correlations were obtained.Conclusions: SFA appears to have potential for promoting improved action naming in aphasia. However, more research is warranted to explore treatment modifications to promote generalisation. Correlational analyses indicated that gains in naming during treatment may not always be reflected in probe performance and thus, require verification through probing in non-treatment conditions.
Article
Groups of aphasic patients and their spouses generated a series of communication situations that they felt were important in their day-to-day life. Using criteria to ensure that the situations were generalizable across people, times, and places, we reduced the number of situations to 36 and constructed an index that allowed the significant others of 11 recovering and 11 stable aphasic individuals to rate their partners' performance in the situations on two occasions 6 weeks apart. These data were then used to evaluate the psychometric properties of the Communicative Effectiveness Index (CETI) as a measure of change in functional communication ability. Further application of a generalization criterion reduced the final index to 16 situations. Results- showed the CETI to be internally consistent and to have acceptable test-retest and interrater reliability. It was valid as a measure of functional communication according to the pattern of correlations found with other measures (Western Aphasia Battery, Speech Questionnaire, and global ratings). Finally, it was responsive to functionally important performance change between testings. Further research with the CETI and its usefulness for clinicians and researchers are discussed. Historically, the focus of aphasia assessment has been on language abilities with general communicative abili- ties as only a secondary consideration. Furthermore, assessment instruments have been validated with more concern for their ability to discriminate aphasic from nonaphasic performance or one aphasia type from another than for their ability to detect change in the severity of the aphasia over time. The development of an instrument with the