Katharine H. Odell

Prosody-voice characteristics of children and adults with apraxia of speech

We address explanatory issues raised by prior findings on the prosody-voice characteristics of suspected apraxia of speech in children (AOSc). Prosody-voice patterns for 14 adults with apraxia of speech (AOS) were compared to the prosody-voice patterns of 14 children with suspected apraxia of speech and inappropriate stress (AOSci) using the same assessment instruments and analysis methods. Compared to the speakers with AOSci, speakers with AOS had significantly fewer utterances meeting criteria for inappropriate stress, and significantly more utterances meeting criteria for inappropriate phrasing and inappropriate rate of speech. Discussion focuses on the implications of these three dissociations for the psycholinguistic locus of the stress deficit in AOSci including candidate loci within linguistic, motor speech, and self-monitoring processes.We address explanatory issues raised by prior findings on the prosody-voice characteristics of suspected apraxia of speech in children (AOSc). Prosody-voice patterns for 14 adults with apraxia of speech (AOS) were compared to the prosody-voice patterns of 14 children with suspected apraxia of speech and inappropriate stress (AOSci) using the same assessment instruments and analysis methods. Compared to the speakers with AOSci, speakers with AOS had significantly fewer utterances meeting criteria for inappropriate stress, and significantly more utterances meeting criteria for inappropriate phrasing and inappropriate rate of speech. Discussion focuses on the implications of these three dissociations for the psycholinguistic locus of the stress deficit in AOSci including candidate loci within linguistic, motor speech, and self-monitoring processes.

Arousal and auditory vigilance in individuals with aphasia during a linguistic and nonlinguistic task

Background: Attentional deficits have been observed in individuals with aphasia. Attention, specifically vigilance, is believed to be related to arousal. However, our understanding of arousal and its impact on vigilance performance in individuals with aphasia is very limited. Aims: The purpose of the current study was to investigate whether there is nonoptimal arousal in individuals with aphasia that would affect auditory processing of linguistic and nonlinguistic stimuli. Additionally, this study explored whether there was generalised, nonoptimal arousal and impaired vigilance or deficits specific to linguistic processing. Methods & Procedures: A total of 20 males (10 with left‐hemisphere stroke and aphasia and 10 nonbrain‐damaged controls) participated in this study. Physiologic arousal indexed by cardiovascular and neuroendocrine measures and vigilance performance was compared between the two groups during linguistic and nonlinguistic vigilance tasks. Outcomes & Results: Results indicated that arousal levels and vigilance performance differed between the two groups. However, within groups arousal and vigilance did not differ between the linguistic and nonlinguistic tasks. Conclusions: The present findings suggest that individuals with aphasia have decreased overall vigilance and nonoptimal arousal regardless of the linguistic or nonlinguistic nature of the stimuli.

Functional outcomes in patients with right hemisphere brain damage

Background : In this era of accountability in health care, the need to document treatment-related changes in health status is critical. However, few studies report outcomes in people with right cerebral hemisphere damage (RHD). Aims : The objective of this study was to document, in a single population of patients with RHD, selected functional outcomes at the termination of inpatient treatment. Of particular interest were cognitive performance and its influence on motor and overall recovery. Methods & Procedures : Functional outcomes were retrospectively examined in 101 RHD patients, at discharge from an in-patient rehabilitation programme. The Functional Independence Measure (FIM; Center for Functional Assessment Research, 1993) was the measurement tool. The five outcomes examined were: final functional status, amount of gain, efficiency of gain, length of stay (LOS), and discharge placement. FIM scores, produced on an ordinal rating scale, were statistically transformed by the Rasch method (Rasch, 1960) to generate interval-level data for regression analyses. Outcomes & Results : Summary by outcomes: Gains were evident in cognitive and motor realms, with greater and more efficient improvement in the latter. Regression analysis indicated that final functional status was best predicted by age, initial motor severity (FIM motor score), and initial total cognitive severity (FIM cognitive scores); amount of gain was best predicted by age, evidence of previous neurological incident, and gender; efficiency of gain by initial cognitive item scores, initial motor severity (FIM score) and age; LOS by initial motor severity (FIM score); and discharge placement by age, marital status, and initial severity (FIM status). Major predictors tended to be age and the family of cognitive FIM scores, especially Problem Solving (PS). Memory and PS were the most challenging cognitive items for these patients, as indicated by scores on admission and discharge reflecting less than functional ability. A sizeable number of patients began and ended rehabilitation with functional levels of ability in comprehension, expression, and social interaction. Significant differences existed between patients with neglect and those without, but neglect was not a significant predictor of any outcome measure. Low initial cognitive FIM scores, presence of neglect, and older age were associated with poorer performance in motor and cognitive realms. Previous neurological episodes were negatively associated with amount of gain. Number of comorbidities was not statistically associated with outcomes. Conclusions : Initial severity levels and age were the most influential factors on these outcomes. The presence of neglect had a relatively minor impact on most outcomes. Performance on the cognitive items was less impaired than motor items, and registered less gain and less efficient gain than motor items, but did predict various final status and gain-related measurements in overall and motor realms. Analyses in this study revealed that the FIM scale is less sensitive to cognitive change than to motor change.

Age-related intraindividual performance variability with practice.

Fluctuations in cognitive task performance in older individuals have been reported. To examine intraindividual variability as a function of practice, 34 younger and 34 older female participants, aged 20–30 years and 70–82 years, respectively, performed a reading span task 16 times over four sessions. Each individuals recall accuracy was analyzed over the practice trials. It was found that intraindividual variability occurred more frequently in older than younger individuals, and that fluctuations were more frequent in mid to later trials of practice. These findings were interpreted within a resource theory framework as evidence for age-related inefficient cognitive processing with practice.

Retrospective study of treatment outcome for individuals with aphasia

Measurement of outcomes subsequent to treatment and documentation of the efficiency with which outcomes are achieved is critical information for healthcare policy makers and third-party payers. This study employed the ASHA Functional Communication Measure (FCM) scales to retrospectively analyse charts of 20 aphasic patients. By discharge, both severe and moderate groups gained a median (across modalities) of 1 FCM level. The severe group remained dependent for communication, while the moderately impaired group typically achieved independent communication levels. Efficiency (amount of FCM level gain relative to number of treatment sessions) was greater for the moderate group; average number of treatment sessions was 40 for the severe group and 22 for the moderate group.

Repetition of Self-Generated Utterances in Conduction Aphasia

Verbal repetition performance was analyzed in four individuals with conduction aphasia. Comparisons at the sentence level included novel versus self-generated, conceptually chained utterances, and ...