Lisa A. Edmonds

Effect of Verb Network Strengthening Treatment (VNeST) on lexical retrieval of content words in sentences in persons with aphasia

Background: Verb Network Strengthening Treatment (VNeST) is a semantic treatment that aims to improve lexical retrieval of content words in sentence context by promoting systematic retrieval of verbs (e.g., measure) and their thematic roles—i.e., agent (doer of the action, e.g., carpenter, chef) and patient (receiver of the action, e.g., lumber, sugar). VNeST is influenced by Loverso and colleagues (e.g., Loverso, Selinger, & Prescott, 1979) who used “verb as core” treatment to improve sentence production with encouraging results, and McRae and colleagues who showed that verbs prime typical agents (e.g., pray–nun) and patients (arrest–criminal) (Ferretti, McRae, & Hatherell, 2001) and vice‐versa (McRae, Hare, Elman, & Ferretti, 2005). Aims: There are four specific questions in this study. Does training a set of verbs using VNeST generalise to the ability to produce (1) an agent (carpenter), trained verb (measure), and patient (stairs) in response to novel picture stimuli and (2) an agent (nurse), untrained semantically related verb (weigh), and patient (baby) in response to novel picture stimuli? (3) Are generalisation effects maintained? (4) Does VNeST generalise to the ability to retrieve nouns and verbs not directly related to treatment items in single word naming, picture description, and connected speech tasks? Methods & Procedures: Four participants with aphasia participated. Participants received VNeST, which involves retrieval of agent–patient pairs (e.g., chef/sugar, surveyor/land) related to trained verbs (e.g., measure), twice per week. A single‐participant, repeated probe, multiple baseline experimental design was used. Generalisation to sentence production for sentences containing trained verbs and untrained semantically related verbs was tested weekly. Outcomes & Results: Results demonstrated generalisation to lexical retrieval of content words in sentences with trained and untrained verbs across participants. Additionally, pre‐ to post‐treatment generalisation was observed on single verb and noun naming and lexical retrieval in sentences across a variety of tasks across participants. Generalisation to connected speech was observed for three of four participants. Conclusions: Although preliminary, these results indicate that VNeST may be effective in promoting generalisation from single word naming to connected speech in persons with moderate aphasia. A number of clinical implications related to treatment efficiency are discussed. The authors would first like to thank the four individuals who participated in this study. Additional thanks go Laura K. Allred for creating the artwork for developed stimuli, and Michela Palmieri and Adam Jacks for assistance with reliability.

Attentive Reading and Constrained Summarisation (ARCS) treatment in primary progressive aphasia: A case study

Background: Primary progressive aphasia (PPA) is a neurodegenerative disease characterised by isolated and gradual language decline that can negatively affect discourse. Behavioural treatments for PPA have typically targeted linguistic processes at the micro‐structure (word or sentence) level rather than the macro‐structure (discourse) level, with minimal generalisation to discourse. There is a growing consensus that non‐linguistic mechanisms such as attention are imperative for complex language execution such as discourse. Intentional language use (Nadeau, Rothi, & Rosenbek, 2008) is another mechanism thought to promote language generalisation by encouraging verbal language to the exclusion of other modalities. Attentive Reading and Constrained Summarisation (ARCS) is a novel discourse‐level treatment derived from cognitive principles and operating on macro‐structure and micro‐structure linguistic levels. Aims: In this case report of one participant with PPA we anticipated post‐treatment discourse‐level improvements in coherence, cohesion, and informativeness/efficiency with unlikely maintenance due to the neurodegenerative nature of PPA. Methods & Procedures: “Stanley”, a 76‐year‐old gentleman with PPA and concomitant attention impairments, received the ARCS treatment. ARCS focuses attention during reading and promotes intentional language use by summarisation with constraints. Outcomes & Results: Pre‐ to post‐treatment and maintenance improvements on coherence, cohesion, and percent correct information units were observed. Conclusions: The current findings are intriguing but must be interpreted with prudence given that this is a case study with limitations related to lack of experimental control. However, ARCS is a novel behavioural treatment for PPA and the post‐treatment and 2‐months maintenance results warrant consideration.

Effect of Semantic Naming Treatment on Crosslinguistic Generalization in Bilingual Aphasia

PURPOSE The effect of semantic naming treatment on crosslinguistic generalization was investigated in 3 participants with English-Spanish bilingual aphasia. METHOD A single-subject experimental designed was used. Participants received semantic treatment to improve naming of English or Spanish items, while generalization was tested to untrained semantically related items in the trained language and translations of the trained and untrained items in the untrained language. RESULTS Results demonstrated a within- and across-languages effect on generalization related to premorbid language proficiencies. Participant 1 (P1; equal premorbid proficiency across languages) showed within-language generalization in the trained language (Spanish) as well as crosslinguistic generalization to the untrained language (English). Participant 2 (P2) and Participant (P3) were more proficient premorbidly in English. With treatment in English, P2 showed within-language generalization to semantically related items, but no crosslinguistic generalization. With treatment in Spanish, both P2 and P3 exhibited no within-language generalization, but crosslinguistic generalization to English (dominant language) occurred. Error analyses indicated an evolution of errors as a consequence of treatment. CONCLUSIONS These results are preliminary because all participants were not treated in both languages. However, the results suggest that training the less dominant language may be more beneficial in facilitating crosslinguistic generalization than training the more proficient language in an unbalanced bilingual individual.

The Effect of Computerized Verb Network Strengthening Treatment on Lexical Retrieval in Aphasia

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. Aims: This study investigates changes to lexical retrieval with four hierarchical outcome measures. The research questions were: Does treatment using Computerised VNeST (VNeST-C) result in pre- to post-treatment increases in: (1) spoken and typed lexical retrieval of trained (e.g., The farmer is weighing the apples.) and untrained words (e.g., The carpenter is measuring the lumber.) in a picture description task, (2) untreated single-word naming accuracy of nouns and verbs in spoken and typed modalities, (3) spoken and typed lexical retrieval as measured by informative words, efficiency of production and complete utterances within discourse, and (4) standardised measures of cognitive and language abilities? Methods & Procedures: Two people with aphasia were treated three times per week for 8 weeks using the VNeST-C program. A single-subject experimental design was used to evaluate changes in trained and untrained stimuli and tasks. Additional pre-treatment and post-treatment testing was also conducted. Outcomes & Results: Results indicate improvements on lexical retrieval during sentence production of trained and untrained stimuli. Additional improvement was observed for single-word naming of untrained nouns and verbs in spoken and typed modalities and standardised measures of aphasia and writing-by-hand. Limited generalisation to discourse was also observed, including a general increase in word output and decrease in typed neologisms. Conclusions: The results of this study suggest that the VNeST-C program and protocol have promise as a broadly generalising treatment for people with aphasia. With refinement of duration and intensity of the protocol, it may be a viable option for treating aphasia.

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

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.

Online priming of agent and patient thematic roles and related verbs in younger and older adults

Background: Online priming studies have found that verbs (e.g., arrest) provide immediate access to typical agents (e.g., policeman) and patients (e.g., criminal) by generating expectancies from a verb to its related thematic roles and vice versa. These findings have contributed significantly to theories of thematic roles. However, these investigations and theoretical implications have been limited to young adults. Investigating verb–thematic role processing in older adults is important for understanding the semantic system in normal ageing, which aids in assessment, characterisation, and treatment of disorders that affect semantic processing in older adults. Aims: The current study investigates verb–thematic role priming in young adults and extends the investigation to older adults. It was predicted that both groups would show priming effects but that the older adult group would have slower reaction times overall. Methods & Procedures: Using a lexical decision task with a short stimulus onset asynchrony (250 ms), the current study investigated bidirectional agent–verb and patient–verb priming of younger and older adults. Outcomes & Results: Consistent with our predictions, the younger participants exhibited bidirectional priming for agent–verb pairs and patient–verb pairs in the participant and item analyses. The older adults also showed priming for patient–verb pairs, but unexpectedly they did not exhibit priming for agent–verb pairs. Reaction times for the older participants were slower than the reaction times for the younger participants in all conditions. Conclusions: Neither participant nor methodological factors readily explain the unexpected results. Theoretical explanations for the findings are explored.

Effect of training Japanese L1 speakers in the production of American English /r/ using spectrographic visual feedback

The present study examines the effects of training native Japanese speakers in the production of American /r/ using spectrographic visual feedback. Within a modified single-subject design, two native Japanese participants produced single words containing /r/ in a variety of positions while viewing live spectrographic feedback with the aim of producing /r/ with a third formant (F3) frequency of less than 2300 Hz (upper threshold for identifiable /r/). Feedback was gradually reduced to promote independent production and monitoring. Both participants showed improvement in /r/ production in trained and untrained single words as indicated by percentage increases and effect sizes. Blind ratings by independent experts indicated significant /r/ production improvements during the reading of the Rainbow Passage. Perceptual distinction of /r/ and /l/ in minimal pairs also showed an upward trend. These findings suggest that spectrographic visual feedback is a promising method for training /r/ to Japanese-speaking English language learners.

Activating Situation Schemas: The Effects of Multiple Thematic Roles on Related Verbs in a Continuous Priming Paradigm

Extensive evidence has shown that presentation of a word (target) following a related word (prime) results in faster reaction times compared to unrelated words. Two primes preceding a target have been used to examine the effects of multiple influences on a target. Several studies have observed greater, or additive, priming effects of multiple related primes compared to single related primes. The present study aims to eliminate attentional factors that may have contributed to findings in previous studies that used explicitly presented primes and targets. Thus, a continuous priming paradigm where targets are unknown to participants is used with noun-noun-verb triads filling agent, patient, and action roles in situation schemas (tourist, car, rent). Results replicate priming of single nouns preceding related verbs but do not suggest an additive effect for two nouns versus one. The absence of additive priming suggests that attentional processes may have been a factor in previous research.

Attentive Reading and Constrained Summarisation (ARCS) discourse treatment for chronic Wernicke’s aphasia

Background: Emerging evidence suggests that discourse-level treatments can improve microlinguistic processes such as lexical retrieval. Attentive Reading and Constrained Summarisation (ARCS) is a cognitive-linguistic discourse treatment that focuses attention on reading aloud and orally summarising text while constraining from non-specific language use. Aims: The primary aim of the current study was to evaluate the effect of ARCS on improving lexical retrieval abilities in two participants with Wernicke’s aphasia. Methods & Procedures: Two women with chronic moderate and severe Wernicke’s aphasia were administered ARCS for this case study. The study design was comprised of pre-treatment testing followed by 18 times of 50-minute sessions of ARCS therapy over 10 weeks and post-treatment testing immediately after and 2 months after the completion of treatment. Treatment stimuli included abridged versions of news articles. Primary outcome measures of lexical retrieval were the Boston Naming Test 2nd edition and informativeness of words during picture description and untreated article retell tasks. Outcomes & Results: The participant with moderate Wernicke’s aphasia improved on all three primary outcome measures, and she reported that the treatment made a functional impact on her life. In contrast, the participant with severe Wernicke’s aphasia did not improve on any of the outcome measures. Individual differences between the participants likely account for the discrepancy in treatment outcomes. Conclusions: ARCS demonstrates potential as a therapy for improving lexical retrieval in discourse with the possibility of generalisation to confrontation naming in persons with moderate Wernicke’s aphasia.

Research applications for An Object and Action Naming Battery to assess naming skills in adult Spanish–English bilingual speakers

Virtually no valid materials are available to evaluate confrontation naming in Spanish–English bilingual adults in the U.S. In a recent study, a large group of young Spanish–English bilingual adults were evaluated on An Object and Action Naming Battery (Edmonds & Donovan in Journal of Speech, Language, and Hearing Research 55:359–381, 2012). Rasch analyses of the responses resulted in evidence for the content and construct validity of the retained items. However, the scope of that study did not allow for extensive examination of individual item characteristics, group analyses of participants, or the provision of testing and scoring materials or raw data, thereby limiting the ability of researchers to administer the test to Spanish–English bilinguals and to score the items with confidence. In this study, we present the in-depth information described above on the basis of further analyses, including (1) online searchable spreadsheets with extensive empirical (e.g., accuracy and name agreeability) and psycholinguistic item statistics; (2) answer sheets and instructions for scoring and interpreting the responses to the Rasch items; (3) tables of alternative correct responses for English and Spanish; (4) ability strata determined for all naming conditions (English and Spanish nouns and verbs); and (5) comparisons of accuracy across proficiency groups (i.e., Spanish dominant, English dominant, and balanced). These data indicate that the Rasch items from An Object and Action Naming Battery are valid and sensitive for the evaluation of naming in young Spanish–English bilingual adults. Additional information based on participant responses for all of the items on the battery can provide researchers with valuable information to aid in stimulus development and response interpretation for experimental studies in this population.