Rebecca Hunting Pompon

Effects of Intensive Phonomotor Treatment on Reading in Eight Individuals With Aphasia and Phonological Alexia

PURPOSE The aim of this study was to investigate effects of a multimodal treatment of phonology, phonomotor treatment, on the reading abilities of persons with aphasia (PWA) with phonological alexia. METHOD In a retrospective, single-group design, this study presents pre-, post-, and 3-months posttreatment data for 8 PWA with phonological alexia. Participants completed 60 hr of phonomotor treatment over 6 weeks. Wilcoxon signed-ranks tests and group effect sizes comparing pre-, immediately post-, and 3-months posttreatment performance on tests of phonological processing and reading were performed. RESULTS Group data showed phonological processing and oral reading of real words and nonwords improved significantly posttreatment; these gains were maintained 3 months later. No group improvement was found for reading comprehension; however, one individual did show improvement immediately post- and 3-months posttreatment. CONCLUSIONS This study provides support that phonomotor treatment is a viable approach to improve phonological processing and oral reading for PWA with phonological alexia. The lack of improvement with comprehension is inconsistent with prior work using similar treatments (Conway et al., 1998; Kendall et al., 2003). However, this difference can, in part, be accounted for by differences in variables, such as treatment intensity and frequency, outcome measures, and alexia severity.

Intentional and Reactive Inhibition During Spoken-Word Stroop Task Performance in People With Aphasia

PURPOSE The integrity of selective attention in people with aphasia (PWA) is currently unknown. Selective attention is essential for everyday communication, and inhibition is an important part of selective attention. This study explored components of inhibition-both intentional and reactive inhibition-during spoken-word production in PWA and in controls who were neurologically healthy (HC). Intentional inhibition is the ability to suppress a response to interference, and reactive inhibition is the delayed reactivation of a previously suppressed item. METHOD Nineteen PWA and 20 age- and education-matched HC participated in a Stroop spoken-word production task. This task allowed the examination of intentional and reactive inhibition by evoking and comparing interference, facilitation, and negative priming effects in different contexts. RESULTS Although both groups demonstrated intentional inhibition, PWA demonstrated significantly more interference effects. PWA demonstrated no significant facilitation effects. HC demonstrated significant reverse facilitation effects. Neither group showed significant evidence of reactive inhibition, though both groups showed similar individual variability. CONCLUSIONS These results underscore the challenge interference presents for PWA during spoken-word production, indicating diminished intentional inhibition. Although reactive inhibition was not different between PWA and HC, PWA showed difficulty integrating and adapting to contextual information during language tasks.

An investigation of aphasic naming error evolution following phonomotor treatment

Background: Though treatments for anomia in aphasia typically use accuracy of trained and untrained targets to determine treatment efficacy, researchers have begun to employ error analyses in order to more closely delineate the mechanisms involved in anomia recovery. Aims: The aim of this study was to examine changes in naming errors of 24 individuals with aphasia after phonomotor treatment (14 new individuals and 10 individuals whose word retrieval error data were previously reported in a separate manuscript). Methods & Procedures: Twenty-four individuals with aphasia received phonomotor treatment. Confrontation naming was assessed pre-treatment, immediately post-treatment, and 3 months post-treatment. Responses were scored for accuracy and error type. Paired-samples t tests comparing pre-treatment versus immediately post-treatment and 3 months post-treatment accuracy and error-type proportions were conducted. Additionally, the role of language severity in error-type proportion shifts was examined through analyses of subgroups and correlational analyses between language measures and error-type change scores. Outcomes & Results: Trained and untrained naming accuracy improved significantly immediately post-treatment, and gains were maintained 3 months post-treatment. No significant changes in error-type proportions were noted; however, trends towards decreases in proportions of omissions were noted immediately post-treatment (trained items) and 3 months post-treatment (trained and untrained items). In a post hoc subgroup analysis, a significant decrease in the proportion of omissions on trained items was noted 3 months post-treatment for the subgroup of individuals with lower lexical retrieval ability. Conclusions: Results are indicative of a shift in linguistic processing in which the linguistic network was holistically altered as a result of phonomotor treatment.

Influence of Linguistic and Nonlinguistic Variables on Generalization and Maintenance Following Phonomotor Treatment for Aphasia

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.

Role of Psychosocial Factors on Communicative Participation among Survivors of Head and Neck Cancer

Objective The purpose of this study was to examine the unique contribution of psychosocial factors, including perceived social support, depression, and resilience to communicative participation, among adult survivors of head and neck cancer (HNC). Study Design Cross-sectional. Setting University-based laboratory and speech clinic. Subjects and Methods Adult survivors of HNC who were at least 2 years posttreatment for HNC completed patient-reported outcome measures, including those related to communicative participation and psychosocial function. Multiple linear regression analysis was conducted to predict communicative participation. Self-rated speech severity, cognitive function, laryngectomy status, and time since diagnosis were entered first as a block of variables (block 1), and psychosocial factors were entered second (block 2). Results Eighty-eight adults who were on average 12.2 years post–HNC diagnosis participated. The final regression model predicted 58.2% of the variance in communicative participation (full model R2 = 0.58, P < .001). Self-rated speech severity, cognitive function, laryngectomy status, and time since diagnosis together significantly predicted 46.1% of the variance in block 1. Perceived social support, depression, resilience, and interactions significantly and uniquely predicted 12.1% of the additional variance in block 2. Conclusion For clinicians, psychosocial factors such as perceived depression warrant consideration when counseling patients with HNC about communication outcomes and when designing future studies related to rehabilitation.

Effects of phonomotor treatment on discourse production

ABSTRACT Background: Aphasia is an acquired language disorder that makes it difficult for people to produce and comprehend language, with all people with aphasia (PWA) demonstrating difficulty accessing and selecting words (anomia). While aphasia treatments typically focus on a single aspect of language, such as word retrieval, the ultimate goal of aphasia therapy is to improve communication, which is best seen at the level of discourse. Aims: This retrospective study investigated the effects of one effective anomia therapy, Phonomotor Treatment (PMT), on discourse production. Methods & Procedures: Twenty-six PWA participated in 60 h of PMT, which focuses on building a person’s ability to recognize, produce, and manipulate phonemes in progressively longer nonword and real-word contexts. Language samples were collected prior to, immediately after, and 3 months after the treatment program. Percent Correct Information Units (CIUs) and CIUs per minute were calculated. Outcomes & Results: Overall, PWA showed significantly improved CIUs per minute, relative to baseline, immediately after treatment and 3 months later, as well as significantly improved percent CIUs, relative to baseline, 3 months following treatment. Conclusions: PMT, which focuses on phonological processing, can lead to widespread improvement throughout the language system, including to the functionally critical level of discourse production.