Rosalea M. Cameron

Retrieval of action names in aphasia: Effects of two cueing treatments

Background: The treatment of word-retrieval deficits in aphasia has most frequently focused on the retrieval of object names. The retrieval of action names has received relatively little attention in terms of rehabilitation despite the important role played by verbs in communication. Treatments that have been successful in promoting improved object name retrieval cannot be assumed to also facilitate improved action name retrieval. Aims: The purpose of this investigation was to examine the effects of two cueing treatments on the retrieval of action names with speakers with chronic aphasia. Methods & Procedures: The effects of two cueing treatments, Phonological Cueing Treatment (PCT) and Semantic Cueing Treatment (SCT), were examined with five speakers with aphasia. Treatment effects on action naming were measured using single subject, multiple baseline, and alternating treatments designs. Outcomes & Results: Results varied across participants. For two speakers, both treatments produced strong positive increases in naming, with effects being similar across treatments. For two other speakers, modest increases in correct naming were observed and for the remaining speaker, no increases were found. Conclusions: These findings indicate that PCT and SCT may have utility in facilitating action naming for some speakers with aphasia, but that the effects may vary across speakers.

Effects of a combined semantic/phonologic cueing treatment on word retrieval in discourse

Background: The application of word‐finding treatments for aphasia, as well as the study of their effects, has typically centred on retrieval of single lexical items (Nickels, 2002b). Little is known about the effects of word‐finding treatments on lexical retrieval in discourse tasks. This research was supported by Rehabilitation Research and Development, Department of Veterans Affairs. Thanks are extended to Michelene Kalinyak‐Fliszar for her assistance with this project. Aims: The purpose of this investigation was to study the effects of a combined semantic/phonologic cueing treatment on trained and untrained single words produced in the context of story retells. Generalisation to additional connected speech tasks was also assessed. Methods & Procedures: A well‐studied story retell procedure (Doyle et al., 2000) was used to guide selection of items for treatment and for measurement of treatment effects. A semantic/phonologic cueing hierarchy was applied to information units (IUs) that were consistently absent from the story retells produced by five participants with aphasia. Treatment effects on retrieval of targeted IUs and overall IUs were measured using single‐subject multiple‐baseline designs. Analyses of efficiency and informativeness of additional discourse tasks were performed prior to and following intervention. Outcomes & Results: Four of five participants demonstrated improved retrieval of targeted IUs and negligible generalisation to production of overall IUs for both treated story forms. The remaining participant exhibited minimal improvements in production of both targeted and untrained IUs for both applications of treatment, but was the only individual who increased informativeness of discourse on a post‐treatment measure of connected speech. Conclusions: Findings indicated that a combined semantic/phonologic cueing treatment may be effective for increasing production of targeted words at a discourse level for some individuals with aphasia, but the effects may vary across speakers.

Individual variability on discourse measures over repeated sampling times in persons with aphasia

Background: Although persons with aphasia typically have difficulty with the production of language at the level of discourse, there is a paucity of reliable measurement systems to quantify the characteristics of spoken language. Nicholas and Brookshire (1993) developed one of the few standardised, rule-based systems to quantify the informativeness of spoken language samples. While the authors reported temporal stability for all measures, they also noted variability at the individual level. Because individual data were not reported, it is difficult to determine the nature and extent of that variability. Aims: The aim of the current investigation was to further explore Nicholas and Brookshires (1993) quantitative linguistic analyses, and to examine individual variability over time in persons with aphasia. Methods & Procedures: Five fluent and six nonfluent persons with aphasia produced language samples over repeated sampling times in response to the 10 stimulus items used by Nicholas and Brookshire (1993). Measurements of mean number of words, mean correct information units (CIUs), percent CIUs, words per minute, and CIUs per minute were calculated, and results from the sessions were compared. To examine factors related to individual variability, correlations between linguistic measures, months post onset of aphasia, and scores on standardised assessment tools were explored. Outcomes & Results: Visual inspection of the data and descriptive statistics suggested that participants were more variable in their repeated productions than previously described by Nicholas and Brookshire (1993). Repeated measures ANOVAs revealed non-significant effects at the group level. There was no pattern of variability uniquely associated with aphasia fluency type. Range of mean number of CIUs was positively and significantly correlated with all test measures; however, the other range correlations were non-significant. Conclusions: The current results suggest greater variability over repeated sampling times in the spoken language of persons with aphasia than previously reported by Nicholas and Brookshire (1993). Clinicians and researchers should consider this variability, and establish stable baselines prior to the initiation of treatment to document meaningful change over time.

Variability in apraxia of speech: Perceptual analysis of monosyllabic word productions across repeated sampling times

Background: Variability in speech sound errors has been regarded as a primary characteristic of apraxia of speech (AOS). Early research deemed errors extremely unpredictable, resulting in a number of different error types on repeated productions of the same stimuli. However, recent research has suggested that errors may not be variable, but there are limited data regarding variability over time (i.e., beyond a single sampling occasion). Furthermore, the influence of conditions of stimulus presentation (i.e., blocked vs random) on sound errors remains unclear. Aims: The purpose of this investigation was to examine variability of sound errors in 11 individuals with AOS and aphasia. Of particular interest were the effects of repeated sampling and method of speech elicitation on the variability of error types as evaluated with narrow phonetic transcription. Methods & Procedures: A total of 28 monosyllabic words served as experimental stimuli. There were four exemplars for each of the seven initial target phonemes (i.e., /h, f, m, d, s, r, n/). Stimuli were elicited on three sampling occasions over a 7-day period with each sampling occasion separated by 2 days. At each sampling time productions were elicited under two conditions: blocked presentation (blocked by sound) and randomised presentation. Speech productions were analysed perceptually utilising narrow phonetic transcription. Outcomes & Results: Findings revealed a similar overall mean percentage of errors for the group in both conditions of stimulus presentation across the three sampling times. The target phoneme with the least number of errors was /h/. The target phoneme with the greatest number of errors was /s/. The predominant error type across target phonemes was distortions. However, the predominant error type varied across target phonemes and appeared to be influenced by number of errors. Conclusions: Repeated sampling or method of speech elicitation did not influence errors, with a similar overall mean percentage of errors for the group in both conditions of stimulus presentation across the three sampling times. Distortions were found to be the predominant error type for the majority of target sounds. A comparison of the number of error types produced by the group in each condition across the three sampling times found no obvious pattern of responding by the group in either condition for individual phonemes. That is, condition of elicitation did not appear to influence the variability of error type for any given sound.

Effects of age, gender, and education on semantic fluency for living and artifact categories

Background: Evidence exists that many individuals with neurological damage exhibit a “category effect”, typically naming more artifact than living items. However, there is a paucity of research exploring the existence of a category effect with neurologically intact individuals. The investigations performed to date have focused on a limited number of categories, and most authors have not controlled for possible age, gender, and/or education‐related effects among groups. Aims: The purpose of this study was to explore the effects of age, gender, and education on semantic fluency for four living and four artifact categories. Methods & Procedures: A total of 60 individuals recruited from four groups participated in the study: younger males, younger females, older males, and older females. Each group of 15 individuals was matched for years of education. Participants were asked to name as many items as possible in four living categories: birds, four‐footed animals, fruits, and vegetables as well as four artifact categories: tools, kitchen utensils, furniture, and clothing. Outcomes & Results: There was no significant difference between living and artifact domains. With regard to specific categories, females named significantly more fruit and furniture items, while males named more tools. Younger females with fewer than 16 years of education named the most fruits, and participants with at least 16 years of education had an advantage for clothing. Older males and younger females named more four‐footed animals than did their gender‐matched peers. Conclusions: In contrast to previous reports, this investigation failed to identify naming differences between living and artifact domains, which might partly be related to dissimilar task demands (i.e., semantic fluency versus confrontation naming). However, several gender‐based differences observed for specific categories were consistent with previous research. Moreover, the use of a broader range of categories exposed additional differences in naming performance.