Sonia Routhier

Treatment of verb anomia in aphasia: efficacy of self-administered therapy using a smart tablet

Aphasia is a chronic condition that usually requires long-term rehabilitation. However, even if many effective treatments can be offered to patients and families, speech therapy services for individuals with aphasia often remain limited because of logistical and financial considerations, especially more than 6 months after stroke. Therefore, the need to develop tools to maximize rehabilitation potential is unquestionable. The aim of this study was to test the efficacy of a self-administered treatment delivered with a smart tablet to improve written verb naming skills in CP, a 63-year-old woman with chronic aphasia. An ABA multiple baseline design was used to compare CP’s performance in verb naming on three equivalent lists of stimuli trained with a hierarchy of cues, trained with no cues, and not trained. Results suggest that graphemic cueing therapy, done four times a week for 3 weeks, led to better written verb naming compared to baseline and to the untrained list. Moreover, generalization of the effects of treatment was observed in verb production, assessed with a noun-to-verb production task. Results of this study suggest that self-administered training with a smart tablet is effective in improving naming skills in chronic aphasia. Future studies are needed to confirm the effectiveness of new technologies in self-administered treatment of acquired language deficits.

Smart tablet for smart self-administered treatment of verb anomia: two single-case studies in aphasia

Background: Studies of verb anomia therapy in poststroke aphasia are rare, even though verbs are central to speech. In the great majority of studies, a traditional face-to-face setting with phonological, semantic, and/or sensorimotor cues is used to enhance lexical access. Technology-based therapy is expanding rapidly and has the potential to help individuals with aphasia improve verb retrieval abilities. Aims: This study aimed to assess the treatment outcome of and satisfaction with a therapy for verb anomia in chronic poststroke aphasia using a tablet for self-administered treatment at home. Methods & Procedures: Single-case studies were conducted with two participants who presented with chronic poststroke verb anomia. The following four phases were completed: (1) baseline measures; (2) training on the use of the tablet; (3) self-administered therapy with the tablet; and (4) follow-up, generalisation, and rating of the therapy measures. Twenty self-administered sessions were completed. Outcomes & Results: A significant improvement in verb naming was observed for the two participants following therapy. No generalisation was found for untreated verbs or for treated verbs in a novel task. Both participants were very satisfied with the self-administered treatment using a tablet. Conclusions: The use of tablet-based therapy to improve verb naming could be an interesting way to enhance rehabilitation of acquired language deficits. New technologies are promising and further studies are needed to demonstrate their usefulness and determine the pros and cons of using them in clinical settings.

Improving verb anomia in the semantic variant of primary progressive aphasia: the effectiveness of a semantic-phonological cueing treatment

The semantic variant of primary progressive aphasia (svPPA) is known to affect the comprehension and production of all content words, including verbs. However, studies of the treatment of anomia in this disorder focused on relearning object names only. This study reports treatment of verb anomia in an individual with svPPA. The semantic-phonological cueing therapy resulted in significant improvement in naming abilities, for treated verbs only. This case study demonstrates that improvement in verb-naming abilities may be possible in svPPA. The almost complete maintenance of the treatment’s effects in the patient 4 weeks after the end of the therapy also suggests improvements may be durable, at least in the short term, for some individuals with svPPA.

The contrast between cueing and/or observation in therapy for verb retrieval in post-stroke aphasia.

BACKGROUND Studies measuring treatment efficacy for post-stroke verb anomia are scarce. These studies mainly assessed the efficacy of three strategies: semantic, phonological and sensorimotor. Following these previous treatments, the performance of most participants improved on treated verbs, while improvement on untreated stimuli and tasks was inconsistent. AIMS This study aimed to measure the effectiveness of a semantic-phonological strategy and a sensorimotor strategy for verb anomia in post-stroke aphasia. METHODS A multiple baseline single-subject experimental study was conducted with two participants (9-37 years post-stroke). Four phases were completed: (1) background assessment, (2) baselines, (3) therapy, and (4) follow-up. Three equivalent lists of verbs were created for each participant and two of them were trained with a different strategy: action observation+semantic-phonological cues, action observation alone. The stimuli of the third list (control list) were not treated. RESULTS The semantic-phonological cueing strategy led to a significant improvement. No improvement was observed after action observation. No generalization to untreated verbs was found. CONCLUSIONS Verb naming can be enhanced by semantic/phonological cueing. In addition, other studies (clinical, neuroimaging, etc.) are needed to document the effect of action observation for the treatment of verb anomia. LEARNING OUTCOMES The reader will be able to (1) describe semantic-phonological therapies used in post-stroke verb anomia, (2) describe sensorimotor therapies used in post-stroke verb anomia, and (3) identify factors contributing to the efficacy of therapies to improve action naming in aphasia.

Non-pharmacological therapies for language deficits in the agrammatic and logopenic variants of primary progressive aphasia: a literature review

Primary progressive aphasia is a neurodegenerative condition characterised by a progressive and isolated disorder of expressive language, associated with atrophy of the left posterior frontoinsular region (nonfluent/agrammatic variant) or with atrophy of the left temporoparietal junction area (logopenic variant). This literature review reports studies about language therapies for these two variants of primary progressive aphasia. More precisely, the review presents the behavioral interventions and the augmentative/alternative communication tools reported in the literature to improve language performances or to compensate for language difficulties. Most of these studies reported that interventions are efficient. However, inconsistent results are found regarding maintenance of improvement and generalization to untreated language abilities. Other studies are still required to establish the clinical relevance of interventions for language and communication disorders in primary progressive aphasia. In these studies, the use of more ecological interventions focusing on the specific needs of people living with this disease should be specifically addressed.

Non-pharmacological therapies of language deficits in semantic dementia

Semantic dementia (SD) is a neurodegenerative condition characterised by a progressive disorder of semantic processing, word comprehension and anomia. This literature review reports behavioural studies about language therapies for SD. More precisely, the review presents the cognitive, participative and alternative/augmentative interventions reported in the literature to improve language performances or to compensate for language worsening associated with the disease. Most studies show that interventions are efficient. However, maintenance of improvement and generalization to untreated language abilities remain limited. Other studies are still required to establish the clinical relevance of interventions for language and communication disorders in semantic dementia. In these studies, the use of more ecological interventions focusing on the specific needs of people living with semantic dementia should be specifically addressed.

Maintenance and Generalization Effects of Semantic and Phonological Treatments of Anomia: A Case Study

Anomia is one of the most frequent manifestations in aphasia. Model-based treatments for anomia usually focus on semantic and/or phonological levels of processing. This study reports treatment of anomia in an individual with chronic aphasia. After baseline testing, she received a training program in which semantic and phonological treatments were contrasted. The semantic treatment resulted in generalization to closely semantically related untreated items. Moreover, this beneficial effect was highly durable and maintained at the immediate posttreatment level for at least 3 months. However, the positive response to the phonological treatment was limited to treated stimuli only. This case study demonstrates that improvement in word-finding abilities may be possible in chronic anomic aphasia, even after a relatively short period of therapy. It also underlines the importance of relying on theoretical models of language processing to adapt treatments to each specific deficit.

The specificity of notation codes in apraxic agraphia: dissociation between Arabic and alphabetical scripts in a patient with severe ideomotor and visuoconstructional apraxia.

This article describes the case of a patient with corticobasal syndrome, who showed severe ideomotor and visuoconstructional apraxia along with handwriting difficulties more marked for letters and words than for digits and numbers. For alphabetical script, these difficulties were less marked when graphic motor patterns were activated with a model, whilst for digits IVs graphic productions were better in dictation. Moreover, IVs graphic production was negatively influenced by graphomotor complexity for letters but not for numbers. IV is the first reported case of a patient with severe limb apraxia, who also showed peripheral agraphia, with dissociation in alphabetical and numerical notation codes resulting from a specific deficit in the activation of graphomotor programs.