Blog Archives

Development of a Short Form of the Boston Naming Test for Individuals With Aphasia

Conclusions: The new short form demonstrates good psychometric properties when used with individuals with aphasia. However, the Mack et al. form proved to be as psychometrically sound as the BNT–Aphasia Short Form and is also appropriate for individuals with aphasia.

from the Journal of Speech, Language, and Hearing Research

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Extending the use of Spanish Computer-assisted Anomia Rehabilitation Program (CARP-2) in people with aphasia

Conclusions
The Spanish Computer-Assisted Rehabilitation Program (CARP-2) for anomia is an active treatment for a range of people who have anomia as part of their aphasia profile.

from the Journal of Communication Disorders

Semantic Feature Analysis Treatment for Aphasic Word Retrieval Impairments: What’s in a Name?

This article delineates differences among treatment paradigms that have been called semantic feature analysis treatment and reviews the outcomes of these treatment studies regarding improved naming of treated items, maintenance of treatment effects over time, and generalized improvement to untreated items. Differences in outcomes among the treatment paradigms highlight the importance of using different names for different treatment paradigms.

from Topics in Stroke Rehabilitation

How intensive does anomia therapy for people with aphasia need to be?

The intensity of aphasia therapy has been a key clinical question. The aim of this case-series study was to compare the outcome of intensive and non-intensive therapy in the relearning of words for people with aphasia. Eight participants took part in a study comparing the intensity of delivery of the therapy. Participants received two courses of the same therapy (each lasting 10 sessions) delivered either intensively or non-intensively. Therapy consisted of confrontation naming with progressive phonemic and orthographic cues. Post-therapy assessments were carried out immediately after the study and one month later. Performance was also monitored during each therapy session. Immediately post-therapy, both types of therapy had improved naming accuracy considerably and there was no significant difference between the two interventions. One month later, seven out of eight participants showed a small yet significant difference in naming accuracy, favouring non-intensive over intense therapy. There were no differences in the learning patterns during the therapy sessions between the intensive and non-intensive therapies. For the majority of people with aphasia post-stroke, both intense and non-intense therapy for anomia leads to improved naming performance. Retention at one-month post therapy is relatively superior after non-intensive therapy.

from Neuropsychological Rehabilitation

Predicting the outcome of anomia therapy for people with aphasia post CVA: Both language and cognitive status are key predictors

The aim of this study was to determine whether it was possible to predict therapy gain from participants’ performance on background tests of language and cognitive ability. To do this, we amalgamated the assessment and therapy results from 33 people with aphasia following cerebral vascular accident (CVA), all of whom had received the same anomia therapy (based on progressive phonemic and orthographic cueing). Previous studies with smaller numbers of participants had found a possible relationship between anomia therapy performance and some language and cognitive assessments. Because this study had access to a larger data set than previous studies, we were able to replicate the previous findings and also to verify two overarching factors which were predictive of therapy gain: a cognitive factor and a phonological factor. The status of these two domains was able to predict both immediate and longer-term therapy gain. Pre-treatment naming ability also predicted gain after the anomia therapy. When combined, both cognitive and language (naming or phonological) skills were found to be independent predictors of therapy outcome.

from Neuropsychological Rehabilitation

Model-oriented naming therapy in semantic dementia: A single-case fMRI study

Conclusions: Cueing hierarchies were successful, resulting in specific and immediate treatment effects, corroborating previous treatment studies in semantic dementia. Treatment-induced changes in cortical activity were mainly concentrated in right temporal cortex. Since right-sided modulation of cortical activity was associated with training-induced improvements in task performance, it may reflect right hemispheric compensatory mechanisms in this participant.

from Aphasiology

Model-oriented naming therapy in semantic dementia: A single-case fMRI study

Conclusions: Cueing hierarchies were successful, resulting in specific and immediate treatment effects, corroborating previous treatment studies in semantic dementia. Treatment-induced changes in cortical activity were mainly concentrated in right temporal cortex. Since right-sided modulation of cortical activity was associated with training-induced improvements in task performance, it may reflect right hemispheric compensatory mechanisms in this participant.

from Aphasiology

Improving language without words: first evidence from aphasia

In support of a multimodal representation of action, these findings univocally demonstrate that gestures interact with the speech production system, inducing long-lasting modification at the lexical level in patients with cerebral damage.

from Neuropsychologia

Phonological and orthographic cueing therapy: A case of generalised improvement

Conclusions: These findings demonstrate that a combined phonological and orthographic cueing therapy targeting word retrieval can have lasting benefits, not just on targeted items but also on untreated words, connected speech, and the views of the person with aphasia. Furthermore, such improvements can be achieved within a prevalent service delivery model.

from Aphasiology

Neural changes after phonological treatment for anomia: An fMRI study

Functional magnetic resonance imaging (fMRI) was used to investigate the neural processing characteristics associated with word retrieval abilities after a phonologically-based treatment for anomia in two stroke patients with aphasia. Neural activity associated with a phonological and a semantic task was compared before and after treatment with fMRI. In addition to the two patients who received treatment, two patients with aphasia who did not receive treatment and 10 healthy controls were also scanned twice. In the two patients who received treatment, both of whose naming improved after treatment, results showed that activation patterns changed after treatment on the semantic task in areas that would have been expected (e.g., left hemisphere frontal and temporal areas). For one control patient, there were no significant changes in brain activation at the second scan; a second control patient showed changes in brain activation at the second scan, on the semantic task, however, these changes were not accompanied with improved performance in naming. In addition, there appeared to be bilateral, or even more right than left hemisphere brain areas activated in this patient than in the treated patients. The healthy control group showed no changes in activation at the second scan. These findings are discussed with reference to the literature on the neural underpinnings of recovery after treatment for anomia in aphasia.

from Brain and Language

How many words should we provide in anomia therapy? A meta-analysis and a case series study

Conclusions: The empicial study suggested that people with anomia could tolerate more items in therapy and that the severity of anomia should not necessarily determine how many words should be given in therapy.

from Aphasiology

Predicting the outcome of anomia therapy for people with aphasia post CVA: Both language and cognitive status are key predictors

The aim of this study was to determine whether it was possible to predict therapy gain from participants’ performance on background tests of language and cognitive ability. To do this, we amalgamated the assessment and therapy results from 33 people with aphasia following cerebral vascular accident (CVA), all of whom had received the same anomia therapy (based on progressive phonemic and orthographic cueing). Previous studies with smaller numbers of participants had found a possible relationship between anomia therapy performance and some language and cognitive assessments. Because this study had access to a larger data set than previous studies, we were able to replicate the previous findings and also to verify two overarching factors which were predictive of therapy gain: a cognitive factor and a phonological factor. The status of these two domains was able to predict both immediate and longer-term therapy gain. Pre-treatment naming ability also predicted gain after the anomia therapy. When combined, both cognitive and language (naming or phonological) skills were found to be independent predictors of therapy outcome.

from Neuropsychological Rehabilitation

Negative optic aphasia: How much semantics does a name need? Wolff ‘s re-examination of Voit

Background: A prominent model of semantic processing in modern cognitive psychology proposes that semantic memory originates in everyday life experience with concrete objects such as plants, animals, and tools (Martin & Chao, 2001). When the meaning of a concrete content word is being acquired, the learner is confronted with stimuli of various modalities related to the word’s meaning. This comes to be stored as sensory knowledge about the object. It is further postulated that there is a conceptual domain remote from the mechanisms of perception, which is often referred to as functional knowledge or verbal semantics. There is a large body of neuropsychological literature trying to establish how much sensory and functional semantics is needed to access a name, and whether the relative contribution of these types of knowledge is the same for all categories of objects. Another controversial issue is whether naming requires access to semantic knowledge, or whether object names can be accessed directly from vision without the intervention of semantics, as is generally accepted for written word naming. Some support for this assumption seems to come from cases of so-called non-optic aphasia, a condition in which patients can name from visual presentation only but not from any other modality of presentation such as auditory, verbal, tactile, etc. In optic aphasia, a condition far better established, naming is possible from all modalities except vision.

Aims: The aim of this paper is to draw attention to the first case description of non-optic or negative optic aphasia described by Wolff (1897, 1904).

Methods & Procedures: The case describes the results of a re-examination of Voit, who was seen by several neurologists in the course of a decade in classical aphasiology. The patient demonstrated anomia in oral but not in written naming of objects in view. Wolff’s examination involves extensive testing of semantic processing in several modalities, especially with respect to the status of functional and sensory semantic features

Outcomes & Results: The re-examination of patient Voit by Wolff in 1897 with new procedures revealed a specific impairment in processing sensory knowledge, while functional knowledge of objects was relatively preserved. This led to a naming impairment in all modalities of presentation except the visual one. Using more refined tasks, Wolff also demonstrated receptive impairments, in contrast to previous researchers who had concluded that the impairment was restricted to oral production.

Conclusions: Although Wolff’s (1904) case of negative optic aphasia has been almost completely forgotten (but see Bartels & Wallesch, 1996), it is astonishingly modern in its conceptual approach and in the central questions it addresses on the mechanisms involved in the process of naming and on the structure of the semantic system. As is usual in classical cases, the methodology may appear less stringent than in most contemporary work, but the approach was brilliant.

from Aphasiology

A meta-analysis of word-finding treatments for aphasia

Background: The research literature on treatment methods for word-finding deficits in aphasia is extensive. A meta-analysis of studies for word-finding therapy was conducted in order to objectively synthesise this information to answer large-scale questions of treatment efficacy.

Aims: The purpose of this study was to examine the efficacy of various treatment approaches for word-finding deficits for individuals with aphasia. This analysis also examined gains made to trained and untrained words, the level of maintenance after therapy, and the effect of the time post-onset of aphasia on the recovery of language function.

Methods & Procedures: Various search methods were used to gather anomia treatment studies for this analysis. From 44 studies, 107 effect sizes were calculated for the final analysis. These data were sorted according to the following moderator variables: treatment category (semantic, phonological, or mixed), word set (trained, exposed-related, exposed-unrelated, unexposed-unrelated, and unexposed-related), follow-up measures, and median number of months post-onset.

Outcomes & Results: All therapy approaches showed evidence of efficacy, although the variance between studies was large. Strong gains were seen for trained and exposed words, but only minor gains for unexposed words. Large effects were seen for up to 2 months post-therapy, with lingering effects at 3 months post-therapy. Treatment appeared efficacious even for individuals that were years post-onset.

Conclusions: An objective synthesis of the literature shows that intervention for word-finding deficits is efficacious. However, the level of gains varied widely across studies and therapy approaches. As expected, little generalisation was found for untrained-unexposed words.

from Aphasiology

The effects of decreasing and increasing cue therapy on improving naming speed and accuracy for verbs and nouns in aphasia

Conclusions: Decreasing cues are as effective in naming therapy as increasing cues, in terms of both accuracy and speed of naming for verbs and nouns.

from Aphasiology