Effects of language proficiency and language of the environment on aphasia therapy in a multilingual
We examined the relative proficiency of four languages (Spanish, German, French, English) of a multilingual speaker with aphasia, JM. JM’s self-rated proficiency was consistent with his naming accuracy for nouns and verbs (The Object and Action Naming Battery, Druks & Masterson, 2000) and with his performance on selected subtests of the Bilingual Aphasia Test (Paradis & Libben, 1987). Within and between-language changes were measured following two periods of language treatment, one in a highly proficient language (Spanish) and one in a less-proficient language (English). The various outcome measures differed in their sensitivity to treatment-associated changes. Cross-language treatment effects were linked to the language of the environment at the time of testing and to relative language proficiency.
from the Journal of Neurolinguistics
Communication problems experienced following a brain injury or stroke not only impact a person’s ability to participate in their desired social and vocational roles but may also impact their ability to participate in decision-making about their care, participate in therapy and receive counseling and education. Many technologies exist, including Augmentative and Alternative Communication (AAC), which can help increase communication and life participation following a brain injury or stroke. This article will define and describe a variety of AAC technologies and interventions for people with communication problems following acquired brain injury as well as discuss assessment, training and funding issues.
Conclusions: As predicted, the participants did not show the same extent of improvement that was observed in participants with more moderate aphasia (Edmonds, Nadeu, & Kiran, 2009). Nonetheless, the findings suggest that VNeST may be appropriate for persons with moderate-to-severe aphasia, especially with a small adaptation to the treatment protocol that will be retained for future iterations of VNeST.
The use of mindfulness training for increasing psychological well-being in a variety of clinical and nonclinical populations has exploded over the last decade. In the area of stuttering, it has been widely recognized that effective long term management often necessitates treatment of cognitive and affective dimensions of the disorder in addition to behavioral components. Yet, mindfulness based strategies and their possible usefulness in stuttering management have not been described in detail in the literature. This article seeks to engage professionals who treat stuttering in a conversation about the possible usefulness of incorporating mindfulness training into stuttering management. A review of the literature reveals that there is a substantial overlap between what is required for effective stuttering management and the benefits provided by mindfulness practices. Mindfulness practice results in decreased avoidance, increased emotional regulation, and acceptance in addition to improved sensory-perceptual processing and attentional regulation skills. These skills are important for successful long term stuttering management on both psychosocial and sensory-motor levels. It is concluded that the integration of mindfulness training and stuttering treatment appears practical and worthy of exploration. Mindfulness strategies adapted for people who stutter may help in the management of cognitive, affective, and behavioral challenges associated with stuttering.
C-Speak Aphasia alternative communication program for people with severe aphasia: Importance of executive functioning and semantic knowledge
Learning how to use a computer-based communication system can be challenging for people with severe aphasia even if the system is not word-based. This study explored cognitive and linguistic factors relative to how they affected individual patients’ ability to communicate expressively using C-Speak Aphasia (CSA), an alternative communication computer program that is primarily picture-based. Ten individuals with severe non-fluent aphasia received at least six months of training with CSA. To assess carryover of training, untrained functional communication tasks (i.e., answering autobiographical questions, describing pictures, making telephone calls, describing a short video, and two writing tasks) were repeatedly probed in two conditions: (1) using CSA in addition to natural forms of communication, and (2) using only natural forms of communication, e.g., speaking, writing, gesturing, drawing. Four of the 10 participants communicated more information on selected probe tasks using CSA than they did without the computer. Response to treatment was also examined in relation to baseline measures of non-linguistic executive function skills, pictorial semantic abilities, and auditory comprehension. Only nonlinguistic executive function skills were significantly correlated with treatment response.
Conclusions: The success (or not) of returning to work with aphasia is multi-faceted and does not rest solely with the person with aphasia. The nature of the work may have a strong bearing on success, as will the ability and willingness of the employer to engage in the process. Partnership with the person and constant review of goals and management is of overwhelming importance. We need to consider what “success” may mean in this context and the need to consider therapeutic and rehabilitation needs over a longer time frame.
The effect of a psycho-educational program on CARS scores and short sensory profile in autistic children
Individually tailored psycho-educational therapy had a significant effect on autism severity according to CARS. Changes in the SSP scores were not significant.
This study examines the reasons for the success of Multiple Oral Re-reading (MOR; Moyer, 1979), a non-invasive, easily administered alexia treatment that has been reported in the literature and is currently in clinical use. The treatment consists of reading text passages aloud multiple times a day. Findings that MOR improves reading speed on practised as well as novel text have been inconsistent, making MOR’s role in the rehabilitation of alexia unclear. We hypothesised that MOR’s treatment mechanism works through repetition of high frequency words (i.e., bottom-up processing). We designed and controlled our text passages to test the hypothesis that participants would not improve on all novel text but would improve on text that includes a critical mass of the words contained in the passages they were re-reading. We further hypothesised that the improvement would be at the level of their specific alexic deficit. We tested four participants with phonological alexia and two with pure alexia during 8 weeks of MOR treatment. Contrary to the conclusions of previous studies, our results indicate that improvements in top-down processing cannot explain generalisation in MOR and that much of the improvement in reading is through repetition of the practised words. However, most patients also showed improvement when specific phrases were re-used in novel passages, indicating that practice of difficult words in context may be crucial to reading improvement.
Speech understanding in noise with an eyeglass hearing aid: Asymmetric fitting and the head shadow benefit of anterior microphones
Conclusions: By integrating microphones in an eyeglass frame, a long array can be used resulting in a higher directionality index and improved speech understanding in noise. An asymmetric fit did not significantly reduce performance and can be considered to increase acceptance and environmental awareness. Directional microphones at the temple seemed to profit more from the head shadow than above the pinna, better suppressing noise from behind the listener.
from the International Journal of Audiology
Conclusion: Findings support the efficacy of this approach for improving production of lexical stress contrasts. Structuring the intervention according to the PML approach likely stimulated strong maintenance and generalization effects.
At the time one in 13 primary care patients had dysphonia resulting in significant functional impairment with reduced voice-specific QOL and greater depression scores. Risk factors for dysphonia and voice-specific QOL impairment were identified and might be useful for identifying patients at risk for dysphonia. Barriers exist that prevent dysphonic patients from receiving evaluation and treatment. Whether improved methods of dysphonia screening leads to better outcomes and reduced societal impact needs investigation.
from The Laryngoscope
A discourse-based approach to semantic feature analysis for the treatment of aphasic word retrieval failures
Conclusions: The changes effected by this discourse-based approach to SFA were as robust and as consistent as has been achieved previously with SFA treatment. The choice to use a discourse-based versus a picture-based approach to SFA treatment might be based on the ecological validity of the discourse-based approach.
Augmented kinematic feedback provided by an EMA system improved production for some, but not all, treated targets. Generalisation to untreated probes was also evident. Predictions concerning the effects of feedback frequency on the acquisition, maintenance, and transfer of trained behaviours were not supported.
Client Perceptions of Effective and Ineffective Therapeutic Alliances during Treatment for Stuttering
The treatment components that contribute to and account for successful therapeutic, outcomes for people who stutter are not well understood and are debated by many. The purpose of, this phenomenological study was to describe in detail the underlying factors that contribute to a, successful or unsuccessful therapeutic interaction between clients and their clinicians. 28 participants, 19 men and 9 women, who had received from 6 months to more than 12 years of therapy for stuttering, were studied. The participants were asked to consider their experience with one or more speechlanguage, pathologists with whom they had received fluency therapy and to describe the characteristics, that made that individual effective or ineffective in promoting successful change in their ability to, communicate. Analysis of these data resulted in 15 primary categories. Finally, the essential structure, of an effective and ineffective therapeutic interaction were described. Results highlighted the, importance for effective therapy of understanding the stuttering experience, forming a positive clientclinician, alliance, and being knowledgeable about stuttering and its treatment.,