Medicine and Health Sciences Commons^™

Benefit Of Visual Speech Information For Word Comprehension In Post-Stroke Aphasia, Anna Krason, Gabriella Vigliocco, Marja-Liisa Mailend, Harrison Stoll, Rosemary Varley, Laurel J. Buxbaum

Moss-Magee Rehabilitation Papers

Aphasia is a language disorder that often involves speech comprehension impairments affecting communication. In face-to-face settings, speech is accompanied by mouth and facial movements, but little is known about the extent to which they benefit aphasic comprehension. This study investigated the benefit of visual information accompanying speech for word comprehension in people with aphasia (PWA) and the neuroanatomic substrates of any benefit. Thirty-six PWA and 13 neurotypical matched control participants performed a picture-word verification task in which they indicated whether a picture of an animate/inanimate object matched a subsequent word produced by an actress in a video. Stimuli were either …

Precision Rehabilitation For Aphasia By Patient Age, Sex, Aphasia Severity, And Time Since Stroke? A Prespecified, Systematic Review-Based, Individual Participant Data, Network, Subgroup Meta-Analysis, Release Collaborators, Jacqueline Hinckley

HPD Articles

BACKGROUND: Stroke rehabilitation interventions are routinely personalized to address individuals' needs, goals, and challenges based on evidence from aggregated randomized controlled trials (RCT) data and meta-syntheses. Individual participant data (IPD) meta-analyses may better inform the development of precision rehabilitation approaches, quantifying treatment responses while adjusting for confounders and reducing ecological bias. AIM: We explored associations between speech and language therapy (SLT) interventions frequency (days/week), intensity (h/week), and dosage (total SLT-hours) and language outcomes for different age, sex, aphasia severity, and chronicity subgroups by undertaking prespecified subgroup network meta-analyses of the RELEASE database. METHODS: MEDLINE, EMBASE, and trial registrations were systematically …

Differential Effects Of Speech And Language Therapy And Rtms In Chronic Versus Subacute Post-Stroke Aphasia: Results Of The Northstar-Ca Trial, Anna Zumbansen, Heike Kneifel, Latifa Lazzouni, Anja Ophey, Sandra E. Black, Joyce L. Chen, Dylan Edwards, Thomas Funck, Alexander Erich Hartmann, Wolf Dieter Heiss, Franziska Hildesheim, Sylvain Lanthier, Paul Lespérance, George Mochizuki, Caroline Paquette, Elizabet Rochon, Ilona Rubi-Fessen, Jennie Valles, Susan Wortman-Jutt, Alexander Thiel

Research outputs 2022 to 2026

Background & objective: Contralesional 1-Hz repetitive transcranial magnetic stimulation (rTMS) over the right pars triangularis combined with speech-language therapy (SLT) has shown positive results on the recovery of naming in subacute (5–45 days) post-stroke aphasia. NORTHSTAR-CA is an extension of the previously reported NORTHSTAR trial to chronic aphasia (>6 months post-stroke) designed to compare the effectiveness of the same rTMS protocol in both phases. Methods: Sixty-seven patients with left middle cerebral artery infarcts (28 chronic, 39 subacute) were recruited (01-2014 to 07-2019) and randomized to receive rTMS (N = 34) or sham stimulation (N = 33) with SLT for …

Dosage, Intensity, And Frequency Of Language Therapy For Aphasia: A Systematic Review-Based, Individual Participant Data Network Meta-Analysis., Rehabilitation And Recovery Of People With Aphasia After Stroke (Release) Collaborators, Jackie Hinckley

HPD Articles

BACKGROUND AND PURPOSE: Optimizing speech and language therapy (SLT) regimens for maximal aphasia recovery is a clinical research priority. We examined associations between SLT intensity (hours/week), dosage (total hours), frequency (days/week), duration (weeks), delivery (face to face, computer supported, individual tailoring, and home practice), content, and language outcomes for people with aphasia.

METHODS: Databases including MEDLINE and Embase were searched (inception to September 2015). Published, unpublished, and emerging trials including SLT and ≥10 individual participant data on aphasia, language outcomes, and time post-onset were selected. Patient-level data on stroke, language, SLT, and trial risk of bias were independently extracted. Outcome …

Conversation As An Outcome Of Aphasia Treatment: A Systematic Scoping Review, Jamie H. Azios, Brent Archer, Nina Simmons-Mackie, Anastasia Raymer, Marcella Carragher, Shriya Shashikanth, Eleanor Gulick

Communication Disorders & Special Education Faculty Publications

PURPOSE: Conversation-focused speech-language pathology services are a top priority for people living with aphasia, but little is known about how researchers measure conversation as an outcome of treatment. This scoping review was undertaken to systematically review the evidence regarding the measurement of conversation in aphasia studies and to identify current practices and existing gaps.

METHOD: A systematic literature search was conducted for studies published between January 1995 and September 2019 in multiple electronic databases. Covidence software was used to manage search results, study selection, and data charting processes. Data were extracted from each study and then collated and organized to …

An Aphasia Research Agenda – A Consensus Statement From The Collaboration Of Aphasia Trialists, Myzoon Ali, Efstathia Soroli, Luis M. T. Jesus, Madeline Cruice, Jytte Isaksen, Evy Visch-Brink, Kleanthes K. Grohmann, C. Jagoe, Tarja Kukkonen, Spyridoula Varlokosta, Carlos Hernandez-Sacristan, Vicente Rosell-Clari, Rebecca Palmer, Silvia Martinez-Ferreiro, Erin Godecke, Sarah J. Wallace, Ruth Mcmenamin, David Copland, Caterina Breitenstein, Audrey Bowen, Ann-Charlotte Laska, Katerina Hilari, Marian C. Brady

Research outputs 2014 to 2021

Coordination of international aphasia research would minimise duplication of effort, support synergistic international activities across languages and multidisciplinary perspectives, and promote high-quality conduct and reporting of aphasia research, thereby increasing the relevance, transparency, and implementation of findings. The Collaboration of Aphasia Trialists (CATs) sought to develop an aphasia research agenda to direct future research activities, based on priorities shared by people with aphasia, family members, and healthcare professionals. Our established international research network spanning 33 countries contributed to this activity. Research literature reporting the priorities of stakeholders was reviewed and synthesized (phase 1). Representatives from Working Groups on Aphasia Assessment …

Utilising A Systematic Review-Based Approach To Create A Database Of Individual Participant Data For Meta- And Network Meta-Analyses: The Release Database Of Aphasia After Stroke, Release Collaborators, Jackie Hinckley

HPD Articles

Background

Collation of aphasia research data across settings, countries and study designs using big data principles will support analyses across different language modalities, levels of impairment, and therapy interventions in this heterogeneous population. Big data approaches in aphasia research may support vital analyses, which are unachievable within individual trial datasets. However, we lack insight into the requirements for a systematically created database, the feasibility and challenges and potential utility of the type of data collated.

Aim

To report the development, preparation and establishment of an internationally agreed aphasia after stroke research database of individual participant data (IPD) to facilitate planned …

Predictors Of Poststroke Aphasia Recovery: A Systematic Review-Informed Individual Participant Data Meta-Analysis, Marian C. Brady, Release Collaborators, Jackie Hinckley

HPD Articles

Background and Purpose:

The factors associated with recovery of language domains after stroke remain uncertain. We described recovery of overall-language-ability, auditory comprehension, naming, and functional-communication across participants’ age, sex, and aphasia chronicity in a large, multilingual, international aphasia dataset.

Methods:

Individual participant data meta-analysis of systematically sourced aphasia datasets described overall-language ability using the Western Aphasia Battery Aphasia-Quotient; auditory comprehension by Aachen Aphasia Test (AAT) Token Test; naming by Boston Naming Test and functional-communication by AAT Spontaneous-Speech Communication subscale. Multivariable analyses regressed absolute score-changes from baseline across language domains onto covariates identified a priori in randomized controlled trials and all …

Diagnosing And Managing Post-Stroke Aphasia, Shannon M. Sheppard, Rajani Sebastian

Communication Sciences and Disorders Faculty Articles and Research

Introduction: Aphasia is a debilitating language disorder and even mild forms of aphasia can negatively affect functional outcomes, mood, quality of life, social participation, and the ability to return to work. Language deficits after post-stroke aphasia are heterogeneous.

Areas covered: The first part of this manuscript reviews the traditional syndrome-based classification approach as well as recent advances in aphasia classification that incorporate automatic speech recognition for aphasia classification. The second part of this manuscript reviews the behavioral approaches to aphasia treatment and recent advances such as noninvasive brain stimulation techniques and pharmacotherapy options to augment the effectiveness of …

Empower: An Adaptable Writing Intervention, Carly Dinnes

The Nebraska Educator: A Student-Led Journal

EmPOWER is a six-stage writing intervention designed by speech-language pathologists to improve the expository writings of school-aged children with language learning and executive function disabilities. The intervention uses scaffolded instruction to transform struggling students into independent and self-regulating writers by training the students to use a variety of supports (e.g., graphic organizers, checklists) and strategies (e.g., referring back to the writing prompt) throughout the writing process. Many key features of the EmPOWER approach to writing instruction directly support components described in cognitive models of writing, which indicates that EmPOWER is a theory-guided writing intervention that may benefit a wide range …

Release: A Protocol For A Systematic Review Based, Individual Participant Data, Meta- And Network Meta-Analysis, Of Complex Speech-Language Therapy Interventions For Stroke-Related Aphasia, Marian C. Brady, Myzoon Ali, Kathryn Vandenberg, Linda J. Williams, Louise R. Williams, Masahiro Abo, Frank Becker, Audrey Bowen, Caitlin Brandenburg, Caterina Breitenstein, Stefanie Bruehl, David A. Copeland, Tamara B. Cranfill, Marie Di Pietro-Bachmann, Pamela Enderby, Joanne Fillingham, Federica Lucia Galli, Marialuisa Gandolfi, Bertrand Glize, Erin Godecke, Neil Hawkins, Katerina Hilari, Jackie Hinckley, Simon Horton, David Howard, Petra Jaecks, Elizabeth Jefferies, Luis M. T. Jesus, Maria Kambanaros, Eun Kyoung Kang, Eman M. Khedr, Anthony Pak Hin Kong, Tarja Kukkonen, Marina Laganaro, Matthew A. Lambon Ralph, Ann Charlotte Laska, Beatrice Leemann, Alexander P. Leff, Roxele R. Lima, Antje Lorenz, Brian Macwhinney, Rebecca Shisler Marshall, Flavia Mattioli, Ilknur Mavis, Marcus Meinzer, Reza Nilipour, Enrique Noe, Nam-Jong Paik, Rebecca Palmer, Ilias Papathanasiou, Brigida F. Patricio, Isabel Pavão Martins, Cathy Price, Tatjana Prizl Jakovac, Elizabeth Rochon, Miranda L. Rose, Charlotte Rosso, Ilona Rubi-Fessen, Marina B. Ruiter, Claerwen Snell, Benjamin Stahl, Jerzy P. Szaflarski, Shirley A. Thomas, Mieke Van De Sandt-Koenderman, Ineke Van Der Meulen, Evy Visch-Brink, Linda Worrall, Heather Harris Wright

HPD Articles

Background: Speech and language therapy (SLT) benefits people with aphasia following stroke. Group level summary statistics from randomised controlled trials hinder exploration of highly complex SLT interventions and a clinically relevant heterogeneous population. Creating a database of individual participant data (IPD) for people with aphasia aims to allow exploration of individual and therapy-related predictors of recovery and prognosis.

Aim: To explore the contribution that individual participant characteristics (including stroke and aphasia profiles) and SLT intervention components make to language recovery following stroke.

Methods and procedures: We will identify eligible IPD datasets (including randomised controlled trials, non-randomised comparison …

A Review Of Attention, Memory, Word Finding, And Executive Function To Support Client Rehabilitation In A Group Therapy Setting, Anna Uftring, Michelle Estand, Annie Heineman, Samantha Marusiak

Graduate Independent Studies - Communication Sciences and Disorders

This paper is a review of attention, memory, word finding, and executive function to support individuals with deficits in these areas seen in a rehabilitative speech-language therapy setting. Each chapter contains a definition of the domain and describes the subdomains included. The chapters also include the neurology associated with the domain and common disorders that include deficits in the areas of attention, memory, word finding, and executive functioning. At the end of each chapter, recommended treatment principles are provided to guide therapy with each domain. This paper was created to accompany a therapy manual titled “Providing Connections Through Group Therapy” …

Promoting Aphasia Awareness, Yvonne M. Faria, Fiona Mcnulty, Veronica C. Gonzalez, Peggy S. Conner

Publications and Research

The National Aphasia Association defines aphasia as an impairment of language, affecting the production or comprehension of speech and ability to write. This communication disorder is typically acquired after a brain injury resulting from an accident or stroke. Nearly 180,000 Americans acquire aphasia each year. Despite efforts to increase awareness about aphasia, via organizations such as the National Aphasia Association, general knowledge is still limited. In 2000 Elman and colleagues collected data on the number of news articles that mentioned the term “aphasia” and compared it to similar health conditions with comparable or lower prevalence rates. They found that these …

Motor Learning Guided Treatment For Acquired Apraxia Of Speech, Rachel K. Johnson

Communication Disorders & Special Education Faculty Publications

Purpose: The purpose of this study was to expand the evidence on the effectiveness of motor learning guided approach for the treatment of acquired apraxia of speech. This study investigated the influence of practice frequency and number of targets per practice set on transfer of speech motor learning.

Method: This is a multiple baseline single-case study across two treatment cycles involving two individuals with chronic acquired apraxia of speech. Treatment Cycle 1 investigated the influence of self-controlled practice on speech motor learning through two conditions of practice. Treatment Cycle 2 investigated the influence of number of targets on transfer of …

A Randomized Controlled Trial Of Very Early Rehabilitation In Speech After Stroke, Erin Godecke, Elizabeth Armstrong, Tapan Rai, Sandy Middleton, Natalie Ciccone, Anne Whitworth, Miranda Rose, Audrey Holland, Fiona Ellery, Graeme Hankey, Dominique Cadilhac, Julie Bernhardt

Research outputs 2014 to 2021

Rationale:

The efficacy of rehabilitation therapy for aphasia caused by stroke is uncertain.

Aims and hypothesis:

The Very Early Rehabilitation of Speech (VERSE) trial aims to determine if intensive prescribed aphasia therapy (VERSE) is more effective and cost saving than non-prescribed, intensive (usual care-plus) and non-intensive usual care (UC) therapy when started within 15 days of stroke onset and continued daily over four weeks. We hypothesize that aphasia therapy when started very early after stroke and delivered daily could enhance recovery of communication compared with UC.

Sample size estimates:

A total of 246 participants (82 per arm) will provide 80% …

Using Visual Scene Displays As Communication Support Options For People With Chronic, Severe Aphasia: A Summary Of Aac Research And Future Research Directions, David R. Beukelman, Karen Hux, Aimee R. Dietz, Miechelle L. Mckelvey, Kristy S.E. Weissling

Department of Special Education and Communication Disorders: Faculty Publications

Research about the effectiveness of communicative supports and advances in photographic technology has prompted changes in the way speech-language pathologists design and implement interventions for people with aphasia. The purpose of this paper is to describe the use of photographic images as a basis for developing communication supports for people with chronic aphasia secondary to sudden-onset events due to cerebrovascular accidents (strokes). Topics include the evolution of AAC-based supports as they relate to people with aphasia, the development and key features of visual scene displays (VSDs), and future directions concerning the incorporation of photographs into communication supports for people with …

Test-Retest Stability Of Word Retrieval In Aphasic Discourse, Mary Boyle

Department of Communication Sciences and Disorders Faculty Scholarship and Creative Works

Purpose: This study examined the test-retest stability of select word-retrieval measures in the discourses of people with aphasia who completed a 5-stimulus discourse task. Method: Discourse samples across 3 sessions from 12 individuals with aphasia were analyzed for the stability of measures of informativeness, efficiency, main concepts, noun and verb retrieval, word-finding difficulty, and lexical diversity. Values for correlation coefficients and the minimal detectable change score were used to assess stability for research and clinical decision making. Results: Measures stable enough to use in group research studies included the number of words; the number of correct information units (CIUs); the …

The Impact Of Interface Design During An Initial High-Technology Aac Experience: A Collective Case Study Of People With Aphasia, Aimee R. Dietz, Kristy S.E. Weissling, Julie Griffith, Miechelle L. Mckelvey, Devan Macke

Department of Special Education and Communication Disorders: Faculty Publications

The purpose of this collective case study was to describe the communication behaviors of five people with chronic aphasia when they retold personal narratives to an unfamiliar communication partner using four variants of a visual scene display (VSD) interface. The results revealed that spoken language comprised roughly 70% of expressive modality units; variable patterns of use for other modalities emerged. Although inconsistent across participants, several people with aphasia experienced no trouble sources during the retells using VSDs with personally relevant photographs and text boxes. Overall, participants perceived the personally relevant photographs and the text as helpful during the retells. These …

Supporting Narrative Retells For People With Aphasia Using Augmentative And Alternative Communication: Photographs Or Line Drawings? Text Or No Text?, Julie Griffith, Aimee R. Dietz, Kristy S.E. Weissling

Department of Special Education and Communication Disorders: Faculty Publications

Purpose: The purpose of this study was to examine how the interface design of an augmentative and alternative communication (AAC) device influences the communication behaviors of people with aphasia during a narrative retell task.

Method: A case-series design was used. Four narratives were created on an AAC device with combinations of personally relevant (PR) photographs, line drawings (LDs), and text for each participant. The narrative retells were analyzed to describe the expressive modality units (EMUs) used, trouble sources experienced, and whether trouble sources were repaired. The researchers also explored the participants’ perceived helpfulness of the interface features.

Results: The participants …

Augmented Input: The Effect Of Visuographic Supports On The Auditory Comprehension Of People With Chronic Aphasia, Sarah E. Wallace, Aimee R. Dietz, Karen Hux, Kristy S.E. Weissling

Department of Special Education and Communication Disorders: Faculty Publications

Background: Augmented input (AI), or the use of visuographic images and linguistic supports, is a strategy for facilitating the auditory comprehension of people with chronic aphasia. To date, researchers have not systematically evaluated the effects of various types of AI strategies on auditory comprehension.

Aims: The purpose of the study was to perform an initial evaluation of the changes in auditory comprehension accuracy experienced by people with aphasia when they received one type of AI. Specifically, the authors examined the effect four types of non-personalized visuographic image conditions on the comprehension of people with aphasia when listening to narratives.

Methods …

Discourse Treatment For Word Retrieval Impairment In Aphasia: The Story So Far, Mary Boyle

Department of Communication Sciences and Disorders Faculty Scholarship and Creative Works

Background: Impairment-focused aphasia treatment has an ultimate goal of improving language production in connected speech and communication in daily life. Although impairment-based treatment has typically been carried out in words or sentences, investigations have begun to explore the efficacy of treatment during discourse production. Focusing treatment on an impaired linguistic process during discourse production is a complex and challenging endeavour. Aims: This paper aims to review investigations of discourse treatment for word retrieval impairment in aphasia in order to identify and discuss variables that emerge as being important considerations in clinical practice and continued research. Main Contribution: Seven investigations that …

Semantic Feature Analysis Treatment For Aphasic Word Retrieval Impairments: What's In A Name?, Mary Boyle

Department of Communication Sciences and Disorders Faculty Scholarship and Creative Works

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.

Translational Research In Aphasia: From Neuroscience To Neurorehabilitation, Anastasia M. Raymer, Pelagie Beeson, Audrey Holland, Diane Kendall, Lynn M. Maher, Nadine Martin, Laura Murray, Miranda Rose, Cynthia K. Thompson, Lyn Turkstra, Lori Altmann, Mary Boyle, Tim Conway, William Hula, Kevin Kearns, Brenda Rapp, Nina Simmons-Mackie, Leslie J. Gonzalez Rothi

Department of Communication Sciences and Disorders Faculty Scholarship and Creative Works

Purpose: In this article, the authors encapsulate discussions of the Language Work Group that took place as part of the Workshop in Plasticity/NeuroRehabilitation Research at the University of Florida in April 2005. Method: In this narrative review, they define neuroplasticity and review studies that demonstrate neural changes associated with aphasia recovery and treatment. The authors then summarize basic science evidence from animals, human cognition, and computational neuroscience that is relevant to aphasia treatment research. They then turn to the aphasia treatment literature in which evidence exists to support several of the neuroscience principles. Conclusion: Despite the extant aphasia treatment literature, …

Repetition Priming And Anomia: An Investigation Of Stimulus Dosage, Catherine A. Off

Speech, Language, Hearing, and Occupational Sciences Faculty Publications

In a recent review of anomia management, Maher & Raymer reported that 30% of aphasia intervention research from 1946 to 2001 focused on naming; however, "despite this proliferation of case reports and small group studies, there is still no clear agreement on how best to manage these deficits" (Maher & Raymer, 2004, p. 13). The inconsistency of acquisition, maintenance, and generalization effects observed across participants and types of treatment protocols is likely to stem from an inadequate knowledge base about how subject and treatment variables influence learning.

One treatment variable that has received increasing attention over the past two or …

Effects Of Gesture+Verbal Treatment For Noun And Verb Retrieval In Aphasia, Anastasia M. Raymer, Floris Singletary, Amy Rodriguez, Maribel Ciampitti, Kenneth M. Heilman, Leslie J. Gonzalez Rothi

Communication Disorders & Special Education Faculty Publications

Links between verbs and gesture knowledge suggest that verb retrieval may be particularly amenable to gesture+verbal training (GVT) in aphasia compared to noun retrieval. This study examines effects of GVT for noun and verb retrieval in nine individuals with aphasia subsequent to left hemisphere stroke. Participants presented an array of noun and verb retrieval deficits, including impairments of semantic and/or phonologic processing. In a single-participant experimental design, we investigated effects of GVT for noun and verb retrieval in two counterbalanced treatment phases. Effects were evaluated in spoken naming and gesture production to pictured objects and actions. Spoken naming improvements associated …