Medicine and Health Sciences Commons^™

”To Be Or Not To Be – It’S Good”: Actor And Student Experiences In A Drama Club For People With Aphasia, Jade K. Hannan

Senior Theses

Individuals with aphasia, a disorder caused by damage to the brain’s language network, confront a variety of social and emotional struggles. While leaving their cognition largely intact, aphasia tremendously impacts a person’s ability to communicate confidently, fracturing their social network and contributing to feelings of loneliness and frustration. To address this persistent need in the chronic aphasia population, the Play on Words drama club at the University of South Carolina provides a forum for people with aphasia (PWA) to engage in dramatic exercises focused on non-verbal communication of emotions, ideas, and stories, culminating the production of an original devised play. …

Impact Of Covid-19 On Individuals With Aphasia: Effects On Quality Of Life And Communication, Kaci L. Gammon

Honors College Theses

Speech-language pathologists (SLPs) help people with aphasia (PWA) manage their communication symptoms and become more independent by supporting them linguistically and emotionally. During COVID-19, speech and language services were not as readily available to PWA due to quarantine restrictions resulting in isolation within this population. Individuals with aphasia had to redirect and find a new way to function daily. This study explored factors that affected quality of communication and quality of life for PWA during the pandemic, including technology, living situation, timing of stroke, and speech-language pathology services. Through an online survey, PWA from across the country expressed how their …

The Impact Of Treatment Dosage On Cognitive-Linguistic Outcomes Of Patients With Aphasia: An Investigation Of Three Service Delivery Models, Adele J. Derendinger

Graduate Student Theses, Dissertations, & Professional Papers

This study addresses the gap in literature by directly comparing the effectiveness of Intensive Comprehensive Aphasia Programs (ICAPs) and modified ICAPs (mICAPs) to usual care service delivery models for people with aphasia. Through a prospective study design, cognitive-linguistic function change scores across different service delivery models were examined. The findings reveal significant within-group improvements in cognitive-linguistic function for participants in ICAPs, with some improvement seen in mICAPs and usual care conditions. Intensive models demonstrated greater improvement compared to non-intensive usual care models, particularly evident in the Western Aphasia Battery – Revised and the Boston Naming Test – Second Edition. …

Recursive Functional Learning In Nonfluent Aphasia, Gerald C. Imaezue

Dissertations, Theses, and Capstone Projects

People with nonfluent aphasia (PWNA) require feedback from an external agent as well self-feedback to facilitate performance of language production tasks. The extent to which PWNA can use self-feedback alone to improve their task performance is unknown. In addition, it is argued that self-feedback may reinforce or minimize performance errors over time. To test whether either is the case, we introduce an original learning mechanism, recursive functional learning, which uses self-feedback loops to optimize recursively multiple subsystems (cognitive and linguistic subsystems) that PWNA engage during task performance. We used this mechanism to underpin a novel automated procedure we developed, recursive …

The Effect Of Visual Feedback On Vocal Compensation Abilities In Individuals With Post-Stroke Aphasia, Marissa Rylee Olson

Theses and Dissertations

Speech production is a complex and highly organized process comprised of various sensory and perceptual components. Post-stroke aphasia can impair speech production abilities by interrupting individuals’ ability to detect and correct speech errors and produce their targeted behavior. Contemporary models of speech production aim to understand the relationship between sensory systems and the human ability to produce perceptually accurate speech. This study seeks to understand the relationship between visual feedback and vocal compensation abilities in individuals with post-stroke aphasia to determine the effectiveness of incorporating visual feedback into therapeutic expressive language intervention. It was hypothesized that that the multi-sensory experimental …

The Relationship Between Communicative Confidence And Identity In Everyday Life For People With Aphasia, Karina Escobar

Rehabilitation, Human Resources and Communication Disorders Undergraduate Honors Theses

Aphasia is primarily a neurological language disorder, which can also affect cognition, attention, and executive functioning skills. In recent years, researcher has taken an interest in understanding quality of life for people with aphasia, specifically communicative confidence, social relationships, and identity. The aim of this study was to determine how communicative confidence and social relationships affect a person’s identity, as well as the importance of therapy groups. We designed and used confidence and independence survey scales pre-aphasia, post-aphasia but before attending aphasia therapy groups, and post-aphasia and after having attended aphasia therapy groups. We also asked clarifying questions based on …

Students' Understanding Of Self-Management In Aphasia Treatment, Maryse Azer

Honors College Theses

Aphasia is a neurogenic language disorder caused by damage to the language areas of the brain in the left hemisphere, resulting in speech and language impairments. People with aphasia (PWA) often receive services from speech-language pathologists (SLPs) who provide screening, assessment, diagnosis, and treatment to address communication deficits. Aphasia is a chronic condition and PWA experience symptoms throughout their lives. Healthcare costs related to aphasia account for $46 billion annually. Provider shortages, lack of transportation, insurance constraints, and travel expenses can leave PWA without adequate care. One possible solution to the costs and access issues is the implementation of self-management …

Indirectly And Directly Involved Students' Perspectives On Multi-Modal Communication Treatment In Persons With Aphasia, Emily Lewis

Honors Theses

Our study investigated the perspectives of students who were either directly or indirectly involved in the Multi-modal communication treatment (MCT) sessions for persons with aphasia. Two undergraduate and two graduate students were recruited from the University of Mississippi who participated in the MCT sessions. We collected their perspectives through semi-structured interviews and used thematic qualitative analysis to analyze our data. We reported themes from the indirectly involved students and the directly involved students and compared how the themes were similar and different between the indirectly and directly involved students. We discussed that both direct and indirect experience for clinical therapy …

Investigating The Impact Of Nonlinguistic Cognitive Reserve On Naming Pre- And Post-Treatment, Lillian Jarold

Theses and Dissertations

Background: The relationship between linguistic and nonlinguistic cognition in persons with aphasia is complex and often debated in the literature. Furthermore, the impact of nonlinguistic cognition on aphasia treatment outcomes is unclear. The present study sought 1) to examine the relationship between WAIS scores and performance on a test of naming and 2) to examine the relationship between WAIS scores and change scores on a test of naming between baseline and post-treatment in persons with chronic aphasia.

Method: This retrospective study utilized data from participants (N=102) who were recruited for a multi-center cross-over trial (POLAR: Predicting Outcomes of Language Rehabilitation). …

Transcranial Alternating Current Stimulation As An Adjuvant For Nonfluent Aphasia Therapy: A Proof-Of-Concept Study, Lynsey Mcgrath Keator

Theses and Dissertations

Identifying effective and efficient rehabilitation tools is crucial to improve language outcomes for persons living with chronic aphasia. Speech entrainment has proved to be particularly successful in improving speech output in nonfluent aphasia. It is hypothesized that, for patients with aberrant oscillatory synchronization between anterior and posterior language regions of the left hemisphere, speech entrainment may act as an external gaiting mechanism to bolster an impaired efference copy and improve synchrony between these regions. Theoretical and empirical evidence supports this idea that speech production relies on anterior-posterior connectivity in the left hemisphere.

Transcranial alternating current stimulation (tACS) delivers low, periodically-alternating …

The Effects Of Spoken Self-Disclosure Scripts On Nonaphasic Listeners' Perceptions Of People With Aphasia, Colleen B. Ward

Masters Theses

Purpose: The purpose of this study was to investigate the effects of spoken self-disclosure scripts on nonaphasic listeners’ perceptions of people with aphasia (PWA). Self-disclosure is a tool that PWA can utilize in the event that they want a conversation partner to know of their communication disorder. However, limited research has been conducted on the effects of aphasia self-disclosure or whether it affects perceptions of PWA from neurotypical communication partners. If self-disclosure is determined to make a positive impact on a communicative interaction, it could be grounds for encouraging PWA who are interested to develop a self-disclosure script or use …

The Impact Of Background Noise On The Communicative Experience Of People With Mild To Moderate Aphasia: A Qualitative Study, Riley Robertson Hegewald

Theses and Dissertations

This study examined how retelling stories with a variety different background noise conditions affected the communicative experiences of people with aphasia (PWA). Participants included 11 adults with mild to moderate aphasia and 11 age- and gender-matched controls. Participants participated in a semi-structured interview immediately following the experimental measure where they were asked open-ended questions regarding their experience retelling stories and how those experiences related to their everyday lives. Results revealed three themes related to how participants responded to communicating in noise: (a) cognitive reactions, (b) emotional reactions, and (c) social reactions. The findings suggest that PWA exert more effort when …

The Nature Of Word Errors And Response Time In Individuals With Aphasia, Alexandra M. Georges

ETD Archive

Anomia is a relevant language deficit secondary to aphasia that is treated in the speech-language pathologist profession. Most aphasia diagnoses utilize aspects of confrontational naming tasks during speech therapy or testing. This study investigated the nature of word errors and the response time (RT) in persons with aphasia (PWA). Six individuals, three with nonfluent and three with fluent aphasia were asked to name objects in four common categories (occupational tools, everyday objects, food, and clothing) presented under two conditions (1) picture objects on a computer screen and (2) real physical objects. To measure RT and word error, participants were instructed …

Exploring Discourse Markers As A Treatment Outcome Measure For Aphasia, Anna K. Cedoz

Masters Theses

Discourse Markers (DMs) are communicative tools or resources that people use to organize conversations. The use of DMs among individuals with aphasia has been documented to support their communicative competence (Simmons-Mackie & Damico, 1996). Further research on the use of DMs by individuals with aphasia has been limited. The current study features a secondary analysis using existing data from Devanga (2020), which studied the effects of Collaborative Referencing Intervention (CRI; Hengst et al., 2010) on three participants with chronic aphasia. This study analyzed 18 conversation probes from one participant across baseline, treatment, and maintenance phases with clinician and spouse partners. …

An Exploratory Study Of Conversational Discourse Produced By Persons With Aphasia Using Speech Function Analysis, Christa M. Akers

Theses, Dissertations and Culminating Projects

Casual conversation is essential to everyday life. Because of their language impairment, most people with stroke-induced aphasia have trouble engaging in social interactions and may, as a result, experience a decrease in psychosocial well-being. There is a great need, therefore, to identify the interventions most likely to improve the everyday talk of individuals affected by aphasia. Approaches to intervention that aim to improve the social participation and communicative success of people with aphasia during real-life interactions, known as conversation-based treatment, have increased in popularity.

When delivered in a group setting, conversation-based treatments have been shown to increase scores on standardized …

Communication-Related Quality Of Life: Perspectives Of People With Aphasia And Speech-Language Pathology Students, Ethan Kristek

All Theses, Dissertations, and Capstone Projects

Physiological and psychosocial communication components impact communication-related quality of life for people with aphasia. This study aimed to understand how these components were addressed in a university clinic speech-language pathology program. Mixed-methods with inductive coding of interviews and documentation data were used to develop a description of communication-related quality of life, including perspectives of people with aphasia and graduate student participants. Qualitative findings revealed three trends: therapy which aids the ability to communicate, connections with additional people with aphasia, and supportive environments emerged from people with aphasia data. Three trends emerged: communicating effectively, a naturalistic environment, and individualization were shown …

Main Concept, Sequencing, And Story Grammar (Mssg) Analyses Of The Cinderella Story In Latent Aphasia, Janet B. Adams

Speech and Hearing Sciences ETDs

Commonly used standardized tests, like the Western Aphasia Battery-Revised (WAB-R), are not sensitive to higher level discourse deficits, leading to certain individuals not meeting diagnostic criteria for aphasia. Consequently, individuals with aphasia are excluded from receiving potentially beneficial services and/or from being included in research. In a large sample of persons with stroke-induced aphasia, this study analyzed discourse samples using Main Concept, Sequencing, and Story Grammar (MSSG) Analyses to examine macrostructural discourse characteristics of persons with latent aphasia (PWLAs) compared to persons with no underlying brain injury (PNBIs) and persons classified as having anomic aphasia (PWAAs) by the WAB-R. A …

Ancillary Data For Refining Computer Adaptive Algorithms For The Assessment Of Anomia, Emily Kathryn Tudorache

Dissertations and Theses

Computer adaptive testing formats, based in item response theory (IRT), are becoming an increasingly popular approach to testing in healthcare because they offer numerous psychometric and practical advantages to assessment when compared to static tests that rely on classical test theory. Fergadiotis and colleagues (2015) have developed computer adaptive versions of the Philadelphia Naming Test (PNT) short-forms, which have demonstrated acceptable precision and standard error of measurement when compared to the static short-forms and original full-length assessment. This study sought to use synthetic data simulations using the catIrt R package (Nydik, 2014) to investigate possible advantages of the use of …

Neural Synchrony During Naturalistic Language Perception In Listeners With Aphasia, Lisa Johnson Norris

Theses and Dissertations

Neural synchrony across listeners during language processing has been found to be associated with successful comprehension in neurotypical adults. At initial presentation of auditory-visual stimuli, neural responses appear to oscillate in different rhythms across brain regions. As the stimulus progresses, the time course of neural activity synchronizes across listeners, particularly in primary auditory and visual processing regions. This phenomenon, which we refer to as ‘neural entrainment,’ has been observed in neurotypical individuals attending to the same stimulus. Neural synchrony occurs due to the inherent neural response elicited by a stimulus and has been shown to be consistent across participants in …

Towards Understanding Therapy Response In Chronic Aphasia, Sigfus Kristinsson

Theses and Dissertations

It remains largely unclear what factors determine who responds to aphasia therapy and to what degree. The current study sought to ameliorate this issue by addressing three aims: 1) To identify baseline predictors that dissociate between therapy responders and nonresponders, 2) to identify predictors of degree of treated recovery in therapy responders, and 3) to examine the generalizability of predictors identified under Aims 1 and 2 in randomly selected subsamples of study participants.

Method: Stroke survivors (N = 102; 43 females; age = 60.5y +/- 11.0y) with chronic aphasia (>12m post-stroke) were recruited as part of a multisite trial. …

The Influence Of Pause On Listeners' Perceptions In Speech Of People With Aphasia, Emily Wright

Theses and Dissertations

The purpose of this study was to examine how varying pause lengths in speech of people with aphasia (PWA) influences listeners' perceptions. The study specifically assesses listeners' perceptions of communicative effectiveness and speaker likability. Speech samples from six people with nonfluent or fluent aphasia were obtained from a previous study conducted by Harmon (2018). The speech samples were modified to create four sets of stimuli, including the original recordings, normalized within utterance pauses, normalized between utterance pauses, and normalized for both within and between utterance pauses. Forty listeners rated each of the speech samples based on the perceived communicative effectiveness …

Correlations Between Cognitive Pause Patterns And Listener Perceptions Of Communicative Effectiveness And Likeability For People With Aphasia, Heidi Raylene Mcconaghie

Theses and Dissertations

A prevalent feature of typical spontaneous speech are speech pauses. Longer speech pauses, known as cognitive pauses, occur in typical speech and are indicative of higher-level cognitive processes. Atypical cognitive pauses, however, are prevalent in the speech of people with aphasia consequent to their communication disorder. Research has shown that these atypical pauses may contribute to negative listener perceptions. This study aimed to determine the influence of atypical speech pause on listener perceptions of communicative effectiveness and speaker likeability. Specifically, this study evaluated the relationship between listener ratings of communicative effectiveness and likeability and acoustic measures of between-utterance pause duration, …

Light And Heavy Verb Usage By People With Non-Fluent Aphasia, Chase Sophia Kozak

Honors Theses

The purpose of the study was to investigate the discourse elicitation task effect and whether it affects the production of verbs with different semantic weight (light verbs with vague semantic representations, e.g., ‘do’, or heavy verbs with specific semantic representations, e.g., ‘deliver’). Thirty people with non-fluent aphasia and twenty people without aphasia were included. The light and heavy verb ratios over the total number of verbs were calculated for two discourse elicitation tasks: sequential picture description and storytelling. The results for the healthy control group showed that they produced a significant higher heavy verb ratio in sequential picture description than …

Telepractice In The Communication Treatment Of Individuals With Post-Stroke Aphasia: Systematic Review, Gayanthi Kodituwakku-Wewalwala

Graduate Theses and Dissertations

Telepractice, a branch of telehealth, which is the delivery of services to distant sites employing telecommunication, has been developing rapidly nowadays. Owing to the nature of the condition and treatment foci in aphasia, telepractice has been identified as a potential mode for intervention to persons with aphasia (PWA) in the field of speech-language pathology. Based on the American Speech-Language Hearing Association (2005), telepractice is considered a means to extend services to a wider context overcoming the barriers of transportation, costs, and limited availability of services. Thus, exploration of treatment accessibility to underserved populations in middle/low-income countries or rural areas via …

Light And Heavy Verb Productions Between Single And Sequential Picture Description Tasks In People With And Without Non-Fluent Aphasia, Jessica Hall

Honors Theses

Background: Previous research has shown that persons with non-fluent aphasia (PWNFA) suffer from the inability to retrieve words, specifically more of a difficulty with verb productions. Various discourse elicitation tasks have shown to have differing effects on verb retrievals in this population. However, there is a lack of research on the relationship between single vs. sequential picture description tasks and the productions of heavy and light verbs in persons with non-fluent aphasia.

Purpose: The purpose of this study was to analyze the ratios of heavy and light verbs produced in both single picture description tasks and sequential picture description tasks …

Remote Supported Communication For Adults With Chronic Aphasia: A Serendipitous Study, Allie Hopper

Theses and Dissertations--Communication Sciences and Disorders

Supported communication is defined as anything that improves access to or participation in communication events or activities (King, Simmons-Mackie, & Beukelman, 2012). This thesis describes the results of a study that took place when a training program to provide graduate students in Communication Sciences and Disorders (CSD) with “hands on” experience in providing supported communication to persons with chronic aphasia (PWA) was interrupted by the outbreak of Coronavirus-19 and switched to a remote delivery format to fulfil service and training obligations to the PWA and the CSD graduate students respectively. The study (1) describes the actions taken to covert a …

Using Dialogic Reading To Facilitate Intergenerational Interactions In Persons With Aphasia: A Feasibility Study, Gillian I. Anderson

Honors Undergraduate Theses

The purpose of this study was to evaluate the effectiveness of teaching dialogic reading (DR) strategies to patients with aphasia (PWA) as measured by DR strategy use during virtual training sessions. The secondary purpose was to improve psychosocial factors, including communicative participation, perceived stress, and confidence. A single subject multiple baseline across behaviors research design was employed via a telehealth model to examine a training program in DR strategies on expressive linguistic abilities and aspects of quality of life (QoL) in a PWA. Treatment was given four to five times a week and the session length varied based on the …

Experiences Of People With Aphasia Communicating With Healthcare Providers, Madelaine Bull

Master's Theses and Doctoral Dissertations

Aphasia is an acquired communication disorder, often resulting from a stroke, that impacts millions of Americans. People with aphasia (PWA) may frequent the hospital for a number of services poststroke and are often accompanied by their primary communication partners (PCP), the person with whom the PWA communicates with the most. This qualitative study explored the experiences of four dyads of PWA and their PCPs’ perspectives on communicating with healthcare providers (HCPs). Findings indicated that there are attributes of HCP interactions which contribute to patient-perceived success, such as collaboration with PCPs, and aphasia knowledge. These attributes were also associated with patient-centered …

An Exploration Of The Relationship Between Aphasia Therapy, Depression And Quality Of Life In Post-Stroke Patients After Rehabilitation At 12 And 26 Weeks After Stroke: A Verse Sub-Study, Alia Rashid Khan

Theses: Doctorates and Masters

Background: Depression is a common consequence of stroke, and people with aphasia (PWA) post-stroke have a higher risk of developing depression compared to stroke survivors without aphasia. However, current stroke interventions featuring aphasia therapy tend to neglect the effect of the treatment on mood. There is also a lack of evidence on the impact of stroke education and counselling on PWA in early stroke recovery. Additionally, the research on post-stroke depression often excludes or insufficiently describes PWA in study populations. The influence of direct aphasia therapy on depression in PWA is undetermined. This sub-study investigated: i) the effect of …

The Relationship Between Narrative Informativeness And Psychosocial Outcomes In Chronic Stroke-Induced Aphasia, Eileen Armes, Jessica Richardson, Rick Arenas, Lori Nelson

Speech and Hearing Sciences ETDs

Currently there is a gap in the literature in understanding the relationship between the newly categorized primary outcome measure of discourse and secondary outcomes related to psychosocial impact, such as participation, psychological impact, social well-being, or mood. In a large sample of persons with stroke-induced aphasia (N=115), this study analyzed discourse samples using main concept analysis to determine how discourse performance correlates with the secondary outcome measures ALA, CCRSA, GDS, and CIQ. As a secondary research question, the differences in these relationships dependent on severity was also explored. Results showed statistically significant positive correlations between main concepts (MCs) and ALA …