Communication Sciences and Disorders Commons^™

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 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 …

Results Of The Compare Trial Of Constraint-Induced Or Multimodality Aphasia Therapy Compared With Usual Care In Chronic Post-Stroke Aphasia, Miranda L. Rose, Lyndsey Nickels, David Copland, Leanne Togher, Erin Godecke, Marcus Meinzer, Tapan Rai, Dominique A. Cadilhac, Joosup Kim, Melanie Hurley, Abby Foster, Marcella Carragher, Cassie Wilcox, John E. Pierce, Gillian Steel

Research outputs 2022 to 2026

Background:

While meta-analyses confirm treatment for chronic post-stroke aphasia is effective, a lack of comparative evidence for different interventions limits prescription accuracy. We investigated whether Constraint-Induced Aphasia Therapy Plus (CIAT-plus) and/or Multimodality Aphasia Therapy (M-MAT) provided greater therapeutic benefit compared with usual community care and were differentially effective according to baseline aphasia severity.

Methods:

We conducted a three-arm, multicentre, parallel group, open-label, blinded endpoint, phase III, randomised-controlled trial. We stratified eligible participants by baseline aphasia on the Western Aphasia Battery-Revised Aphasia Quotient (WAB-R-AQ). Groups of three participants were randomly assigned (1:1:1) to 30 hours of CIAT-Plus or M-MAT or to …

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. …

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 …

Effects Of Positive And Negative Emotion On Picture Naming For People With Mild To Moderate Aphasia: A Preliminary Investigation, Tyson G. Harmon, Courtney Nielsen, Corinne Loveridge, Camille Williams

Faculty Publications

Purpose: To investigate how emotional arousal and valence affect confrontational naming accuracy and response time in people with mild to moderate aphasia compared with adults without aphasia. We hypothesized that negative and positive emotions would facilitate naming for people with aphasia but lead to slower responses for adults with no aphasia.

Method: Eight participants with mild to moderate aphasia, 15 older adults, and 17 young adults completed a confrontational naming task across three conditions (positive, negative, neutral) in an ABA case series design. Immediately following each naming condition, participants self-reported their perceived arousal and pleasure. Accuracy and response time were …

What Can Aphasia Tell Us About How The First-Acquired Language Is Instantiated In The Brain?, Mira Goral

Publications and Research

Recent neurolinguistic theories converge on the hypothesis that the languages of multilingual people are processed as one system in the brain. One system for the multiple languages is also at the core of a translanguaging framework of multilingualism—a framework that focuses on each speaker’s complete linguistic repertoire rather than on the separate languages they know. However, evidence from neuroimaging studies suggests at least some nonoverlapping activations of the first-acquired language (L1) and other (non-L1) languages of multilingual people, especially when the age of acquisition and/or levels of proficiency differ across the languages. Neurolinguistic studies of acquired language disorders have demonstrated …

Comparison Of Maintenance Gains From Two Treatment Approaches For Patients Diagnosed With Apraxia Of Speech And Broca’S Aphasia: A Critically Appraised Topic, Kalli B. Whiting

The Graduate Review

Three peer-reviewed research articles demonstrated benefits in using the articulatory-kinematic approaches of sound production treatment (SPT) and speech motor learning (SML) for intervention of patients diagnoses with apraxia of speech (AOS) concomitant with aphasia over the age of 50. This CAT was intended to review and compare the treatment maintenance between the two approaches using a specific search question; however, there was limited evidence for the specified population in that question. Although both approaches warranted positive outcomes, the SML approach may demonstrate a stronger linkage to the underlying features of apraxia of speech based on the method’s rationale. Through the …

Creating A Novel Approach To Discourse Treatment Through Coproduction With People With Aphasia And Speech And Language Therapists, M. Cruice, S. Aujla, J. Bannister, N. Botting, M. Boyle, N. Charles, V. Dhaliwal, S. Grobler, Deborah Hersh, J. Marshall, S. Morris, M. Pritchard, L. Scarth, R. Talbot, L. Dipper

Research outputs 2014 to 2021

Background:

Although spoken discourse is an outcome prioritised by all stakeholders in aphasia rehabilitation, assessment and treatment of discourse are not routine clinical practice. The small evidence base, varied clinical expertise, multiple barriers in the workplace, and challenges for clients in understanding their altered language abilities all contribute to this situation. These factors need serious consideration when developing a new treatment. Involving intended stakeholders as partners in the development process is recommended. This assists with future implementation by ensuring assessment and treatment are practical, feasible, and acceptable to those who will deliver and undertake it.

Aims:

This paper reports on …

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 …

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 …

Patients’ Experiences Of A Communication Enhanced Environment Model On An Acute/Slow Stream Rehabilitation And A Rehabilitation Ward Following Stroke: A Qualitative Description Approach, Sarah D'Souza, Deborah J. Hersh, Erin Godecke, Natalie Ciccone, Heidi Janssen, Elizabeth Armstrong

Research outputs 2014 to 2021

Background

Patients in hospital following stroke express a desire to continue therapy tasks outside of treatment activities. However, they commonly describe experiences of boredom and inactivity. An enriched environment aims to provide opportunities for physical, cognitive and social activity and informed the development of a Communication Enhanced Environment (CEE) model to promote patient engagement in language activities.

Purpose

Explore patient perceptions of a CEE model, and barriers and facilitators to engagement in the model.

Methods

A qualitative description study from a larger project that implemented a CEE model into acute and rehabilitation private hospital wards in Western Australia. Semi-structured interviews …

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 …

Standardizing Assessment Of Spoken Discourse In Aphasia: A Working Group With Deliverables, Tyson G. Harmon, Brielle C. Stark, Manaswita Dutta, Laura L. Murray, Lucy Bryant, Davida Fromm, Brian Macwhinney, Amy E. Ramage, Angela Roberts, Dirk B Den Ouden, Kris Brock, Katy Mckinney-Bock, Eun Jin Paek, Si On Yoon, Charalambos Themistocleous, Hyunsoo Yoo, Katharine Aveni, Stephanie Gutierrez, Saryu Sharma

Faculty Publications

Purpose: The heterogeneous nature of measures, methods, and analyses reported in the aphasia spoken discourse literature precludes comparison of outcomes across studies (e.g., meta-analyses) and inhibits replication. Furthermore, funding and time constraints significantly hinder collecting test-retest data on spoken discourse outcomes. This research note describes the development and structure of a working group, designed to address major gaps in the spoken discourse aphasia literature, including a lack of standardization in methodology, analysis, and reporting, as well as nominal data regarding the psychometric properties of spoken discourse outcomes. Method: The initial initiatives for this working group are to (a) propose recommendations …

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 …

Individualized Response To Semantic Versus Phonological Aphasia Therapies In Stroke, Sigfus Kristinsson, Alexandra Basilakos, Jordan Elm, Leigh Ann Spell, Leonardo Bonilha, Chris Rorden, Dirk B. Den Ouden, Christy Cassarly, Souvik Sen, Argye Hillis, Gregory Hickok, Julius Fridriksson

Communication Sciences and Disorders Faculty Articles and Research

Attempts to personalize aphasia treatment to the extent where it is possible to reliably predict individual response to a particular treatment have yielded inconclusive results. The current study aimed to (i) compare the effects of phonologically versus semantically focussed naming treatment and (ii) examine biographical and neuropsychological baseline factors predictive of response to each treatment. One hundred and four individuals with chronic post-stroke aphasia underwent 3 weeks of phonologically focussed treatment and 3 weeks of semantically focussed treatment in an unblinded cross-over design. A linear mixed-effects model was used to compare the effects of treatment type on proportional change in …

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 …

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. …

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 …

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, …

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 …

Current Approaches To The Treatment Of Post-Stroke Aphasia, Julius Fridriksson Ph.D., Argye Elizabeth Hillis

Faculty Publications

Aphasia, impairment of language after stroke or other neurological insult, is a common and often devastating condition that affects nearly every social activity and interaction. Behavioral speech and language therapy is the mainstay of treatment, although other interventions have been introduced to augment the effects of the behavioral therapy. In this narrative review, we discuss advances in aphasia therapy in the last 5 years and focus primarily on properly powered, randomized, controlled trials of both behavioral therapies and interventions to augment therapy for post-stroke aphasia. These trials include evaluation of behavioral therapies and computer-delivered language therapies. We also discuss outcome …

Neural Regions Underlying Object And Action Naming: Complementary Evidence From Acute Stroke And Primary Progressive Aphasia, Bonnie L. Breining, Andreia V. Feria, Brian Caffo, Erin L. Meier, Shannon M. Sheppard, Rajani Sebastian, Donna C. Tippett, Argye E. Hillis

Communication Sciences and Disorders Faculty Articles and Research

Background: Naming impairment is commonly noted in individuals with aphasia. However, object naming receives more attention than action naming. Furthermore, most studies include participants with aphasia due to only one aetiology, commonly stroke. We developed a new assessment, the Hopkins Action Naming Assessment (HANA), to evaluate action naming impairments.

Methods >& Procedures: Participants (N = 138 PPA, N = 37 acute stroke) completed the BNT and HANA. Behavioural performance was compared. A subset of participants (N = 31 PPA, N = 37 acute stroke) provided neuroimaging data. The whole brain was automatically segmented into regions of interest (ROIs). …

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 …

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 …

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 …