1
|
Gallée J, Tilton-Bolowsky VE, Stark BC. The Communication Success Screener: A Preliminary Investigation of Perceived Communicative Success Across Modalities, Environments, and Demands. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:149-169. [PMID: 37956866 PMCID: PMC11000814 DOI: 10.1044/2023_jslhr-23-00171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/10/2023] [Accepted: 09/18/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE Behavioral intervention targeting speech, language, and communication concerns is an established therapeutic approach for patients with communication concerns across a range of acquired neurogenic disorders. The multidimensional factors that contribute to a person's self-identified communication challenges and strengths in their daily communication needs must be considered to provide functional and person-centered care. While assessments grounded in clinician observation or client self-report exist, there is a direct need for a screening tool that comprehensively evaluates the roles of modality (verbal, text, gesture) and environment (in-person, virtual) on self-reported success across communicative demands. In this study, we describe a preliminary approach to monitoring the progression of receptive and expressive communication skills in people with chronic poststroke aphasia in the context of communication practices of the 21st century, culminating in the development and exploratory implementation of a novel clinical instrument: the Communication Success Screener (COMSS). METHOD Thirty-three participants with aphasia due to stroke were recruited to complete and evaluate the COMSS via an online survey. Quantitative responses and open-ended participant feedback were collected to validate and propose adaptations to the COMSS. Group-level analyses and case presentations were used to highlight COMSS features and outcomes. RESULTS Participant responses to the COMSS questionnaire suggest that this screening tool creates differentiated communicative success profiles based on self-report. Participant feedback also indicated that the COMSS appropriately evaluates self-reported success across modalities of verbal, text, and gesture in the context of in-person and virtual environments. CONCLUSIONS The communication concerns experienced by people with aphasia are often heterogeneous and vary as a function of their daily activities of living, preferred language modalities, and environmental supports. We present preliminary feasibility analyses of the COMSS as a potential tool to support the monitoring of functional change by evaluating self-reported communicative success across form, modality, environment, and task demand. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24521044.
Collapse
Affiliation(s)
- Jeanne Gallée
- Department of Psychology, Institute for Learning and Brain Sciences, University of Washington, Seattle
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Charlestown, MA
| | | | - Brielle C. Stark
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington
| |
Collapse
|
2
|
Tetnowski JT, Tetnowski JA, Damico JS. Looking at gesture: The reciprocal influence between gesture and conversation. JOURNAL OF COMMUNICATION DISORDERS 2023; 106:106379. [PMID: 37769381 DOI: 10.1016/j.jcomdis.2023.106379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 09/04/2023] [Accepted: 09/12/2023] [Indexed: 09/30/2023]
Abstract
INTRODUCTION There is limited research in group communication treatment for people with aphasia but existing studies report benefits of gesture to support conversation. Gesture supports conversation through recipient design features and reducing linguistic demands of lexical retrieval and formulation. Additionally, gesture serves an affiliative function. However, the relationship between gesture use and gestural capacity has not been widely examined. As part of a larger study on group cohesiveness and conversation, this investigation examined the patterns of co-speech gesture within authentic conversations among persons with aphasia to discern the functions of gesture use for the participants, changes in the use of gesture over time, and the relationship between gesture use and gesture ability. METHODS Conversation Analysis (CA) was applied in an embedded case-study design. Three participants received an academic semester of group and individual conversation-based treatment according to Facilitating Authentic Conversation (Damico et al., 2015). Four conversations from the treatment were selected and transcribed for multi-modality communication with CA conventions applied, and then cyclically analysed for patterns of gesture. RESULTS Participants demonstrated gesture that served social and linguistic functions: ratifying clinicians' proxy turns, turn-allocation, turn repair, relaying novel visual information, emphasizing content, demonstrating affiliation with the prior speaker, demonstrating their assessment others' talk, and demonstrating humor. All three participants showed an increased rate of gesture per turn and increasingly used gesture to repair conversation breakdown. Increased gesture use over the course of the semester coincided with increased scores for pantomime on the Porch Index of Communicative Ability (Porch, 1981, PICA). CONCLUSION Individuals with aphasia demonstrated increased use of gesture for varied purposes and improved gestural processing following a semester of conversation-based treatment. This is significant because gesture is an effective support for the repair of conversation breakdown typical of persons with aphasia.
Collapse
Affiliation(s)
- Jennifer Thompson Tetnowski
- University of Oklahoma Health Sciences Center, Department of Communication Sciences and Disorders, Oklahoma City, OK, USA.
| | - John A Tetnowski
- Oklahoma State University, Department of Communication Sciences and Disorders, Stillwater, OK, USA
| | - Jack S Damico
- University of Colorado Boulder, Department of Speech, Language, and Hearing Sciences, Boulder, CO, USA
| |
Collapse
|
3
|
Fridriksson J, Basilakos A, Boyle M, Cherney LR, DeDe G, Gordon JK, Harnish SM, Hoover EL, Hula WD, Pompon RH, Johnson LP, Kiran S, Murray LL, Rose ML, Obermeyer J, Salis C, Walker GM, Martin N. Demystifying the complexity of aphasia treatment: Application of the Rehabilitation Treatment Specification System (RTSS). Arch Phys Med Rehabil 2021; 103:574-580. [PMID: 34748758 DOI: 10.1016/j.apmr.2021.08.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/13/2021] [Accepted: 08/01/2021] [Indexed: 11/15/2022]
Abstract
A considerable body of research supports the use of behavioral communication treatment as the standard of care for aphasia. In spite of robust progress in clinical aphasiology, many questions regarding optimal care remain unanswered. One of the major challenges to progress in the field is the lack of a common framework to adequately describe individual treatments, which, if available, would allow comparisons across studies as well as improved communication among researchers, clinicians, and other stakeholders. Here, we describe how aphasia treatment approaches can be systematically characterized using the Rehabilitation Treatment Specification System (RTSS). At the core of the RTSS is a tripartite structure that focuses on targets (the behavior that is expected to change as a result of treatment), ingredients (what a clinician does to affect change in the target), and mechanism(s) of action (why a given treatment works by linking the ingredients to the target). Three separate papers in the current issue specifically describe how the RTSS can be used to describe different kinds of aphasia treatment approaches: functional approaches, cognitive-linguistic approaches, and biological approaches. It is our hope that the application of the RTSS in clinical aphasiology will improve communication in published studies, grant proposals, and in the clinical care of persons with aphasia.
Collapse
Affiliation(s)
- Julius Fridriksson
- Center for the Study of Aphasia Recovery (C-STAR), University of South Carolina.
| | - Alexandra Basilakos
- Center for the Study of Aphasia Recovery (C-STAR), University of South Carolina
| | - Mary Boyle
- Department of Communication Sciences and Disorders, Montclair State University, Montclair, NJ
| | - Leora R Cherney
- Think and Speak, Shirley Ryan Ability Lab, Chicago, IL; Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Gayle DeDe
- Department of Communication Sciences and Disorders, Temple University
| | - Jean K Gordon
- Department of Communication Sciences and Disorders, University of Iowa
| | - Stacy M Harnish
- Department of Speech and Hearing Science, The Ohio State University
| | | | - William D Hula
- Geriatric Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA; Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA
| | | | | | - Swathi Kiran
- Department of Speech-Language and Hearing Sciences, Boston University
| | - Laura L Murray
- School of Communication Sciences and Disorders, Western University, London, Canada
| | - Miranda L Rose
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Jessica Obermeyer
- Department of Communication Sciences and Disorders, University of North Carolina at Greensboro, Greensboro, NC
| | - Christos Salis
- Speech and Language Sciences, Newcastle University, Newcastle upon Tyne
| | - Grant M Walker
- Department of Cognitive Sciences, University of California, Irvine, Irvine, CA
| | - Nadine Martin
- Department of Communication Sciences and Disorders, Temple University
| |
Collapse
|
4
|
Caute A, Dipper L, Roper A. The City Gesture Checklist: The development of a novel gesture assessment. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2021; 56:20-35. [PMID: 33051977 DOI: 10.1111/1460-6984.12579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/02/2020] [Accepted: 09/08/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND People with aphasia rely on gesture more than healthy controls to get their message across, but use a limited range of gesture types. Gesture therapy is thus a potential avenue of intervention for people with aphasia. However, currently no gesture assessment evaluates how they use gesture. Such a tool could inform therapy targets and measure outcomes. In gesture research, many different coding categories are used to describe gesture forms and functions. These coding methods are prohibitively time-consuming to use in clinical practice. There is therefore a need for a 'quick and dirty' method of assessing gesture use. AIMS To investigate current practice among UK-based clinicians (speech and language therapists) in relation to gesture assessment and therapy, to synthesize gesture-coding frameworks used in aphasia research, to develop a gesture checklist based on the synthesized coding frameworks suitable for use in clinical practice, and to investigate the interrater reliability (IRR) of the checklist among experienced and unfamiliar users. METHODS & PROCEDURES The research team synthesized seven gesture-coding frameworks and trialled three resulting prototype checklists at a co-design workshop with 20 clinicians. Attending clinicians were also consulted about their current clinical gesture practice using a questionnaire. A final City Gesture Checklist (CGC) was developed based upon outcomes and feedback from the workshop. The IRR of the CGC was evaluated between the research team and 11 further clinicians within a second workshop. Both groups used the CGC to count gestures in video clips of people with aphasia talking to a conversation partner. MAIN CONTRIBUTION A total of 18 workshop attendees completed the current practice questionnaire. Of these, 10 reported assessing gesture informally and five also used formal assessment. Gesture-coding synthesis highlighted six main categories of gesture form. Clinicians at the co-design workshop provided feedback on prototype checklists regarding the relevance and usability of the gesture categories, layout, use of images and instructions. A final version of the CGC was created incorporating their recommendations. The IRR for the CGC was moderate between both the researchers and clinicians. CONCLUSIONS & IMPLICATIONS The CGC can be used to assess the types of gesture that people with aphasia produce. The IRR was moderate amongst both experienced users and new users who had received no training. Future research directions include investigating how to improve IRR, evaluating intra-rater reliability and sensitivity to change, and exploring use of the CGC in clinical practice. What this paper adds What is already known on the subject People with aphasia rely on gesture more than healthy speakers, yet use a more limited range of gesture types. Gesture therapy is used by clinicians with the aim of helping people with aphasia to compensate for their language impairment and/or to facilitate speech. What this paper adds to existing knowledge This study explores current gesture assessment practice among UK-based clinicians and synthesizes the coding categories used in the literature about gesture research in aphasia. It describes the development of a novel outcome measure, the CGC, and preliminary testing of its IRR. What are the potential or actual clinical implications of this work? This 'quick and dirty' tool enables clinicians to analyse and record the types of gesture produced by people with aphasia without the need for gesture coding. Preliminary findings suggest that clinicians can use it with a fair degree of reliability by following the checklist's written instructions.
Collapse
Affiliation(s)
- Anna Caute
- School of Health and Social Care, University of Essex, Colchester, UK
| | - Lucy Dipper
- Division of Language and Communication Science, City, University of London, London, UK
| | - Abi Roper
- Division of Language and Communication Science, City, University of London, London, UK
| |
Collapse
|
5
|
Vibrac C, Avias A, François PO, Isner-Horobeti ME, Krasny-Pacini A. Charlie Chaplin and gesture training in severe aphasia: A controlled double-blind single-case experimental design. Ann Phys Rehabil Med 2020; 64:101356. [PMID: 32032804 DOI: 10.1016/j.rehab.2019.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 12/12/2019] [Accepted: 12/21/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Aphasia following a stroke is a frequent and disabling condition that decreases quality of life. The use of gesture has been proposed as a way to enhance aphasia recovery. OBJECTIVE We aimed to explore whether 2 types of gesture interventions could improve communication in individuals with severe aphasia. METHODS This was a pilot study performed at home in routine care by an outreach team. The study had a controlled double-blind single-case experimental design (SCED): a controlled multiple baseline design across 3 participants and 2 behaviors (gesture and naming). Three male patients with stroke-induced severe chronic aphasia, non-functional perseverative speech and severe associated impairments underwent a passive gesture intervention, in which participants watched movies selected for their intensive use of gesture, and an active gesture intervention, in which they actively practiced gestures by using visual action therapy. The main outcome measures were naming score, gesture score and nonverbal subscale score of the Lillois Test of Communication, with 3-month follow-up. RESULTS In all 3 participants, gesture interventions improved the ability to gesture a list of words (Tau-U=0.38-0.67 for combined gesture intervention effect) and increased nonverbal communication activity. Benefits were maintained at 3-month follow-up. CONCLUSIONS Mute films that use intensive nonverbal communication may be a useful add-on to speech therapy for individuals with aphasia. Improving naming in severe and chronic aphasia may not be feasible, and more effort could be devoted to improving gesture-based and nonverbal communication.
Collapse
Affiliation(s)
- Clemence Vibrac
- Pôle Ambroise-Paré, service d'ORL, Hôpitaux civils de Colmar, 39, avenue de la Liberté, 68024 Colmar cedex, France; Pôle psychiatrie, service de psychiatrie infanto juvénile, Hôpitaux civils de Colmar, 39, avenue de la Liberté, 68024 Colmar cedex, France; Centre de formation universitaire en orthophonie de Strasbourg, 4, rue Kirschleger, 67000 Strasbourg, France
| | - Amelie Avias
- Centre de formation universitaire en orthophonie de Strasbourg, 4, rue Kirschleger, 67000 Strasbourg, France
| | - Pierre-Olivier François
- Pôle de médecine physique et de réadaptation, Institut Universitaire de réadaptation Clemenceau-Strasbourg, 45, boulevard Clémenceau, 67082 Strasbourg cedex, France
| | - Marie-Eve Isner-Horobeti
- Pôle de médecine physique et de réadaptation, Institut Universitaire de réadaptation Clemenceau-Strasbourg, 45, boulevard Clémenceau, 67082 Strasbourg cedex, France; Strasbourg university, Fédération de médecine translationnelle de Strasbourg, EA 3072 "mitochondrie, stress oxydant et protection musculaire", Strasbourg, France
| | - Agata Krasny-Pacini
- Pôle de médecine physique et de réadaptation, Institut Universitaire de réadaptation Clemenceau-Strasbourg, 45, boulevard Clémenceau, 67082 Strasbourg cedex, France; Strasbourg university, unité Inserm 1114 Neuropsychologie cognitive et physiopathologie de la schizophrénie, département de psychiatrie, Hôpital civil de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
| |
Collapse
|
6
|
Murteira A, Nickels L. Can gesture observation help people with aphasia name actions? Cortex 2019; 123:86-112. [PMID: 31760340 DOI: 10.1016/j.cortex.2019.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 09/04/2019] [Accepted: 10/15/2019] [Indexed: 11/19/2022]
Abstract
It has been suggested that gesture can play a role in the treatment of naming impairments in aphasia, however investigation is still sparse, especially when compared to research on verbal treatments. Critically, previous studies have included either verbal or gesture production in the training. However, while in speakers without language impairment, action naming is facilitated by gesture observation, no study has yet systematically determined whether gesture observation alone influences word retrieval in people with aphasia. This is the aim of the research presented here. In a gesture priming experiment, participants with aphasia named actions that were preceded by the observation of videos of congruent or unrelated gestures or a non-gesture control condition. At the group-level, action naming was facilitated by observation of congruent gestures. However, single-case analyses revealed variability in the extent to which the participants benefited from gesture cueing. The potential mechanisms underlying the effects of gesture observation on action picture naming in people with aphasia were examined by exploring participant-related and item-related predictors of improvement. It is concluded that gesture observation may facilitate verb retrieval at either semantic or lexical levels. In addition, and despite variability across individuals, gesture observation seems more likely to facilitate action naming in people with spared gesture semantics and mild-moderate deficits in lexical-semantic or post-semantic processing.
Collapse
Affiliation(s)
- Ana Murteira
- Department of Cognitive Science, Macquarie University, Sydney, Australia; International Doctorate of Experimental Approaches to Language and Brain - IDEALAB, Universities of Trento, Groningen, Potsdam, Newcastle and Macquarie University, Australia.
| | - Lyndsey Nickels
- Department of Cognitive Science, Macquarie University, Sydney, Australia
| |
Collapse
|
7
|
Wortman-Jutt S, Edwards D. Poststroke Aphasia Rehabilitation: Why All Talk and No Action? Neurorehabil Neural Repair 2019; 33:235-244. [PMID: 30900528 DOI: 10.1177/1545968319834901] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
There is ample agreement in the scientific literature, across diverse areas of study, that suggests that language and movement are interrelated. In particular, it is widely held that the upper limb and hand play a key role in language use. Aphasia, a common, disabling language disorder frequently associated with stroke, requires new restorative methods. A combinatorial hand-arm-language paradigm that capitalizes on shared neural networks may therefore prove beneficial for aphasia recovery in stroke patients and requires further exploration.
Collapse
Affiliation(s)
- Susan Wortman-Jutt
- 1 Burke Rehabilitation Hospital, White Plains, NY, USA
- 2 Burke Neurological Institute, White Plains, NY, USA
| | - Dylan Edwards
- 3 Moss Rehabilitation Research Institute, Elkins Park, PA, USA
- 4 Edith Cowan University, Joondalup, Western Australia, Australia
| |
Collapse
|
8
|
Persad C, Wozniak L, Kostopoulos E. Retrospective Analysis of Outcomes from Two Intensive Comprehensive Aphasia Programs. Top Stroke Rehabil 2015; 20:388-97. [DOI: 10.1310/tsr2005-388] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
9
|
Pritchard M, Cocks N, Dipper L. Iconic gesture in normal language and word searching conditions: a case of conduction aphasia. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2013; 15:524-534. [PMID: 23534389 DOI: 10.3109/17549507.2012.712157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Although there is a substantive body of research about the language used by individuals with aphasia, relatively little is known about their spontaneous iconic gesture. A single case study of LT, an individual with conduction aphasia indicated qualitative differences between the spontaneous iconic gestures produced alongside fluent speech and in tip of the tongue states. The current study examined the iconic gestures produced by another individual with conduction aphasia, WT, and a group of 11 control participants. Comparisons were made between iconic gestures produced alongside normal language and those produced alongside word-searching behaviour. Participants recounted the Tweety and Sylvester cartoon Canary Row. All gesture produced was analysed qualitatively and quantitatively. WT produced more iconic gestures than controls accompanying word searching behaviour, whereas he produced a similar frequency of iconic gestures to control participants alongside normal language. The iconic gestures produced in the two language contexts also differed qualitatively. Frequency of iconic gesture production was not affected by limb apraxia. This study suggests that there are differences between iconic gestures that are produced alongside normal language and those produced alongside word-searching behaviour. Theoretical and clinical implications of these findings are discussed.
Collapse
|
10
|
Lim KB, Kim YK, Lee HJ, Yoo J, Hwang JY, Kim JA, Kim SK. The therapeutic effect of neurologic music therapy and speech language therapy in post-stroke aphasic patients. Ann Rehabil Med 2013; 37:556-62. [PMID: 24020037 PMCID: PMC3764351 DOI: 10.5535/arm.2013.37.4.556] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 10/19/2012] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To investigate the therapeutic effect of neurologic music therapy (NMT) and speech language therapy (SLT) through improvement of the aphasia quotient (AQ) in post-stroke aphasic patients. METHODS Twenty-one post-stroke, nonfluent aphasia patients who had ischemic/hemorrhagic stroke on radiologic evaluation were divided into the NMT and SLT groups. They received NMT and SLT for 1 month. Language function was assessed by Korean version-Western Aphasia Battery before and after therapy. NMT consisted of therapeutic singing and melodic intonation therapy, and SLT consisted of language-oriented therapy. RESULTS Significant improvements were revealed in AQ, repetition, and naming after therapy in the NMT group and improvements in repetition in the SLT group of chronic stroke patients (p<0.05). There were significant improvements in language ability in the NMT group of subacute stroke patients. However, there was no significant improvement in the SLT group of subacute stroke patients. CONCLUSION We concluded that the two therapies are effective treatments in the chronic stage of stroke and NMT is effective in subacute post-stroke aphasic patients.
Collapse
Affiliation(s)
- Kil-Byung Lim
- Department of Rehabilitation Medicine, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | | | | | | | | | | | | |
Collapse
|
11
|
Linebarger MC, Schwartz MF, Kohn SE. Computer-based training of language production: An exploratory study. Neuropsychol Rehabil 2010. [DOI: 10.1080/09602010042000178] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- M. C. Linebarger
- a Natural Language Understanding, Unisys Corporation, Malvern, PA, USA; Moss Rehabilitation Research Institute, Philadelphia, PA, USA
| | - M. F. Schwartz
- b Moss Rehabilitation Research Institute, Philadelphia, PA, USA
| | - S. E. Kohn
- c National Analysts, Philadelphia, PA, USA
| |
Collapse
|
12
|
Lasker J, Hux K, Garrett K, Moncrief E, Eischeid T. Variations on the written choice communication strategy for individuals with severe aphasia. Augment Altern Commun 2009. [DOI: 10.1080/07434619712331277908] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
13
|
Jacobs B, Drew R, Ogletree BT, Pierce K. Augmentative and Alternative Communication (AAC) for adults with severe aphasia: where we stand and how we can go further. Disabil Rehabil 2009; 26:1231-40. [PMID: 15513721 DOI: 10.1080/09638280412331280244] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To review literature specific to the use of AAC with adults who have severe aphasia. METHOD The authors reviewed studies involving AAC interventions for adults with severe aphasia. RESULTS Published data support the use of aided and unaided AAC with adults with severe aphasia in controlled treatment contexts. Reported gains in communication typically have not generalized to everyday settings. CONCLUSIONS The application of AAC with persons with severe aphasia must address factors potentially limiting treatment success outside of training environments.
Collapse
Affiliation(s)
- B Jacobs
- Departmenmt of Human Services, Western Carolina University, Cullowhee, NC 28729, USA.
| | | | | | | |
Collapse
|
14
|
|
15
|
Kemmerer D, Chandrasekaran B, Tranel D. A case of impaired verbalization but preserved gesticulation of motion events. Cogn Neuropsychol 2008; 24:70-114. [PMID: 18386190 DOI: 10.1080/02643290600926667] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In most cultures, most of the time, when people talk they gesture. We took advantage of a rare opportunity to explore the relation between the verbalization and gesticulation of motion events by studying Marcel, an English speaker with a unilateral left-hemisphere lesion affecting frontal, parietal, and temporal sectors of the perisylvian cortex. Marcel has intact semantic knowledge of the three major classes of words that are commonly used in English descriptions of motion events - specifically, concrete nouns, action verbs, and spatial prepositions - as well as intact syntactic knowledge of how these word classes are typically combined in the intransitive motion construction (e.g., The ball rolled down the hill). However, his ability to retrieve the lexical-phonological structures of these words is severely impaired. Despite this profound anomia, he is still remarkably skilled at producing iconic manual depictions of motion events, as demonstrated in two experiments involving spontaneous gestures and one experiment involving elicited gestures. Moreover, the structural characteristics of Marcel's gestures are clearly sensitive to the idiosyncratic meanings of English verbs and prepositions, and they may also be sensitive to the way motion events are syntactically packaged in the intransitive motion construction. These findings improve our understanding of how some brain-damaged individuals with severe aphasia but without manual apraxia can successfully employ gesture to augment the semantic content of their speech.
Collapse
Affiliation(s)
- David Kemmerer
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN 47907-1353, USA.
| | | | | |
Collapse
|
16
|
|
17
|
Cicerone KD, Dahlberg C, Kalmar K, Langenbahn DM, Malec JF, Bergquist TF, Felicetti T, Giacino JT, Harley JP, Harrington DE, Herzog J, Kneipp S, Laatsch L, Morse PA. Evidence-based cognitive rehabilitation: recommendations for clinical practice. Arch Phys Med Rehabil 2000; 81:1596-615. [PMID: 11128897 DOI: 10.1053/apmr.2000.19240] [Citation(s) in RCA: 638] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To establish evidence-based recommendations for the clinical practice of cognitive rehabilitation, derived from a methodical review of the scientific literature concerning the effectiveness of cognitive rehabilitation for persons with traumatic brain injury (TBI) or stroke. DATA SOURCES A MEDLINE literature search using combinations of these key words as search terms: attention, awareness, cognition, communication, executive, language, memory, perception, problem solving, reasoning, rehabilitation, remediation, and training. Reference lists from identified articles also were reviewed; a total bibliography of 655 published articles was compiled. STUDY SELECTION Studies were initially reviewed according to the following exclusion criteria: nonintervention studies; theoretical, descriptive, or review papers; papers without adequate specification of interventions; subjects other than persons with TBI or stroke; pediatric subjects; pharmacologic interventions; and non-English language papers. After screening, 232 articles were eligible for inclusion. After detailed review, 61 of these were excluded as single case reports without data, subjects other than TBI and stroke, and nontreatment studies. This screening yielded 171 articles to be evaluated. DATA EXTRACTION Articles were assigned to 1 of 7 categories according to their primary area of intervention: attention, visual perception and constructional abilities, language and communication, memory, problem solving and executive functioning, multi-modal interventions, and comprehensive-holistic cognitive rehabilitation. All articles were independently reviewed by at least 2 committee members and abstracted according to specified criteria. The 171 studies that passed initial review were classified according to the strength of their methods. Class I studies were defined as prospective, randomized controlled trials. Class II studies were defined as prospective cohort studies, retrospective case-control studies, or clinical series with well-designed controls. Class III studies were defined as clinical series without concurrent controls, or studies with appropriate single-subject methodology. DATA SYNTHESIS Of the 171 studies evaluated, 29 were rated as Class I, 35 as Class II, and 107 as Class III. The overall evidence within each predefined area of intervention was then synthesized and recommendations were derived based on consideration of the relative strengths of the evidence. The resulting practice parameters were organized into 3 types of recommendations: Practice Standards, Practice Guidelines, and Practice Options. CONCLUSIONS Overall, support exists for the effectiveness of several forms of cognitive rehabilitation for persons with stroke and TBI. Specific recommendations can be made for remediation of language and perception after left and right hemisphere stroke, respectively, and for the remediation of attention, memory, functional communication, and executive functioning after TBI. These recommendations may help to establish parameters of effective treatment, which should be of assistance to practicing clinicians.
Collapse
Affiliation(s)
- K D Cicerone
- JFK-Johnson Rehabilitation Institute, Edison, NJ 08820, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Robey RR. A meta-analysis of clinical outcomes in the treatment of aphasia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 1998; 41:172-187. [PMID: 9493743 DOI: 10.1044/jslhr.4101.172] [Citation(s) in RCA: 244] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
An extensive search of aphasia-treatment literature yielded 55 reports of clinical outcomes satisfying the essential criteria for inclusion in a meta-analysis. The results confirmed those of an earlier meta-analysis in demonstrating the utility of aphasia treatments, generally considered, for bringing about desirable clinical outcomes. Beyond the general case, the new findings address clinical utility in finer detail than was previously possible. Effects of treatment for aphasia are synthesized and assessed for each of four important dimensions: amount of treatment, type of treatment, severity of aphasia, and type of aphasia.
Collapse
Affiliation(s)
- R R Robey
- University of Virginia, Charlottesville 22903, USA
| |
Collapse
|
19
|
|
20
|
Holland AL, Fromm DS, DeRuyter F, Stein M. Treatment efficacy: aphasia. JOURNAL OF SPEECH AND HEARING RESEARCH 1996; 39:S27-S36. [PMID: 8898264 DOI: 10.1044/jshr.3905.s27] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
This article presents a brief overview of aphasia, followed by a summary of research studies and program evaluation data addressed to answering the question of the efficacy of treatment for aphasia. Selected studies are reviewed in terms of the quality of evidence they present. In addition, a number of questions that remain unanswered are also presented. Several tables, designed to provide clarifying information concerning several aspects of research design (number and types of patients studied, examples of well-designed small-group or single-subject studies, clinical techniques for which efficacy data are available), are included. The conclusion of this review is that, generally, treatment for aphasia is efficacious.
Collapse
Affiliation(s)
- A L Holland
- Department of Speech and Hearing Sciences, University of Arizona, Tucson 85721, USA
| | | | | | | |
Collapse
|
21
|
Records NL. A measure of the contribution of a gesture to the perception of speech in listeners with aphasia. JOURNAL OF SPEECH AND HEARING RESEARCH 1994; 37:1086-1099. [PMID: 7823555 DOI: 10.1044/jshr.3705.1086] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The contribution of a visual source of contextual information to speech perception was measured in 12 listeners with aphasia. The three experimental conditions were: Visual-Only (referential gesture), Auditory-Only (computer-edited speech), and Audio-Visual. In a two-alternative, forced-choice task, subjects indicated which picture had been requested. The stimuli were first validated with listeners without brain damage. The listeners with aphasia were subgrouped as having high or low language comprehension based on standardized test scores. Results showed a significantly larger contribution of gestural information to the responses of the lower-comprehension subgroup. The contribution of gesture was significantly correlated with the amount of ambiguity experienced with the auditory-only information. These results show that as the auditory information becomes more ambiguous, individuals with impaired language comprehension deficits make greater use of the visual information. The results support clinical observations that speech information received without visual context is perceived differently than when received with visual context.
Collapse
|
22
|
|
23
|
|
24
|
Anderson SW, Damasio H, Damasio AR, Klima E, Bellugi U, Brandt JP. Acquisition of signs from American sign language in hearing individuals following left hemisphere damage and aphasia. Neuropsychologia 1992; 30:329-40. [PMID: 1376447 DOI: 10.1016/0028-3932(92)90106-v] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Three severely aphasic hearing patients with no prior knowledge of sign language were able to acquire competency in aspects of American Sign Language (ASL) lexicon and finger spelling, in contrast to a near complete inability to speak the English counterparts of these visuo-gestural signs. Two patients with damage in left postero-lateral temporal and inferior parietal cortices mastered production and comprehension of single signs and short meaningful sign sequences, but the one patient with damage to virtually all left temporal cortices was less accurate in single sign processing and was unable to produce sequences of signs at all. These findings suggest that conceptual knowledge is represented independently of the auditory-vocal records for the corresponding lexical entries, and that left anterior temporal cortices outside of traditional "language areas" are part of the neural network which supports the linkage between conceptual knowledge and linguistic signs, especially as they are used in the sequenced activations required for production or comprehension of meaningful sentences.
Collapse
Affiliation(s)
- S W Anderson
- Department of Neurology, University of Iowa College of Medicine, Iowa City
| | | | | | | | | | | |
Collapse
|
25
|
Affiliation(s)
- A R Damasio
- Department of Neurology, University of Iowa College of Medicine, Iowa City 52242
| |
Collapse
|
26
|
Cubelli R, Trentini P, Montagna CG. Re-education of Gestural Communication in a Case ol Chronic Global Aphasia and Limb Apraxia. Cogn Neuropsychol 1991. [DOI: 10.1080/02643299108253378] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
27
|
Borod JC, Fitzpatrick PM, Helm-Estabrooks N, Goodglass H. The relationship between limb apraxia and the spontaneous use of communicative gesture in aphasia. Brain Cogn 1989; 10:121-31. [PMID: 2469448 DOI: 10.1016/0278-2626(89)90079-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
This study investigated the relationship between limb apraxia, as assessed by a formal clinical test, and the production of spontaneous communicative gesture, as measured by a newly designed rating scale--the Nonvocal Communication Scale (NCS). Subjects were aphasic adult males with cerebrovascular lesions of the left hemisphere. The performance of aphasic patients on the praxis test and the NCS was independent of demographic, neuroanatomic, linguistic, or cognitive variables, except for global aphasics who were low-scoring across the board. There was a significant positive correlation, however, between praxis ability and spontaneous gestural communication. Clinical implications of these findings are discussed.
Collapse
Affiliation(s)
- J C Borod
- Queens College, City University of New York, Department of Psychology, Flushing 11367
| | | | | | | |
Collapse
|
28
|
|
29
|
Abstract
A 59-year-old, right-handed, college-educated male examined after stroke presented spelling alexia with relative sparing of writing. He was not aphasic. A striking feature of the alexia was preserved recognition of letters printed in view by the clinician. He was able to read words through letter-by-letter oral spelling when letters were presented in this dynamic fashion. We describe this as a dynamic form of spelling alexia. Head CT scan showed a large left hemisphere posterior lesion infringing on the corpus callosum, and a right hemisphere opercular lesion. We suggest that sparing of the right parietal-occipital cortex may contribute to the remarkable sparing of dynamic letter reading.
Collapse
|
30
|
Abstract
The chapter begins with a brief history of the behavioral medicine movement along with an overview of contemporary activities in the field. Three subsequent sections review technical innovations in major areas of clinical behavioral medicine: treatment, health care delivery, and preventive health care. The final section describes the methodological characteristics of research in behavioral medicine, discusses the field in light of the psychosomatic medicine and behavior modification movements, and calls for a conceptual integration that is authentically behavioristic. Already the quality of research in behavioral medicine appears comparable to that of research in behavior therapy. Even so, when viewed in terms of contemporary methodological desiderata, most of the work is fairly unimpressive. Possibly needed are "hybrid" experimental approaches in which the inferential power of intrasubject phase manipulations and between-subject outcome comparisons are combined. There is good reason to believe that behavioral medicine will follow the historical course of behavior therapy/modification, not the course of psychosomatic medicine. Behaviorally knowledgeable psychologists can become major service providers in liaison with well-informed medical practitioners. Some potentially deleterious influences on the behavioral medicine movement are (inevitable) mentalistic and dualistic thinking and a retreat toward psychosomatic medicine. Field behaviorism as an organizing schema can, in principle, serve as a safeguard against such untoward influences.
Collapse
|