A thesis submitted in partial fulfilment of - Queen Margaret University

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A number of methodological issues arose for both the presentation and content of the stimuli. To address this, the methodology was amended (see section 4.4.4) and was considered suitable for teaching and assessing new vocabulary to an adult with normal cognitive and linguistic abilities. However, the aim of the main investigation was to assess if adults who had language impairment, as a result of a stroke could learn this new vocabulary. To ensure that any difficulties encountered by post-stroke adults in learning the new vocabulary was a reflection of their impaired language rather than some other variable of poststroke impairment pilot study two was carried out with participant P2 who had a stroke but was not aphasic. 4.5 PILOT STUDY TWO This study used the amended methodology (from pilot study one) to appraise the procedure with an adult who had a stroke but did not have aphasia. It was expected that the participant would be able to demonstrate learning of the new vocabulary presented during the training procedure. Also the timing of all sessions and assessments were evaluated with an adult who had experienced a stroke. 4.5.1 Participant details P2 was recruited from a local Chest, Heart and Stroke Association group. She was female (aged 59;06 years) and was 20 months post-stroke at the time of the study. She completed 17 years in education and did not seek employment following graduation. P2 lived with her husband and had no physical impairment or aphasia following her stroke, although there was a mild dysarthric quality (see section 2.2) to her speech. She reported that she mainly experienced memory difficulties. 121
4.5.2 Results of P2’s performance on screening assessments The screening assessments from pilot study one (see section 4.2) were administered to P2. Her performance on the subtests of the CLQT (Helm- Estabrooks, 2001) (see Table 4.6) indicated that P2’s attention, executive function, language and visuospatial skills were within normal limits (WNL) while memory and clock drawing skills were both mildly impaired. Table 4.6 Pilot Study Two Raw scores and severity rating for the CLQT (Helm-Estabrooks, 2001) by P2 Attention Memory Executive function Language Visuospatial skills Clock drawing severity 180 152 28 29 98 11 WNL Mild WNL WNL WNL Mild P2 demonstrated her ability to learn non-linguistic information by achieving 100% accuracy on the stepping-stone maze route (see section 4.2.2.2) for immediate recall and a score of 78% on the 3-minute delayed-recall. P2 scores on the HADs (Zigmond & Snaith, 1983) self-rating scale indicated that she was feeling both anxious (score = 14) and depressed (score = 18). P2’s language screening assessment results are displayed in Table 4.7. Her 100% performance confirmed that she did not present with aphasia. Table 4.7 Pilot Study Two Raw and percentage correct scores for P2’s language screening assessments Task Words Non-words Shapes Pictures Repetition 8 (100%) 8 (100%) Auditory lexical decision 8 (100%) 8 (100%) Reading 8 (100%) 8 (100%) Naming 12 (100%) Visual lexical decision 8 (100%) 8 (100%) Categorisation 15 (100%) 15 (100%) 15 (100%) Spelling 6 (100%) 6 (100%) 122
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An Investigation into the Ability o
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Abstract Recent studies have establ
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Christine Malcolm (Chief Speech and
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2.6.2.1 Lesion size and site 37 2.6
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3.6.1.2 Number and type of items to
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4.8 Chapter summary 132 Chapter 5 T
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5.9.1.1 Personal attributes 176 5.9
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5.15.1.1 Personal attributes 208 5.
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6.3.3.5 The impact of clock drawing
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Appendices 2.1 Main representative
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5.2 Raw and percentage scores for n
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Figures 2i Cognitive neuropsycholog
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Younger people who are having and s
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Chapter 2 Review of the literature
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sentences. As aphasia also affects
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continue to experience significant
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noted that there were three areas t
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natural reaction to the loss of abi
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2.3.3 Impact of aphasia on the fami
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facets of a person’s life as well
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with the literature regarding the l
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Rehabilitation is not thought to al
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everything that we learn and experi
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eorganisation in hemiplegic stroke
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(Kasten and Sabel, 1995) and replic
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1998), tingling, itching or painful
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Emission Tomography (PET) scans ana
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ehabilitation, function can be limi
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Studies have not always found age t
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larger intracranial capacity could
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permanent loss of particular skills
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depression in people with severe ap
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maintenance of permanent records of
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intensity aphasia rehabilitation wa
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2.7 CURRENT THEORETICAL ACCOUNTS OF
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people with apparently similar char
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Additionally, harmful or redundant
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information about a word (Harley, 2
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(as in semantic dementia) as well a
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esearchers (Breedin et al., 1998; W
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As many adults have acquired a wide
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healthy individuals as mentioned ab
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et al. (2001) evaluated the ability
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of new vocabulary where both the wo
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syllables in each word, therefore t
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vocabulary; facilitate the demonstr
Page 93 and 94: methodology developed and used in t
Page 95 and 96: Chapter 3 Preliminary Studies 3.1 I
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Page 117 and 118: Fifty four percent of participants
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Page 129 and 130: 4.3 TRAINING SESSION PROCEDURE Each
Page 131 and 132: 4.3.2.1 Training of stimuli: phonol
Page 133 and 134: assessments was administered both i
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Page 137 and 138: 4.4.3 Results of P1’s post-traini
Page 139 and 140: Table 4.4 Pilot Study One Total raw
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Page 151 and 152: 4.6.3 Methodological issues A numbe
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Page 155 and 156: 4.8 CHAPTER SUMMARY The three pilot
Page 157 and 158: Chapter 5 Main Investigation 5.1 IN
Page 159 and 160: - The medical stability of particip
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Page 163 and 164: (i.e. C1, P3 and C2) remained the t
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Page 167 and 168: Table 5.5 Characteristics of error
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Page 177 and 178: SPOKEN WORD PICTURE WRITTEN WORD Au
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C3’s narration of the Cinderella
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errors with six out of the 20 new w
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5.9.1.1 Personal attributes C4 was
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5.9.1.4 Rehearsal and consolidation
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achieved 100% recognition on the li
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any other fictional stories so he w
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the reading task. C5 matched eight
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some word-finding difficulties with
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5.12 PARTICIPANT C7 Participant C7
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pathways), spell words and non-word
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(reading) words she made 15 false p
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and PLC pathways). C8’s speech wa
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C9’s data (see Table 5.26 and Fig
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assessments indicated that she had
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5.15.1.1 Personal attributes C10 wa
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naming. C10 had some difficulties c
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SPOKEN WORD PICTURE WRITTEN WORD Au
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Table 5.31 C11’s detailed perform
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influencing factors (for example, a
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each participant’s relevant data,
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Table 5.32 Hierarchical cluster ana
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for months post-stroke, severity of
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Table 5.33 Correlation co-efficient
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ecency and primacy effect, however,
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drawing skills and the ability to l
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with the creation of new neuronal c
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5.8.2.1). Secondly, the participant
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6.3.1.1 The impact of age on the le
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education that an individual experi
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unethical, even perhaps illegal, to
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assessment and treatment of emotion
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theories on the negative effects of
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(CLQT) was developed as a screening
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6.3.3.2 The impact of memory on the
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(executive scores of moderate, mild
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320). Additionally, the CLQT indica
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6.3.4.1 Pre-training language scree
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abilities of each participant and a
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person with aphasia only ever produ
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6.4.2 Methodology As previous resea
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assessing the learning of new vocab
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provided flexibility not only for s
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presentation. It was proposed that
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participants also lexicalised the n
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module and how it communicates with
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theory of rehabilitation and in rel
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experience in different ways and ch
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upon language rehabilitation, for e
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the investigation of people with po
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Further statistical analyses with a
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extend the examination of the abili
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task), severity of aphasia and amou
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References Alexander, M. P. (1994)
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Candia, V., Schafer, Th., Taub, E.,
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Fillingham, J. K., Sage, K. and Lam
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Howard and Hatfield (1987) Aphasia
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Linebaugh, C. W. (1999) Merging the
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Nation, I. S. P. (1983) Teaching an
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Scheibel, A., Conrad, T., Perdue, S
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Warrington, E. K. and McCarthy (198
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Appendix 3.1 Preliminary study one:
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Appendix 3.2 (continued) Preliminar
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Appendix 3.4a Preliminary study two
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Appendix 3.6 Stimuli used for the m
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Appendix 3.6 (continued) Stimuli us
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Appendix 4.1 Methods of learning ne
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Appendix 4.2 Hospital Anxiety and D
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Appendix 4.2 (Continued) Hospital A
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Appendix 4.4 Non-linguistic learnin
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Appendix 4.5 Language screening ass
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Appendix 4.6 Familiar, trained and
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Appendix 4.8 Examples of written an
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APPENDIX 5.2 Participant consent fo
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Appendix 5.3 (Continued) Narrations
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Appendix 5.3 (Continued) Narrations
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Appendix 5.4 (continued) Hierarchic
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Appendix 5.5 (continued) Group corr
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Appendix 5.5 (continued) Group corr
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Appendix 5.7 Total recall of tasks
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A thesis submitted in partial fulfilment of - Queen Margaret University

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