A thesis submitted in partial fulfilment of - Queen Margaret University

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The way the cognitive neuropsychological model was used to support the design of the training and assessment tasks and procedures are discussed in the relevant sections of 4.3 and summarised in Figure 4ii below. SPOKEN WORD PICTURE WRITTEN WORD Listening– identification of sounds Pre-exposure of creature image Reading – identification of letters Listening recognition of new words Written recognition of new words Repetition of new words Judgement, image concept, skill, habitat / food Read aloud new words Picture syllable pairs Syllable completion Copy new words Buffer for speaking Spelling of new words Buffer for writing Speech Figure 4ii Support of cognitive neuropsychological model for learning procedure Writing 131
4.8 CHAPTER SUMMARY The three pilot studies described in this chapter narrate the evolution of the methodology to its final completion. The screening assessments were evaluated for use in the main investigation. The HADs self-rating scale (Zigmond and Snaith, 1983) was considered adequate for evaluating the emotional well-being of participants in terms of anxiety and depression, as the scores appeared to reflect participants’ report of how they felt at the time of the studies. All participants in the main investigation completed the HADs with the help of the researcher who read the individual statements aloud to ensure that those participants who presented with acquired reading difficulties as a result of their stroke understood the task. The CLQT (Helm-Estabrooks, 2001) appeared to be adequate in screening the cognitive abilities and difficulties of participants. The ‘stepping-stone route’ appeared to be appropriate for assessing non-verbal learning tasks as based on Evans et al. (2000). Additionally, the language screening assessment was considered to be sufficient to differentiate between varying degrees of aphasia severity and would be used in conjunction with the language screening sub-test of the CLQT (Helm-Estabrooks, 2001). The stimuli and methodology proved successful in training and assessing participants in the acquisition of new vocabulary. Participants P1 and P2 demonstrated that it was possible to learn this novel vocabulary (see section 4.4.3.1 and 4.5.3.1) and retain it in long-term memory (see section 4.4.3.2 and 4.5.3.2). The methodology was also suitable for training and assessing participant P3 who presented with aphasia (see section 4.6) and therefore considered suitable for training and evaluating the ability of participants with aphasia to learn new vocabulary in the main investigation. As reported by De Groot and Keijzer (2000) participants were motivated to learn the nonsense vocabulary (see section 2.8.5.1) and reported that they found it enjoyable and that the novelty help maintain their attention. The methodology was discussed in relation to the robustness of the cognitive neuropsychology model in supporting 132
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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
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methodology developed and used in t
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Chapter 3 Preliminary Studies 3.1 I
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for the main investigation by the n
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3.2.1.4 Delayed recall Approximatel
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written recall assessment task (par
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Page 115 and 116: 3.5 PRELIMINARY STUDY FOUR This stu
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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 143 and 144: 4.4.5 Summary of pilot study one Pi
Page 145 and 146: 4.5.2 Results of P2’s performance
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Page 151 and 152: 4.6.3 Methodological issues A numbe
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Page 157 and 158: Chapter 5 Main Investigation 5.1 IN
Page 159 and 160: - The medical stability of particip
Page 161 and 162: The methodology for the training an
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 173 and 174: 5.4.2.3 Severity of aphasia While t
Page 175 and 176: 5.5 PARTICIPANT C1 Participant C1
Page 177 and 178: SPOKEN WORD PICTURE WRITTEN WORD Au
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Page 195 and 196: C3’s narration of the Cinderella
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5.10.1.1 Personal attributes C5 was
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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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