A thesis submitted in partial fulfilment of - Queen Margaret University

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the methodology for the learning and assessment procedure. The effectiveness of the cognitive neuropsychology approach in supporting the main investigation and its strengths and weaknesses are discussed in Chapter 6 (see section 6.5). The next chapter addresses the question of whether post-stroke young adults can learn new vocabulary despite having language difficulties. Chapter 5 presents the findings of the main investigation and describes the profiles of 12 post-stroke adults with aphasia (six male and six female) who participated in the main investigation. As discussed, various factors are thought to affect the outcome of aphasia rehabilitation and it is possible that these factors may also influence the learning of new vocabulary (see section 2.6). Therefore, the main investigation also evaluated the contribution of each participant’s pre-existing characteristics to their learning abilities. These included personal attributes (age, education, employment, months post-stroke and emotional status); cognitive abilities (attention, memory, executive function and performance on the nonlinguistic learning task) and also their language abilities (word recognition, categorisation, reading, naming and spelling). This information was utilised to explain the ability (or inability) of each participant to learn the new vocabulary and additionally, to enable predictions to be made which may inform speech and language therapists regarding which adults would be most successful in learning new linguistic information and why. 133
Chapter 5 Main Investigation 5.1 INTRODUCTION The pilot studies (Chapter 4) have demonstrated that the novel stimuli and procedure were suitable for the training and assessment of new vocabulary learning by healthy adults and post-stroke adults with and without aphasia. The main investigation reported in this chapter whether adults with aphasia could learn new vocabulary. As previously discussed (see section 2.7) this knowledge could inform any theory of rehabilitation as it is currently not known if aphasia rehabilitation merely facilitates the accessing of previously known information which is now inaccessible due to cortical damage or if new learning is involved in the therapeutic process. This information could also have implications for the methods and stimuli employed in aphasia rehabilitation. This chapter reports the recruitment criteria of participants for the main investigation and outlines the procedure as developed through the process of the preliminary studies (Chapter 3) and pilot studies (Chapter 4). The results are divided into three main sections. Firstly, the findings relating to the main research question i.e. whether post-stroke adults with aphasia (
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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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indicates a large reduction of item
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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 155: 4.8 CHAPTER SUMMARY The three pilot
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 175 and 176: 5.5 PARTICIPANT C1 Participant C1
Page 177 and 178: SPOKEN WORD PICTURE WRITTEN WORD Au
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Page 187 and 188: 5.7.1.1 Personal attributes C2 was
Page 189 and 190: GOB pathways). C2’s speech was ch
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Page 195 and 196: C3’s narration of the Cinderella
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Page 201 and 202: 5.9.1.4 Rehearsal and consolidation
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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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5.11.1.1 Personal attributes C6 was
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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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5.13.1.1 Personal attributes C8 was
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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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