A thesis submitted in partial fulfilment of - Queen Margaret University

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5.4 CASE SERIES This investigation has established that people with post-stroke aphasia can demonstrate the learning of new vocabulary. The variation in learning ability has been highlighted above. The individual profiles of each participant will now be presented, incorporating relevant personal and medical information as well as raw scores on pre-training assessments (see section 4.2). Additionally, each participant’s individual ability to learn and retain the new vocabulary is also presented. 5.4.1 Individual profile structure In order to orientate the reader to the information presented the contents of the following tables will now be explained (see Table 5.6 below for an example). Personal details Gender Age Education (yrs) Pre-morbid employment - Months post-stroke Stroke details - HADs anxiety HADs depression Independent learning Table 5.6 Example of participant profile table Language screening scores Listening lexical decision Repetition Reading lexical decision Read aloud Spelling Categorisation Naming CLQT language Aphasia score Word N-word Cognitive sub-test scores on CLQT Attention Memory Executive function Visuospatial skills Clock drawing Stepping-stone Route Non-linguistic learning The first column in each table displays participant personal details including gender, age, number of years in education, pre-morbid employment, number of months post-stroke and brief details of their stroke type and location. This column will also present anxiety and depression levels from the HADs self-rating 145
scores (Zigmond and Snaith, 1983) as well as the total time taken by each participant for independent learning during the training procedure (see section 4.3.2.3). The second column presents each person’s raw scores for the language screening assessment as described in the previous chapter (see section 4.2.3) and includes the listening and reading lexical decision of words and non-words; repetition of words and non-words; reading aloud and written spelling of words and non-words; categorisation of shapes, pictures and words and the confrontation naming of pictures. The language score sub-test from the CLQT (Helm-Estabrooks, 2001) (see section 4.2.2.1) and the total language screening scores, representing a person’s severity of aphasia (see section 4.2.3), are also presented in this column. The remaining individual sub-tests of the CLQT (Helm-Estabrooks, 2001) are presented at the bottom of this table (i.e. attention, memory, executive function, visuospatial skills and clock drawing skills) and an indication of the severity of impairment in each domain is presented (normative scores are presented in Appendix 4.3 for reference). Finally, the immediate and delayed recall scores for the non-linguistic learning task are combined and presented in this table (see section 4.2.2.2). Qualitative data is also presented and summarised for each participant. This includes a description of each participant’s relevant social and medical background. As discussed earlier (see section 4.4.4.2), each participant narrated the Cinderella story in spoken and written formats (where able) to provide qualitative data on participants’ connected speech. These narrations are reported in Appendix 5.3a-5.3h. Characteristics of participants’ language are summarised using data from the Cinderella narrative and performance on language screening assessments. A representation of each participant’s single word processing strengths and difficulties is mapped on to cognitive neuropsychology architectures (see section 2.9.3). The legend for individual module details on the model consists of the following; a plain coloured 146
Page 1 and 2:
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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ehearsal taking place prior to the
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one were discussed with each partic
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Graph 3.2 Comparison of number of i
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As with preliminary study one, part
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during the training session, some p
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3.5 PRELIMINARY STUDY FOUR This stu
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Page 119 and 120: preliminary studies the British Nat
Page 121 and 122: where main investigation participan
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Page 125 and 126: preliminary studies as described in
Page 127 and 128: emember the route taking them from
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
Page 135 and 136: to match the name and skill present
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
Page 141 and 142: session. This reflected the general
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
Page 147 and 148: P2 recalled 14 (70%) of the new wor
Page 149 and 150: demonstrate this learning during im
Page 151 and 152: 4.6.3 Methodological issues A numbe
Page 153 and 154: would be asked not to repeat the wo
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
Page 161 and 162: The methodology for the training an
Page 163 and 164: (i.e. C1, P3 and C2) remained the t
Page 165 and 166: the immediate recall was not the sa
Page 167: Table 5.5 Characteristics of error
Page 171 and 172: expected that younger participants
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
Page 179 and 180: written form again without the aid
Page 181 and 182: vocabulary than younger participant
Page 183 and 184: was non-fluent with many repetition
Page 185 and 186: emembering 49% of information origi
Page 187 and 188: 5.7.1.1 Personal attributes C2 was
Page 189 and 190: GOB pathways). C2’s speech was ch
Page 191 and 192: assessment tasks (see Table 5.2), w
Page 195 and 196: C3’s narration of the Cinderella
Page 197 and 198: errors with six out of the 20 new w
Page 201 and 202: 5.9.1.4 Rehearsal and consolidation
Page 203 and 204: achieved 100% recognition on the li
Page 207 and 208: any other fictional stories so he w
Page 209 and 210: the reading task. C5 matched eight
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Page 215 and 216: 5.12 PARTICIPANT C7 Participant C7
Page 217 and 218: 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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5.14 PARTICIPANT C9 Participant C9
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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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5.16 PARTICIPANT C11 Participant C1
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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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