A thesis submitted in partial fulfilment of - Queen Margaret University

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number of studies have provided evidence for cortical plasticity in the language areas of the brain during the chronic stages of stroke (see section 2.5.5). Information regarding the ability to learn new vocabulary in both the acute and chronic stages of aphasia would be informative to the theory of rehabilitation. The number of months post-stroke was used to denote the recovery stage for each participant. It would be predicted that the brain would be more stable in the chronic stages of recovery and have the capacity for cortical plasticity therefore it would be predicted that the longer post-stroke participants are, the more new vocabulary they would learn. 5.4.2.2 Cognitive abilities and the capacity to learn The cognitive abilities that were considered for the main investigation were assessed using the CLQT (see section 4.2.2.1) and included attention, memory, executive function and clock drawing skills. Visuospatial skills were observed to ensure there were no difficulties with task materials. The presence of cognitive impairment is considered to be an influencing factor on recovery and is thought to be involved in the acquisition and management of knowledge (see section 2.6.3.3), therefore it would be predicted that participants with cognitive difficulties would learn less new vocabulary than those without any impairment. Another factor that would be predicted to influence participant learning of the new vocabulary is the ability of participants to demonstrate the cognitive capacity to learn. If a person could not demonstrate the general capacity to learn, they would not be expected to be able to learn domain specific information such as language. Therefore, for those participants in this investigation who were unable to demonstrate the capacity to learn the non-linguistic steppingstone route it was predicted that they would also not be able to demonstrate the learning of the new vocabulary. 149
5.4.2.3 Severity of aphasia While the initial severity of aphasia experienced by participants was also not known (see section 2.6.3.1), it was decided to consider the potential for learning the new vocabulary in respect of current severity of aphasia as determined by total scores from the language screening assessments (see section 4.2.3). Each language screening assessment result was depicted on a cognitive neuropsychology model in terms of the various modules and pathways utilised for each task, highlighting each participant’s strengths and difficulties in their single word processing abilities. This was used to predict individual ability to learn the word forms and meanings of the new vocabulary both in spoken and written form. The language sub-section of the CLQT was also considered in noting the severity of aphasia. 5.4.2.4 Rehearsal and consolidation of learning The importance of rehearsal in the acquisition of knowledge has been discussed. Mental rehearsal has been demonstrated to invoke neuronal activity changes and foster synaptic connections between neurones and is considered fundamental in transferring knowledge from short-term memory to long-term memory (see section 2.5.2). The independent learning time of 30 minutes was incorporated into each training session (see section 3.7 and 4.3.2.3), however participants were not required to use the full 30 minutes. It would be predicted that participants who employed all 30 minutes independent learning time to rehearse and consolidate the new vocabulary would learn more vocabulary than participants who did not. A participant’s ability to demonstrate the learning of the new vocabulary is presented individually providing both quantitative and qualitative information about their particular language characteristics. An evaluation of the predictions is discussed in the final chapter (see section 6.5.4). The summary of each individual’s results refers to the cold recall tasks both spoken and written form in 150
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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Fifty four percent of participants
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preliminary studies the British Nat
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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
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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 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 and 168: Table 5.5 Characteristics of error
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Page 171: expected that younger participants
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
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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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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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