A thesis submitted in partial fulfilment of - Queen Margaret University

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5.6 PARTICIPANT P3 As participant P3 was included in the pilot studies his personal profile was presented in section 4.6.1 and also in Table 5.10 below. Table 5.10 P3’s personal, medical, language and cognitive data Personal details Language screening Word N-word scores Gender M Listening lexical decision 8 8 Age 64;04 Repetition 8 8 Education (yrs) 20 Reading lexical decision 8 8 Pre-morbid employment - Pharmacist Read aloud 7 4 Months post-stroke 7 Spelling 6 3.5 Stroke details – Categorisation 15 15 14 Left fronto parietal infarct HADs anxiety 1 Naming 12 HADs depression 1 CLQT language 26 Mild Independent learning 120mins Aphasia score 124.5 93.6% Cognitive sub-test scores on CLQT Stepping-stone Route Attention Memory Executive function Visuospatial skills Clock drawing Non-linguistic learning 144 149 21 78 13 18 Mild Mild Mild Mild WNL 100% 5.6.1 Predictive factors for learning new vocabulary The various factors for determining predictors of new learning are discussed in section 5.4.2 and are evaluated below for P3 with reference to the data in Table 5.10. 5.6.1.1 Personal attributes P3 was aged 64.04 at the time of the investigation and was one of the oldest participants. It would therefore be predicted that P3 would learn less new 157
vocabulary than younger participants. However, P3 had experienced 20 years of formal education and had completed undergraduate and post-graduate degrees (see section 4.6.1), and therefore would be expected to have highly developed skills in learning (see section 2.6.1.2). P3’s employment as a pharmacist involved specialist training and having excellent organisation skills, being able to work methodically, have logical thought processes and highly developed communication skills (www.learndirect-advice.co.uk - profile 163). P3’s selfrating for anxiety and depression placed him within normal limits and he was seven months post-stroke. Despite P3’s age it would be predicted that his experience in education and employment would have a positive impact on his ability to learn new vocabulary. Additionally, there were no adverse emotional factors to impact upon his learning ability. 5.6.1.2 Cognitive abilities and the capacity to learn The CLQT indicated that P3 had mild cognitive difficulties in attention, memory, executive function and visuospatial skill domains. Clock drawing skills were within normal limits. P3 demonstrated adequate attention, memory and executive function skills to achieve 100% accuracy in learning the non-linguistic task for both immediate and delayed recall. His ability to copy words and draw the creature images in detail demonstrated that any visuospatial difficulties did not affect the tasks involved in the investigation. As P3’s cognitive difficulties were mild in nature and he had demonstrated the capacity to learn new information it was predicted that cognitive factors would not severely impact upon his learning of the new vocabulary. 5.6.1.3 Severity of aphasia The language sub-test of the CLQT indicated that P3 had mild language difficulties. Language screening scores for P3 are displayed in Table 5.10 for each task and mapped on to a cognitive neuropsychology model in Figure 5iii below. 158
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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where main investigation participan
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perhaps reduce the number of items
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preliminary studies as described in
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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
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 and 168: Table 5.5 Characteristics of error
Page 169 and 170: scores (Zigmond and Snaith, 1983) a
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: written form again without the aid
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
Page 213 and 214: some word-finding difficulties with
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Page 219 and 220: (reading) words she made 15 false p
Page 223 and 224: and PLC pathways). C8’s speech wa
Page 227 and 228: C9’s data (see Table 5.26 and Fig
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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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