A thesis submitted in partial fulfilment of - Queen Margaret University

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5.8 PARTICIPANT C3 Participant C3’s personal details are presented in Table 5.14. C3 had a history of vascular disease from an early age and presented with severe right upper and lower limb hemiparesis. She mobilised with an electronic wheelchair and her husband’s assistance. She mainly stayed in her home enjoying television programmes and occasional day trips with her husband. She was not receiving speech and language therapy at the time of the investigation. Table 5.14 C3’s personal, medical, language and cognitive data Personal details Language screening Word N-word scores Gender F Listening lexical decision 8 8 Age 54;03 Repetition 8 8 Education (yrs) 13 Reading lexical decision 8 8 Pre-morbid employment - Homemaker Read aloud 8 5 Months post-stroke 96 Spelling 6 1.5 Stroke details - Left parietal extension Categorisation 15 14 15 HADs anxiety 10 Naming 12 HADs depression 1 CLQT language 25 Mild Independent learning 120mins Aphasia score 124.5 93.6% Cognitive scores on CLQT Stepping-stone Route Attention Memory Executive function Visuospatial skills Clock drawing Non-linguistic learning 185 133 24 88 13 18 WNL Moderate WNL WNL WNL 100% 5.8.1 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 C3 with reference to the data in Table 5.14. 169
5.8.1.1 Personal attributes C3 was aged 54.03 at the time of the investigation and was one of the older participants. It would therefore be predicted that C3 would learn less vocabulary than younger participants but more than older participants. C3 had spent 13 years in education and pre-morbidly was a homemaker. Although homemaking and motherhood requires many organisational and planning skills (http://www.stepfour.com/jobs/301474010.htm) it would be predicted that participants with more education and more highly specialised employment might learn more vocabulary than C3. C3 self-rating for anxiety was quite high with depression rating considered to be within normal limits. She was 96 months post-stroke. Being one of the older participants and having less education and involvement in skilled employment would predict that C3 may not learn as many new words as other more highly skilled and younger participants. 5.8.1.2 Cognitive abilities and the capacity to learn The cognitive sub-tests of the CLQT indicated that C3’s cognitive abilities were within normal limits with the exception of memory, which was moderately impaired. It was felt that this was reflective of C3’s word-finding difficulties in the story-retelling task and word generation tasks. Memory impairment would predict some difficulty learning and recalling the new vocabulary (see section 2.6.3.3) however, she demonstrated the capacity to recall newly learned information by recalling 100% of the non-linguistic task for both immediate and delayed recall. 5.8.1.3 Severity of aphasia The language sub-test of the CLQT suggested that C3 had mild language difficulties. Her language screening scores are displayed in Table 5.14 for each task and mapped on to a cognitive neuropsychology model in Figure 5v below. C3’s data (see Table 5.14 and Figure 5v below) indicated that her main difficulty 170
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
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4.3 TRAINING SESSION PROCEDURE Each
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4.3.2.1 Training of stimuli: phonol
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assessments was administered both i
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to match the name and skill present
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4.4.3 Results of P1’s post-traini
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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 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
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Page 167 and 168: Table 5.5 Characteristics of error
Page 169 and 170: scores (Zigmond and Snaith, 1983) a
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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
Page 179 and 180: written form again without the aid
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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: 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
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Page 207 and 208: any other fictional stories so he w
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Page 217 and 218: pathways), spell words and non-word
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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Page 231 and 232: 5.15.1.1 Personal attributes C10 wa
Page 233 and 234: naming. C10 had some difficulties c
Page 237 and 238: SPOKEN WORD PICTURE WRITTEN WORD Au
Page 239 and 240: Table 5.31 C11’s detailed perform
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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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