A thesis submitted in partial fulfilment of - Queen Margaret University

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5.10 PARTICIPANT C5 Participant C5’s personal details are presented in Table 5.18. He was single and lived with his elderly father. He presented with moderate dominant upper and lower limb hemiparesis following his multiple strokes (all left hemisphere) and was independently mobile. C5 enjoyed watching television, in particular sport. Table 5.18 C5’s personal, medical, language and cognitive data Personal details Language screening Word N-word scores Gender M Listening lexical decision 8 8 Age 56;03 Repetition 8 8 Education (yrs) 13 Reading lexical decision 8 8 Pre-morbid employment - Army Chef Read aloud 8 6 Months post-stroke 20 Spelling 5 4 Stroke details – Categorisation 15 15 15 Multiple left hemispheric infarcts HADs anxiety 6 Naming 11.5 HADs depression 10 CLQT language 20 Severe Independent learning 109mins Aphasia score 127.5 95.9% Cognitive scores on CLQT Stepping-stone Route Attention Memory Executive function Visuospatial skills Clock drawing Non-linguistic learning 148 129 20 79 0 13 Mild Moderate Mild Mild Severe 72% 5.10.1 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 C5 with reference to the data in Table 5.18. 181
5.10.1.1 Personal attributes C5 was aged 56.03 at the time of the investigation and was one of the older participants. C5 spent 13 years in formal education and had worked as a chef in the army. The skills he required for this included, to be able to operate multiple tasks, be creative and imaginative, have good organisational skills and to have good communication skills (www.learndirect-advice.co.uk - profile 151). It was predicted that C5 would learn less vocabulary than younger participants and also less than participants with more education. C5’s self-rating for anxiety was considered within normal limits while his score for depression was ‘borderline abnormal’ and he was 20 months post-stroke. As the literature suggests that emotional difficulties impact upon cognitive and linguistic performance (see section 2.6.3.2) it was predicted that C5’s emotional status might negatively impact upon his ability to learn the new vocabulary. 5.10.1.2 Cognitive abilities and the capacity to learn The cognitive sub-tests of the CLQT indicated that C5 had mild deficits in attention, executive function and visuospatial skills. As he was able to copy the new words accurately and draw detailed pictures of the creatures the mild impairment of visuospatial skills was not considered to affect the training or assessment tasks. C5’s clock drawing skills were severely impaired. His moderate memory impairment was considered to be reflective of C5’s difficulties remembering the details of the story-retelling task and word-finding difficulties in generation naming tasks. Attention and memory impairments would predict some difficulty learning and recalling the new vocabulary (see section 2.6.3.3) and while C5 demonstrated some ability to learn new information he only achieved 72% accuracy in learning the non-linguistic task. 182
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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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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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session. This reflected the general
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4.4.5 Summary of pilot study one Pi
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4.5.2 Results of P2’s performance
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P2 recalled 14 (70%) of the new wor
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demonstrate this learning during im
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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
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
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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
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: 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 217 and 218: pathways), spell words and non-word
Page 219 and 220: (reading) words she made 15 false p
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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
Page 241 and 242: influencing factors (for example, a
Page 243 and 244: each participant’s relevant data,
Page 245 and 246: Table 5.32 Hierarchical cluster ana
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Page 249 and 250: 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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