A thesis submitted in partial fulfilment of - Queen Margaret University

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5.13 PARTICIPANT C8 Participant C8’s personal details are presented on Table 5.24. He lived alone and was independent despite arthritis and obesity affecting mobility. Since his stroke main activities included watching television and walking to the local shops. He occasionally travelled by train to visit his family. Table 5.24 C8’s personal, medical, language and cognitive data Personal details Language screening Word N-word scores Gender M Listening lexical decision 8 5 Age 55;08 Repetition 6 3 Education (yrs) 11 Reading lexical decision 8 8 Pre-morbid employment – Read aloud 2 1 Miner and then Ship Stewart Months post-stroke 5 Spelling 5.5 2.5 Stroke details - Left fronto-parietal Categorisation 15 14 15 and lateral ventricle infarcts HADs anxiety 5 Naming 6 HADs depression 3 CLQT language 16 Severe Independent learning 80mins Aphasia score 99 74.4% Cognitive sub-test scores on CLQT Stepping-stone Route Attention Memory Executive function Visuospatial skills Clock drawing Non-linguistic learning 195 114 26 99 10 18 WNL Moderate WNL WNL Mild 100% 5.13.1 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 C8 with reference to the data in Table 5.24. 197
5.13.1.1 Personal attributes C8 was aged 55;08 at the time of the investigation and was one of the older participants. C8 spent 11 years in education and was previously employed as a miner (www.stepfour.com/jobs/850381010.htm) and then as a stewart on a ship (www.stepfour.com/jobs/350677026.htm). Both of these jobs involved manual labour requiring good attention and concentration skills. C8’s self-rating for anxiety and depression was considered to be within normal limits and he was five months post-stroke. In consideration of C8’s age, years in education and employment skills it would be anticipated that he would not learn as many words as other younger and more educated participants. Additionally, as he was only five months post-stroke he may not learn as many words as people with more chronic aphasia (see section 5.4.2.1). 5.13.1.2 Cognitive abilities and the capacity to learn The cognitive sub-tests of the CLQT indicated that C8’s attention, executive function and visuospatial skills were within normal limits and he had mild difficulties completing the clock drawing task. He presented with moderate memory impairment, which was felt to be a reflection of his severe aphasia. Memory impairment would predict difficulty learning and recalling the new vocabulary (see section 2.6.3.3) however as with participant C2 (see section 5.7.1.2) it was felt that the CLQT score did not give an accurate reflection of C8’s memory. He demonstrated the capacity to recall newly learned information by recalling 100% of the non-linguistic task for immediate and delayed recall. 5.13.1.3 Severity of aphasia The language sub-test of the CLQT suggested that C8 had severe language difficulties. His language screening scores are displayed in Table 5.24 for each task and mapped on to a cognitive neuropsychology model in Figure 5x below. C8’s data (see Table 5.24 and Figure 5x below) indicated that he had a number of language difficulties at single word level. 198
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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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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would be asked not to repeat the wo
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4.8 CHAPTER SUMMARY The three pilot
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Chapter 5 Main Investigation 5.1 IN
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- The medical stability of particip
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The methodology for the training an
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(i.e. C1, P3 and C2) remained the t
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the immediate recall was not the sa
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Table 5.5 Characteristics of error
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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 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
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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
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: (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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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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Page 259 and 260: with the creation of new neuronal c
Page 261 and 262: 5.8.2.1). Secondly, the participant
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Page 267 and 268: unethical, even perhaps illegal, to
Page 269 and 270: 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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