A thesis submitted in partial fulfilment of - Queen Margaret University

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pre-morbid presentations and functional severity. These were appraised in order to evaluate if those factors which affected the recovery of aphasia also impacted upon the ability to learn and/ or retain new vocabulary. This data would contribute to information about new learning in the language domain and also inform language rehabilitation theory by identifying factors that may impact upon the potential to learn new words. The various factors are now presented and discussed in relation to how they were measured; an evaluation of the method of measuring the factors, where appropriate; the impact of these factors on the learning of new vocabulary as tested by statistical correlations; and the implications for new learning in the language domain. It is noted that these observations do not reflect the effect of individual factors in isolation but rather a pooling and interaction of all relevant factors. Additionally, while the results from the statistical analyses in Chapter 5 represent the group of participants as a whole, individual participant variances from the group findings were noted and will be discussed for each factor. The factors are now presented and discussed under various headings. Those factors considered to be personal attributes incorporated participants’ age, education, cognitive reserve, emotional status and stage of recovery (see section 6.3.1 and sub-headings). Biological limitations are also discussed (see section 6.3.2). Cognitive abilities and the capacity to learn incorporated a number of factors including, attention, memory, executive functions, non-linguistic learning and clock drawing skills (see section 6.3.3 and sub-headings). The language ability of participants (see section 6.3.4 and sub-headings) and learning strategies used by participants (see section 6.3.5) were considered important factors to evaluate and are also discussed below. 6.3.1 Personal attributes The factors considered under the heading of personal attributes incorporated the age of participants, the number of years spent in formal education, emotional status of anxiety and depression and the number of months post-stroke. 239
6.3.1.1 The impact of age on the learning of new vocabulary As the literature indicates, the evidence is equivocal regarding the impact of age on the recovery from aphasia. Some evidence suggests that age is not a prognostic factor in the recovery from stroke, whereas other evidence indicates that overall younger people demonstrate better recovery than older adults following cortical damage (see section 5.4.2.1). The age of participants in the main investigation varied between 33;11 to 64;04 years of age and it was predicted that younger participants would demonstrate better learning of the new vocabulary than older participants. The hypothesis, ‘age correlates negatively with the recall of new vocabulary’ was supported both for immediate (r = -.755; p
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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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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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scores (Zigmond and Snaith, 1983) a
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expected that younger participants
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5.4.2.3 Severity of aphasia While t
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5.5 PARTICIPANT C1 Participant C1
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SPOKEN WORD PICTURE WRITTEN WORD Au
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written form again without the aid
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vocabulary than younger participant
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was non-fluent with many repetition
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emembering 49% of information origi
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5.7.1.1 Personal attributes C2 was
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GOB pathways). C2’s speech was ch
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assessment tasks (see Table 5.2), w
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C3’s narration of the Cinderella
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errors with six out of the 20 new w
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5.9.1.4 Rehearsal and consolidation
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achieved 100% recognition on the li
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any other fictional stories so he w
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the reading task. C5 matched eight
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Page 215 and 216: 5.12 PARTICIPANT C7 Participant C7
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Page 223 and 224: and PLC pathways). C8’s speech wa
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Page 231 and 232: 5.15.1.1 Personal attributes C10 wa
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Page 237 and 238: SPOKEN WORD PICTURE WRITTEN WORD Au
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Page 249 and 250: Table 5.33 Correlation co-efficient
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Page 261: 5.8.2.1). Secondly, the participant
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Page 273 and 274: (CLQT) was developed as a screening
Page 275 and 276: 6.3.3.2 The impact of memory on the
Page 277 and 278: (executive scores of moderate, mild
Page 279 and 280: 320). Additionally, the CLQT indica
Page 281 and 282: 6.3.4.1 Pre-training language scree
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Page 287 and 288: 6.4.2 Methodology As previous resea
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Page 307 and 308: Further statistical analyses with a
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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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