A thesis submitted in partial fulfilment of - Queen Margaret University

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investigation, achieving the second highest learning score (although he only remembered 49% of this information), whereas C11 was one of the youngest (aged 45;03 at the time of the investigation) but was ranked 12 th having learned the least amount of new information. While P3 was ranked last in the amount of information retained from the training sessions (retaining 49% of information originally learned) this was not true for all older participants. C3 who was the third oldest participant, ranked third in the amount of information retained i.e. 74%. Therefore a blanket statement cannot be made regarding older people’s ability to retain newly learned vocabulary. 6.3.1.2 The impact of education on the learning of new vocabulary The level of education that a person has experienced throughout their lifespan is another factor in the literature relating to the recovery of language function for which equivocal findings have been reported (see section 2.6.1.2). Research suggests that the more education that a person experiences, the greater the complexity and number of neuronal patterns that they develop in the language areas of the brain. However it has not yet been ascertained if this complexity is as a direct result of the education experience itself (Jacobs et al., 1993b). Additional research indicates that the education experience develops skills required for learning, such as planning, memorising and problem solving (Robertson 1999). The number of years of formal education experienced by participants with aphasia in the main investigation varied from nine to 21.5 years. It was therefore predicted that participants with a greater number of years in education would demonstrate better learning of the new vocabulary than participants with less education experience. The hypothesis ‘the number of years in education will correlate positively with the recall of new vocabulary’ was supported for both immediate (r = +.869; p
education that an individual experiences the more learning skills they acquire. The findings are also possibly consistent with the assertion that the more education individuals experience leads to more complex and greater neuronal patterns pre-morbidly, which may be less easily destroyed when damaged (see section 2.5). However brain-scanning techniques would be required to provide evidence for this hypothesis. 6.3.1.3 The impact of cognitive reserve on the learning of new vocabulary Interestingly, qualitative examination of the employment experience of participants appeared to reflect participants’ learning performance. With the exception of C3, participants with employment requiring more specialist skills such as pharmacy, engineering and managerial posts appeared to demonstrate more success at learning the new words than participants who experienced less skilled employment, such as factory work and homemaking. However these highly skilled participants have also experienced more education therefore more complex occupations may reflect long-term intellectual experiences resulting from education rather than employment status itself being a prognostic factor in learning new vocabulary. Another possible explanation could be related to the hypothetical cognitive reserve discussed in Chapter 2 (see section 2.6.1.3). Although not statistically analysed in the main investigation, qualitative data indicates some interesting findings. Two of the factors thought to influence and accumulate cognitive reserve are education and occupational levels. The type of occupation pursued by an individual is thought to contribute significantly to their non-verbal reasoning (Staff et al., 2004) and complex occupations are thought to require continuing education and sustained intellectual engagement, requiring mental effort and learning the ability to conceptualise problems (Stern, 2003). Additionally, both occupation and education are thought to act as reserves for verbal memory. Those participants who had experienced more education (13 242
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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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 213 and 214: some word-finding difficulties with
Page 215 and 216: 5.12 PARTICIPANT C7 Participant C7
Page 217 and 218: pathways), spell words and non-word
Page 219 and 220: (reading) words she made 15 false p
Page 221 and 222: 5.13.1.1 Personal attributes C8 was
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
Page 263: 6.3.1.1 The impact of age on the le
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Page 269 and 270: assessment and treatment of emotion
Page 271 and 272: theories on the negative effects of
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
Page 283 and 284: abilities of each participant and a
Page 285 and 286: person with aphasia only ever produ
Page 287 and 288: 6.4.2 Methodology As previous resea
Page 289 and 290: assessing the learning of new vocab
Page 291 and 292: provided flexibility not only for s
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Page 295 and 296: participants also lexicalised the n
Page 297 and 298: module and how it communicates with
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Page 307 and 308: Further statistical analyses with a
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Page 313 and 314: 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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