A thesis submitted in partial fulfilment of - Queen Margaret University

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ninth and tenth in the ability to learn new vocabulary. Therefore there does not appear to be any merit in using this test as a prognostic tool for language rehabilitation. It might be useful however, to evaluate the recovery of a person from aphasia and their ability to learn more complex non-linguistic tasks that may be more sensitive for executive function and memory recruitment. 6.3.3.5 The impact of clock drawing task on the learning of new vocabulary Helm-Estabrooks (2001) advises that the clock drawing task recruits all five cognitive processes, i.e. attention, memory, executive function, visuospatial skills and language, and can therefore be used independently as a miniscreening assessment of cognitive functioning. The data from this task was analysed to ascertain if the clock drawing task might be useful as a prognostic factor in new vocabulary learning. Participant ability to complete the clock drawing task varied from within normal limits to severely impaired. As cognitive processes have been shown to be important in the acquisition and recall of new information and in language processing itself (see section 2.6.3.3) it was predicted that participants who had good clock drawing skills would learn more vocabulary than those with no impairment for this task. The hypothesis ‘clock drawing skills are correlated positively with the recall of new vocabulary’ was supported both for immediate (r = +.774; p
320). Additionally, the CLQT indicated that C6’s attention, executive functions and visuospatial skills were within normal limits and while he presented with moderate memory difficulties, instructions for the task were presented in written form, which could be read time and again. It was therefore not possible to identify what cognitive difficulties affected C6’s ability to complete this task. Therefore it is not possible to predict the usefulness of this task. Its robustness in assessing the various components of cognitive ability or claims for the predictive ability of the clock drawing task are questionable. 6.3.3.6 Summary The hypotheses relating to the impact of attention, memory and executive functions on the acquisition of new vocabulary have been supported for both the learning and retaining of new vocabulary. This group trend indicated that the greater the impairment in these cognitive domains, the more impact there was on the ability to demonstrate the learning of new vocabulary. It is speculated that, as indicated by the literature (see section 2.6.3.3), these hypotheses would also be supported for learning investigations involving populations other than stroke who experience these cognitive impairments. However, it was felt that more robust cognitive screening assessments (based on a robust theoretical model) should be used to facilitate the measurement of cognitive domains for people whose language difficulties may underestimate their cognitive abilities. The group trends suggest that the most appropriate person for language rehabilitation would be someone who had intact attention, memory and executive function because of their learning potential, however mild impairments would appear to be adequate for rehabilitation as demonstrated by P3 who was mildly impaired in all cognitive domains but ranked second in his ability to learn the new vocabulary. Fillingham, Sage and Lambon Ralph (2005) report that immediate and long-term improvements of naming ability related to participants’ executive functions and recognition memory, therefore these abilities impact not only upon the learning of new vocabulary but also the restitution of a damaged 256
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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some word-finding difficulties with
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pathways), spell words and non-word
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(reading) words she made 15 false p
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and PLC pathways). C8’s speech wa
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Page 227 and 228: C9’s data (see Table 5.26 and Fig
Page 229 and 230: assessments indicated that she had
Page 231 and 232: 5.15.1.1 Personal attributes C10 wa
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Page 235 and 236: 5.16 PARTICIPANT C11 Participant C1
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 257 and 258: drawing skills and the ability to l
Page 259 and 260: with the creation of new neuronal c
Page 261 and 262: 5.8.2.1). Secondly, the participant
Page 263 and 264: 6.3.1.1 The impact of age on the le
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Page 267 and 268: unethical, even perhaps illegal, to
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: (executive scores of moderate, mild
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
Page 293 and 294: presentation. It was proposed that
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 311 and 312: task), severity of aphasia and amou
Page 313 and 314: References Alexander, M. P. (1994)
Page 315 and 316: Candia, V., Schafer, Th., Taub, E.,
Page 317 and 318: Fillingham, J. K., Sage, K. and Lam
Page 319 and 320: Howard and Hatfield (1987) Aphasia
Page 321 and 322: Linebaugh, C. W. (1999) Merging the
Page 323 and 324: Nation, I. S. P. (1983) Teaching an
Page 325 and 326: Scheibel, A., Conrad, T., Perdue, S
Page 327 and 328: 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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