A thesis submitted in partial fulfilment of - Queen Margaret University

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language system. Intervention for cognitive impairments has been reported to be successful for both improving cognitive functioning as well as decreasing severity of aphasia (Helm-Estabrooks, 1998). Therefore the treatment of higher order cognitive impairments should precede language rehabilitation (Van Mourik, Verschaeve, Boon, Paquier and Van Harskamp, 1992) or at least the provision of support which may facilitate the expression of other relatively intact abilities (Manley, Hawkins, Evans, Woldt and Roberston, 2001). Higher order processes are not yet completely understood. Currently there are a number of researchers investigating the fractionation of higher order processes with a view to developing a comprehensive theory which is anticipated to result in more successful instrumentation, for example, intelligence (Anderson, 2001), theory of mind (Stone, 1999), social cognition (Lough, Kipps, Treise, Watson, Blair and Hodges, in press) and higher cognitive process impairment observed in dementia (Salmon and Hodges, 2005). 6.3.4 Language ability The language abilities of participants were observed using a number of language assessments. The pre-training language screening assessment was compiled by the researcher and included extracts from published assessments and picture stimuli from the literature to evaluate both spoken and written single word processing abilities (see section 4.2.3). The language sub-test of the CLQT assessed the spoken language abilities of participants with tasks such as giving personal facts (i.e. name, address, date of birth etc.), confrontational naming, story retelling and generative naming (see section 4.2.2.1). Additionally, participants were asked to narrate the Cinderella story both in spoken and written form. The Cinderella story was not analysed but rather provided qualitative data on participant language in connected speech (see section 4.4.4.2 and Appendices 5.3a to 5.3h). 257
6.3.4.1 Pre-training language screening assessments The initial severity of aphasia is considered to be a prognostic factor in its recovery (see section 2.6.3.1) however this information was not available for this investigation. Instead the severity of aphasia of each participant was measured immediately prior to participation in the main investigation and the impact of aphasia severity was assessed using this data. The language ability of participants was assessed using the sub-test of the CLQT (Helm-Estabrooks, 2001) and data provided by the pre-training language screening assessments (see section 4.2.3). There was a range of severity of aphasia among participants. The CLQT language sub-test data indicated language processing abilities ranging from within normal limits to severely aphasic. The range of aphasia scores from the language screening assessments varied between 94% (raw score of 124.5 out of a possible maximum of 133) to 51% (raw score of 68) – the lower scores indicating more language severity. It was speculated that participants with more severely impaired language abilities would learn fewer new words than their less severely aphasic peers. The hypothesis ‘severity of aphasia is positively correlated with the recall of new vocabulary’ was supported for immediate recall by both the CLQT (r=+.605; 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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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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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
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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 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 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
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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: 320). Additionally, the CLQT indica
Page 283 and 284: abilities of each participant and a
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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 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
Page 329 and 330: 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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