A thesis submitted in partial fulfilment of - Queen Margaret University

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Acknowledgements “…those who hope in the Lord will renew their strength, they will soar on wings like eagles, they will run and not grow weary they will walk and not be faint” Isaiah 40; 31 I cannot count the number of people who have helped me, even in what might seem the smallest of ways. Thank you – you have all contributed greatly to the final completion of this thesis. Much thanks must go to my Director of Studies and supervisors who helped guide and teach me throughout my research. Dr. Linda Armstrong, go raibh mile maith agat for your guidance, support and friendship and for having patience with my own individual ‘learning’ style. Thank you Dr. Daphne Waters and Duncan Robb for your invaluable help and advice. Many thanks to Laorag Hunter (Speech and Language Therapist, Dundee) for helping me in a last minute request to review my work. I’m very grateful for all your help. Particular appreciation must go to all the participants in this investigation – preliminary and pilot study participants from the staff and research students at QMUC and undergraduate students at QMUC for providing normative data for my methodology. A special thank you to all participants with aphasia and your partners for offering your time and energy in order to provide data for this investigation at no benefit to yourselves. It is much appreciated. Thank you also to the Speech and Language Therapists and managers from Lothian and Fife Trust, Chest, Heart and Stroke, Edinburgh and Telford College, Edinburgh for your help in recruiting participants for this investigation. The first three years of my PhD was supported by a studentship from QMUC, Edinburgh enabling me to study fulltime. To all staff and PhD students past and present in Speech and Language Sciences at QMUC, Edinburgh for all your support and encouragement along the way. Thank you to my fellow PhD students at the time – Olga, Ben, Ann, Rebecca, Richard and Fay for your friendship, fun and support. Special thanks to Steve for your IT support and for always being there when my computer took on a life of it’s own!! Thanks also to QMUC staff for advice on statistical methods for my data especially Dr. Stuart Wilson who generously gave his time at the eleventh and twelfth hour. Thanks to Dr. Carmel Lum for your advice and support the first three months of my thesis.
Christine Malcolm (Chief Speech and Language Therapist, Fife NHS Trust) I am grateful for all your support, encouragement and study leave when working fulltime. Thanks also to all my work colleagues for their support and encouragement. For my partner, Peter, my mam and my family– your love and belief in my ability to achieve anything I put my heart to has helped sustain me especially through the past two years. For Smokey our cat who guarded my thesis drafts by sitting on them and remained calm even when the printer was going crazy!! Thanks also to all my friends for their prayers and support when I was going crazy!!
Page 1 and 2: An Investigation into the Ability o
Page 3: Abstract Recent studies have establ
Page 7 and 8: 2.6.2.1 Lesion size and site 37 2.6
Page 9 and 10: 3.6.1.2 Number and type of items to
Page 11 and 12: 4.8 Chapter summary 132 Chapter 5 T
Page 13 and 14: 5.9.1.1 Personal attributes 176 5.9
Page 15 and 16: 5.15.1.1 Personal attributes 208 5.
Page 17 and 18: 6.3.3.5 The impact of clock drawing
Page 19 and 20: Appendices 2.1 Main representative
Page 21 and 22: 5.2 Raw and percentage scores for n
Page 23 and 24: Figures 2i Cognitive neuropsycholog
Page 25 and 26: Younger people who are having and s
Page 27 and 28: Chapter 2 Review of the literature
Page 29 and 30: sentences. As aphasia also affects
Page 31 and 32: continue to experience significant
Page 33 and 34: noted that there were three areas t
Page 35 and 36: natural reaction to the loss of abi
Page 37 and 38: 2.3.3 Impact of aphasia on the fami
Page 39 and 40: facets of a person’s life as well
Page 41 and 42: with the literature regarding the l
Page 43 and 44: Rehabilitation is not thought to al
Page 45 and 46: everything that we learn and experi
Page 47 and 48: eorganisation in hemiplegic stroke
Page 49 and 50: (Kasten and Sabel, 1995) and replic
Page 51 and 52: 1998), tingling, itching or painful
Page 53 and 54: Emission Tomography (PET) scans ana
Page 55 and 56:
ehabilitation, function can be limi
Page 57 and 58:
Studies have not always found age t
Page 59 and 60:
larger intracranial capacity could
Page 61 and 62:
permanent loss of particular skills
Page 63 and 64:
depression in people with severe ap
Page 65 and 66:
maintenance of permanent records of
Page 67 and 68:
intensity aphasia rehabilitation wa
Page 69 and 70:
2.7 CURRENT THEORETICAL ACCOUNTS OF
Page 71 and 72:
people with apparently similar char
Page 73 and 74:
Additionally, harmful or redundant
Page 75 and 76:
information about a word (Harley, 2
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(as in semantic dementia) as well a
Page 79 and 80:
esearchers (Breedin et al., 1998; W
Page 81 and 82:
As many adults have acquired a wide
Page 83 and 84:
healthy individuals as mentioned ab
Page 85 and 86:
et al. (2001) evaluated the ability
Page 87 and 88:
of new vocabulary where both the wo
Page 89 and 90:
syllables in each word, therefore t
Page 91 and 92:
vocabulary; facilitate the demonstr
Page 93 and 94:
methodology developed and used in t
Page 95 and 96:
Chapter 3 Preliminary Studies 3.1 I
Page 97 and 98:
for the main investigation by the n
Page 99 and 100:
3.2.1.4 Delayed recall Approximatel
Page 101 and 102:
written recall assessment task (par
Page 103 and 104:
indicates a large reduction of item
Page 105 and 106:
ehearsal taking place prior to the
Page 107 and 108:
one were discussed with each partic
Page 109 and 110:
Graph 3.2 Comparison of number of i
Page 111 and 112:
As with preliminary study one, part
Page 113 and 114:
during the training session, some p
Page 115 and 116:
3.5 PRELIMINARY STUDY FOUR This stu
Page 117 and 118:
Fifty four percent of participants
Page 119 and 120:
preliminary studies the British Nat
Page 121 and 122:
where main investigation participan
Page 123 and 124:
perhaps reduce the number of items
Page 125 and 126:
preliminary studies as described in
Page 127 and 128:
emember the route taking them from
Page 129 and 130:
4.3 TRAINING SESSION PROCEDURE Each
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4.3.2.1 Training of stimuli: phonol
Page 133 and 134:
assessments was administered both i
Page 135 and 136:
to match the name and skill present
Page 137 and 138:
4.4.3 Results of P1’s post-traini
Page 139 and 140:
Table 4.4 Pilot Study One Total raw
Page 141 and 142:
session. This reflected the general
Page 143 and 144:
4.4.5 Summary of pilot study one Pi
Page 145 and 146:
4.5.2 Results of P2’s performance
Page 147 and 148:
P2 recalled 14 (70%) of the new wor
Page 149 and 150:
demonstrate this learning during im
Page 151 and 152:
4.6.3 Methodological issues A numbe
Page 153 and 154:
would be asked not to repeat the wo
Page 155 and 156:
4.8 CHAPTER SUMMARY The three pilot
Page 157 and 158:
Chapter 5 Main Investigation 5.1 IN
Page 159 and 160:
- The medical stability of particip
Page 161 and 162:
The methodology for the training an
Page 163 and 164:
(i.e. C1, P3 and C2) remained the t
Page 165 and 166:
the immediate recall was not the sa
Page 167 and 168:
Table 5.5 Characteristics of error
Page 169 and 170:
scores (Zigmond and Snaith, 1983) a
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expected that younger participants
Page 173 and 174:
5.4.2.3 Severity of aphasia While t
Page 175 and 176:
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
Page 181 and 182:
vocabulary than younger participant
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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
Page 191 and 192:
assessment tasks (see Table 5.2), w
Page 193 and 194:
Page 195 and 196:
C3’s narration of the Cinderella
Page 197 and 198:
errors with six out of the 20 new w
Page 199 and 200:
Page 201 and 202:
5.9.1.4 Rehearsal and consolidation
Page 203 and 204:
achieved 100% recognition on the li
Page 205 and 206:
Page 207 and 208:
any other fictional stories so he w
Page 209 and 210:
the reading task. C5 matched eight
Page 211 and 212:
Page 213 and 214:
some word-finding difficulties with
Page 215 and 216:
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:
Page 223 and 224:
and PLC pathways). C8’s speech wa
Page 225 and 226:
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
Page 233 and 234:
naming. C10 had some difficulties c
Page 235 and 236:
Page 237 and 238:
SPOKEN WORD PICTURE WRITTEN WORD Au
Page 239 and 240:
Table 5.31 C11’s detailed perform
Page 241 and 242:
influencing factors (for example, a
Page 243 and 244:
each participant’s relevant data,
Page 245 and 246:
Table 5.32 Hierarchical cluster ana
Page 247 and 248:
for months post-stroke, severity of
Page 249 and 250:
Table 5.33 Correlation co-efficient
Page 251 and 252:
Page 253 and 254:
Page 255 and 256:
ecency and primacy effect, however,
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
Page 265 and 266:
education that an individual experi
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 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
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
Page 299 and 300:
theory of rehabilitation and in rel
Page 301 and 302:
experience in different ways and ch
Page 303 and 304:
upon language rehabilitation, for e
Page 305 and 306:
the investigation of people with po
Page 307 and 308:
Further statistical analyses with a
Page 309 and 310:
extend the examination of the abili
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:
Page 331 and 332:
Appendix 3.2 (continued) Preliminar
Page 333 and 334:
Appendix 3.4a Preliminary study two
Page 335 and 336:
Appendix 3.6 Stimuli used for the m
Page 337 and 338:
Appendix 3.6 (continued) Stimuli us
Page 339 and 340:
Appendix 4.1 Methods of learning ne
Page 341 and 342:
Appendix 4.2 Hospital Anxiety and D
Page 343 and 344:
Appendix 4.2 (Continued) Hospital A
Page 345 and 346:
Appendix 4.4 Non-linguistic learnin
Page 347 and 348:
Appendix 4.5 Language screening ass
Page 349 and 350:
Appendix 4.6 Familiar, trained and
Page 351 and 352:
Appendix 4.8 Examples of written an
Page 353 and 354:
APPENDIX 5.2 Participant consent fo
Page 355 and 356:
Appendix 5.3 (Continued) Narrations
Page 357 and 358:
Appendix 5.3 (Continued) Narrations
Page 359 and 360:
Appendix 5.4 (continued) Hierarchic
Page 361 and 362:
Page 363 and 364:
Page 365 and 366:
Appendix 5.5 (continued) Group corr
Page 367 and 368:
Appendix 5.5 (continued) Group corr
Page 369:
Appendix 5.7 Total recall of tasks
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