A thesis submitted in partial fulfilment of - Queen Margaret University

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ascertain if the adult brain can learn new vocabulary following cortical damage therefore evidence of plasticity in the recovery of language function will now be presented. 2.5.5 Evidence of plasticity in the recovery of language functions The adaptability of the brain to recover motor function following neuronal damage has been presented above (see section 2.5.3). As this investigation is concerned with the restitution of language function, the evidence regarding the plasticity of the language areas of the brain will be presented and discussed, beginning with the ability of the child’s brain to learn language despite the presence of language impairment. Specific language impairment is a developmental disorder where children may have difficulty in the recognition, learning and expression of language, in the presence of normal development in all other areas. The rehabilitation of phoneme discrimination with these children in a number of studies found that the repeated auditory stimuli exercises improved both the recognition and discrimination of the target trained sounds (Merzenich, Jenkins, Johnston, Schreiner, Miller and Tallal, 1996; Tallal, Miller, Bedi, Byma, Wang, Nagarajan, Schreiner, Jenkins and Merzenich, 1996). The authors assert that this training procedure may have caused the plastic reorganisation of the relevant neurones responsible for temporal segmentation in these children’s brains. Therefore plastic reorganisation of language function is evidenced in children but as previously discussed children’s brains are considered to be more pliable than the adult brain (see section 2.5). It has been demonstrated that the adult brain can reorganise following neural damage to the motor and sensory cortex (see section 2.5.3) however, language is a highly specialised mental function and one that is not readily taken over by adjoining parts of the brain following damage (Cappa, 2000; Robertson, 1999). There is however empirical evidence that demonstrates that the adult language system is receptive to rehabilitation training. An investigation using Positron 29
Emission Tomography (PET) scans analysed six people who had survived strokes affecting large areas on the Wernicke’s region of the brain (crucial for understanding language) and who had received intensive language therapy (Weiller, Isensee, Rijntjes, Huber, Muller, Bier, Dutschka, Woods, North and Diener, 1995). Following this therapy they recovered their understanding and expression of language. The PET scans revealed the outcome of this recovery. Cortical regions outside Wernicke’s area were illuminated (in both the left and right hemisphere) when these individuals performed tasks using functions that had originally involved the now severely damaged Wernicke’s area. This indicated that cortical reorganisation occurred enabling the restoration of language function. A further study of three left hemisphere stroke participants (2- 14 years post-stroke) investigated cortical plasticity following treatment for wordfinding difficulties (anomia) using magnetoencephalography (Cornelissen, Laine, Tarkiainen, Jarvensivu, Martin and Salmelin, 2003). The treatment elicited statistically significant training induced changes in cortical activity adjacent to each participant’s site of lesion. Additionally, there was no evidence of increased right hemispheric involvement following training, supporting the view that restoration of language-related networks in the damaged left hemisphere is crucial for recovery from anomia (Cornelissen et al. 2003). The success of constraint-induced therapy (CIT) in the restoration of limb function for people in the chronic stages of stroke has been discussed and incorporates the restraining of the unaffected limb forcing intensive use of the damaged limb (see section 2.5.3). Pulvermüller, Neininger, Elbert, Mohr, Rockstroh, Koebbel and Taub (2001) modified this CIT for language rehabilitation and evaluated it with people who had previously participated in conventional language therapy and who had reached a maximum in recovery of language function. Pulvermüller et al. (2001) observed that constraint-induced aphasia therapy, which constrained the use of compensatory communication strategies such as drawing and gesture, led to a significant improvement in the 30
Page 1 and 2: An Investigation into the Ability o
Page 3 and 4: Abstract Recent studies have establ
Page 5 and 6: Christine Malcolm (Chief Speech and
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: 1998), tingling, itching or painful
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
Page 77 and 78: (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
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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
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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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assessments indicated that she had
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5.15.1.1 Personal attributes C10 wa
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naming. C10 had some difficulties c
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Page 237 and 238:
SPOKEN WORD PICTURE WRITTEN WORD Au
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Table 5.31 C11’s detailed perform
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influencing factors (for example, a
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each participant’s relevant data,
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Table 5.32 Hierarchical cluster ana
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for months post-stroke, severity of
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Table 5.33 Correlation co-efficient
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Page 253 and 254:
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ecency and primacy effect, however,
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drawing skills and the ability to l
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with the creation of new neuronal c
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5.8.2.1). Secondly, the participant
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6.3.1.1 The impact of age on the le
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education that an individual experi
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unethical, even perhaps illegal, to
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assessment and treatment of emotion
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theories on the negative effects of
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(CLQT) was developed as a screening
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6.3.3.2 The impact of memory on the
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(executive scores of moderate, mild
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320). Additionally, the CLQT indica
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6.3.4.1 Pre-training language scree
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abilities of each participant and a
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person with aphasia only ever produ
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6.4.2 Methodology As previous resea
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assessing the learning of new vocab
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provided flexibility not only for s
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presentation. It was proposed that
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participants also lexicalised the n
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module and how it communicates with
Page 299 and 300:
theory of rehabilitation and in rel
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experience in different ways and ch
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upon language rehabilitation, for e
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the investigation of people with po
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Further statistical analyses with a
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extend the examination of the abili
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task), severity of aphasia and amou
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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
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Nation, I. S. P. (1983) Teaching an
Page 325 and 326:
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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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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A thesis submitted in partial fulfilment of - Queen Margaret University

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