No abstract

No abstract

Purpose We piloted two new treatments, one based on sentence to picture matching (SPM) and the other based on object manipulation (OM), that train participants on the thematic roles of sentences using pictures or by manipulating objects. Methods Using a single subject multiple baseline design, sentence comprehension was trained on the affected sentence type in one task-related protocol in 15 participants with aphasia. The two tasks were SPM and OM and the treatment stimuli were Object relatives; Object clefts; Passives and Unaccusatives as well as two control structures; Object relatives with a complex NP, active sentences with three NPs. Results The criteria for efficacious treatment was an increase in the level of performance from the pre-treatment probes to post-treatment probes for the treated structure such that accuracy rose from at or below chance to above chance and either a) accuracy on rose by 33% or b) the effect size was 2.6. Based on these criteria, the success rate for training the target structure was 4/7 participants in the OM condition and 2/6 participants in the SPM condition. Conclusions The outcome of this study illustrates the utility of this theoretically-motivated and efficacious treatment for sentence comprehension deficits in participants with aphasia.

Persons with aphasia (PWA) often report difficulty understanding spoken language in noisy environments that require listeners to identify and selectively attend to target speech while ignoring competing background sounds or "maskers." This study compared the performance of PWA and age-matched healthy controls (HC) on a masked speech identification task and examined the consequences of different types of masking on performance. Twelve PWA and 12 age-matched HC completed a speech identification task comprising three conditions designed to differentiate between the effects of energetic and informational masking on receptive speech processing. The target and masker speech materials were taken from a closed-set matrix-style corpus, and a forced-choice word identification task was used. Target and maskers were spatially separated from one another in order to simulate real-world listening environments and allow listeners to make use of binaural cues for source segregation. Individualized frequency-specific gain was applied to compensate for the effects of hearing loss. Although both groups showed similar susceptibility to the effects of energetic masking, PWA were more susceptible than age-matched HC to the effects of informational masking. Results indicate that this increased susceptibility cannot be attributed to age, hearing loss, or comprehension deficits and is therefore a consequence of acquired cognitivelinguistic impairments associated with aphasia. This finding suggests that aphasia may result in increased difficulty segregating target speech from masker speech, which in turn may have implications for the ability of PWA to comprehend target speech in multitalker environments, such as restaurants, family gatherings, and other everyday situations.

This study was conducted to investigate the static and dynamic relationships between impairmentlevel cognitive-linguistic abilities and activity-level functional communication skills in persons with aphasia (PWA). Method: In Experiment 1, a battery of standardized assessments was administered to a group of PWA (N = 72) to examine associations between cognitive-linguistic ability and functional communication at a single time point. In Experiment 2, impairment-based treatment was administered to a subset of PWA from Experiment 1 (n = 39) in order to examine associations between change in cognitive-linguistic ability and change in function and associations at a single time point. Results: In both experiments, numerous significant associations were found between scores on tests of cognitive-linguistic ability and a test of functional communication at a single time point. In Experiment 2, significant treatment-induced gains were seen on both types of measures in participants with more severe aphasia, yet cognitive-linguistic change scores were not significantly correlated with functional communication change scores. Conclusions: At a single time point, cognitive-linguistic and functional communication abilities are associated in PWA. However, although changes on standardized assessments reflecting improvements in both types of skills can occur following an impairment-based therapy, these changes may not be significantly associated with each other. A phasia is an acquired neurogenic disorder that is characterized by various deficits in cognitivelinguistic abilities (i.e., specific skills such as word retrieval, syntactic production, or visual scanning that may be relatively spared or impaired in persons with aphasia) that can impact an individual's functional communication (i.e., an individual's ability to successfully complete communicative acts such as introducing a new topic during a conversation, requesting information, or responding in an emergency) and participation in everyday activities. Most modern frameworks of health and disability indicate that, although cognitive-linguistic skills and functional communication abilities are separate, these constructs are closely linked. One such framework, the World Health Organization's International Classification of Functioning, Disability and Health (ICF; 2001), was intended to allow for comparisons between different conditions on the basis of the impact they have on an individual in terms of body functions and structure, activity, and participation while also accounting for external factors (i.e., physical, social, or attitudinal factors) and personal factors (e.g., age, gender, and psychoemotional state). Within the ICF, cognitivelinguistic skills are classified within the body structures and functions component, and, for persons with aphasia (PWA), deficits in cognitive-linguistic abilities are considered impairment-level deficits. Functional communication abilities fall into the activity component, and deficits in these skills are considered activity-level deficits....