A controlled study of changes in conversation following aphasia therapy for anomia

Abstract

This paper investigates the relationship between change in picture naming with anomia therapy and changes in word retrieval in conversations between adults with aphasia and a regular conversational partner. We present data from two therapy projects (Hickin et al. [1] and Best et al. [2]). In each study, therapy involved cueing with the aim of improving retrieval of a set of nouns. Naming of the experimental items was assessed twice prior to therapy and again immediately afterwards. There was a significant change in word finding, as measured by picture naming, for the group and for 11 of the 13 participants. At the same time points, we collected conversations between the person with aphasia and a regular conversational partner. We analysed these using Profile of Word Errors and Retrieval in Speech (Herbert et al. [3]) and investigated a set of conversational variables predicted to change with therapy. Unsurprisingly, the conversation data is not straightforward. There is no significant change on the conversation measures for the group but some changes for individuals. We predicted change in word retrieval after therapy would relate to change in everyday conversations and tested this by correlating the change (post-therapy minus mean pre-therapy) in picture naming with the change in conversation variables. There was a significant positive relationship between the change in picture naming and change in some conversation measures including the number of nouns produced in 5 min of conversation (r = 0.50, p < 0.05, one-tailed) and the number of nouns produced per substantive turn (r = 0.55, p < 0.05, one-tailed). The findings suggest changes in word finding following therapy for aphasia can be reflected in changes in conversation. The clinical implications of the complex results are explored.

A comparison of remote therapy, face to face therapy and an attention control intervention for people with aphasia: a quasi-randomised controlled feasibility study

“…29,39,40 An alternative explanation may lie in the therapy dose and/or content. Participants received only 8 hours of therapist led intervention, supplemented by homework practice.…”

“…This might involve raising the dose and including communicative as well as single word tasks in therapy. 29 Turning to assessment, a follow up study should explore word finding gains in conversation as well as naming. However, further constraints might be imposed on the conversational measure, e.g.…”

“…This test is sensitive to therapy induced change 26 and the materials have at least 95% name agreement when tested with healthy controls. 29 190 pictures were presented for naming at week 1 and week 4. Each participant's responses were examined in order to select 100 'difficult' items that would remain in the experiment.…”

“…The measure correlates with other assessments of word production 31 , and is sensitive to therapy induced change. 29 Three POWERS indices were used to explore change over time:…”

Effects of syntactic cueing therapy on picture naming and connected speech in acquired aphasia

“…Exceptions are Herbert, Best, Hickin, Osborne & Howard, 2003;Hickin et al (2007), Peach andReuter (2009), Greenwood, Grassley, Hickin &, and Best, Grassley, Greenwood, et al (2011), which attempted to track changes in conversation or connected speech. Findings to date are mixed, for example Best et al (2011) found no improvement in conversation for around half of the participants.…”