Does Naming Therapy Make Ordering in a Restaurant Easier? Dynamics of Co-Occurring Change in Cognitive-Linguistic and Functional Communication Skills in Aphasia

Abstract

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....

Cultural adaptation and psychometric testing of The Scenario Test UK for people with aphasia

“…Moreover, it has been suggested that composite cognitive scores, such as those derived by the CLQT, are strongly associated with functional communication scores (Meier et al . ) and this was the case in our study. Further, the significant correlation between The Scenario Test UK and measures of praxis indicate a relationship between the ability to convey a message and the ability to gesture.…”

“…, Meier et al . ). Visuospatial skills are important when people with aphasia attempt to use alternative means of communication such as drawing or pictorial supports.…”

“…, Meier et al . ). Lastly, there is a strong positive relation between limb praxis ability and spontaneous gesture ability (Borod et al .…”

“…, Meier et al . ). In other words, patterns of improvement at the impairment and functional levels also diverge and therefore both types of assessment should be used regularly.…”

“…In the UK, The Royal College of Speech and Language Therapists Clinical Guidelines (RCSLT 2005) recommend that assessment comprises: (1) language im-measures following therapy have found that though both types of measures may find improvements following therapy, language change scores are not significantly correlated with functional communication change scores (Aftonomos et al 2001, Meier et al 2017. In other words, patterns of improvement at the impairment and functional levels also diverge and therefore both types of assessment should be used regularly.…”