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In einer multiplen Einzelfallstudie mit zehn aphasischen Patienten wurde die Wirksamkeit eines semantischen und eines phonologischen Therapieansatzes zur Behandlung von Wortabrufstörungen verglichen. Detaillierte Einzelfalluntersuchungen ermöglichten die Diagnose der zugrundeliegenden funktionalen Störungen bei jedem Patienten. Auf diese Weise konnten die erzielten Therapieeffekte auf die individuellen kognitiv-neurolinguistischen Störungsmuster bezogen werden. Im Vordergrund der Therapie stand in beiden Ansätzen das mündliche Benennen von Objektabbildungen mit unterschiedlichen Arten von Hilfen. Während in der semantischen Therapie Teilaspekte des semantischen Zielkonzepts als Benennhilfen eingesetzt wurden, handelte es sich bei den phonologischen Hilfen um Teilinformationen der Zielwortform. Bei der Erhebung von spezifischen Therapieeffekten wurde zwischen itemspezifischen und itemübergreifenden Verbesserungen sowie kurz- und langfristigen Effekten auf die mündlichen Benennleistungen unterschieden. Dabei wurden neben den quantitativen Verbesserungen (% korrekt) auch die qualitativen Effekte (Fehlertypen) der beiden Ansätze berücksichtigt, und es wurden Transfereffekte in die Spontansprache der Patienten untersucht. Zusätzlich wurden auch die Soforteffekte der verschiedenen Benennhilfen in den Therapiesitzungen erhoben. Im Methodenvergleich zeigte sich, dass die phonologische Therapiephase kurzfristig bei der Mehrzahl der Patienten signifikante Verbesserungen beim Bildbenennen bewirkte, diese Effekte haben sich jedoch überwiegend als nicht stabil erwiesen. Im Gegensatz dazu erwies sich die semantische Therapiephase auch als langfristig effektiv. Im Unterschied dazu erwiesen sich die phonologischen Benennhilfen bei fast allen Patienten als unmittelbar effektiver als die semantischen Benennhilfen. Somit waren die Soforteffekte der Hilfetypen in den Therapiesitzungen kein sicherer Indikator für die Dauer der Gesamteffekte einer Therapiephase. Außerdem zeigte sich nicht bei allen Patienten ein direkter Zusammenhang zwischen der Art ihrer zugrundeliegenden funktionalen Störung und den erzielten Therapieeffekten. Einerseits profitierten Patienten mit erhaltenen semantischen Verarbeitungsleistungen von der semantischen Therapie, andererseits zeigten sich signifikante phonologische Therapieeffekte bei Patienten mit zentral-semantischen Störungen. Die Wirkmechanismen der beiden Therapieansätze werden unter Berücksichtigung unterschiedlicher kognitiv-neurolinguistischer Theorien zum mündlichen Wortabrufprozess beim Bildbenennen interpretiert.
Most studies investigating the impact of literacy on oral language processing have shown that literacy provides phonological awareness skills in the processing of oral language. The implications of these results on aphasia tests could be significant and pose questions on the adequacy of such tools for testing non-literate individuals. Aiming at examining the impact of literacy on oral language processing and its implication on aphasia tests, this study tested 12 non-literate and 12 literate individuals with a modified Amharic version of the Bilingual Aphasia Test (Paradis and Amberber, 1991, Bilingual Aphasia Test. Amharic version. Hillsdale, NJ: Lawrence Erlbaum.). The problems of phonological awareness skills in oral language processing in non-literates are substantiated. In addition, compared with literate participants, non-literate individuals demonstrated difficulties in the word/sentence-picture matching tasks. This study has also revealed that the Amharic version of the Bilingual Aphasia Test may be viable for testing Amharic-speaking non-literate individuals with aphasia when modifications are incorporated.
Objective: How do patients with severe aphasia perform in the clock test? Methods:Ten patients with severe aphasia performed the clock test in two modes: copy a given clock (copy condition) and set a clock by drawing the clock hands, where a given digital display (11:10) should be transformed into an analogue display (time setting condition). Results: Not a single patient with severe aphasia was able to master any mode of the clock test. Both copy and time conditions were severely impaired by executive, conceptual, motoric visuospatial and apraxic disorders - impairments of language system were only one of numerous influencing factors. Conclusions and clinical relevance:The clock test measures and requires for its execution so many different cognitive, motoric and perceptual functions that it cannot adequately differentiate between patients with severe aphasia and other severe brain damage.
Das Herbsttreffen Patholinguistik wird seit 2007 jährlich vom Verband für Patholinguistik e.V. (vpl) durchgeführt. Das 6. Herbsttreffen mit dem Schwerpunktthema "Labyrinth Grammatik: Therapie von syntaktischen Störungen bei Kindern und Erwachsenen" fand am 17.11.2012 in Potsdam statt. Im vorliegenden Tagungsband finden sich alle Beiträge der Veranstaltung: die vier Hauptvorträge zum Schwerpunkthema, die Vorträge aus Praxis und Forschung von vier Patholinguistinnen in der Reihe Spektrum Patholinguistik sowie die Abstracts der Posterpräsentation.
Background: In a previous study, we demonstrated that narratives containing direct speech constructions were easier to comprehend than narratives with indirect speech constructions for Dutch listeners with and without aphasia. There were two possible explanations for this finding: either that direct speech has increased liveliness compared to indirect speech or that direct speech is less grammatically complex.
Aims: This study aimed to provide further insight into the mechanisms underlying the differences between direct and indirect speech constructions on discourse comprehension in Dutch. More specifically, it aimed to examine the role that the grammatical characteristics of direct and indirect speech play in discourse comprehension success by comparing English- and Dutch-speaking individuals with and without aphasia.
Methods & Procedures: An English version of the Dutch iPad-based Direct Speech Comprehension (DISCO) test was developed. Twenty individuals with aphasia and 19 neurologically healthy control participants were presented with spoken narratives that contained either direct or indirect speech constructions. Their performance was compared to that of the participants of the Dutch DISCO study. To assess the effect of language on performance, we conducted a single analysis in which we contrasted the English data with the Dutch data.
Outcomes & Results: Control participants performed better than participants with aphasia; English-speaking participants performed worse than Dutch participants, and narratives containing direct speech were easier to comprehend than narratives with indirect speech constructions. However, a subsequent analysis including only individuals with aphasia showed that the Dutch group differed from the English-speaking group: direct speech was only beneficial for the Dutch participants with aphasia.
Conclusions: This study expanded on the findings of a previous study, in which a facilitating effect of direct over indirect speech constructions for audiovisual discourse comprehension was found. The differential effects of direct speech on comprehension in Dutch and English showed that rather than one or other explanation being "correct", both liveliness and grammatical characteristics play a role in discourse comprehension success. Grammatically less complex constructions (direct speech) are not necessarily always easier to comprehend than grammatically more complex constructions (indirect speech) for individuals with aphasia. In our study grammatically simple constructions introduced grammatical ambiguity and therefore possible interpretation difficulties for the English-speaking participants with aphasia.
Discourse production in aphasia: a current review of theoretical and methodological challenges
(2016)
Background: Discourse abilities play an important role in the assessment, classification, and therapy outcome evaluation of people with aphasia. Discourse production in aphasia has been studied quite extensively in the last 15 years. Nevertheless, many questions still do not have definitive answers.Aims: The aim of this review is to present the current situation in the research on a number of crucial aspects of discourse production in aphasia, focusing on methodological progress and related challenges. This review continues the discussion of the core themes in the field, aiming to render it as up-to-date as possible.Main Contribution: The review focuses on a number of unexplored theoretical issues, specifically, the interface between micro- and macrolinguistic abilities, and the relationship between linguistic competence and communicative success in aphasia. The emphasis on theoretical challenges, along with the thorough discussion of methodological problems in the field, makes this review a starting point and a comprehensive information source for researchers planning to address language production in people with aphasia.Conclusion: Although the picture is not yet complete, recent advancements lead to a better understanding of the processes involved in aphasic discourse production. Different approaches provide insights into the complex multifaceted nature of discourse-level phenomena; however, methodological issues, including low comparability, substantially slow down the progress in the field.
Background: Word retrieval in aphasia involves different levels of processinglemma retrieval, grammatical encoding, lexeme retrieval, and phonological encodingbefore articulation can be programmed and executed. Several grammatical, semantic, lexical, and phonological characteristics, such as word class, age of acquisition, imageability, and word frequency influence the degree of success in word retrieval. It is, however, not yet clear how these factors interact. The current study focuses on the retrieval of nouns and verbs in isolation and in sentence context and evaluates the impact of the mentioned factors on the performance of a group of 54 aphasic speakers.Aims: The main aim is to measure the effect of word frequency on the retrieval of nouns and verb by disentangling the influence of word class, age of acquisition, imageability, and lemma and lexeme frequencies on word retrieval in aphasia.Methods & Procedures: Four tests for retrieval of nouns, verbs in isolation, and infinitives and finite verbs were administered to 54 aphasic speakers. The influence of lemma and lexeme frequency, Age of Acquisition on the word retrieval abilities was analysed.Outcomes and Results: Word class, age of acquisition, and imageability play a significant role in the retrieval of nouns and verbs: nouns are easier than verbs; the earlier a word has been learned and the more concrete it is, the easier it is to retrieve. When performance is controlled for these factors, lemma frequency turns out to play a minor role: only in object naming does it affect word retrieval: the higher the lemma frequency of a noun, the easier it is to access. Such an effect does not exist for verbs, neither on an action-naming test, nor when verbs have to be retrieved in sentence context. Lexeme frequency was not found to be a better predictor than lemma frequency in predicting word retrieval in aphasia.Conclusions: Word retrieval in aphasia is influenced by grammatical, semantic, and lexical factors. Word frequency only plays a minor role: it affects the retrieval of nouns, but not of verbs.
Discourse production is crucial for communicative success and is in the core of aphasia assessment and treatment. Coherence differentiates discourse from a series of utterances/sentences; it is internal unity and connectedness, and, as such, perhaps the most inherent property of discourse. It is unclear whether people with aphasia, who experience various language production difficulties, preserve the ability to produce coherent discourse. A more general question of how coherence is established and represented linguistically has been addressed in the literature, yet remains unanswered. This dissertation presents an investigation of discourse production in aphasia and the linguistic mechanisms of establishing coherence.
Age of acquisition (AOA) is a psycholinguistic variable that significantly influences behavioural measures (response times and accuracy rates) in tasks that require lexical and semantic processing. Its origin is – unlike the origin of semantic typicality (TYP), which is assumed at the semantic level – controversially discussed. Different theories propose AOA effects to originate either at the semantic level or at the link between semantics and phonology (lemma-level).
The dissertation aims at investigating the influence of AOA and its interdependence with the semantic variable TYP on particularly semantic processing in order to pinpoint the origin of AOA effects. Therefore, three studies have been conducted that considered the variables AOA and TYP in semantic processing tasks (category verifications and animacy decisions) by means of behavioural and partly electrophysiological (ERP) data and in different populations (healthy young and elderly participants and in semantically impaired individuals with aphasia (IWA)).
The behavioural and electrophysiological data of the three studies provide evidence for distinct processing levels of the variables AOA and TYP. The data further support previous assumptions on a semantic origin for TYP but question the same for AOA. The findings, however, support an origin of AOA effects at the transition between the word form (phonology) and the semantic level that can be captured at the behavioural but not at the electrophysiological level.