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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.
The present study aims to contribute to the ongoing discussion about the impact of discourse-linking deficits on the performance of individuals with aphasia by providing new data from a set of rarely investigated constructions: sentences in which a clitic pronoun coexists alongside with the full DP it agrees with. To do so, we use data of individuals with non-fluent aphasias who need to overcome the difficulties in direct object (accusative) clitic production. This results in overproduction of non-target clitic right dislocations (RDs) and clitic doubling (CD). Data from 15 individual’s native speakers of Spanish and Catalan are discussed. Data complement the results of previous investigations on discourse-linking effects in these languages, allowing the interpretation of results across constructions.
There is consensus that word retrieval starts with activation of semantic representations.
However, in adults without language impairment, relatively little attention has been paid to the effects of the semantic attributes of to-be-retrieved words.
This paper, therefore, addresses the question of which item-inherent semantic factors influence word retrieval.
Specifically, it reviews the literature on a selection of these factors: imageability, concreteness, number of semantic features, typicality, intercorrelational density, featural distinctiveness, concept distinctiveness, animacy, semantic neighbourhood density, semantic similarity, operativity, valence, and arousal.
It highlights several methodological challenges in this field, and has a focus on the insights from studies with people with aphasia where the effects of these variables are more prevalent.
The paper concludes that further research simultaneously examining the effects of different semantic factors that are likely to affect lexical co-activation, and the interaction of these variables, would be fruitful, as would suitably scaled computational modelling of these effects in unimpaired language processing and in language impairment.
Such research would enable the refinement of theories of semantic processing and word production, and potentially have implications for diagnosis and treatment of semantic and lexical impairments.
Individuals with aphasia vary in the speed and accuracy they perform sentence comprehension tasks. Previous results indicate that the performance patterns of individuals with aphasia vary between tasks (e.g., Caplan, DeDe, & Michaud, 2006; Caplan, Michaud, & Hufford, 2013a). Similarly, it has been found that the comprehension performance of individuals with aphasia varies between homogeneous test sentences within and between sessions (e.g., McNeil, Hageman, & Matthews, 2005). These studies ascribed the variability in the performance of individuals with aphasia to random noise. This conclusion would be in line with an influential theory on sentence comprehension in aphasia, the resource reduction hypothesis (Caplan, 2012). However, previous studies did not directly compare variability in language-impaired and language-unimpaired adults. Thus, it is still unclear how the variability in sentence comprehension differs between individuals with and without aphasia. Furthermore, the previous studies were exclusively carried out in English. Therefore, the findings on variability in sentence processing in English still need to be replicated in a different language.
This dissertation aims to give a systematic overview of the patterns of variability in sentence comprehension performance in aphasia in German and, based on this overview, to put the resource reduction hypothesis to the test. In order to reach the first aim, variability was considered on three different dimensions (persons, measures, and occasions) following the classification by Hultsch, Strauss, Hunter, and MacDonald (2011). At the dimension of persons, the thesis compared the performance of individuals with aphasia and language-unimpaired adults. At the dimension of measures, this work explored the performance across different sentence comprehension tasks (object manipulation, sentence-picture matching). Finally, at the dimension of occasions, this work compared the performance in each task between two test sessions. Several methods were combined to study variability to gain a large and diverse database. In addition to the offline comprehension tasks, the self-paced-listening paradigm and the visual world eye-tracking paradigm were used in this work.
The findings are in line with the previous results. As in the previous studies, variability in sentence comprehension in individuals with aphasia emerged between test sessions and between tasks. Additionally, it was possible to characterize the variability further using hierarchical Bayesian models. For individuals with aphasia, it was shown that both between-task and between-session variability are unsystematic. In contrast to that, language-unimpaired individuals exhibited systematic differences between measures and between sessions. However, these systematic differences occurred only in the offline tasks. Hence, variability in sentence comprehension differed between language-impaired and language-unimpaired adults, and this difference could be narrowed down to the offline measures.
Based on this overview of the patterns of variability, the resource reduction hypothesis was evaluated. According to the hypothesis, the variability in the performance of individuals with aphasia can be ascribed to random fluctuations in the resources available for sentence processing. Given that the performance of the individuals with aphasia varied unsystematically, the results support the resource reduction hypothesis. Furthermore, the thesis proposes that the differences in variability between language-impaired and language-unimpaired adults can also be explained by the resource reduction hypothesis. More specifically, it is suggested that the systematic changes in the performance of language-unimpaired adults are due to decreasing fluctuations in available processing resources. In parallel, the unsystematic variability in the performance of individuals with aphasia could be due to constant fluctuations in available processing resources. In conclusion, the systematic investigation of variability contributes to a better understanding of language processing in aphasia and thus enriches aphasia research.
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.
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.
Background: Individuals with aphasia after stroke (IWA) often present with working memory (WM) deficits. Research investigating the relationship between WM and language abilities has led to the promising hypothesis that treatments of WM could lead to improvements in language, a phenomenon known as transfer. Although recent treatment protocols have been successful in improving WM, the evidence to date is scarce and the extent to which improvements in trained tasks of WM transfer to untrained memory tasks, spoken sentence comprehension, and functional communication is yet poorly understood.
Aims: We aimed at (a) investigating whether WM can be improved through an adaptive n-back training in IWA (Study 1–3); (b) testing whether WM training leads to near transfer to unpracticed WM tasks (Study 1–3), and far transfer to spoken sentence comprehension (Study 1–3), functional communication (Study 2–3), and memory in daily life in IWA (Study 2–3); and (c) evaluating the methodological quality of existing WM treatments in IWA (Study 3). To address these goals, we conducted two empirical studies – a case-controls study with Hungarian speaking IWA (Study 1) and a multiple baseline study with German speaking IWA (Study 2) – and a systematic review (Study 3).
Methods: In Study 1 and 2 participants with chronic, post-stroke aphasia performed an adaptive, computerized n-back training. ‘Adaptivity’ was implemented by adjusting the tasks’ difficulty level according to the participants’ performance, ensuring that they always practiced at an optimal level of difficulty. To assess the specificity of transfer effects and to better understand the underlying mechanisms of transfer on spoken sentence comprehension, we included an outcome measure testing specific syntactic structures that have been proposed to involve WM processes (e.g., non-canonical structures with varying complexity).
Results: We detected a mixed pattern of training and transfer effects across individuals: five participants out of six significantly improved in the n-back training. Our most important finding is that all six participants improved significantly in spoken sentence comprehension (i.e., far transfer effects). In addition, we also found far transfer to functional communication (in two participants out of three in Study 2) and everyday memory functioning (in all three participants in Study 2), and near transfer to unpracticed n-back tasks (in four participants out of six). Pooled data analysis of Study 1 and 2 showed a significant negative relationship between initial spoken sentence comprehension and the amount of improvement in this ability, suggesting that the more severe the participants’ spoken sentence comprehension deficit was at the beginning of training, the more they improved after training. Taken together, we detected both near far and transfer effects in our studies, but the effects varied across participants. The systematic review evaluating the methodological quality of existing WM treatments in stroke IWA (Study 3) showed poor internal and external validity across the included 17 studies. Poor internal validity was mainly due to use of inappropriate design, lack of randomization of study phases, lack of blinding of participants and/or assessors, and insufficient sampling. Low external validity was mainly related to incomplete information on the setting, lack of use of appropriate analysis or justification for the suitability of the analysis procedure used, and lack of replication across participants and/or behaviors. Results in terms of WM, spoken sentence comprehension, and reading are promising, but further studies with more rigorous methodology and stronger experimental control are needed to determine the beneficial effects of WM intervention.
Conclusions: Results of the empirical studies suggest that WM can be improved with a computerized and adaptive WM training, and improvements can lead to transfer effects to spoken sentence comprehension and functional communication in some individuals with chronic post-stroke aphasia. The fact that improvements were not specific to certain syntactic structures (i.e., non-canonical complex sentences) in spoken sentence comprehension suggest that WM is not involved in the online, automatic processing of syntactic information (i.e., parsing and interpretation), but plays a more general role in the later stage of spoken sentence comprehension (i.e., post-interpretive comprehension). The individual differences in treatment outcomes call for future research to clarify how far these results are generalizable to the population level of IWA. Future studies are needed to identify a few mechanisms that may generalize to at least a subpopulation of IWA as well as to investigate baseline non-linguistic cognitive and language abilities that may play a role in transfer effects and the maintenance of such effects. These may require larger yet homogenous samples.