Speech-Language Pathologyhttp://hdl.handle.net/10211.3/1409042024-03-29T15:02:37Z2024-03-29T15:02:37ZAssessing and Treating a Severe Word-Finding Deficit in a Person with Transcortical Sensory Aphasia: A Single Case StudyYang, Dorothyhttp://hdl.handle.net/10211.3/2157552020-05-06T00:05:32Z2020-05-05T00:00:00ZAssessing and Treating a Severe Word-Finding Deficit in a Person with Transcortical Sensory Aphasia: A Single Case Study
Yang, Dorothy
Simply defined, aphasia is a language-specific disorder that results from an acquired neurological injury. There are many different types of aphasia, but one of the rarer and therefore less understood forms is transcortical sensory aphasia (TSA). Individuals with TSA often exhibit fluent output with many paraphasias, a strong ability to repeat, and poor auditory comprehension skills. Furthermore, given that almost all individuals with aphasia present with some degree of anomia or word-finding difficulty, naming impairments are also commonly observed in individuals with TSA.
Several treatment approaches have been developed to target word-finding in individuals with aphasia, including Verb Network Strengthening Treatment (VNeST). VNeST is based on the assumption that verbs have argument structure (i.e., thematic roles such as agent and theme). As such, when a verb is activated (e.g., bake), activation spreads to the associated nouns that could potentially fill the verb’s thematic roles (e.g., agent: baker, cook; theme: bread, lasagna). There is considerable evidence demonstrating that VNeST is an effective and efficacious approach to improving word-finding in spontaneous speech. Interestingly, none of the studies supporting its use have included individuals with TSA. Thus, it is unknown how individuals with this aphasia type would respond to VNeST; in fact, because TSA occurs so infrequently, there is very little guidance offered in the literature for clinicians to follow regarding how to approach treatment with this population.
This thesis describes a person (“John”) with TSA who received intense VNeST therapy for his severe anomia. A single case study design was implemented in three phases: 1) pre-treatment/baseline, 2) treatment, and 3) post-treatment. In the pre-treatment phase, a comprehensive profile of John’s relative strengths and deficits was obtained using various assessments of speech, language, communication, and cognition. Once baseline performance and functioning were established, John was trained on ten verbs via VNeST for a total of thirty hours (i.e., three hours a day for ten consecutive days). Following completion of the treatment phase, select assessments were re-administered immediately post-treatment and one month later to evaluate generalization and maintenance.
Results revealed generalization to verbs trained in VNeST but not to untrained verbs that were semantically related to the trained verbs (e.g., trained verb: read; untrained verb: write). John produced more agents and themes for trained items following treatment than at baseline, whereas no change in performance was noted across time points for untrained items (a finding that is contradictory to what has been reported in the literature). While no observable gains were detected for untrained verbs, John’s communicative informativeness and efficiency as measured by the number of relevant content words that he produced in discourse increased from baseline. John also achieved a higher overall score on the Porch Index of Communicative Ability (PICA) after treatment, suggesting that he had made some improvement in his general ability to communicate through different modalities. Furthermore, John independently generated more verbs on a confrontational naming task post-treatment than prior to treatment (although this was not found for noun naming). All of the gains identified in this study were maintained for at least one month after treatment had concluded. In terms of gains made in the areas of sentence production and comprehension, results were mixed and were most likely impacted by various internal and external factors. Though quality of life was not formally assessed following treatment, John and his wife reported high satisfaction with VNeST, stating that he had made some slight but personally significant progress in his ability to functionally communicate at home.
This study continues to show that VNeST is an effective and efficacious approach to targeting naming/word-finding deficits in individuals with aphasia. More specifically, it is one of the first studies to support the use of VNeST with individuals who have TSA and a severe anomia. The findings from this study also raise several new and interesting questions regarding neurolinguistic processing that should be explored in future research investigations.
2020-05-05T00:00:00ZFeelings and Attitudes for Cleft EducationGlaspell, Molliehttp://hdl.handle.net/10211.3/2157412020-05-05T16:48:06Z2020-05-05T00:00:00ZFeelings and Attitudes for Cleft Education
Glaspell, Mollie
Children with cleft lip and/or palate experience psychosocial challenges such as teasing, bullying, low self-esteem, social rejection, and unsolicited attention. Furthermore, typically developing peers make negative judgments toward children with cleft lip and palate. There is a need for a school-based program for children with cleft lip and palate to promote positive attitudes and decrease barriers that children with unintelligible speech face in their daily routines. There is a deficiency of awareness, acceptance, and resources for children with craniofacial disorders in educational settings. An evidence-based educational and psychosocial intervention program for children with cleft lip and palate has been created, called Feelings and Attitudes for Cleft Education (FACE). The purpose of the FACE program is to increase positive and meaningful interactions between children with cleft lip and palate and their peers and teachers, as well as improving their own self-perception and self-esteem. The FACE program consists of a curriculum letter for teachers and staff, a teacher in-service presentation, a multimedia classroom presentation (i.e., video and coloring activity), a take-home program for children with cleft lip and palate, and quality of life questionnaires designated for the child with cleft lip and palate, his/her parent(s)/caregiver(s), and his/her teacher. This program promotes awareness and acceptance of children with craniofacial disorders and encourages children and adults to refrain from making assumptions about this population. The FACE program has been piloted within elementary schools in Capistrano Unified School District as well as to graduate students in the California State University San Marcos M.A. Special Education Program. Each professional completed an open-ended survey following the FACE implementation. The results included quantitative data, qualitative comments, and constructive feedback that will contribute to the revisions and future directions of the program.
2020-05-05T00:00:00ZCleft Palate Speech Therapy: Telesupport as a Home Program SupplementLowe, Naomihttp://hdl.handle.net/10211.3/2100542019-05-13T18:16:41Z2019-05-13T00:00:00ZCleft Palate Speech Therapy: Telesupport as a Home Program Supplement
Lowe, Naomi
International humanitarian efforts in cleft palate care often lack follow-up support for speech deficits. Ten Spanish speaking participants in Tijuana Mexico, age 3-12, with cleft palate were randomly assigned to a home speech program or a home speech program with additional weekly telesupport. Speech production was measured before an eight-week home treatment program and after treatment to determine the effectiveness of adding telesupport to a parent-implemented articulation approach. Age was significantly related to amount of time practiced, with older participants practicing more at home, with marginally increased practice for older students provided telesupport. There were no significant differences in speech production between the two treatment groups, yet the parent report was positive. Parents in the telesupport group were more comfortable with therapy implementation. Possible reasons for lack of phonemic outcomes are explored, as well as the potential that telesupport holds for treating cleft palate speech in children with limited access to resources, such as trained speech-language pathologists.
2019-05-13T00:00:00ZA Family Guide for Increasing Augmentative and Alternative Communication SuccessDawson, Nicole Jeannehttp://hdl.handle.net/10211.3/2099432020-05-09T10:00:39Z2019-05-09T00:00:00ZA Family Guide for Increasing Augmentative and Alternative Communication Success
Dawson, Nicole Jeanne
Augmentative and Alternative Communication (AAC) systems have been shown to help many individuals with complex communication needs, from young children with developmental disabilities (Drager, Light & McNaughton, 2010) to adults with acquired disabilities (Beukelman, Fager, Ball & Dietz, 2007). AAC has become a more prominent area within the field of speech-language pathology. It continues to be recognized as a promising intervention method for a variety of individuals with complex communication needs, and the increase in technological advances continue to increase its potential (Light & McNaughton, 2012). As the prevalence of AAC rises, more universities are including AAC coursework within their Speech-Language Pathology graduate programs. While more Speech-Language Pathologists (SLPs) are being instructed on how to approach AAC with their clients successfully, 30% of devices are still abandoned (Phillips & Zhao, 1993). Recent research has found that lack of family involvement, lack of family instruction, and lack of opportunities provided by the family, are some of the top reasons for AAC abandonment (Johnson, Inglebret, Jones & Ray, 2006). This project emerged from the research to meet the needs of encouraging meaningful interactions between SLPs and family members of school-age children who are taking part in the AAC process. The project is a two-part resource: part 1) Family Guide to AAC consists of handouts, forms, and interaction examples to engage the family members; part 2) Supplemental Research Guide consists of summaries of the research articles which led to the creation of each component found in the Family Guide.
2019-05-09T00:00:00Z