Word-Retrieval Treatment for Aphasia: Facilitation of Generalization

Transcription

1 Word-Retrieval Treatment for Aphasia: Facilitation of Generalization Shannon Mauszycki, Ph.D., CCC-SLP Julie Wambaugh, Ph.D., CCC-SLP Rosalea Cameron, M.S., M. Cl. Sc., CCC-SLP Salt Lake City VA Healthcare System University of Utah Salt Lake City, UT

2 Background There has been much research aimed at the development and testing of effective treatments for wordfinding deficits (LaPointe, 2004) A number of treatment approaches have resulted in improved word-retrieval, but limited to trained stimuli (Nickels, 2002) A few treatment approaches that have utilized compensatory strategies appear to have potential in promoting improved retrieval of untrained items (Best, Howard, Bruce, & Gatehouse, 1997; Hickin, Herbert, Best Howard, & Osborne, 2002; Boyle & Coelho, 1995)

3 Background Semantic Feature Analysis (Boyle, 2004; Boyle & Coelho, 1995; Coelho, McHugh & Boyle, 2000; Conley & Coelho, 2003) is one such treatment approach that has shown promise in improving naming of trained and untrained object names

4 Background Semantic oriented treatment conducted by Kiran and colleagues (2003; 2008) found treating atypical exemplars of a category facilitated generalization to typical items, but not vice versa

5 Purpose This investigation examined the effects of semantic feature treatment on word retrieval on typicality across different semantic categories (living and artifact) facilitates within category generalization by improving semantic processing and training a compensatory strategy

6 Participants

7 Pretreatment Assessment

8 Treatment Stimuli Twenty-six items (13 typical and 13 atypical) from four categories (2 living and 2 artifact) Eight items were designated as treatment items & five were designated as generalization items for both typical and atypical exemplars of a category Items were matched as closely as possible for factors that could influence retrieval or production

9 Dependent Variable The accuracy of verbal naming of the experimental stimuli (both treatment and generalization items) in probes was the behavior of interest Response were scored using a modified multidimensional scoring system (Wambaugh,Cameron, Kalinyak-Flizar, Nessler, and Wright, 2004)

10 Multidimensional Scoring System

11 Experimental Design Single subject multiple baseline design across behaviors & subjects The behaviors of interest were measured repeatedly Baseline Treatment Maintenance Follow-up (2 & 6 weeks) The order of typicality and category trained was counterbalanced across participants

12 Treatment A modified version of Semantic Feature Analysis Treatment in order to accommodate for living and artifact categories. Treatment procedures similar to Boyle & Coelho (1995) For each treatment item, 15 yes/no questions were presented regarding semantic features similar to Kiran & Thompson (2003)

13 Semantic Feature Chart

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15 Treatment Treatment was provided by Certified Speech/Language Pathologist One presentation of the eight treatment items constituted one trial one trial completed during a treatment session Participants received treatment two to three times per week for minutes Treatment was applied to one set of pictures until: at least 88% accuracy in naming trained objects in two consecutive probe sessions OR 20 treatment sessions were completed

16 Reliability Fifteen percent of baseline/probe sessions were randomly selected to determine interrater reliability Responses were transcribed and rescored via audio recording Point to point agreement on accuracy of responses was 95% (92% to 99%)

17 Results for Participant 1

18 Results for Participant 2

19 Discussion This investigation examined the effects of semantic feature treatment on word retrieval, specifically: Examining the effects of treatment on typicality across different semantic categories Determining if treatment facilitates within category generalization

20 Discussion The results of this investigation indicate: positive acquisition effects of treatment for one participant moderate increase in production of treated object names with application of treatment for other participant no positive generalization effects to untrained experimental items

21 These results are partially in keeping with previous findings of semantic feature analysis treatment by Boyle and colleagues (1995; 2000; 2003; 2004) showing positive changes for trained items However findings are not similar to research by Kiran and colleagues (2003; 2007; 2008) that found treating atypical exemplars of a category facilitated generalization to typical items

22 Results from both treatment approaches have found not all participants respond to treatment in the same way Lack of generalization to untrained items No typicality effect for treated category Cognitive Functioning

23 Summary/Conclusion The two participants in this study exhibited positive treatment effects, but only one participant demonstrated positive acquisition effects for the majority of treatment items Treatment of atypical exemplars did not facilitate generalization to typical exemplars Treatment did not facilitate within category generalization

24 Direction for Future Research Modification of treatment Re-evaluate development of treatment categories with regard to typicality of exemplars Re-evaluate development of semantic features for treatment items Include orthographic/phonological information for items during treatment Directly train compensatory strategies during treatment

25 Acknowledgements This research was supported in part by Rehabilitation Research and Development, Department of Veterans Affairs