The purpose of this study was to examine the effects of an especially designed small-stepped treatment program utilizing the Apple II microcomputer on the graphic output of eight chronically aphasic adults. The subjects manifested moderate/ severe to severe communicative impairment as determined by performance on the Aphasic Language Performance Scales (ALPS) (Keenan and Brassell, 1974) and were receiving management at the Communicative disorders Clinic at the University of Central Florida. Pretreatment status of each subject was measured via a visual and hearing screening. In addition, the Aphasia Language Performance Scales were administered as an indicant of overall communicative ability. Spelling proficiency was measured via a written spelling test. Each subject then initiated a ten-session (one-half hour twice weekly) treatment program. Treatment objective progressed in increasingly complex small steps from prelinguistic (letter-matching) through linguistic (spelling single words) levels. The Apple II microcomputer was utilized in the areas of stimulus presentation, response contingency, and data keeping. Subsequent to the completion of the treatment condition, the Aphasia Language Performance Scales (Keenan and Brassell, 1974) and the written spelling test were readministered to each subject. Pretreatment and post-treatment scores were subjected to statistic analysis. Findings indicated a significant correlation between pretreatment scores on the Aphasia Language Performance Scales (Keenan and Brassell, 1974). Significant changes were observed in pretreatment and post-treatment written spelling test scores with evidence that skills learned on the computer keyboard transferred to manual writing. The implications of the results of this study were discussed within the framework of future treatment and research in the area of aphasia.

Studies have found that people with aphasia demonstrate reduced nonverbal and verbal short-term memory (STM) and working memory (WM) and discourse measures related to topic maintenance such as global and local coherence. Research also suggests that STM capacity and WM abilities may influence discourse measures such as global and local coherence in people with aphasia and acquired brain injuries (ABI). The purpose of this study was to determine how differences in the domain (nonverbal or verbal) or linguistic level (phonological or semantic) of information held and manipulated in STM may influence global and local coherence in people with mild-moderate fluent aphasia. A forward Corsi block and subtests from the Temple University Assessment of Language and Verbal Short-term Memory in Aphasia (TALSA) were used to assess nonverbal, phonological, and semantic WM. 13 participants with mild-moderate fluent aphasia and 4 neurotypical adults completed the forward Corsi block and phonological and semantic WM subtests from the TALSA. These included various probe spans and pointing tasks (rhyming and synonymy triplets subtests), which required the participant to maintain a number of words and make different semantic and phonological decisions about these words (e.g. making judgements related to the rhyme (phonological) or the categorization (semantic) of the words). Pointing tasks (rhyming and synonymy triplets) involved participants pointing to words on a screen that shared a similar phonological (rhyme of the words) or semantic (meaning of the word) relationship in a high and low WM condition. All participants with aphasia and neurotypical adults completed 10 discourse samples from the Nicholas and Brookshire narratives. Global and local coherence were assessed by rating each C-unit from participants’ discourse samples on a 1-5-point global and local coherence rating scale. This study determined if there was a relationship between the nonverbal, phonological, and semantic WM tasks and global and local coherence in the people with mild-moderate fluent aphasia. This study found that only the synonymy triplets change score (difference between the low WM condition and the high WM conditions), a semantic WM task, from the TALSA demonstrated a trend towards significance with local coherence in the participants with aphasia group. Additionally, a similar relationship was found when the same correlations were run on a group that combined the neurotypical adults and participants with aphasia group. Similarly, this study found that only the synonymy triplets change score had a significant correlation with local coherence in the combined group. None of the other WM tasks were significantly correlated with global and local coherence. Based on these results, this study provides some evidence that the integrity of the cognitive resources used for the maintenance and manipulation of semantic information held in verbal STM may be important for maintaining the topic or semantic coherence between adjacent utterances (measured by local coherence) in participants with mild-moderate fluent aphasia and neurotypical adults. More research is needed to determine if this relationship exists in other populations with aphasia and in an independent sample of neurotypical adults. / Communication Sciences

Research in communication disorders suggests that training linguistically complex forms will generalize to untrained, simpler forms with similar structural properties (see Thompson, 2007 for review). The present study investigated generalization patterns from transitive verbs to two classes of intransitive verbs following administration of Verb Network Strengthening Treatment (VNeST; Edmonds, Nadeau & Kiran, 2009). Based on the Argument Structure Complexity Hypothesis (ASCH; Thompson, 2003), it was predicted that greater generalization would occur to unergatives because unergatives bear a structural relationship to transitive verbs and unaccusatives do not. Results at post-treatment supported the hypothesis with both intransitive verb types showing generalization and slightly higher effect sizes observed for unergative than for unaccusative verbs. At maintenance, this pattern was not maintained due to improvements in production of unaccusative verbs. Results support the findings of Edmonds et al. (2009) that administration of VNeST results in gains on measures of untrained, semantically related verbs as well as standardized measures of lexical retrieval and connected speech. These results also suggest that training transitive verbs results in slight generalization to untrained intransitive verbs; however, it is inconclusive whether unergative and unaccusatives intransitives show differential improvement. / Communication Sciences

Research suggests that novel word learning tasks engage both verbal short-term memory (STM) and lexical processing, and may serve as a potential treatment for word processing and functional language in aphasia (e.g., Gupta, Martin, Abbs, Schwartz, Lipinski, 2006; Tuomiranta, Grönroos, Martin, & Laine, 2014). The purpose of this study was to gain support for the hypotheses that novel word learning engages verbal STM and lexical access processes and can be used to promote improvements in these abilities in treatment of aphasia. We used a novel word learning task as a treatment with three participants: KT, UP, and CN, presenting with different types and severities of aphasia and predicted that treatment would result in (1) acquisition of trained novel words (2) improved verbal STM capacity and (3) improved access to and retrieval of real words. Twenty novel words were trained for 1 hour x 2 days/week x 4 weeks. Language and learning measures were administered pre- and post-treatment. All three participants showed receptive learning and some improvement on span tasks, while UP and CN demonstrated some expressive learning. KT also improved in performance on the Peabody Picture Vocabulary Test and the Philadelphia Naming Test. UP showed significant improvement on proportion Correct Information Units (CIUs) in discourse. CN showed some minimal improvement in narrative production for proportion CIUs and proportion of closed class words. These findings support that novel word learning treatment, which engages verbal STM processes and lexical retrieval pathways, can improve input lexical processing. Theoretically, this study provides further evidence for models that propose common mechanisms supporting novel word learning, short-term memory, and lexical processing. / Communication Sciences

Bakgrund: I Sverige drabbas ca 10 000 personer årligen av afasi som beror på skador i språkcentrum i hjärnan. Afasi innebär att den drabbade begränsas i sin förmåga att uttrycka sig, förstå eller formulera sig meningsfullt. Sjuksköterskor möter personer med afasi i olika kontexter och behöver kunskap om olika sätt att kommunicera för att främja autonomi och delaktighet. Syfte: Syftet var att belysa sjuksköterskans erfarenheter av kommunikation med personer med afasi i sluten- och öppenvård.  Metod: En litteraturöversikt med kvalitativ metod och induktiv ansats utfördes som baserades på elva vetenskapliga artiklar. Artiklarna analyserades utifrån Fribergs femstegs modell (Friberg, 2022). Resultat: I resultatet framkommer tre kategorier som innehåller sjuksköterskors erfarenheter av kommunikation med personer med afasi. Dessa är: Organisatoriska och miljömässigt inflytande på kommunikation, främjande faktorer och barriärer för kommunikation samt sjuksköterskans förhållningssätt i mötet med personer med afasi.  Slutsats: Osäkerhet i kommunikation med personer med afasi kan minskas med rätt resurser och förhållningssätt. Vissa kommunikationsverktyg är användbara men framför allt är utrymme i tid och arbetsmiljöfaktorer avgörande för lyckad kommunikation. Att våga stanna kvar är viktigt för att upprätta en relation som främjar kommunikationen mellan sjuksköterskan och personen med afasi. / Background: In Sweden, about 10 000 people suffer from aphasia every year, which is due to damage to the language center in the brain. Aphasia means that the sufferer is limited in their ability to express themselves, understand or formulate themselves meaningfully. Nurses meet people with aphasia in different contexts and need knowledge of different ways of communicating to promote autonomy and participation. Aim: The aim was to illustrate the nurse´s experiences of communication with people with aphasia in both in- and outpatient care.  Method: A literature review with a qualitative method and inductive approach was performed which was based on eleven scientific articles. The articles were analyzed based on Friberg´s five step model (Friberg, 2022).  Results: The result show three categories that contain nurses experience of communication with people with aphasia. These are: Organizational and environmental influence on communication, promoting factors and barriers to communication and the nurse´s approach in meeting people with aphasia. Conclusion: Uncertainty in communication with people with aphasia can be reduced with the right resources and approach. Some communication tools are useful, but above all, space in time and work environment are factors that are decisive for successful communication. Dare to stay with the person is important to establish a relationship that promotes communication between the nurse and the person with aphasia.

Introduction : L'aphasie, un trouble de la communication dû à des lésions cérébrales, entraîne des limitations dans la vie quotidienne et un isolement social. Même après une réadaptation orthophonique, de nombreuses personnes continuent de rencontrer des difficultés, affectant aussi leurs proches. Des organisations communautaires proposant des activités artistiques, comme le théâtre, visent à améliorer la réadaptation et la réintégration sociale des personnes vivant avec une aphasie (PVA). Le Théâtre Aphasique (TA) au Québec est un exemple intéressant à étudier pour élargir nos connaissances sur ce sujet. Objectifs: L’objectif principal de notre étude est d’explorer les retombées d’activités communautaires de nature théâtrale pour les PVA ainsi que leurs proches en utilisant le TA comme étude de cas. Nous cherchons également à identifier les éléments clés qui contribuent au succès de cet organisme. Méthodologie : L'étude a adopté une méthodologie de recherche qualitative basée sur un paradigme interprétatif. Elle a impliqué la réalisation de deux tables rondes ainsi que six entretiens individuels avec des PVA et un entretien de groupe avec des proches. Au total, dix PVA, six proches et quatre intervenants ont participé à notre étude. Les transcriptions des entretiens ont été soumises à une analyse qualitative inductive du contenu. Résultats : L’analyse nous a permis de développer 49 codes qui ont été regroupés en 12 sous- thèmes, à savoir les recommandations par le personnel de la santé, l’espoir, le lieu artistique, le lieu de socialisation inclusif, les caractéristiques des personnes, l'apprentissage, la valorisation, le plaisir, la complicité entre les participants, l'engagement, les effets thérapeutiques (espérés et attendus), et l'amélioration de la participation sociale. Ces sous-thèmes ont été ensuite regroupés en 4 thèmes finaux : leviers, composantes et caractéristiques, mécanismes et retombées. Enfin, ces thèmes ont été interconnectés pour former un modèle logique du TA. Conclusion : Le Théâtre Aphasique semble être plus qu’une simple activité de loisirs. Il semble répondre à des besoins des PVA et de leurs proches et génère des résultats positifs. / Introduction: Aphasia, a communication disorder resulting from brain injuries, leads to limitations in daily life and social isolation. Even after speech therapy rehabilitation, many individuals continue to face challenges, affecting also their relatives. Community organizations offering artistic activities, such as theater, aim to enhance the rehabilitation and social reintegration of people with aphasia (PWA). Le Théâtre Aphasique (TA) in Quebec serves as an interesting case study to expand our knowledge on this topic. Objectives: The primary goal of our study is to explore the impact of community-based theatrical activities on PWA and their families, using TA as a case study. We also aim to identify key elements contributing to the organization's success. Methodology: The study employed a qualitative research methodology based on an interpretive paradigm. It involved conducting two focus group discussions as well as six individual interviews with PWA and one group interview with their family members. In total, ten PWA, six family members, and four caregivers participated in our study. Transcripts of the interviews underwent inductive qualitative content analysis. Results: Our analysis allowed us to develop 49 codes grouped into 12 subthemes, including recommendations by healthcare personnel, hope, artistic space, inclusive socialization space, individuals’ characteristics, learning, valorization, enjoyment, complicity between participants, engagement, therapeutic effects (hoped and expected), and improved social participation. These subthemes were then grouped into four final themes: levers, components and features, mechanisms, and outcomes. These themes are interconnected to form a logical model of TA. Conclusion: The Théâtre Aphasique seems to go beyond a mere leisure activity, addressing some needs of PWA and their families, resulting in positive outcomes.

Bakgrund Afasi är en störning där personen har svårigheter att förstå och uttrycka sig verbalt. Personer som drabbas av afasi har försämrad kommunikationsförmåga och därför är det väsentligt att sjuksköterskan skapar en relation till patienten för att underlätta kommunikationen. Syfte Syftet var att beskriva sjuksköterskors erfarenheter av kommunikation med patienter som drabbats av afasi. Metod En systematisk litteraturöversikt, baserad på tio vetenskapliga artiklar, gjordes genom sökningar i databaserna Cinahl Complete och PubMed. Av de tio artiklarna var 5 kvalitativa, 2 kvantitativa och 3 av mixade metoder.  Resultat Ett huvudtema och ett tema framkom av resultaten: Olika strategier för kommunikation med patienter och Hinder för en god kommunikation. Huvudtemat Olika strategier för kommunikation med patienter byggs upp i sin tur av två underteman: Icke-verbal kommunikation och Vårdmiljöns betydelse. Utifrån sjuksköterskors erfarenheter framkom det att vissa kommunikationsstrategier, såsom korta meningar och bilder, påverkade kommunikationen med patienter som lider av afasi. Icke-verbal kommunikation och vårdmiljö spelade också en väsentlig roll för att underlätta kommunikationen med patienter. Faktorer som enligt sjuksköterskor utgjorde hinder för en god kommunikation med patienter var tidsbrist och bristande kompetens. Sjuksköterskors höga arbetsbelastning och tidspress gjorde att kommunikationen upplevdes även som tidskrävande. Bristande kompetens upplevde sjuksköterskor försvårade kommunikationen med patienter som lider av afasi.  Slutsats Kommunikationsstrategier upplevdes av sjuksköterskor främja en god kommunikation med patienter som drabbas av afasi, men tidsbrist utgjorde ett hinder för implementering av sådana strategier i praktiken. Bristande kompetens hos sjuksköterskor skapade tvivel vilket resulterade i att patienter som drabbas av afasi exkluderades från vården. En utveckling av kunskap hos sjuksköterskor är därför viktig för att ge en god omvårdnad, där patienten känner sig delaktig i sitt vårdande. / Background Aphasia is a disorder in which the person experiences difficulties in understanding and expressing themselves verbally. Individuals affected by aphasia have impaired communication abilities, so it is essential for nurses to establish a relationship to facilitate communication with patients. Aim The purpose of the study was to describe nurses' experiences in communication with patients affected by aphasia. Method A systematic literature review, based on ten scientific articles, was conducted through searches in the databases Cinahl Complete and PubMed. Out of these ten scientific articles, 5 were qualitative, 2 were quantitative, and 3 were mixed methods.  Results One main theme and one theme emerged from the results: Different strategies for communication with patients and Barriers to good communication. The main theme Different strategies for communication with patients is built upon two subthemes: Non-verbal communication and The importance of the care environment. Based on nurses' experiences, it emerged that certain communication strategies, such as short sentences and pictures, influenced communication with patients suffering from aphasia. Non-verbal communication and the care environment also played a significant role in facilitating communication with patients. Factors identified by nurses as obstacles to effective communication with patients were time constraints and inadequate competence. Nurses' high workload and time pressure made communication feel time-consuming. Nurses perceived insufficient competence as complicating communication with patients suffering from aphasia. Conclusions Nurses perceived communication strategies as facilitating good communication with patients affected by aphasia, but time constraints posed a barrier to implementing such strategies in practice. Inadequate competence among nurses created doubts, resulting in patients affected by aphasia being excluded from care. Therefore, the development of knowledge among nurses is important for providing quality care, where the patient feels involved in their own care.

This thesis explores speech-language pathologists' (SLPs) perceptions of, experiences with, and perceived barriers to providing psychosocial support to couples impacted by aphasia. A survey was conducted, with 50 responses analyzed. All participants were licensed SLPs who work in the United States and have people with aphasia (PWA) on their caseload. Participants responded to a portion of survey questions, viewed five short videos of Relationship-Centered Communication Partner Training (RC-CPT), then answered a portion of repeated questions to measure the change in perceived confidence, comfort, knowledge, and experience. Results indicate that SLPs perceive counseling to be within their scope of practice and are aware of the psychological distress experienced by PWA. Additionally, SLPs reported increased confidence in counseling couples impacted by aphasia after watching the RC-CPT video vignettes. However, reported barriers to providing counseling to PWA and their significant others included lack of significant other availability, and time/caseload pressures. SLPs reported greater comfort in tasks such as coaching couples on communication strategies and less comfort on topics such as addressing relationship roles and responsibilities or helping couples set goals regarding relationship roles and responsibilities. These findings have implications for SLP training and practice, emphasizing the importance of addressing the psychosocial needs of both individuals and couples impacted by aphasia. Further research is needed to determine the impact of counseling training for SLPs and the development of effective training to increase SLPs' confidence and comfort in counseling couples affected by aphasia.

Including response delays in language tasks yields variable results for people with aphasia. Some improve relative to immediate response conditions, others perform more poorly, and others show no significant change. The effect of response delays on performance accuracy varies within individuals depending on the language task. The mechanism that drives this heterogeneity is unknown. In these studies, we investigated factors contributing to differences in performance accuracy in naming and repetition following a response delay. In Experiment 1, we explored the contribution of stimulus duration to accuracy in delay conditions by manipulating picture exposure time in naming. We hypothesized that shorter picture exposure times would lead to lower accuracy in delayed naming conditions, similar to an established trend in delayed repetition (Sayers et al. 2023c). Shorter picture exposure time was associated with lower accuracy and greater variety of temporal impairments (i.e., improved or poorer performance) than naming with longer exposure times. Shortening picture exposure time may reduce contributions of visual semantics, increasing reliance on the language system. In Experiment 2, we compared the measures of the timeliness of semantic and phonological activation transmission with performance in immediate and delayed naming and repetition. Slower semantic activation transmission was associated with relatively improved performance in delayed naming but poorer performance in delayed repetition. We attribute this to the order of access to linguistic representations. In naming, semantic activation initiates the retrieval process, while in repetition, it supports phonological activation, making it more enduring in the face of decay in delayed response conditions. / Communication Sciences

Introduction: Conversation treatment for individuals with aphasia (IwAs) aims to enhance language and communication skills within naturalistic settings. Group dynamics, including psychosocial support (PSS) and vicarious learning (VL), are important components of this treatment. However, the lack of established aphasia-friendly methods for quantifying group dynamics impedes understanding of its contribution to treatment efficacy. This study addresses three key research goals: (1) Can group dynamics be reliably quantified? (2) Do measures of group dynamics vary with group size or time? (3) Are group dynamics linked to changes in self-reported psychosocial health measures? Methods: IwAs were assigned to participate in either a large group or dyadic condition as part of a larger study. Participants completed multiple standardized assessments before and after receiving conversation treatment for one hour twice a week for ten weeks. A coding system was developed to track PSS and VL during sessions. Video recordings of sessions at the start (Session 2) and end (Session 19) of the treatment period were analyzed for five large groups and six dyads, with seven additional dyads coded for Session 19 after reliability was confirmed. Intrarater and interrater reliability were assessed by recoding 21% of the videos randomly. Results: To address the first research goal, group dynamics were defined and then a code was created to represent occurrences of PSS and VL. After establishing a reliable coding system, instances of PSS and VL were compared across size conditions to address the second research goal. The results suggested that PSS differed between conditions later in treatment, but VL did not. For research goal three, the data suggest that large groups experience larger gains in quality of life measures, possibly due to increased exposure to PSS. Conclusion: Findings indicate that group dynamics can be reliably tracked and used for quantitative analysis. PSS was more common in groups than dyads later in the 10 week treatment period, but VL did not vary across conditions or at the start or end of treatment. Further, there is some evidence that PSS in larger groups contributes to improvements in quality of life measures. / Communication Sciences