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Thesis (Ed.M.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2999-01-01

Thesis (M.A.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2999-01-01

Primary Progressive aphasia (PPA) is a disorder characterized by gradual decline in language functions, with relative sparing of other cognitive abilities. This behavioral profile results from neurodegenerative disease that preferentially affects language cortex. As is the case in aphasia resulting from stroke, any of several critical language processing domains may be affected in PPA, including syntax, semantics, phonology, and orthography. In stroke-induced aphasia, traditional lesion mapping approaches have provided important insight into the localization of cortical regions supporting these domains. Specifically, left perisylvian cortex has been implicated in syntactic and phonological aspects of language, whereas left extrasylvian cortical regions are associated with lexical-semantic and orthographic functions. The goal of the present study was to seek converging evidence for the role of left hemisphere cortical regions in language using a voxel-based imaging technique in individuals with PPA. Fifteen individuals with progressive aphasia and fifteen normal controls were given a comprehensive language battery comprising tasks in the domains of syntax, semantics, phonology, and orthography. A subset of patients and all normal controls underwent high-resolution structural MRI scanning. Voxel-based morphometry (VBM) was used to characterize patterns of regional cortical atrophy in the patients relative to controls and to correlate language tasks with gray matter volumes. Results confirm a key role for left perisylvian cortex in phonological and syntactic processes, and indicate that left temporal regions are critically involved in semantic processes. Findings shed light on the veracity of the "primary systems" hypothesis of written language, which posits that written language impairments arise from core cognitive deficits affecting semantic and phonological systems.

This study attempted to investigate the effects of aphasia on word retrieval skills in a bilingual (Spanish-English) anomic patient. Two aspects of word finding difficulties were considered. First, an attempt was made to determine whether the patient exhibited the same degree of difficulty in both languages. Second, after the presentation of three different types of facilatory cues (initial syllable, sentence completion, translated word) the correct number of correct responses per cue were analyzed to determine whether or not the same kinds of cues were equally effective in English and in Spanish. Results indicated that word retrieval was affected to essentially the same degree in both languages, with performance in Spanish only slightly better than in English. Cue effectiveness also appeared to differ across languages.

Script training is a technique that allows persons with acquired speech and language disorders, such as nonfluent aphasia, to have islands of fluent speech during which they can speak about a topic without pausing or having word-finding errors. Scripts relevant to specific functional situations are written and practiced until memorized. Script training delivered verbally has been effective with clients with aphasia but the role of written cues in the training has not been explored. Therefore the purpose of this study was to compare the effectiveness of script training taught verbally, or verbally with a written script, in persons with aphasia. Three adults, one with Broca’s aphasia and apraxia of speech (AOS), one with Broca’s aphasia, and one with Anomic aphasia were recruited for this study. Participants selected three topics for script training and with the clinician’s help wrote a script and a script prompt for each topic. Scripts were trained one sentence or phrase at a time until 95% repetition accuracy was achieved, then training began for the next script. The effects of two training procedures, verbal only and verbal + written script, were evaluated with a multiple baseline design across training procedures, the order of which was counterbalanced across participants. Maintenance data were collected after each script was mastered and after the study ended. Results revealed that 3 persons with aphasia (PWA) demonstrated mastery of 2-3 scripts each using V+W script training methods, but only 1 participant maintained script accuracy at 16 weeks post-study. More research is needed to explore the role of written and verbal cues on script mastery and generalization.