Purpose: This study investigated whether gesture, naming and communication therapy enhanced the communication skills of 14 people with severe aphasia. It compared the gains made in gesture and naming therapy and evaluated whether there were any cross-modality gains. It also investigated whether improvements generalised to untreated items and explored factors that might influence individual participants' success in therapy. It probed whether participants were able to use gestures and words learnt in communicative scenarios with a partner and the benefits of involving the partner in therapy. Method: All participants received 15 hours of therapy that aimed to teach 20 pantomime gestures and 20 spoken or written words (Therapy A). Seven participants then progressed to a second is-hour phase of therapy that aimed to develop the communicative use of gesture alongside other strategies (Therapy B). Their partners attended all sessions and were actively involved. The other seven participants received_ no further therapy. A repeated measures design was used. Outcome measures evaluated the intelligibility of pantomime gestures and the accuracy of spoken or written words. Two novel tasks investigated the communicative use of gesture and naming. These evaluated participants' ability to convey messages and narratives to their partner. All assessments included items that had been treated for gesture and for naming as well as untreated items. Results: The outcome measures showed that participants' ability to name and gesture items was stable at baseline and then improved significantly following Therapy A. Improvements on these assessments were confined to treated items with no evidence of cross-modality generalisation. Overall, gains were greater for naming than gesturing items, although there was considerable individual variation with three participants making greater gains in gesture than naming. Performance on the communicative assessments was also stable at baseline and improved following Therapy A. On these tasks gains were evident in messages and video narratives that involved untreated as well as treated items. Participants who received Therapy B made further improvements on the message assessment, but not the video narrative assessment. Conclusions: People with severe aphasia improved in their ability to produce both pantomime gestures and words following therapy, but they generally made greater gains in naming items. However, there was considerable individual variation in response to therapy in the two modalities, suggesting that gesture therapy may be a more fruitful approach for some but not all people with severe aphasia. Gains were confined to treated items, suggesting that gesture therapy should focus on items that are likely to be used in everyday communication. The results suggest that gesture and naming therapy can lead to improvements in people with aphasia's ability to convey information to their partner. Therapy involving communication partners led to some further gains in conveying messages, but the benefits of this approach were less marked.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:654986 |
| Date | January 2013 |
| Creators | Caute, Anna |
| Publisher | City University London |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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