Determinants of Multilevel Discourse Outcomes in Anomia Treatment for Aphasia.
Purpose: Individuals with aphasia identify discourse-level communication (i.e., language in use) as a high priority for treatment. The central premise of most aphasia treatments is that restoring language at the phoneme, word, and/or sentence level will generalize to discourse. However, treatment-re...
| Publicado en: | Journal of Speech, Language & Hearing Research Vol. 67; no. 9; pp. 3094 - 3113 |
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| Autores principales: | , , , , , , , |
| Formato: | Artículo |
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American Speech-Language-Hearing Association
Sep2024
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=179677799&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 179677799 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 10924388 1SM jtl: Journal of Speech, Language & Hearing Research issn: 10924388 maglogo: N pubinfo: dt: Sep2024 vid: 67 iid: 9 pid: 42 pub: American Speech-Language-Hearing Association artinfo: ui: 179677799 10.1044/2024_JSLHR-24-00030 ppf: 3094 ppct: 19 formats: fmt: @attributes: type: P size: 1MB tig: atl: Determinants of Multilevel Discourse Outcomes in Anomia Treatment for Aphasia. aug: au: Cavanaugh, Robert Dickey, Michael Walsh Hula, William D. Fromm, Davida Golovin, Jennifer Wambaugh, Julie Fergadiotis, Gerasimos Evans, William S. affil: Northeastern University, Portland, ME University of Pittsburgh, PA VA Pittsburgh Healthcare System, PA Carnegie Mellon University, Pittsburgh, PA The University of Utah, Salt Lake City Portland State University, OR su: United States Comparative grammar Executive function Retrospective studies Evaluation of medical care Attention Linguistics Motivation (Psychology) Memory Communication Semantics Anomia Phonological awareness Aphasia Data analysis software sug: subj: Comparative grammar Executive function Retrospective studies Evaluation of medical care Attention Linguistics Motivation (Psychology) Memory Communication Semantics United States Anomia Phonological awareness Aphasia Data analysis software ab: Purpose: Individuals with aphasia identify discourse-level communication (i.e., language in use) as a high priority for treatment. The central premise of most aphasia treatments is that restoring language at the phoneme, word, and/or sentence level will generalize to discourse. However, treatment-related changes in discourse-level communication are modest, are poorly understood, and vary greatly among individuals with aphasia. In response, this study consisted of a multilevel discourse analysis of archival, monologic discourse outcomes across two high-intensity Semantic Feature Analysis (SFA) clinical trials. Aim 1 evaluated changes in theoretically motivated discourse outcomes representing lexical-semantic processing, lexical diversity, grammatical complexity, and discourse informativeness. Aim 2 explored the potential moderating role of nonlanguage cognitive factors (semantic memory, divided attention, and executive function) on discourse outcomes. Method: This study was a retrospective analysis of archival monologic discourse outcomes after intensive SFA for n = 60 (Aim 1) and a subset n = 44 (Aim 2). Outcome measures included lexical-semantic processing (% semantic errors), lexical diversity (moving average type-token ratio), grammatical complexity (mean utterance length), and discourse informativeness (% correct information units). Bayesian generalized mixed-effects models were used to examine changes across four study time points: enrollment, entry, exit, and 1-month follow-up. Results: The present study found no evidence for meaningful or statistically reliable improvements in monologue discourse performance after SFA when measured using standard, general-topic discourse stimuli. There was weak and inconsistent evidence that nonlanguage cognitive factors may play a role in moderating treatment response. Conclusions: These findings indicate a clear need to pair theoretically informed treatments designed to facilitate generalization to discourse with intentional measurement paradigms designed to capture it. Furthermore, there is a clear need to examine how established treatments, restorative or compensatory, can better facilitate generalization to discourse-level communication. These priorities are critical for meaningfully improving everyday communication and reducing the profound communication and psychosocial consequences of aphasia. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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