Topics in Language Disorders

From the Editors: Considering Principles of Learning in the Treatment of Acquired Communication Disorders No abstract available

Considering Principles of Learning in the Treatment of Acquired Communication Disorders No abstract available

Identification of Key Therapy Ingredients for SLPs Serving on Multidisciplinary Teams Facilitating Return to Learn for Students With Prolonged Cognitive Effects After Concussion: A Retrospective Case Series Analysis Purpose: This retrospective case series utilized clinical data mining (CDM) to understand the potential key components in an integrated treatment approach delivered by speech–language pathologists (SLPs) treating adolescents experiencing persistent cognitive effects postconcussion. The first purpose was to describe the profiles of students treated in our clinic, how they were treated, and the nature of multidisciplinary communication. The second purpose was to generate testable hypotheses about effective intervention options for this population. Methods: Fifteen students aged 13–18 years experiencing prolonged concussion symptoms (PCS) were referred to our SLP graduate training clinic by a local pediatric neuropsychologist for cognitive rehabilitation services. Clinical data mining extracted clinical data in 4 main categories: (a) student characteristics, (b) SLP treatment parameters, (c) clinical outcomes following SLP treatment, and (d) the nature of multidisciplinary communication between practitioners. Results: Aligned with risk factors for PCS as reported in the literature, data on student characteristics revealed that the majority of students had sustained multiple previous concussions and reported a history of depression/anxiety. Data on SLP treatment parameters identified metacognitive strategy instruction and the training of assistive technology for cognition as the most frequent interventions selected to address academic goals. Data showing the frequency and type of multidisciplinary communication revealed that SLPs communicated most often with the pediatric neuropsychologist and educational liaison. Clinical outcome data revealed that 12 of the 15 students achieved their academic goals at the time of discharge. Conclusions: Overall, CDM results suggested that when working in a multidisciplinary team, SLPs can provide cognitive rehabilitation, support symptom reduction, and deliver psychoeducation potentially effective for students experiencing PCS. Key treatment and outcome measurement issues important for developing testable interventions are discussed.

A Review of the Application of Distributed Practice Principles to Naming Treatment in Aphasia It is uncontroversial in psychological research that different schedules of practice, which govern the distribution of practice over time, can promote radically different outcomes in terms of gains in performance and durability of learning. In contrast, in speech–language treatment research, there is a critical need for well-controlled studies examining the impact of distribution of treatment on efficacy. In this article, we enumerate key findings from psychological research on learning and memory regarding how different schedules of practice differentially confer durable learning. We review existing studies of aphasia treatment with a focus on naming impairment that have examined how the distribution of practice affects treatment efficacy. We close by discussing potential productive lines of research to elaborate the clinical applicability of distributed practice principles to language treatment.

The Time Course of Priming in Aphasia: An Exploration of Learning Along a Continuum of Linguistic Processing Demands This study investigates learning in aphasia as manifested through automatic priming effects. There is growing evidence that people with aphasia have impairments beyond language processing that could affect their response to treatment. Therefore, better understanding these mechanisms would be beneficial for improving methods of rehabilitation. This study assesses semantic and repetition priming effects at varied interstimulus intervals, using stimuli that are both nonlinguistic and linguistic in tasks that range from requiring nearly no linguistic processing to requiring both lexical and semantic processing. Results indicate that people with aphasia maintain typical patterns of learning across both linguistic and nonlinguistic tasks as long as the implicit prime-target relationship does not depend on deep levels of linguistic processing. As linguistic processing demands increase, those with agrammatic aphasia may require more time to take advantage of learning through implicit prime-target relationships, and people with both agrammatic and nonagrammatic aphasia are more susceptible to breakdown of the semantic networks as processing demands on that system increase.

Word Learning in Aphasia: Treatment Implications and Structural Connectivity Analyses Objective: Of current interest in aphasia research is the relevance of what we can learn from studying word learning ability in aphasia. In a preliminary study, we addressed 2 issues related to the novel word learning ability of individuals with aphasia. First, as word learning engages large-scale cognitive-linguistic systems (language skills, verbal short-term memory [STM], other memory and executive functions), we probed whether novel word learning practice in 3 people with aphasia could stimulate these language-related systems. Second, as lesion correlates affecting word learning in aphasia remain unclear, we examined whether the structural integrity of the left arcuate fasciculus (AF) in the same 3 individuals is related to outcomes of novel word learning practice. Method: To stimulate word learning systems, our 3 participants practiced for 4 weeks with an explicit novel word—novel referent word learning task, adopted from the Ancient Farming Equipment learning paradigm (Laine & Salmelin, 2010). The participants' progress on receptive and expressive novel word learning was followed up, and their language and verbal STM abilities as well as single-session novel word learning (Learning to Name Aliens by Gupta, Martin, Abbs, Schwartz, & Lipinski, 2006) were tested before and after the practice period. To address the second question, we analyzed the participants' structural magnetic resonance images with respect to the integrity of the left AF and its overlap with the lesion areas. Results: All participants showed some receptive word learning in the trained task, as well as improvements in verbal STM span at posttesting. Two of the 3 participants also showed improved performance on some of the language outcome measures. One participant with a partially spared left AF, especially temporoparietal connections, exhibited better word learning performance than the other 2 who had larger damage and disconnection of the AF. Conclusions: Although the present results are preliminary, they open the possibility that novel word learning practice in aphasia may stimulate remaining word learning mechanisms in aphasia and thereby influence language and verbal STM abilities. These results also suggest that preservation of novel word learning ability in aphasia in part depends on the integrity of the left arcuate track.

Investigating Attentional Allocation With Eye Tracking During Category Learning in People With Aphasia Studies have identified deficits in attention in individuals with aphasia in language and nonlanguage tasks. Attention may play a role in the construction and use of language, as well as in learning and the process of rehabilitation, yet the role of attention on rehabilitation is not fully understood. To improve the understanding of attention and learning in aphasia, this study replicated an experiment that utilized category learning to examine attentional allocation. Ten individuals with aphasia subsequent to left hemisphere stroke and 20 age-matched controls completed a computer-based category learning task while eye gaze data were collected using an eye tracker. Stimulus items comprised 4 features that differed in the reliability with which they predicted category membership (referred to as their diagnosticity). In this study, no differences were observed between individuals with aphasia and control participants on behavioral measures of accuracy and response time, though accuracies overall were lower than those of prior studies examining this task in young adults. Eye gaze data demonstrated that over the course of training, controls and individuals with aphasia learned to reduce the number of looks to the feature of lowest diagnosticity, suggestive of optimized attentional allocation. Eye gaze patterns, however, did not show increased looking or look times to all features of highest diagnosticity, which has been seen in young adults. Older adults and individuals with aphasia may benefit from additional processing time or additional trials during category learning to optimize attention and behavioral accuracy. Findings are relevant to consider in clinical settings where visual stimuli are presented as instructional, supporting, and/or compensatory tools.

Continuing Education Instructions and Questions No abstract available