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Lee DJ, Byeon JY, Park DH, Oh CG, Lee J, Choi YD, Kang DW, An KY, Courneya KS, Lee DH, Jeon JY. Effects of exercise during active surveillance for prostate cancer: A systematic review and meta-analysis. Support Care Cancer 2024; 32:406. [PMID: 38833183 DOI: 10.1007/s00520-024-08606-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/24/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE The efficacy of exercise in men with prostate cancer (PCa) on active surveillance (AS) remains unclear. In this meta-analysis, we aimed to examine the effects of exercise in PCa patients on AS. METHODS A literature search was conducted in PubMed, EMBASE, and the Cochrane Library using search terms, including exercise, PCa, AS, and randomized controlled trials (RCTs). The means and standard deviations for peak oxygen consumption (VO2peak), prostate-specific antigen (PSA) levels, and quality of life (QoL) were extracted for the intervention and control groups. A random-effects model was used to summarize the effects of exercise. RESULTS Of the 158 identified studies, six RCTs with 332 patients were included. The interventions included lifestyle modifications (aerobic exercise + diet) in three studies and different exercise modalities in three studies. The intervention duration was 2-12 months; three interventions were supervised and three were self-directed. The pooled weighted mean difference between exercise and usual care for VO2peak was 1.42 mL/kg/min (95% confidence interval [CI]: 0.30 to 2.54, P ≤ 0.001). A non-significant effect was observed for QoL (pooled standardized mean difference [SMD]: 0.24, 95% CI: - 0.03 to 0.51, P = 0.08) which became statistically significant and stronger after excluding one outlier study (P < 0.001). Exercise also had a positive effect on PSA levels (pooled SMD: - 0.43, 95% CI: - 0.87 to 0.01, P = 0.05). CONCLUSION Exercise improves cardiorespiratory fitness and may improve QoL and PSA levels in men with PCa on AS. Further studies with larger sample sizes are warranted to obtain more reliable results.
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Affiliation(s)
- Dong-Jun Lee
- Department of Sport Industry Studies, Yonsei University, Seoul, Republic of Korea
- Department of Physical Therapy, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Ji Yong Byeon
- Department of Sport Industry Studies, Yonsei University, Seoul, Republic of Korea
| | - Dong-Hyuk Park
- Department of Sport Industry Studies, Yonsei University, Seoul, Republic of Korea
| | - Chang Geun Oh
- Department of Sport Industry Studies, Yonsei University, Seoul, Republic of Korea
| | - Jongsoo Lee
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Deuk Choi
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dong-Woo Kang
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, 02215, USA
| | - Ki-Yong An
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, 02215, USA
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Dong Hoon Lee
- Department of Sport Industry Studies, Yonsei University, Seoul, Republic of Korea.
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Justin Y Jeon
- Department of Sport Industry Studies, Yonsei University, Seoul, Republic of Korea.
- Cancer Prevention Center, Yonsei Cancer Center, Seoul, Republic of Korea.
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Lee S, Faroqi-Shah Y. A Meta-Analysis of Anomia Treatment in Bilingual Aphasia: Within- and Cross-Language Generalization and Predictors of the Treatment Outcomes. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:1558-1600. [PMID: 38629966 PMCID: PMC11087086 DOI: 10.1044/2024_jslhr-23-00026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 09/15/2023] [Accepted: 01/14/2024] [Indexed: 05/09/2024]
Abstract
PURPOSE The present meta-analysis investigated the efficacy of anomia treatment in bilingual and multilingual persons with aphasia (BPWAs) by assessing the magnitudes of six anomia treatment outcomes. Three of the treatment outcomes pertained to the "trained language": improvement of trained words (treatment effect [TE]), within-language generalization of semantically related untrained words (WLG-Related), and within-language generalization of unrelated words (WLG-Unrelated). Three treatment outcomes were for the "untrained language": improvement of translations of the trained words (cross-language generalization of trained words [CLG-Tx]), cross-language generalization of semantically related untrained words (CLG-Related), and cross-language generalization of unrelated untrained words (CLG-Unrelated). This study also examined participant- and treatment-related predictors of these treatment outcomes. METHOD This study is registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD42023418147. Nine electronic databases were searched to identify word retrieval treatment studies of poststroke BPWAs of at least 6 months postonset. Pre- and posttreatment single-word naming scores were extracted for each eligible participant and used to calculate effect sizes (within-case Cohen's d) of the six treatment outcomes. Random-effects meta-analyses were conducted to assess weighted mean effect sizes of the treatment outcomes across studies. Multiple linear regression analyses were used to examine the effects of participant-related variables (pretreatment single-word naming and comprehension representing poststroke lexical processing abilities) and treatment-related variables (type, language, and duration). The methodological quality of eligible studies and the risk of bias in this meta-analysis were assessed. RESULTS A total of 17 published studies with 39 BPWAs were included in the meta-analysis. The methodological quality of the included studies ranged from fair (n = 4) to good (n = 13). Anomia treatment produced a medium effect size for TE (M = 8.36) and marginally small effect sizes for WLG-Related (M = 1.63), WLG-Unrelated (M = 0.68), and CLG-Tx (M = 1.56). Effect sizes were nonsignificant for CLG-Related and CLG-Unrelated. TE was significantly larger than the other five types of treatment outcomes. TE and WLG-Related effect sizes were larger for BPWAs with milder comprehension or naming impairments and for treatments of longer duration. WLG-Unrelated was larger when BPWAs received phonological treatment than semantic and mixed treatments. The overall risk of bias in the meta-analysis was low with a potential risk of bias present in the study identification process. CONCLUSIONS Current anomia treatment practices for bilingual speakers are efficacious in improving trained items but produce marginally small within-language generalization and cross-language generalization to translations of the trained items. These results highlight the need to provide treatment in each language of BPWAs and/or investigate other approaches to promote cross-language generalization. Furthermore, anomia treatment outcomes are influenced by BPWAs' poststroke single-word naming and comprehension abilities as well as treatment duration and the provision of phonological treatment. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25595712.
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Affiliation(s)
- Seongsil Lee
- Department of Hearing and Speech Sciences, University of Maryland, College Park
| | - Yasmeen Faroqi-Shah
- Department of Hearing and Speech Sciences, University of Maryland, College Park
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Neumann K, Kauschke C, Fox-Boyer A, Lüke C, Sallat S, Kiese-Himmel C. Interventions for Developmental Language Delay and Disorders. DEUTSCHES ARZTEBLATT INTERNATIONAL 2024; 121:155-162. [PMID: 38377329 DOI: 10.3238/arztebl.m2024.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Approximately 9.9 % of children present with difficulties in language development (DLD), 7.6 % without serious additional impairments and 2.3 % associated with languagerelevant comorbidities, e.g., hearing loss. Notably, in a consensus statement by experts in German-speaking countries, in the guideline presented here, and further in this article, all of these disorders are referred to as "developmental language disorders" (DLD), whereas the international consortium CATALISE only refers to those without comorbidities as DLD. DLDs are among the most commonly treated childhood disorders and, if persistent, often reduce educational and socio-economic outcome. Children in their third year of life with developmental language delay (late talkers, LT) are at risk of a later DLD. METHODS This German interdisciplinary clinical practice guideline reflects current knowledge regarding evidence-based interventions for developmental language delay and disorders. A systematic literature review was conducted on the effectiveness of interventions for DLD. RESULTS The guideline recommends parent training (Hedges g = 0.38 to 0.82) for LTs with expressive language delay, language therapy (Cohen's d = -0.20 to 0.90) for LTs with additional receptive language delay or further DLD risk factors, phonological or integrated phonological treatment methods (Cohen's d = 0.89 to 1.04) for phonological speech sound disorders (SSDs), a motor approach for isolated phonetic SSDs (non-DLD), and for lexical-semantic and morpho-syntactic impairments combinations of implicit and explicit intervention approaches (including input enrichment, modeling techniques, elicitation methods, creation of production opportunities, metalinguistic- approaches, visualizations; Cohen's d = 0.89-1.04). Recom mendations were also made for DLD associated with pragmatic-communicative impairment, bi-/ multilingualism, hearing loss, intellectual disability, autism-spectrum disorders, selective mutism, language- relevant syndromes or multiple disabilities, and for intensive inpatient language rehabilitation. CONCLUSION Early parent- and child-centered speech and language intervention implementing evidence-based intervention approaches, frequency, and settings, combined with educational language support, can improve the effectiveness of management of developmental language delay and disorders.
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Affiliation(s)
- Katrin Neumann
- Department of Phoniatrics and Pediatric Audiology, University Hospital of Muenster, University of Muenster, Germany; Department of German Linguistics, Clinical Linguistics, University of Marburg, Marburg, Germany; Institute of Health Sciences, University of Luebeck, Germany; Special Education and Therapy in Language and Communication Disorders, University of Wuerzburg, Germany; Department of Pedagogy for Speech and Communication Disorders, Halle, Germany
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Hashemi Hosseinabad H, Xing Y. Feasibility of using ultrasound visual biofeedback to treat persistent speech sound disorders in children with cleft palate- a case series. CLINICAL LINGUISTICS & PHONETICS 2024:1-32. [PMID: 38282211 DOI: 10.1080/02699206.2024.2306468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 01/12/2024] [Indexed: 01/30/2024]
Abstract
The current study aimed to assess the effectiveness of incorporating ultrasound visual biofeedback (UVB) into a treatment programme addressing persistent speech sound disorders linked to cleft palate in children who have been unresponsive to traditional therapy approaches. Materials and Methods. A single-subject multiple baseline experiment was conducted with five children aged 6:5-13:5 over a period of 16 therapy sessions. Treatment focused on providing cues from real-time ultrasound images to assist children in modifying their tongue movements. Probe data were collected before, mid, and post-treatment to assess target consonant accuracy for 50 untreated words. The results of the statistical analysis suggested participants showed a significant increase in percent target consonant accuracy as a result of intervention using UVB. Although most of the participants exhibited progress in generalising learned phonemes to untreated words, some did not show improvement in gaining generalisation from treated phonemic contexts to those untreated ones. When traditional methods fail to yield significant progress, incorporating ultrasound biofeedback into the treatment programme emerges as a viable option to enhance sound accuracy in children with persistent speech sound disorders resulting from cleft palate.
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Affiliation(s)
- Hedieh Hashemi Hosseinabad
- Department of Audiology and Speech-Language Pathology, College of Health and Public Service, University of North Texas, Denton, Texas, USA
| | - Yixun Xing
- Department of Advanced Data Analytics, Toulouse Graduate School, University of North Texas, Denton, Texas, USA
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Leaman MC, Edmonds LA. Pilot Results for ECoLoGiC-Tx: A New Conversation-Level Intervention Improving Language in People With Moderate to Severe Aphasia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:153-172. [PMID: 37934890 DOI: 10.1044/2023_ajslp-23-00141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
PURPOSE This study reports pilot data for a novel intervention, ECoLoGiC-Tx, delivered to four people with moderate to severe aphasia. ECoLoGiC-Tx addresses language and communication in unstructured, participant-led conversation. The speech-language pathologist (SLP) uses a framework to choose turns that facilitate a social interaction. When communication breakdown occurs, the SLP implements a least-to-most hierarchy to maximize the people with aphasia's (PWA's) independence in self-repair. ECoLoGiC-Tx draws its theoretical underpinnings from conversation analysis and theories of rehabilitation, including principles of complexity, neuroplasticity, and learning. METHOD Four PWA attended 60-min sessions twice weekly for 10 weeks. Assessment occurred at pretreatment, posttreatment, and 6-week maintenance. Outcomes included established discourse measures for conversation and monologue, tests of language and functional communication, and patient-/family-reported outcome measures (P/FROMs). Discourse samples were collected three times per assessment. Interrater reliability and fidelity for assessment and treatment procedures are reported. RESULTS Participants presented with Broca's aphasia (one moderate, one severe) or conduction aphasia (one moderate, one severe). Each demonstrated improvements in discourse, test batteries, and P/FROMs. They all demonstrated reduced aphasia severity measured by the Western Aphasia Battery-Revised at posttreatment or maintenance. Change in conversation and monologue was robust for three participants, but was mixed for one person (P1: moderate Broca's aphasia). P/FROMs indicated improvement at posttreatment and maintenance for all participants. Most treatment gains were maintained at 6-week follow-up. CONCLUSIONS This study provides promising results for ECoLoGiC-Tx to improve language function of people with chronic moderate to severe aphasia. Generalization occurred to tests, functional communication, spontaneous conversation, and structured monologue tasks.
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Affiliation(s)
| | - Lisa A Edmonds
- Teachers College, Columbia University, New York City, NY
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Ochs LC, Leece MC, Preston JL, McAllister T, Hitchcock ER. Traditional and Visual-Acoustic Biofeedback Treatment via Telepractice for Residual Speech Sound Disorders Affecting /ɹ/: Pilot study. PERSPECTIVES OF THE ASHA SPECIAL INTEREST GROUPS 2023; 8:1533-1553. [PMID: 38764857 PMCID: PMC11101137 DOI: 10.1044/2023_persp-23-00120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
Purpose This study aimed to examine the feasibility of telepractice delivery of a treatment package including visual-acoustic biofeedback and motor-based treatment for residual speech sound disorder affecting /ɹ/ in school-age children. The overall study used a single-case randomization design; however, this preliminary report will simply quantify changes in accuracy before and after completion of the treatment package. The present analysis did not differentiate between the relative contributions of biofeedback and motor-based treatments. Method Seven children aged 9-14 received speech therapy for /ɹ/ distortions via telepractice. The study design consisted of three phases: baseline (four sessions), treatment (20 sessions), and post-treatment (three sessions). Treatment included two sessions weekly for a duration of 10 weeks. The participants received one motor-based/non-biofeedback session and one visual-acoustic biofeedback session per week. The order of treatment within each week was randomly determined prior to the start of therapy. Overall progress was assessed using untrained listeners' ratings of word probes administered in the baseline and posttreatment phases. Results Findings revealed that six of the seven participants showed a clinically significant response to the overall treatment package, although the magnitude of individual responses varied across speech contexts (consonantal and vocalic) and participants. Conclusion The present results suggest that a treatment combining visual-acoustic biofeedback and motor-based treatment for residual /ɹ/ errors treatment can be effectively delivered via telepractice. Considerations for technology setup and treatment protocols are provided.
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Hashimoto N. Using a combined working memory - Semantic feature analysis approach to treat anomia in aphasia: A Pilot Study. JOURNAL OF COMMUNICATION DISORDERS 2023; 106:106384. [PMID: 37871472 DOI: 10.1016/j.jcomdis.2023.106384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 08/30/2023] [Accepted: 10/13/2023] [Indexed: 10/25/2023]
Abstract
INTRODUCTION The purpose of the study was to pilot a working memory (WM) - and modified Semantic Feature Analysis (SFA) approach to treat word finding deficits in a group of people with aphasia (PwA). Two research questions were posed: 1. Will the group of PwA be able to complete the WM tasks used in the approach? 2. Will the approach improve naming performance in PwA? METHOD Three individuals with mild - moderate aphasia participated in this singlesubject multiple baseline treatment design. Pre-treatment assessments of language, and pre- to post-treatment assessments of WM abilities were carried out. The treatment protocol incorporated WM and linguistic tasks in order to improve naming accuracy across two treatment lists. Probes were carried out prior to treatment on each list, and at one-month following completion of treatment. Two outcome measures were obtained: Percent accuracy in completing the WM steps, and treatment effect sizes (Beeson & Robey, 2006). Additionally, modified t-tests (Crawford & Garthwaite, 2012; Crawford & Howell, 1998), were calculated in which post-treatment WM measures were compared against neurotypical control groups to detect any improvements in WM functions. RESULTS All three participants completed the WM steps with a high degree of accuracy. A range of small to large ESs were obtained for all three participants across the two treated lists, while no meaningful ESs were obtained for the control (untreated) list. All three participants demonstrated improved scores across most of the WM measures with significant improvements noted on certain WM assessments. CONCLUSIONS The findings revealed that the WM - SFA approach can be used successfully in individuals with mild - moderate aphasia. The proposed approach holds promise as feasible intervention designed to remediate anomia in PwA.
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Savage SA, Suárez-González A, Stuart I, Christensen I. Successful word retraining, maintenance and transference of practice to everyday activities: A single case experimental design in early onset alcohol-induced brain damage. Neuropsychol Rehabil 2023; 33:1488-1511. [PMID: 35984770 DOI: 10.1080/09602011.2022.2107545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 07/26/2022] [Indexed: 10/15/2022]
Abstract
Word retraining programs have been shown to improve naming ability post-stroke and in progressive aphasias. Here, we investigated benefits for a 22-year-old Danish man (DJ), whose difficulties followed brain damage from heavy alcohol misuse. Using a multiple baseline-across-behaviours design (target behaviour: retrieval of word list items), DJ completed a 4-week "Look, Listen, Repeat" program on a computer. Ninety personally relevant target words were selected to create three matched lists. List 1 was trained for 10 sessions over 2 weeks, followed by 9 sessions for List 2 over 2 weeks, while the third list remained untrained. Naming performance was evaluated at baseline, during the intervention, and at 1 and 4 months post-training. Naming improved following each intervention block (p < .001), with only one data point overlapping between the baseline and treatment phases for trained items. Untrained words remained unchanged (p = 1.00), with 50% of data points non-overlapping across baseline to treatment phases. Performance was maintained over time, and appeared to generalize, with DJ naming more trained objects in their natural setting (85%) than untrained items (64%). While more evidence is needed, brief (20-minute), intensive (5-day/week) word retraining programs may assist word retrieval for people with brain damage associated with alcohol misuse.
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Affiliation(s)
- Sharon A Savage
- School of Psychological Sciences, The University of Newcastle, Newcastle, Australia
- Psychology Department, University of Exeter , Exeter, UK
| | - Aida Suárez-González
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Ida Stuart
- Neurorehabilitation Selma Marie, Ølstykke, Denmark
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Tilton-Bolowsky VE, Brock L, Nunn K, Evans WS, Vallila-Rohter S. Incorporating Metacognitive Strategy Training Into Semantic Treatment Promotes Restitutive and Substitutive Gains in Naming: A Single-Subject Investigation. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:1979-2020. [PMID: 37433115 PMCID: PMC10561971 DOI: 10.1044/2023_ajslp-22-00230] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/22/2022] [Accepted: 02/17/2023] [Indexed: 07/13/2023]
Abstract
PURPOSE This study tested the effectiveness of a modified semantic feature analysis (SFA) treatment protocol that incorporated metacognitive strategy training (MST). Regarding its restitutive component, SFA most reliably results in improved word retrieval for treated items and untreated, semantically related items, but evidence of response generalization is often small/inconsistent. Regarding its substitutive component, SFA is thought to facilitate successful communication via habituation of the SFA circumlocution strategy. However, repeated practice with SFA's strategy in the absence of direct MST may not result in independent strategy use and/or generalization. Furthermore, people with aphasia's independent use of the SFA strategy in moments of anomia is presently underreported. To address these limitations, we incorporated MST into SFA and directly measured substitutive outcomes. METHOD Four people with aphasia participated in 24 treatment sessions of SFA + MST in a single-subject, A-B experimental design with repeated measurements. We measured word retrieval accuracy, strategy use, and explicit strategy knowledge. We calculated effect sizes to measure changes in word retrieval accuracy and strategy use and used visual inspection to assess gains in explicit strategy knowledge from pre- to posttreatment and retention. RESULTS Participants achieved marginally small to medium effects in word retrieval accuracy for treated; untreated, semantically related; and untreated, semantically unrelated items and marginally small to large effects in independent strategy use. Explicit strategy knowledge was variable. CONCLUSIONS Across participants, SFA + MST yielded positive changes in word retrieval accuracy or strategy use, or both. Positive changes in word retrieval accuracy were comparable to other SFA studies. Positive changes in strategy use demonstrate preliminary evidence of this treatment's ability to yield restitutive and substitutive gains. Overall, this study offers preliminary evidence of SFA + MST's effectiveness and highlights the importance of directly measuring SFA's substitutive outcomes, which showed that people with aphasia can respond to this treatment in multiple successful ways-not just improved target word production.
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Sandberg CW, Khorassani H, Gray T, Dickey MW. Novel participant-level meta-analytic evidence for AbSANT efficacy. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1017389. [PMID: 37608806 PMCID: PMC10441547 DOI: 10.3389/fresc.2023.1017389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 07/24/2023] [Indexed: 08/24/2023]
Abstract
The current study employed interrupted time series (ITS) models to analyze all available (published and unpublished) Abstract Semantic Associative Network Training (AbSANT) data. AbSANT is a semantically focused anomia treatment that targets not only concrete but abstract words, unique among existing anomia treatments. However, evidence to date for the positive effects of AbSANT comes only from small-sample, single-subject design studies, limiting the strength of this evidence and the inferences that can be drawn from it. The statistical power and greater representativeness afforded by this larger aggregated sample enabled us to look for group-level efficacy evidence for AbSANT, examine specific questions about AbSANT's direct training and generalization effects, and identify potential predictors and mechanisms of AbSANT treatment response. We found that across 33 participants from four different data sources, AbSANT appears to be a robust word retrieval therapy protocol, with overall direct training and generalization effects that were more meaningful than exposure effects. Similar to previous smaller-sample study conclusions, we found that in this large sample, training abstract words results not only in larger direct training effects than training concrete words, but also larger generalization effects, suggesting that while AbSANT successfully improves both abstract and concrete word retrieval, it may be better suited for training abstract words. In general, direct training effects were more persistent after treatment ended than generalization effects and effects for concrete words were more persistent than for abstract words. Additionally, the effects of generalization appear to be distinct from the effects of simple exposure to words, and generalization effects are consistent with AbSANT's hypothesized mechanism of action: spreading activation from directly trained concepts to related concepts. Also consistent with this mechanism, we found that milder aphasia and both conceptual and lexical semantic processing ability predicted both direct training and generalization gains, and that executive function was predictive of generalization effects. These factors are thus important to consider when evaluating the appropriateness of AbSANT for individual clients.
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Affiliation(s)
- Chaleece W. Sandberg
- Department of Communication Sciences and Disorders, Penn State University, University Park, PA, United States
| | - Hannah Khorassani
- Department of Speech, Language and Hearing Sciences, San Francisco State University, San Francisco, CA, United States
| | - Teresa Gray
- Department of Speech, Language and Hearing Sciences, San Francisco State University, San Francisco, CA, United States
| | - Michael Walsh Dickey
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA, United States
- Geriatric Research Education and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, United States
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Thomas D, Murray E, Williamson E, McCabe P. Weekly Treatment for Childhood Apraxia of Speech With Rapid Syllable Transition Treatment: A Single-Case Experimental Design Study. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-22. [PMID: 37536463 DOI: 10.1044/2023_jslhr-22-00665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
PURPOSE The aim of this study was to pilot the efficacy of rapid syllable transition (ReST) treatment when provided once per week for a 50-min treatment session for 12 weeks with five children with childhood apraxia of speech. Of central importance was the children's retention and generalization of gains from treatment as indicators of speech motor learning. METHOD A multiple-baseline across-participant design was employed to investigate (a) treatment effect on the 20 treated pseudowords, (b) generalization to 40 untreated real words and 10 untreated polysyllabic word sentences, and (c) maintenance of any treatment and generalization goals to up to 4 months posttreatment. To investigate any difference between in-session performance and retention, a comparison was made between data collected during treatment and probe sessions. RESULTS Treatment data collected during therapy showed all children improving across their 12 treatment sessions. Three of the five children showed a treatment effect on treated pseudowords in the probe sessions, but only one child showed generalization to untreated real words, and no children showed generalization to sentences. CONCLUSIONS ReST treatment delivered at a dose frequency of once per week was efficacious for only one of the five children. In-session treatment data were not a reliable indicator of children's learning. One session per week of ReST therapy is therefore not recommended. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23751018.
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Affiliation(s)
- Donna Thomas
- Faculty of Medicine and Health, The University of Sydney, Australia
| | - Elizabeth Murray
- Faculty of Medicine and Health, The University of Sydney, Australia
- Remarkable Speech and Movement, Sydney, Australia
| | - Eliza Williamson
- Faculty of Medicine and Health, The University of Sydney, Australia
| | - Patricia McCabe
- Faculty of Medicine and Health, The University of Sydney, Australia
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Cavanaugh R, Quique YM, Swiderski AM, Kallhoff L, Terhorst L, Wambaugh J, Hula WD, Evans WS. Reproducibility in Small- N Treatment Research: A Tutorial Using Examples From Aphasiology. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:1908-1927. [PMID: 36542852 PMCID: PMC10465158 DOI: 10.1044/2022_jslhr-22-00333] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/19/2022] [Accepted: 08/27/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE Small-N studies are the dominant study design supporting evidence-based interventions in communication science and disorders, including treatments for aphasia and related disorders. However, there is little guidance for conducting reproducible analyses or selecting appropriate effect sizes in small-N studies, which has implications for scientific review, rigor, and replication. This tutorial aims to (a) demonstrate how to conduct reproducible analyses using effect sizes common to research in aphasia and related disorders and (b) provide a conceptual discussion to improve the reader's understanding of these effect sizes. METHOD We provide a tutorial on reproducible analyses of small-N designs in the statistical programming language R using published data from Wambaugh et al. (2017). In addition, we discuss the strengths, weaknesses, reporting requirements, and impact of experimental design decisions on effect sizes common to this body of research. RESULTS Reproducible code demonstrates implementation and comparison of within-case standardized mean difference, proportion of maximal gain, tau-U, and frequentist and Bayesian mixed-effects models. Data, code, and an interactive web application are available as a resource for researchers, clinicians, and students. CONCLUSIONS Pursuing reproducible research is key to promoting transparency in small-N treatment research. Researchers and clinicians must understand the properties of common effect size measures to make informed decisions in order to select ideal effect size measures and act as informed consumers of small-N studies. Together, a commitment to reproducibility and a keen understanding of effect sizes can improve the scientific rigor and synthesis of the evidence supporting clinical services in aphasiology and in communication sciences and disorders more broadly. Supplemental Material and Open Science Form: https://doi.org/10.23641/asha.21699476.
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Affiliation(s)
- Robert Cavanaugh
- Department of Communication Science and Disorders, University of Pittsburgh, PA
- Audiology and Speech Pathology Program, VA Pittsburgh Healthcare System, PA
| | - Yina M. Quique
- Center for Education in Health Sciences and Shirley Ryan Ability Lab, Northwestern University, Evanston, IL
| | - Alexander M. Swiderski
- Department of Communication Science and Disorders, University of Pittsburgh, PA
- Audiology and Speech Pathology Program, VA Pittsburgh Healthcare System, PA
- Center for Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, PA
| | - Lydia Kallhoff
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City
| | - Lauren Terhorst
- Department of Occupational Therapy, University of Pittsburgh, PA
| | - Julie Wambaugh
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City
| | - William D. Hula
- Department of Communication Science and Disorders, University of Pittsburgh, PA
- Audiology and Speech Pathology Program, VA Pittsburgh Healthcare System, PA
| | - William S. Evans
- Department of Communication Science and Disorders, University of Pittsburgh, PA
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Stark BC, Alexander JM, Hittson A, Doub A, Igleheart M, Streander T, Jewell E. Test-Retest Reliability of Microlinguistic Information Derived From Spoken Discourse in Persons With Chronic Aphasia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-30. [PMID: 37335766 DOI: 10.1044/2023_jslhr-22-00266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
PURPOSE The purpose of this study was to characterize test-retest reliability of discourse measures across a battery of common tasks in individuals with aphasia and prospectively matched adults without brain damage. METHOD We collected spoken discourse during five monologue tasks at two timepoints (test and retest; within 2 weeks apart) in an aphasia group (n = 23) and a peer group with no brain damage (n = 24). We evaluated test-retest reliability for percentage of correct information units, correct information units per minute, mean length of utterance, verbs per utterance, noun/verb ratio, open/closed class word ratio, tokens, sample duration (seconds), propositional idea density, type-token ratio, and words per minute. We explored reliability's relationship with sample length and aphasia severity. RESULTS Rater reliability was excellent. Across tasks, both groups demonstrated discourse measures with poor, moderate, and good reliability, with the aphasia group having measures demonstrating excellent test-retest reliability. When evaluating measures within each task, test-retest reliability again ranged from poor to excellent for both groups. Across groups and task, measures that appeared most reliable appeared to reflect lexical, informativeness, or fluency information. Sample length and aphasia severity impacted reliability, and this differed across and by task. CONCLUSIONS We identified several discourse measures that were reliable across and within tasks. Test-retest statistics are intimately linked to the specific sample, emphasizing the importance of multiple baseline studies. Task itself should be considered an important variable, and it should not be assumed that discourse measures found to be reliable across several tasks (averaged) are likewise reliable for a single task. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23298032.
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Affiliation(s)
- Brielle C Stark
- Department of Speech, Language and Hearing Sciences, Indiana University Bloomington
| | - Julianne M Alexander
- Department of Speech, Language and Hearing Sciences, Indiana University Bloomington
| | - Anne Hittson
- Department of Speech, Language and Hearing Sciences, Indiana University Bloomington
| | - Ashleigh Doub
- Speech and Hearing Sciences, University of Illinois at Urbana-Champaign, Champaign
| | - Madison Igleheart
- Department of Speech, Language and Hearing Sciences, Indiana University Bloomington
| | - Taylor Streander
- Department of Speech, Language and Hearing Sciences, Indiana University Bloomington
| | - Emily Jewell
- Department of Speech, Language and Hearing Sciences, Indiana University Bloomington
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14
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Mettler HM, Neiling SL, Figueroa CR, Evans-Reitz N, Alt M. Vocabulary Acquisition and Usage for Late Talkers: The Feasibility of a Caregiver-Implemented Telehealth Model. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:257-275. [PMID: 36580564 PMCID: PMC10023173 DOI: 10.1044/2022_jslhr-22-00285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/21/2022] [Accepted: 09/30/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE This feasibility study examined a caregiver-implemented telehealth model of the Vocabulary Acquisition and Usage for Late Talkers (VAULT) protocol. We asked whether caregivers could reach fidelity on VAULT, if the protocol was socially and ecologically valid, and if late-talking toddlers could learn new words with this model. METHOD Five late-talking monolingual and bilingual toddlers and four caregivers participated. The caregiver-related research questions involved measurements taken at multiple time points and replication across subjects but did not follow a specific research design. The toddler-related research questions included elements of a single-case design. Caregivers completed self-paced online training modules and then provided 8 weeks of VAULT to their children with remote coaching. Fidelity data were collected during coached sessions and through rating scales. Social and ecological validity data were collected via surveys and interviews. Children's word learning was measured before, during, and after treatment via production of targets and controls and via standardized vocabulary inventories. RESULTS Caregivers demonstrated high fidelity to VAULT throughout treatment. They reported being comfortable with many aspects of VAULT. Feedback was mixed regarding the time required. Many reported their child was talking more as a result of the program. Visual analysis revealed that toddlers learned more target than control words, which was corroborated by Tau-U and d effect size analyses. CONCLUSION A caregiver-implemented telehealth model of VAULT was feasible, was socially and ecologically valid, and benefited toddlers, making this a worthwhile model for future studies to examine. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21753872.
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Affiliation(s)
- Heidi M. Mettler
- Department of Speech, Language, & Hearing Sciences, The University of Arizona, Tucson
| | - Sarah Lynn Neiling
- Department of Speech, Language, & Hearing Sciences, The University of Arizona, Tucson
| | - Cecilia R. Figueroa
- Department of Speech, Language, & Hearing Sciences, The University of Arizona, Tucson
| | - Nora Evans-Reitz
- Department of Speech, Language, & Hearing Sciences, The University of Arizona, Tucson
| | - Mary Alt
- Department of Speech, Language, & Hearing Sciences, The University of Arizona, Tucson
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15
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Hitchcock ER, Ochs LC, Swartz MT, Leece MC, Preston JL, McAllister T. Tutorial: Using Visual-Acoustic Biofeedback for Speech Sound Training. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:18-36. [PMID: 36623212 PMCID: PMC10023147 DOI: 10.1044/2022_ajslp-22-00142] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
PURPOSE This tutorial summarizes current practices using visual-acoustic biofeedback (VAB) treatment to improve speech outcomes for individuals with speech sound difficulties. Clinical strategies will focus on residual distortions of /ɹ/. METHOD Summary evidence related to the characteristics of VAB and the populations that may benefit from this treatment are reviewed. Guidelines are provided for clinicians on how to use VAB with clients to identify and modify their productions to match an acoustic representation. The clinical application of a linear predictive coding spectrum is emphasized. RESULTS Successful use of VAB requires several key factors including clinician and client comprehension of the acoustic representation, appropriate acoustic target and template selection, as well as appropriate selection of articulatory strategies, practice schedules, and feedback models to scaffold acquisition of new speech sounds. CONCLUSION Integrating a VAB component in clinical practice offers additional intervention options for individuals with speech sound difficulties and often facilitates improved speech sound acquisition and generalization outcomes. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21817722.
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Burda A, Squires L, Krupke D, Arthur A, Bahia M, Bernard K, Easley M, English M, Hicks J, Johnson V, Lancaster M, O'Loughlin E, Skaar S. Effectiveness of Intense Accent Modification Training With Refugees From Burma. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2688-2706. [PMID: 36301994 DOI: 10.1044/2022_ajslp-21-00280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE This pilot research project sought to determine if an intensive accent modification training program that included See the Sound-Visual Phonics and prosodic gestures improved articulation, prosody, and intelligibility measures in refugees from Burma. PARTICIPANTS Four individuals (two men, two women) aged 20-67 participated in this study, and they were recruited from a state organization supporting refugees who have resettled in the United States. METHOD All participants completed the Proficiency in Oral English Communication (POEC) and Assessment of Intelligibility of Dysarthric Speech (AIDS) to measure pre- and posttraining changes. The duration of this study was 6 weeks and consisted of 1 week of pretesting, 4 weeks of accent modification training, and 1 week of posttesting. Participants attended a total of twelve 50-min accent modification training sessions, including eight individual sessions (twice per week) and four group sessions (once per week), which provided a functional way to practice newly acquired skills in a scripted conversational-type format. Trained and untrained articulation and prosody probes were used to establish baselines and measure change. RESULTS All four participants showed gains across articulation and prosody (in untrained and trained items). On pre- and posttest measures, three of the four participants also made gains on the broad measures of the AIDS and the POEC. CONCLUSION Findings support that a brief and intensive multimodality accent modification program can be beneficial.
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Richardson K, Huber JE, Kiefer B, Kane C, Snyder S. Respiratory Responses to Two Voice Interventions for Parkinson's Disease. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:3730-3748. [PMID: 36167066 PMCID: PMC9937051 DOI: 10.1044/2022_jslhr-22-00262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE The purpose of this study was to examine the respiratory strategies used by persons with Parkinson's disease (PD) to support louder speech in response to two voice interventions. Contrasting interventions were selected to investigate the role of internal and external cue strategies on treatment outcomes. LSVT LOUD, which uses an internal cueing framework, and the SpeechVive prosthesis, which employs an external noise cue to elicit louder speech, were studied. METHOD Thirty-four persons with hypophonia secondary to idiopathic PD were assigned to one of three groups: LSVT LOUD (n = 12), SpeechVive (n = 12), or a nontreatment clinical control (n = 10). The LSVT LOUD and SpeechVive participants received 8 weeks of voice intervention. Acoustic and respiratory kinematic data were simultaneously collected at pre-, mid- and posttreatment during a monologue speech sample. Intervention outcomes included sound pressure level (SPL), utterance length, lung volume initiation, lung volume termination, and lung volume excursion. RESULTS As compared to controls, the LSVT LOUD and SpeechVive participants significantly increased SPL at mid- and posttreatment, thus confirming a positive intervention effect. Treatment-related changes in speech breathing were further identified, including significantly longer utterance lengths (syllables per breath group) at mid- and posttreatment, as compared to pretreatment. The respiratory strategies used to support louder speech varied by group. The LSVT LOUD participants terminated lung volume at significantly lower levels at mid- and posttreatment, as compared to pretreatment. This finding suggests the use of greater expiratory muscle effort by the LSVT LOUD participants to support louder speech. Participants in the SpeechVive group did not significantly alter their respiratory strategies across the intervention period. Single-subject effect sizes highlight the variability in respiratory strategies used across speakers to support louder speech. CONCLUSIONS This study provides emerging evidence to suggest that the LSVT LOUD and SpeechVive therapies elicit different respiratory adjustments in persons with PD. The study highlights the need to consider respiratory function when addressing voice targets in persons with PD.
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Affiliation(s)
- Kelly Richardson
- Department of Communication Disorders, University of Massachusetts Amherst
| | - Jessica E. Huber
- Department of Communication Disorders, University of Massachusetts Amherst
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN
| | - Brianna Kiefer
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN
| | - Caitlin Kane
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN
| | - Sandy Snyder
- Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN
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18
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Masson-Trottier M, Dash T, Berroir P, Ansaldo AI. French Phonological Component Analysis and aphasia recovery: A bilingual perspective on behavioral and structural data. Front Hum Neurosci 2022; 16:752121. [PMID: 36211123 PMCID: PMC9535680 DOI: 10.3389/fnhum.2022.752121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/08/2022] [Indexed: 11/13/2022] Open
Abstract
Studies show bilingualism entails an advantage in cognitive control tasks. There is evidence of a bilingual advantage in the context of aphasia, resulting in better cognitive outcomes and recovery in bilingual persons with aphasia compared to monolingual peers. This bilingual advantage also results in structural changes in the right hemisphere gray matter. Very few studies have examined the so-called bilingual advantage by reference to specific anomia therapy efficacy. This study aims to compare the effect of French-Phonological Component Analysis (Fr-PCA) in monolinguals and bilingual persons with aphasia, both at the linguistic and cognitive control level, and to examine the structural impact of left hemisphere lesion location and right hemisphere structural data. Eight participants with chronic aphasia received Fr-PCA for a total of 15 h over 5 weeks. The results showed improved accuracy for treated words and generalization to untreated items and discourse in both groups, and improved Flanker task performance for some participants. Bilingual participants improved more than monolinguals for picture-naming tasks and narrative discourse. Damage to the left postcentral gyrus and the middle frontal gyrus was associated with less therapy-induced improvement. Additionally, left hemisphere damage to the inferior parietal gyrus and postcentral gyrus was associated with reduced cognitive control pre-therapy. Undamaged right hemisphere cortical thicknesses were significantly different between groups; the inferior frontal gyrus and the middle frontal gyrus were greater for the bilingual participants and correlated with cognitive control skills. These results suggest a bilingual advantage in anomia recovery following Fr-PCA, potentially resulting from enhanced cognitive control abilities that could be supported by right hemisphere neural reserve.
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Affiliation(s)
- Michèle Masson-Trottier
- Laboratoire de Plasticité Cérébrale, Communication et Vieillissement, Centre de Recherche de l’Institut de Gériatrie de Montréal, Montréal, QC, Canada
- École d’Orthophonie et d’Audiologie, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
| | - Tanya Dash
- Laboratoire de Plasticité Cérébrale, Communication et Vieillissement, Centre de Recherche de l’Institut de Gériatrie de Montréal, Montréal, QC, Canada
| | - Pierre Berroir
- Laboratoire de Plasticité Cérébrale, Communication et Vieillissement, Centre de Recherche de l’Institut de Gériatrie de Montréal, Montréal, QC, Canada
| | - Ana Inés Ansaldo
- Laboratoire de Plasticité Cérébrale, Communication et Vieillissement, Centre de Recherche de l’Institut de Gériatrie de Montréal, Montréal, QC, Canada
- École d’Orthophonie et d’Audiologie, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada
- *Correspondence: Ana Inés Ansaldo,
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Peterson L, Savarese C, Campbell T, Ma Z, Simpson KO, McAllister T. Telepractice Treatment of Residual Rhotic Errors Using App-Based Biofeedback: A Pilot Study. Lang Speech Hear Serv Sch 2022; 53:256-274. [PMID: 35050705 DOI: 10.1044/2021_lshss-21-00084] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Although mobile apps are used extensively by speech-language pathologists, evidence for app-based treatments remains limited in quantity and quality. This study investigated the efficacy of app-based visual-acoustic biofeedback relative to nonbiofeedback treatment using a single-case randomization design. Because of COVID-19, all intervention was delivered via telepractice. METHOD Participants were four children aged 9-10 years with residual errors affecting American English /ɹ/. Using a randomization design, individual sessions were randomly assigned to feature practice with or without biofeedback, all delivered using the speech app Speech Therapist's App for /r/ Treatment. Progress was assessed using blinded listener ratings of word probes administered at baseline, posttreatment, and immediately before and after each treatment session. RESULTS All participants showed a clinically significant response to the overall treatment package, with effect sizes ranging from moderate to very large. One participant showed a significant advantage for biofeedback over nonbiofeedback treatment, although the order of treatment delivery poses a potential confound for interpretation in this case. CONCLUSIONS While larger scale studies are needed, these results suggest that app-based treatment for residual errors can be effective when delivered via telepractice. These results are compatible with previous findings in the motor learning literature regarding the importance of treatment dose and the timing of feedback conditions. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.18461576.
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Affiliation(s)
- Laura Peterson
- Department of Speech-Language Pathology, Rocky Mountain University of Health Professions, Provo, UT
| | | | - Twylah Campbell
- Department of Communicative Sciences and Disorders, New York University, NY
| | - Zhigong Ma
- Department of Communicative Sciences and Disorders, New York University, NY
| | - Kenneth O Simpson
- Department of Speech-Language Pathology, Rocky Mountain University of Health Professions, Provo, UT
| | - Tara McAllister
- Department of Communicative Sciences and Disorders, New York University, NY
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20
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Boliek CA, Halpern A, Hernandez K, Fox CM, Ramig L. Intensive Voice Treatment (Lee Silverman Voice Treatment [LSVT LOUD]) for Children With Down Syndrome: Phase I Outcomes. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1228-1262. [PMID: 35230877 DOI: 10.1044/2021_jslhr-21-00228] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE This study examined the effects of an intensive voice treatment Lee Silverman Voice Treatment (LSVT LOUD) on children with Down syndrome (DS) and motor speech disorders. METHOD A Phase I, multiple baseline, single-subject design with replication across nine participants with DS was used. Single-word intelligibility, acoustic measures of vocal functioning, and parent perceptions of pre- and posttreatment communication function were used as treatment outcome measures. RESULTS All participants completed the full dose of LSVT LOUD and showed gains on one or more of the outcome measures. Patterns of posttreatment improvements were not consistent across participants but were more frequently observed on trained maximum performance tasks compared to tasks reflecting generalization of the treatment skillset. Some participants exhibited a stronger response to treatment, whereas others showed a mixed or weaker response. Parents liked the treatment protocol, perceived benefits from intensive intervention, and indicated they would strongly recommend LSVT LOUD to other parents who have children with DS and motor speech disorders. CONCLUSIONS These preliminary results show that children with DS tolerated intensive voice treatment without adverse effects and made select meaningful therapeutic gains. The treatment evidence from this study warrants Phase II treatment studies using LSVT LOUD with a larger group of children with DS.
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Affiliation(s)
- Carol A Boliek
- Faculty of Rehabilitation Medicine, Department of Communication Sciences and Disorders, University of Alberta, Edmonton, Canada
- Neurosciences and Mental Health Institute, University of Alberta, Edmonton, Canada
| | - Angela Halpern
- LSVT Global, Inc., Tucson, AZ
- National Center for Voice and Speech, Denver, CO
| | - Keren Hernandez
- Faculty of Arts, Department of Linguistics, University of Alberta, Edmonton, Canada
| | | | - Lorraine Ramig
- LSVT Global, Inc., Tucson, AZ
- National Center for Voice and Speech, Denver, CO
- Columbia University, New York City, NY
- University of Colorado, Boulder
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21
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Schaffer KM, Wauters L, Berstis K, Grasso SM, Henry ML. Modified script training for nonfluent/agrammatic primary progressive aphasia with significant hearing loss: A single-case experimental design. Neuropsychol Rehabil 2022; 32:306-335. [PMID: 33023372 PMCID: PMC8252664 DOI: 10.1080/09602011.2020.1822188] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Speech-language pathology caseloads often include individuals with hearing loss and a coexisting neurogenic communication disorder. However, specific treatment techniques and modifications designed to accommodate this population are understudied. Using a single-case experimental design, the current study investigated the utility of modified Video Implemented Script Training for Aphasia (VISTA) for an individual with nonfluent/agrammatic variant primary progressive aphasia and severe-to-profound, bilateral hearing loss. We analyzed the impact of this intervention, which incorporates orthographic input and rehearsal, on script production accuracy, speech intelligibility, grammatical complexity, mean length of utterance, and speech rate. Treatment resulted in comparable positive outcomes relative to a previous study evaluating script training in nonfluent/agrammatic primary progressive aphasia patients with functional hearing. Follow-up data obtained at three months, six months, and one year post-treatment confirmed maintenance of treatment effects for trained scripts. To our knowledge, this is the first study to investigate a modified speech-language intervention tailored to the needs of an individual with PPA and hearing loss, with findings confirming that simple treatment modifications may serve to broaden the range of treatment options available to those with concomitant sensory and communication impairments.
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Affiliation(s)
- Kristin M. Schaffer
- Department of Communication Sciences and Disorders, The University of Texas, Austin
| | - Lisa Wauters
- Department of Communication Sciences and Disorders, The University of Texas, Austin
| | - Karinne Berstis
- Department of Communication Sciences and Disorders, The University of Texas, Austin
| | - Stephanie M. Grasso
- Department of Communication Sciences and Disorders, The University of Texas, Austin
| | - Maya L. Henry
- Department of Communication Sciences and Disorders, The University of Texas, Austin
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22
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Somer E, Gische C, Miočević M. Methods for Modeling Autocorrelation and Handling Missing Data in Mediation Analysis in Single Case Experimental Designs (SCEDs). Eval Health Prof 2022; 45:36-53. [PMID: 35225017 PMCID: PMC8980456 DOI: 10.1177/01632787211071136] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Single-Case Experimental Designs (SCEDs) are increasingly recognized as a valuable alternative to group designs. Mediation analysis is useful in SCEDs contexts because it informs researchers about the underlying mechanism through which an intervention influences the outcome. However, methods for conducting mediation analysis in SCEDs have only recently been proposed. Furthermore, repeated measures of a target behavior present the challenges of autocorrelation and missing data. This paper aims to extend methods for estimating indirect effects in piecewise regression analysis in SCEDs by (1) evaluating three methods for modeling autocorrelation, namely, Newey-West (NW) estimation, feasible generalized least squares (FGLS) estimation, and explicit modeling of an autoregressive structure of order one (AR(1)) in the error terms and (2) evaluating multiple imputation in the presence of data that are missing completely at random. FGLS and AR(1) outperformed NW and OLS estimation in terms of efficiency, Type I error rates, and coverage, while OLS was superior to the methods in terms of power for larger samples. The performance of all methods is consistent across 0% and 20% missing data conditions. 50% missing data led to unsatisfactory power and biased estimates. In light of these findings, we provide recommendations for applied researchers.
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Affiliation(s)
- Emma Somer
- Department of Psychology, 5620McGill University, Montreal, QC, Canada
| | - Christian Gische
- Department of Psychology, 9373Humboldt-Universitätzu Berlin, Berlin, Germany
| | - Milica Miočević
- Department of Psychology, 5620McGill University, Montreal, QC, Canada
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23
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Tabrizi R, Walton L, Simon E, Silkes JP. Repetition Priming in Treatment of Anomia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:48-66. [PMID: 34029115 DOI: 10.1044/2021_ajslp-20-00278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE Repetition priming has been suggested as a method for targeting implicit processes in anomia treatment. Prior studies have used masked priming for this purpose. This study extends that work with visible primes, a more clinically feasible approach. METHOD This study used a single-subject design across three participants with aphasia. Treatment involved repeated exposure to identity primes (trained condition) or sham primes (untrained condition) paired with pictures. Analyses assessed acquisition effects for trained items and untrained items that were seen during the training period, generalization to untrained items that had not been seen, and generalization to broader language skills, immediately and 3 months post-treatment. RESULTS All participants improved in naming trained items immediately after treatment, with greater improvements for trained than for untrained items. All participants maintained some degree of improvement on trained items 3 months post-treatment, although the degree differed across participants. Inconsistent generalization occurred to unexposed items. Improvements were noted in some areas of broader language ability, although these varied. CONCLUSIONS These data suggest a repetition priming treatment paradigm may increase naming accuracy for individuals with anomia and may benefit other aspects of language. Participant factors may have influenced response to treatment. Directions for future investigation are discussed.
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Affiliation(s)
- Rana Tabrizi
- School of Speech, Language, and Hearing Sciences, San Diego State University, CA
| | - Logan Walton
- Department of Speech and Hearing Sciences, University of Washington, Seattle
| | - Emily Simon
- School of Speech, Language, and Hearing Sciences, San Diego State University, CA
| | - JoAnn P Silkes
- School of Speech, Language, and Hearing Sciences, San Diego State University, CA
- Department of Speech and Hearing Sciences, University of Washington, Seattle
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Figeys M, Kim ES, Hopper T. Does Right-Hemispheric Anodal tDCS Enhance the Impact of Script Training in Chronic Aphasia? A Single-Subject Experimental Study. FRONTIERS IN REHABILITATION SCIENCES 2022; 2:793451. [PMID: 36188817 PMCID: PMC9397953 DOI: 10.3389/fresc.2021.793451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/02/2021] [Indexed: 12/03/2022]
Abstract
Background: Script training is an aphasia treatment approach that has been demonstrated to have a positive effect on communication of individuals with aphasia; however, it is time intensive as a therapeutic modality. To augment therapy-induced neuroplasticity, transcranial direct current stimulation (tDCS) may be implemented. tDCS has been paired with other speech-language treatments, however, has not been investigated with script training. Aims: The purpose of this study was to determine if tDCS improves communication proficiency when paired with script training, compared to script training alone. Methods and Procedures: A single-subject experimental design was implemented with a participant with non-fluent aphasia, using two scripts across treatment conditions: script training with sham-tDCS, and script training with anodal-tDCS. Treatment sessions were 75 min long, administered three times weekly. Anodal tDCS was implemented for 20 min with a current of 1.5 mA over the right inferior frontal gyrus. Results: Large effect sizes were obtained on script mastery for both stimulation conditions (anodal d2 = 9.94; sham d2 = 11.93). tDCS did not improve script accuracy, however, there was a significant improvement in the rate of change of script pace relative to baseline (3.99 seconds/day, p < 0.001) in the anodal tDCS condition. Conclusion: Despite a null tDCS result on accuracy, the script training protocol increased script performance to a near-fluent level of communication. There is preliminary evidence to suggest that tDCS may alter the rate of script acquisition, however, further research to corroborate this finding is required. Implications for future studies are discussed.
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Affiliation(s)
- Mathieu Figeys
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Esther Sung Kim
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Communication Sciences and Disorders, University of Alberta, Edmonton, AB, Canada
- *Correspondence: Esther Sung Kim
| | - Tammy Hopper
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Communication Sciences and Disorders, University of Alberta, Edmonton, AB, Canada
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25
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Sharma VK, Wong LK. Middle Cerebral Artery Disease. Stroke 2022. [DOI: 10.1016/b978-0-323-69424-7.00024-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Johnson JP, Meier EL, Pan Y, Kiran S. Abnormally weak functional connections get stronger in chronic stroke patients who benefit from naming therapy. BRAIN AND LANGUAGE 2021; 223:105042. [PMID: 34695614 PMCID: PMC8638784 DOI: 10.1016/j.bandl.2021.105042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/07/2021] [Accepted: 10/12/2021] [Indexed: 06/03/2023]
Abstract
Language recovery in aphasia is likely supported by a network of brain regions, but few studies have investigated treatment-related changes in functional connectivity while controlling for the absence of treatment. We examined functional connectivity in a 38-region picture-naming network in 30 patients with chronic aphasia who did or did not receive naming therapy. Compared to healthy controls, patients had abnormally low connectivity in a subset of connections from the naming network. Linear mixed models showed that the connectivity of abnormal connections increased significantly in patients who benefited from therapy, but not in those who did not benefit from or receive therapy. Changes in responders were specific to abnormal connections and did not extend to the larger network. Thus, successful naming therapy was associated with increased connectivity in connections that were abnormal prior to treatment. The potential to strengthen such connections may be a prerequisite for a successful treatment response.
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Affiliation(s)
- Jeffrey P Johnson
- Aphasia Research Laboratory, Department of Speech, Language, & Hearing Sciences, Sargent College of Health & Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Room 326, Boston, MA 02215, USA.
| | - Erin L Meier
- Aphasia Research Laboratory, Department of Speech, Language, & Hearing Sciences, Sargent College of Health & Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Room 326, Boston, MA 02215, USA
| | - Yue Pan
- Aphasia Research Laboratory, Department of Speech, Language, & Hearing Sciences, Sargent College of Health & Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Room 326, Boston, MA 02215, USA
| | - Swathi Kiran
- Aphasia Research Laboratory, Department of Speech, Language, & Hearing Sciences, Sargent College of Health & Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Room 326, Boston, MA 02215, USA
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Ambron E, Buxbaum LJ, Miller A, Stoll H, Kuchenbecker KJ, Coslett HB. Virtual Reality Treatment Displaying the Missing Leg Improves Phantom Limb Pain: A Small Clinical Trial. Neurorehabil Neural Repair 2021; 35:1100-1111. [PMID: 34704486 DOI: 10.1177/15459683211054164] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Phantom limb pain (PLP) is a common and in some cases debilitating consequence of upper- or lower-limb amputation for which current treatments are inadequate. OBJECTIVE This small clinical trial tested whether game-like interactions with immersive VR activities can reduce PLP in subjects with transtibial lower-limb amputation. METHODS Seven participants attended 5-7 sessions in which they engaged in a visually immersive virtual reality experience that did not require leg movements (Cool! TM), followed by 10-12 sessions of targeted lower-limb VR treatment consisting of custom games requiring leg movement. In the latter condition, they controlled an avatar with 2 intact legs viewed in a head-mounted display (HTC Vive TM). A motion-tracking system mounted on the intact and residual limbs controlled the movements of both virtual extremities independently. RESULTS All participants except one experienced a reduction of pain immediately after VR sessions, and their pre session pain levels also decreased over the course of the study. At a group level, PLP decreased by 28% after the treatment that did not include leg movements and 39.6% after the games requiring leg motions. Both treatments were successful in reducing PLP. CONCLUSIONS This VR intervention appears to be an efficacious treatment for PLP in subjects with lower-limb amputation.
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Affiliation(s)
- Elisabetta Ambron
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,University of Delaware, Newark, DE, USA
| | - Laurel J Buxbaum
- Moss Rehabilitation Research Institute, Elkins Park, Philadelphia, PA, USA.,Thomas Jefferson University, Philadelphia, PA, USA
| | - Alexander Miller
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Harrison Stoll
- Moss Rehabilitation Research Institute, Elkins Park, Philadelphia, PA, USA
| | | | - H Branch Coslett
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Cho SH, Shin IS. A Reporting Quality Assessment of Systematic Reviews and Meta-Analyses in Sports Physical Therapy: A Review of Reviews. Healthcare (Basel) 2021; 9:1368. [PMID: 34683046 PMCID: PMC8544369 DOI: 10.3390/healthcare9101368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 10/10/2021] [Accepted: 10/11/2021] [Indexed: 12/11/2022] Open
Abstract
This review of reviews aimed to evaluate the reporting quality of published systematic reviews and meta-analyses in the field of sports physical therapy using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This review of reviews included a literature search; in total, 2047 studies published between January 2015 and December 2020 in the top three journals related to sports physical therapy were screened. Among the 125 identified articles, 47 studies on sports physical therapy were included in the analysis (2 systematic reviews and 45 meta-analyses). There were several problems areas, including a lack of reporting for key components of the structured summary (10/47, 21.3%), protocol and registration (18/47, 38.3%), risk of bias in individual studies (28/47, 59.6%), risk of bias across studies (24/47, 51.1%), effect size and variance calculations (5/47, 10.6%), additional analyses (25/47, 53.2%), and funding (10/47, 21.3%). The quality of the reporting of systematic reviews and meta-analyses of studies on sports physical therapy was low to moderate. For better evidence-based practice in sports physical therapy, both authors and readers should examine assumptions in more detail, and report valid and adequate results. The PRISMA guideline should be used more extensively to improve reporting practices in sports physical therapy.
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Affiliation(s)
- Sung-Hyoun Cho
- Department of Physical Therapy, Nambu University, 23 Cheomdan Jungang-ro, Gwangsan-gu, Gwangju 62271, Korea;
| | - In-Soo Shin
- AI Convergence Education, Graduate School of Education, Dongguk University, 30, Pildong-ro 1 gil, Jung-gu, Seoul 04620, Korea
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Nicholas K, Plante E, Gómez R, Vance R. The Role of Spontaneous Repetitions During Treatment of Morphosyntactic Forms for Children With Developmental Language Disorder. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:3995-4003. [PMID: 34533999 PMCID: PMC9132045 DOI: 10.1044/2021_jslhr-20-00367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 04/15/2021] [Accepted: 06/11/2021] [Indexed: 06/13/2023]
Abstract
Purpose Children with developmental language disorder sometimes spontaneously repeat clinician models of morphemes targeted for treatment. We examine how spontaneous repeating of clinician models in the form of recasts associates with improved child production of those emerging morphemes. Method Forty-seven preschool children with developmental language disorder participated in Enhanced Conversational Recast therapy and were monitored for spontaneous repetitions of morphemes modeled by the clinician through conversational recasting. We calculated proportion of correct and incorrect productions elicited during treatment and for generalization probes as well as treatment effect sizes. We then used odds ratios to determine the probability that a spontaneous repetition may precede treatment gains and calculated correlations of correct repetitions with correct in-treatment productions of targets and treatment effect sizes. Results Spontaneous repetitions were highly likely to happen just prior to meaningful treatment progress. Children with higher frequencies of correct spontaneous repetitions of morpheme targets also showed higher frequencies of correct productions of these forms during the course of treatment. Furthermore, children with an earlier onset of repetitions and higher frequencies of correct repetitions showed overall larger effect sizes at the end of treatment. Conclusions Children's use of correct forms in their repetitions may serve as a self-scaffold for mastering productions of the correct form via structural priming mechanisms. Tracking spontaneously repeated targets may be a useful milestone for identifying response to treatment.
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Affiliation(s)
- Katrina Nicholas
- Department of Speech, Language, and Hearing Sciences, California State University, East Bay, Hayward
| | - Elena Plante
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson
| | - Rebecca Gómez
- Department of Psychology, The University of Arizona, Tucson
| | - Rebecca Vance
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson
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Sandberg CW, Zacharewicz M, Gray T. Bilingual Abstract Semantic Associative Network Training (BAbSANT): A Polish-English case study. JOURNAL OF COMMUNICATION DISORDERS 2021; 93:106143. [PMID: 34364041 DOI: 10.1016/j.jcomdis.2021.106143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 07/08/2021] [Accepted: 07/16/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION This article presents a novel approach to anomia therapy (i.e., BAbSANT: Bilingual Abstract Semantic Associative Network Training) for bilingual persons with aphasia (B-PWA) that capitalizes both on lexico-semantic theories in bilingualism and general theories of semantic organization and learning. Based on previous work, we hypothesized that training abstract words in either language would promote within-language generalization, while training in the nondominant language would promote both within- and cross-language generalization. METHODS This case study used a single-subject A1BA2CA3 design. The participant was living with aphasia secondary to stroke and spoke both Polish and English, with Polish being his native and dominant language. Phase B consisted of abstract word training in Polish and phase C consisted of abstract word training in English. Prior to initiating therapy, in addition to a comprehensive language battery, we administered a cognitive control task to explore the relationship between cognitive control and treatment outcome. RESULTS We found within-language generalization regardless of the trained language, replicating previous work in monolingual persons with aphasia, further supporting the utility of training abstract words. However, contrary to our second hypothesis, cross-language generalization only occurred when the stronger language was trained. CONCLUSIONS The discussion of the results of this case study is framed within previous work and theories of bilingualism. The lack of cross-language generalization when the weaker language was trained is discussed, taking into account nonverbal cognitive control deficits. In addition to showing the efficacy of BAbSANT, these results highlight the importance of considering cognitive control as a factor influencing therapeutic outcomes in anomia treatment in bilingual PWA.
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Affiliation(s)
- Chaleece W Sandberg
- Department of Communication Sciences and Disorders, Penn State University, 308 Ford Building, University Park, PA 16802, United States.
| | - Monika Zacharewicz
- Department of Speech, Language, and Hearing Sciences, San Francisco State University, 1600 Holloway Avenue, Burk Hall, Room 114, San Francisco, CA 94132, United States
| | - Teresa Gray
- Department of Speech, Language, and Hearing Sciences, San Francisco State University, 1600 Holloway Avenue, Burk Hall, Room 114, San Francisco, CA 94132, United States.
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Benway NR, Hitchcock ER, McAllister T, Feeny GT, Hill J, Preston JL. Comparing Biofeedback Types for Children With Residual /ɹ/ Errors in American English: A Single-Case Randomization Design. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1819-1845. [PMID: 34232693 PMCID: PMC8702873 DOI: 10.1044/2021_ajslp-20-00216] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/13/2020] [Accepted: 03/27/2021] [Indexed: 05/23/2023]
Abstract
Purpose Research comparing different biofeedback types could lead to individualized treatments for those with residual speech errors. This study examines within-treatment response to ultrasound and visual-acoustic biofeedback, as well as generalization to untrained words, for errors affecting the American English rhotic /ɹ/. We investigated whether some children demonstrated greater improvement in /ɹ/ during ultrasound or visual-acoustic biofeedback. Each participant received both biofeedback types. Individual predictors of treatment response (i.e., age, auditory-perceptual skill, oral somatosensory skill, and growth mindset) were also explored. Method Seven children ages 9-16 years with residual rhotic errors participated in 10 treatment visits. Each visit consisted of two conditions: 45 min of ultrasound biofeedback and 45 min of visual-acoustic biofeedback. The order of biofeedback conditions was randomized within a single-case experimental design. Acquisition of /ɹ/ was evaluated through acoustic measurements (normalized F3-F2 difference) of selected nonbiofeedback productions during practice. Generalization of /ɹ/ was evaluated through acoustic measurements and perceptual ratings of pretreatment/posttreatment probes. Results Five participants demonstrated acquisition of practiced words during the combined treatment package. Three participants demonstrated a clinically significant degree of generalization to untreated words on posttreatment probes. Randomization tests indicated one participant demonstrated a significant advantage for visual-acoustic over ultrasound biofeedback. Participants' auditory-perceptual acuity on an /ɹ/-/w/ identification task was identified as a possible correlate of generalization following treatment. Conclusions Most participants did not demonstrate a statistically significant difference in acoustic productions between the ultrasound and visual-acoustic conditions, but one participant showed greater improvement in /ɹ/ during visual-acoustic biofeedback. Supplemental Material https://doi.org/10.23641/asha.14881101.
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Affiliation(s)
- Nina R. Benway
- Department of Communication Sciences & Disorders, Syracuse University, NY
| | - Elaine R. Hitchcock
- Department of Communication Sciences and Disorders, Montclair State University, NJ
| | - Tara McAllister
- Department of Communicative Sciences and Disorders, New York University, NY
| | | | - Jennifer Hill
- Department of Applied Statistics, Social Science, and Humanities, New York University, NY
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Teh EJ, Vijayakumar R, Tan TXJ, Yap MJ. Effects of Physical Exercise Interventions on Stereotyped Motor Behaviours in Children with ASD: A Meta-Analysis. J Autism Dev Disord 2021; 52:2934-2957. [PMID: 34236592 DOI: 10.1007/s10803-021-05152-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2021] [Indexed: 12/17/2022]
Abstract
Studies have reported that physical exercise reduces maladaptive stereotyped motor behaviours (SMB) in children with ASD, but these intervention studies vary in design and outcome. The present systematic review and meta-analysis included 22 studies, involving 274 children with ASD, to quantify the effect of exercise on SMB and its potential moderators. Multi-level modelling revealed a large overall effect, Hedges' g = 1.16, with significant heterogeneity across participant, treatment, and study levels. Further, a more appropriate model using between-case estimation for within-subject effects to improve comparability between single-case and group-design studies, yielded a smaller but still significant effect, g = 0.51. Lastly, higher exercise intensity, but not age, exercise duration or settings, reliably predicted treatment effectiveness. Implications for clinical practice and research are discussed.
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Affiliation(s)
- Elizabeth J Teh
- Department of Otolaryngology/Division of Graduate Medical Studies, Yong Loo Lin School of Medicine, National University of Singapore, MD3, Level 2, 16 Medical Drive, Singapore, 117600, Singapore.
| | - Ranjith Vijayakumar
- Department of Psychology, National University of Singapore, Singapore, Singapore
| | - Timothy Xing Jun Tan
- Department of Psychology, National University of Singapore, Singapore, Singapore
| | - Melvin J Yap
- Department of Psychology, National University of Singapore, Singapore, Singapore
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Paek EJ, Murray LL, Newman SD. Effects of concurrent action and object naming treatment on naming skills and functional brain activation patterns in primary progressive aphasia: An fMRI study with a case-series design. BRAIN AND LANGUAGE 2021; 218:104950. [PMID: 33836414 DOI: 10.1016/j.bandl.2021.104950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 11/18/2020] [Accepted: 03/28/2021] [Indexed: 06/12/2023]
Abstract
Individuals with primary progressive aphasia (PPA) exhibit differential impairment patterns in noun and verb naming, but it remains unclear whether anomia treatment results in similar improvements in noun and verb naming. Therefore, we examined the immediate and long-term (3-months post-treatment) behavioral and neural effects of an anomia treatment on object and action naming skills in PPA. A case-series design was utilized involving two individuals with PPA. Object and action words were trained concurrently and probed regularly using word lists matched on a number of lexical characteristics. One participant showed improvements in all word categories with different effect sizes whereas the other participant demonstrated improved naming only on trained object words. Treatment-induced fMRI changes were found in both hemispheres, with distinct patterns observed across participants. Further research is needed to better understand the effects of residual language and cognitive skills on behavioral and neurophysiological outcomes following anomia treatment for PPA.
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Affiliation(s)
- Eun Jin Paek
- Department of Audiology and Speech Pathology, College of Health Professions, The University of Tennessee Health Science Center, Knoxville, TN 37996, United States.
| | - Laura L Murray
- School of Communication Sciences and Disorders, Western University, London, Ontario N6G 1H1, Canada.
| | - Sharlene D Newman
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN 47401, United States; Department of Psychology, University of Alabama, Tuscaloosa, AL 35487, United States.
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Irvine A, Rawlinson C, Bor W, Hoehn E. Evaluation of a collaborative group intervention for mothers with moderate to severe perinatal mental illness and their infants in Australia. Infant Ment Health J 2021; 42:560-572. [PMID: 34170035 PMCID: PMC8453701 DOI: 10.1002/imhj.21922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Perinatal mental illness is a known risk to maternal–infant attachment and healthy infant development. Mothers experiencing complex mental health issues in the first year following birth are less likely to become involved in parenting programs or day stay interventions because of their mental health difficulties and perceived stigma. Currently, most perinatal day or group treatment programs only include the mother and not their infant. This paper describes “Together in Mind,” a perinatal and infant mental health day program developed by the Queensland Centre for Perinatal and Infant Mental Health, targeting mothers with moderate to severe mental illness and their infants under 12 months. The service model was a 6‐week, 1 day per week psychoeducation intervention. Psychoeducational material and support were provided across each day session by an adult perinatal mental health clinician, an infant mental health clinician, and a child health nurse working in collaboration. The program was trialed across seven Hospital and Health Service sites in Queensland, Australia, during 2016–18. In total, 24 group day programs were delivered with 84 mothers and their infants. Pre and post intervention quantitative measures and a post‐program qualitative survey about participant satisfaction were collected. Statistically significant improvements in all quantitative measures showed a large to medium effect size on the: Health of the Nation Outcome Scale (HoNOS) (d = 0.82; p < .000); Depression, Anxiety and Stress Scale (DASS‐21) (d = 0.5; p < .000); Karitane Parenting Confidence Scale (KPCS) (d = 0.63; p < .000); Maternal Postnatal Attachment Scale (MPAS) (d = 0.49; p < .000), Ages and Stages Questionnaire: Social‐Emotional (6 months) (d = 0.83; p < .000). The results indicate collaboration and early intervention contributes to strengthening the emerging development of the maternal–infant relationship within the context of complex maternal mental health issues.
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Affiliation(s)
- Adrienne Irvine
- Queensland Centre for Perinatal and Infant Mental HealthChild and Youth Mental HealthChildren's Health Queensland Hospital and Health ServiceBrisbaneAustralia
| | - Catherine Rawlinson
- Queensland Centre for Perinatal and Infant Mental HealthChild and Youth Mental HealthChildren's Health Queensland Hospital and Health ServiceBrisbaneAustralia
| | - William Bor
- Children's Health Queensland Child and Youth Mental Health Service Academic Research UnitChildren's Health Research CentreSouth BrisbaneAustralia
| | - Elisabeth Hoehn
- Queensland Centre for Perinatal and Infant Mental HealthChild and Youth Mental HealthChildren's Health Queensland Hospital and Health ServiceBrisbaneAustralia
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Scarcella I, Michelazzo L, McCabe P. A Pilot Single-Case Experimental Design Study of Rapid Syllable Transition Treatment for Italian Children With Childhood Apraxia of Speech. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1496-1510. [PMID: 33830791 DOI: 10.1044/2021_ajslp-20-00133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Background The Rapid Syllable Transition (ReST) treatment is an effective intervention designed to address the planning and programming disorder found in childhood apraxia of speech. To date, no study has considered its use with children who speak languages other than English. Aim This pilot study aimed to examine the use of ReST treatment with Italian children. We hypothesized that the ReST approach would improve the overall accuracy of the targeted behaviors of lexical stress, smoothness, and phonemic accuracy, whereas phonemic and phonetic accuracy of untreated items would remain stable. Method Two monolingual Italian-speaking children with childhood apraxia of speech received therapy in 12 one-hour sessions, 2-3 times per week, using a single-case experimental design. The treatment procedures used in English were replicated in Italian with one change: In English, two stress patterns are treated. Italian commonly uses three stress patterns; therefore, the stimuli were modified accordingly. Accuracy of articulation, lexical stress, and smoothness were assessed at pretreatment and 1 day, 1 week, and 4 months posttreatment in treated and untreated pseudowords and in real words and sentences. Results Both children improved on treated pseudowords and real words with moderate effect sizes, but only one child generalized to untreated pseudowords. Maintenance of treatment results was observed in both participants. Articulation of control phonemes did not change. Conclusions ReST treatment in Italian is feasible, and a treatment effect was found, showing that its use may be valid in languages other than English. Further research is required. Supplemental Material https://doi.org/10.23641/asha.14348060.
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Affiliation(s)
- Ilaria Scarcella
- The University of Sydney, Camperdown, New South Wales, Australia
| | | | - Patricia McCabe
- The University of Sydney, Camperdown, New South Wales, Australia
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Beiting M, Maas E. Autism-Centered Therapy for Childhood Apraxia of Speech (ACT4CAS): A Single-Case Experimental Design Study. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1525-1541. [PMID: 33684309 DOI: 10.1044/2020_ajslp-20-00131] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose A subset of children with autism spectrum disorder (ASD) has speech sound disorders, including childhood apraxia of speech (CAS). To date, virtually all speech treatment studies consider ASD an exclusionary criterion, resulting in little scientific evidence for treatment of CAS for children who also have ASD. This study proposes and tests a novel approach, Autism-Centered Therapy for Childhood Apraxia of Speech (ACT4CAS), as a theoretically and clinically informed speech treatment option for this population. Method Using a multiple-baseline design within and across participants, three children with co-occurring ASD and CAS received 11-18 treatment sessions. Treatment targets were individually designed and matched with untreated control words. Probes were administered at the start of each session to assess speech production accuracy perceptually. Changes in production accuracy were examined through visual inspection and quantified with effect sizes. Results Findings were mixed, with one child showing significant gains for half of the treated targets at follow-up and two children showing no clear improvement. Conclusions Preliminary evidence suggests potentially positive treatment effects for ACT4CAS when implemented as intended, although treatment intensity and disorder severity likely influence treatment outcome. Replication and comparison of ACT4CAS to other speech treatments is needed. Supplemental Material https://doi.org/10.23641/asha.14110445.
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Affiliation(s)
- Molly Beiting
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA
| | - Edwin Maas
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, PA
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Levy ES, Chang YM, Hwang K, McAuliffe MJ. Perceptual and Acoustic Effects of Dual-Focus Speech Treatment in Children With Dysarthria. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:2301-2316. [PMID: 33656916 DOI: 10.1044/2020_jslhr-20-00301] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose Children with dysarthria secondary to cerebral palsy may experience reduced speech intelligibility and diminished communicative participation. However, minimal research has been conducted examining the outcomes of behavioral speech treatments in this population. This study examined the effect of Speech Intelligibility Treatment (SIT), a dual-focus speech treatment targeting increased articulatory excursion and vocal intensity, on intelligibility of narrative speech, speech acoustics, and communicative participation in children with dysarthria. Method American English-speaking children with dysarthria (n = 17) received SIT in a 3-week summer camplike setting at Columbia University. SIT follows motor-learning principles to train the child-friendly, dual-focus strategy, "Speak with your big mouth and strong voice." Children produced a story narrative at baseline, immediate posttreatment (POST), and at 6-week follow-up (FUP). Outcomes were examined via blinded listener ratings of ease of understanding (n = 108 adult listeners), acoustic analyses, and questionnaires focused on communicative participation. Results SIT resulted in significant increases in ease of understanding at POST, that were maintained at FUP. There were no significant changes to vocal intensity, speech rate, or vowel spectral characteristics, with the exception of an increase in second formant difference between vowels following SIT. Significantly enhanced communicative participation was evident at POST and FUP. Considerable variability in response to SIT was observed between children. Conclusions Dual-focus treatment shows promise for improving intelligibility and communicative participation in children with dysarthria, although responses to treatment vary considerably across children. Possible mechanisms underlying the intelligibility gains, enhanced communicative participation, and variability in treatment effects are discussed.
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Affiliation(s)
- Erika S Levy
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Younghwa M Chang
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - KyungHae Hwang
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY
| | - Megan J McAuliffe
- School of Psychology, Speech and Hearing and New Zealand Institute of Language, Brain and Behaviour, University of Canterbury, Christchurch, New Zealand
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Martin N, Schlesinger J, Obermeyer J, Minkina I, Rosenberg S. Treatment of verbal short-term memory abilities to improve language function in aphasia: A case series treatment study. Neuropsychol Rehabil 2021; 31:731-772. [PMID: 32114906 PMCID: PMC7483269 DOI: 10.1080/09602011.2020.1731554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 02/11/2020] [Indexed: 10/24/2022]
Abstract
Recent approaches to interventions for aphasia have incorporated verbal short-term memory (STM) and working memory (WM) components. We investigated whether a treatment involving repetition of word sequences after a response delay would improve tolerance of increased verbal STM load in repetition and, consequently, improve performance on repetition and other language tasks. Eight individuals with aphasia participated. We used a single subject design with outcome measures on near-transfer tasks closely related to the treatment task and far-transfer tasks more distantly related to the treatment task. We minimized repeated presentation of stimuli in all phases of treatment to control for confounding effects of repeated exposure of treated items. Four participants demonstrated modest acquisition effects. On outcome measures, we observed improvements by some participants on near-transfer tasks, (repetition of concrete and abstract word strings and verbal spans) and far-transfer tasks (naming and discourse). Some participants demonstrated a significant decline in word repetition accuracy after a response delay before treatment, indicating difficulty in maintaining activation of linguistic representations. It was these participants who showed the most improvement on outcome measures. More studies are needed to determine who will respond to this treatment and what factors might influence the effectiveness of this treatment approach.
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Peñaloza C, Scimeca M, Gaona A, Carpenter E, Mukadam N, Gray T, Shamapant S, Kiran S. Telerehabilitation for Word Retrieval Deficits in Bilinguals With Aphasia: Effectiveness and Reliability as Compared to In-person Language Therapy. Front Neurol 2021; 12:589330. [PMID: 34093382 PMCID: PMC8172788 DOI: 10.3389/fneur.2021.589330] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 03/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Bilinguals with post-stroke aphasia (BWA) require treatment options that are sensitive to their particular bilingual background and deficits across languages. However, they may experience limited access to bilingual clinical resources due to reduced availability of bilingual practitioners, geographical constraints, and other difficulties. Telerehabilitation can improve access to bilingual clinical services for BWA and facilitate the delivery of specific language treatments at distance, but more evidence on its effectiveness and reliability is needed. This study aimed to determine the equivalence of effectiveness and reliability of a semantic treatment for word retrieval deficits in BWA delivered via telerehabilitation relative to in-person therapy. Methods: We examined the retrospective data of 16 BWA who received 20 sessions of therapy based on semantic feature analysis for word retrieval deficits in person (n = 8) or via telerehabilitation (n = 8). The two groups were comparable on age, years of education, time of post-stroke onset, aphasia severity, and naming ability in both languages. Treatment effectiveness (i.e., effect sizes in the treated and the untreated language, and change on secondary outcome measures) and reliability (i.e., clinician adherence to treatment protocol) were computed for each delivery modality and compared across groups. Results: Significant improvements were observed in most patients, with no significant differences in treatment effect sizes or secondary outcomes in the treated and the untreated language between the teletherapy group and the in-person therapy group. Also, the average percentage of correctly delivered treatment steps by clinicians was high for both therapy delivery methods with no significant differences between the telerehabilitation vs. the in-person modality. Discussion: This study provides evidence of the equivalence of treatment gains between teletherapy and in-person therapy in BWA and the high reliability with which treatment for word retrieval deficits can be delivered via telerehabilitation, suggesting that the essential treatment components of the intervention can be conducted in a comparable manner in both delivery modalities. We further discuss the benefits and potential challenges of the implementation of telerehabilitation for BWA. In the future, telerehabilitation may increase access to therapy for BWA with varying linguistic and cultural backgrounds, thus, offering a more inclusive treatment approach to this population.
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Affiliation(s)
- Claudia Peñaloza
- Aphasia Research Laboratory, Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA, United States
| | - Michael Scimeca
- Aphasia Research Laboratory, Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA, United States
| | - Angelica Gaona
- Aphasia Research Laboratory, Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA, United States
| | - Erin Carpenter
- Aphasia Research Laboratory, Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA, United States
| | - Nishaat Mukadam
- Aphasia Research Laboratory, Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA, United States
| | - Teresa Gray
- Gray Matter Laboratory, Department of Speech, Language and Hearing Sciences, San Francisco State University, San Francisco, CA, United States
| | | | - Swathi Kiran
- Aphasia Research Laboratory, Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA, United States
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Maggu AR, Kager R, To CKS, Kwan JSK, Wong PCM. Effect of Complexity on Speech Sound Development: Evidence From Meta-Analysis Review of Treatment-Based Studies. Front Psychol 2021; 12:651900. [PMID: 33995208 PMCID: PMC8113766 DOI: 10.3389/fpsyg.2021.651900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/26/2021] [Indexed: 11/23/2022] Open
Abstract
In the current study, we aimed at understanding the effect of exposure to complex input on speech sound development, by conducting a systematic meta-analysis review of the existing treatment-based studies employing complex input in children with speech sound disorders. In the meta-analysis review, using a list of inclusion criteria, we narrowed 280 studies down to 12 studies. Data from these studies were extracted to calculate effect sizes that were plotted as forest plots to determine the efficacy of complexity-based treatment approaches. The outcome variables of interest were improvement on the treated and generalization to the untreated sounds. Meta-analysis revealed that the exposure to complex input not only promoted improvement in production of complex speech sounds (d = 1.08, CI = 0.98–1.19) but also facilitated the production of untreated simple speech sounds (d = 2.69, CI = 1.98–3.54). Overall, the current findings revealed that the exposure to complex input promotes acquisition of both complex and simple speech sounds. The current findings are in line with the models of language learnability. The current findings have implications in the treatment of speech sound disorders.
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Affiliation(s)
- Akshay R Maggu
- Department of Linguistics and Modern Languages, The Chinese University of Hong Kong, Hong Kong, China.,Department of Psychology and Neuroscience, Duke University, Durham, NC, United States.,Brain and Mind Institute, The Chinese University of Hong Kong, Hong Kong, China
| | - René Kager
- Department of Languages, Literature and Communication, Utrecht Institute of Linguistics OTS, Utrecht University, Utrecht, Netherlands.,The Chinese University of Hong Kong - Utrecht University Joint Centre for Language, Mind and Brain, Hong Kong, China
| | - Carol K S To
- Division of Speech and Hearing Sciences, The University of Hong Kong, Hong Kong, China
| | - Judy S K Kwan
- Department of Linguistics and Modern Languages, The Chinese University of Hong Kong, Hong Kong, China
| | - Patrick C M Wong
- Department of Linguistics and Modern Languages, The Chinese University of Hong Kong, Hong Kong, China.,Brain and Mind Institute, The Chinese University of Hong Kong, Hong Kong, China.,The Chinese University of Hong Kong - Utrecht University Joint Centre for Language, Mind and Brain, Hong Kong, China
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Alt M, Figueroa CR, Mettler HM, Evans-Reitz N, Erikson JA. A Vocabulary Acquisition and Usage for Late Talkers Treatment Efficacy Study: The Effect of Input Utterance Length and Identification of Responder Profiles. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:1235-1255. [PMID: 33784467 PMCID: PMC8608147 DOI: 10.1044/2020_jslhr-20-00525] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/09/2020] [Accepted: 12/10/2020] [Indexed: 06/12/2023]
Abstract
Purpose This study examined the efficacy of the Vocabulary Acquisition and Usage for Late Talkers (VAULT) treatment in a version that manipulated the length of clinician utterance in which a target word was presented (dose length). The study also explored ways to characterize treatment responders versus nonresponders. Method Nineteen primarily English-speaking late-talking toddlers (aged 24-34 months at treatment onset) received VAULT and were quasirandomly assigned to have target words presented in grammatical utterances matching one of two lengths: brief (four words or fewer) or extended (five words or more). Children were measured on their pre- and posttreatment production of (a) target and control words specific to treatment and (b) words not specific to treatment. Classification and Regression Tree (CART) analysis was used to classify responders versus nonresponders. Results VAULT was successful as a whole (i.e., treatment effect sizes of greater than 0), with no difference between the brief and extended conditions. Despite the overall significant treatment effect, the treatment was not successful for all participants. CART results (using participants from the current study and a previous iteration of VAULT) provided a dual-node decision tree for classifying treatment responders versus nonresponders. Conclusions The input-based VAULT treatment protocol is efficacious and offers some flexibility in terms of utterance length. When VAULT works, it works well. The CART decision tree uses pretreatment vocabulary levels and performance in the first two treatment sessions to provide clinicians with promising guidelines for who is likely to be a nonresponder and thus might need a modified treatment plan. Supplemental Material https://doi.org/10.23641/asha.14226641.
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Affiliation(s)
- Mary Alt
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson
| | - Cecilia R. Figueroa
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson
| | - Heidi M. Mettler
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson
| | - Nora Evans-Reitz
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson
| | - Jessie A. Erikson
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson
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Cherney LR, Babbitt EM, Wang X, Pitts LL. Extended fMRI-Guided Anodal and Cathodal Transcranial Direct Current Stimulation Targeting Perilesional Areas in Post-Stroke Aphasia: A Pilot Randomized Clinical Trial. Brain Sci 2021; 11:306. [PMID: 33671031 PMCID: PMC7997197 DOI: 10.3390/brainsci11030306] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/22/2021] [Accepted: 02/25/2021] [Indexed: 11/17/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) may enhance speech and language treatment (SLT) for stroke survivors with aphasia; however, to date, there is no standard protocol for the application of tDCS in post-stroke aphasia. We explored the safety and efficacy of fMRI-guided tDCS on functional language and cortical activity when delivered to the lesioned left hemisphere concurrently with SLT across an extended, six-week treatment period. Twelve persons with chronic, nonfluent aphasia following a single left-hemisphere stroke participated in the three-arm (anodal vs. cathodal vs. sham) single-blind, parallel, pilot trial. No serious adverse events occurred during 30 treatment sessions or in the following six weeks. All groups demonstrated functional language gains following intensive treatment; however, active tDCS resulted in greater gains in standardized, probe, and caregiver-reported measures of functional language than sham. Evidence declaring one polarity as superior for inducing language recovery was mixed. However, cathodal stimulation to the lesioned left hemisphere, expected to have a down-regulating effect, resulted in increased areas of cortical activation across both hemispheres, and specifically perilesionally. Generalization of these preliminary findings is limited; however, results are nevertheless compelling that tDCS combined with SLT can be safely applied across extended durations, with the potential to enhance functional language and cortical activation for persons with aphasia.
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Affiliation(s)
- Leora R. Cherney
- Think + Speak Lab, Shirley Ryan AbilityLab, Chicago, IL 60611, USA; (E.M.B.); (L.L.P.)
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL 60208, USA
| | - Edna M. Babbitt
- Think + Speak Lab, Shirley Ryan AbilityLab, Chicago, IL 60611, USA; (E.M.B.); (L.L.P.)
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Xue Wang
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA;
| | - Laura L. Pitts
- Think + Speak Lab, Shirley Ryan AbilityLab, Chicago, IL 60611, USA; (E.M.B.); (L.L.P.)
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
- Department of Communication Sciences and Disorders, University of Northern Iowa, Cedar Falls, IA 50614, USA
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McAllister T, Hitchcock ER, Ortiz JA. Computer-assisted challenge point intervention for residual speech errors. PERSPECTIVES OF THE ASHA SPECIAL INTEREST GROUPS 2021; 6:214-229. [PMID: 35493921 PMCID: PMC9053469 DOI: 10.1044/2020_persp-20-00191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Purpose This preliminary case series investigated the effects of biofeedback intervention for residual rhotic errors delivered within a modified challenge point framework. In the challenge point framework, practice difficulty is adaptively adjusted with the goal of enhancing generalization learning. This study more specifically evaluated the feasibility of a computer-mediated implementation of challenge point treatment for rhotic errors using a custom open-source software, the Challenge Point Program (CPP). Method Participants were five native English speakers, ages 7;3-15;5, who had established but not generalized correct rhotic production in previous treatment; overall treatment duration was flexible. Treatment incorporated either electropalatographic or visual-acoustic biofeedback and was structured by challenge point principles implemented using the CPP software. Results Participants were highly variable in the magnitude of generalization gains attained. However, the median overall effect size was 4.24, suggesting that participants' response in treatment tended to exceed the minimum value considered clinically significant. Conclusions These findings provide preliminary evidence that computer-mediated implementation of the challenge point framework can be effective in producing generalization in some participants.
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Affiliation(s)
- Tara McAllister
- Department of Communicative Sciences and Disorders, New York University, New York, NY
| | - Elaine R. Hitchcock
- Department of Communication Sciences and Disorders, Montclair State University, Montclair, NJ
| | - Jose A. Ortiz
- Department of Hearing and Speech Sciences, University of Maryland, MD
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Lee B, Yoon S, Lee JW, Kim Y, Chang J, Yun J, Ro JC, Lee JS, Lee JH. Statistical Characterization of the Morphologies of Nanoparticles through Machine Learning Based Electron Microscopy Image Analysis. ACS NANO 2020; 14:17125-17133. [PMID: 33231065 DOI: 10.1021/acsnano.0c06809] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Although transmission electron microscopy (TEM) may be one of the most efficient techniques available for studying the morphological characteristics of nanoparticles, analyzing them quantitatively in a statistical manner is exceedingly difficult. Herein, we report a method for mass-throughput analysis of the morphologies of nanoparticles by applying a genetic algorithm to an image analysis technique. The proposed method enables the analysis of over 150,000 nanoparticles with a high precision of 99.75% and a low false discovery rate of 0.25%. Furthermore, we clustered nanoparticles with similar morphological shapes into several groups for diverse statistical analyses. We determined that at least 1,500 nanoparticles are necessary to represent the total population of nanoparticles at a 95% credible interval. In addition, the number of TEM measurements and the average number of nanoparticles in each TEM image should be considered to ensure a satisfactory representation of nanoparticles using TEM images. Moreover, the statistical distribution of polydisperse nanoparticles plays a key role in accurately estimating their optical properties. We expect this method to become a powerful tool and aid in expanding nanoparticle-related research into the statistical domain for use in big data analysis.
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Affiliation(s)
- Byoungsang Lee
- School of Advanced Materials Science and Engineering, Sungkyunkwan University (SKKU), Suwon 16419, South Korea
| | - Seokyoung Yoon
- SKKU Advanced Institute of Nanotechnology (SAINT), Sungkyunkwan University (SKKU), Suwon 16419, South Korea
| | - Jin Woong Lee
- School of Advanced Materials Science and Engineering, Sungkyunkwan University (SKKU), Suwon 16419, South Korea
| | - Yunchul Kim
- School of Advanced Materials Science and Engineering, Sungkyunkwan University (SKKU), Suwon 16419, South Korea
| | - Junhyuck Chang
- School of Advanced Materials Science and Engineering, Sungkyunkwan University (SKKU), Suwon 16419, South Korea
| | - Jaesub Yun
- Department of Systems Management Engineering, Sungkyunkwan University (SKKU), Suwon 16419, South Korea
| | - Jae Chul Ro
- School of Advanced Materials Science and Engineering, Sungkyunkwan University (SKKU), Suwon 16419, South Korea
| | - Jong-Seok Lee
- Department of Systems Management Engineering, Sungkyunkwan University (SKKU), Suwon 16419, South Korea
| | - Jung Heon Lee
- School of Advanced Materials Science and Engineering, Sungkyunkwan University (SKKU), Suwon 16419, South Korea
- SKKU Advanced Institute of Nanotechnology (SAINT), Sungkyunkwan University (SKKU), Suwon 16419, South Korea
- Biomedical Institute for Convergence at SKKU (BICS), Sungkyunkwan University (SKKU), Suwon 16419, South Korea
- Institute of Quantum Biophysics (IQB), Sungkyunkwan University (SKKU), Suwon 16419, South Korea
- Research Center for Advanced Materials Technology, Sungkyunkwan University (SKKU), Suwon 16419, South Korea
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Milman L, Anderson E, Thatcher K, Amundson D, Johnson C, Jones M, Valles L, Willis D. Integrated Discourse Therapy After Glioblastoma: A Case Report of Face-To-Face and Tele-NeuroRehabilitation Treatment Delivery. Front Neurol 2020; 11:583452. [PMID: 33329328 PMCID: PMC7710897 DOI: 10.3389/fneur.2020.583452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/27/2020] [Indexed: 11/28/2022] Open
Abstract
Background: Language and communication impairments are among the most frequently reported long-term behavioral consequences of brain tumor. Such deficits may persist long after a patient has been discharged from the hospital and can significantly impact return to work, resumption of prior social roles, and interpersonal relations, as well as full engagement in leisure activities. While considerable research has centered on identifying and describing communication impairments in brain tumor survivors, relatively little research has investigated language therapy for this population. Aims: This report (1) reviews the literature and describes the language and cognitive-communicative profile of a 35-year-old man 6 years post glioblastoma excision with subsequent chemo- and radiation therapies; (2) presents cognitive-communication outcome data for this individual following an integrated discourse therapy; and (3) assesses treatment feasibility in face-to-face (F2F) and tele-neurorehabilitation (TNR) contexts. Methods: A battery of tests and weekly conversation probes were administered to evaluate baseline performance and potential changes associated with F2F and TNR treatment delivery. Integrated Conversation Therapy (ICT) was administered across four alternating (F2F and TNR) treatment blocks over 2 months. ICT is a solution-focused discourse intervention that simultaneously targets word finding, sentence processing, and authentic patient-selected conversational interactions. Results: Although the participant presented with long term-language impairments that were clinically distinct from stroke-associated aphasia, statistically significant post-treatment gains (>2 SEM) were evident following F2F and TNR treatment delivery on standardized measures of apraxia, discourse production, verbal memory, and self-ratings of discourse production, communication, and living with aphasia. While objective measures of treatment effect size (probes of CIU discourse data) were consistent across F2F and TNR delivery models, results of a satisfaction survey indicated a slight but statistically significant participant preference for TNR treatment delivery. Conclusions: This study provides preliminary support for F2F and TNR delivery of ICT discourse intervention for glioblastoma survivors. It also highlights the need for more research specifically dedicated to language therapy for this population.
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Affiliation(s)
- Lisa Milman
- Language and Aphasia NeuroRehabilitation Lab, Department of Communicative Disorders and Deaf Education, Utah State University, Logan, UT, United States
| | - Emma Anderson
- Language and Aphasia NeuroRehabilitation Lab, Department of Communicative Disorders and Deaf Education, Utah State University, Logan, UT, United States
| | - Katelyn Thatcher
- Language and Aphasia NeuroRehabilitation Lab, Department of Communicative Disorders and Deaf Education, Utah State University, Logan, UT, United States
| | - Deborah Amundson
- Language and Aphasia NeuroRehabilitation Lab, Department of Communicative Disorders and Deaf Education, Utah State University, Logan, UT, United States
| | - Chance Johnson
- Language and Aphasia NeuroRehabilitation Lab, Department of Communicative Disorders and Deaf Education, Utah State University, Logan, UT, United States
| | - Morgan Jones
- Language and Aphasia NeuroRehabilitation Lab, Department of Communicative Disorders and Deaf Education, Utah State University, Logan, UT, United States
| | - Louie Valles
- Utah Education and Telehealth Network, Logan, UT, United States
| | - Dale Willis
- Utah Education and Telehealth Network, Logan, UT, United States
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S-Y Ng C, Stokes SF, Alt M. Successful Implicit Vocabulary Intervention for Three Cantonese-Speaking Toddlers: A Replicated Single-Case Design. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:4148-4161. [PMID: 33197356 DOI: 10.1044/2020_jslhr-20-00087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose We report on a replicated single-case design study that measured the feasibility of an expressive vocabulary intervention for three Cantonese-speaking toddlers with small expressive lexicons relative to their age. The aim was to assess the cross-cultural and cross-linguistic feasibility of an intervention method developed for English-speaking children. Method A nonconcurrent multiple-baseline design was used with four baseline data points and 16 intervention sessions per participant. The intervention design incorporated implicit learning principles, high treatment dosage, and control of the phonological neighborhood density of the stimuli. The children (24-39 months) attended 7-9 weeks of twice weekly input-based treatment in which no explicit verbal production was required from the child. Each target word was provided as input a minimum of 64 times in at least two intervention sessions. Treatment feasibility was measured by comparison of how many of the target and control words the child produced across the intervention period, and parent-reported expressive vocabulary checklists were completed for comparison of pre- and postintervention child spoken vocabulary size. An omnibus effect size for the treatment effect of the number of target and control words produced across time was calculated using Kendall's Tau. Results There was a significant treatment effect for target words learned in intervention relative to baselines, and all children produced significantly more target than control words across the intervention period. The effect of phonological neighborhood density on expressive word production could not be evaluated because two of the three children learned all target words. Conclusion The results provide cross-cultural evidence of the feasibility of a model of intervention that incorporated a high-dosage, cross-situational statistical learning paradigm to teach spoken word production to children with small expressive lexicons.
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Affiliation(s)
- Christine S-Y Ng
- Human Communication, Development, and Information Sciences, Faculty of Education, University of Hong Kong
| | - Stephanie F Stokes
- Human Communication, Development, and Information Sciences, Faculty of Education, University of Hong Kong
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Peñaloza C, Dekhtyar M, Scimeca M, Carpenter E, Mukadam N, Kiran S. Predicting treatment outcomes for bilinguals with aphasia using computational modeling: Study protocol for the PROCoM randomised controlled trial. BMJ Open 2020; 10:e040495. [PMID: 33208330 PMCID: PMC7677370 DOI: 10.1136/bmjopen-2020-040495] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 10/15/2020] [Accepted: 10/26/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Bilinguals with aphasia (BWA) present varying degrees of lexical access impairment and recovery across their two languages. Because both languages may benefit from therapy, identifying the optimal target language for treatment is a current challenge for research and clinical practice. Prior research has demonstrated that the BiLex computational model can accurately simulate lexical access in healthy bilinguals, and language impairment and treatment response in bilingual aphasia. Here, we aim to determine whether BiLex can predict treatment outcomes in BWA in the treated and the untreated language and compare these outcome predictions to determine the optimal language for rehabilitation. METHODS AND ANALYSIS The study involves a prospective parallel-group, double-blind, randomised controlled trial. Forty-eight Spanish-English BWA will receive 20 sessions of semantic treatment for lexical retrieval deficits in one of their languages and will complete assessments in both languages prior and after treatment. Participants will be randomly assigned to an experimental group receiving treatment in the optimal language determined by the model or a control group receiving treatment in the language opposite to the model's recommendation. Primary treatment outcomes include naming probes while secondary treatment outcomes include tests tapping additional language domains. Treatment outcomes will be compared across the two groups using 2×2 mixed effect models for repeated measures Analysis of variance (ANOVA) on metrics of treatment effects commonly employed in rehabilitation studies (ie, effect size and percentage change). ETHICS AND DISSEMINATION All procedures included in this protocol (protocol number 29, issue date: 19 March 2019) were approved by the Boston University Charles River Campus Institutional Review Board at Boston, Massachusetts (reference number: 4492E). The results of this study will be published in peer-reviewed scientific journals and will be presented at national and international conferences. TRIAL REGISTRATION NUMBER NCT02916524.
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Affiliation(s)
- Claudia Peñaloza
- Aphasia Research Laboratory, Department of Speech, Language and Hearing Sciences, Boston University, Boston, Massachusetts, USA
| | - Maria Dekhtyar
- Aphasia Research Laboratory, Department of Speech, Language and Hearing Sciences, Boston University, Boston, Massachusetts, USA
| | - Michael Scimeca
- Aphasia Research Laboratory, Department of Speech, Language and Hearing Sciences, Boston University, Boston, Massachusetts, USA
| | - Erin Carpenter
- Aphasia Research Laboratory, Department of Speech, Language and Hearing Sciences, Boston University, Boston, Massachusetts, USA
| | - Nishaat Mukadam
- Aphasia Research Laboratory, Department of Speech, Language and Hearing Sciences, Boston University, Boston, Massachusetts, USA
| | - Swathi Kiran
- Aphasia Research Laboratory, Department of Speech, Language and Hearing Sciences, Boston University, Boston, Massachusetts, USA
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Kapa LL, Meyers-Denman C, Plante E, Doubleday K. Predictors of Treatment Response for Preschool Children With Developmental Language Disorder. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:2082-2096. [PMID: 32997549 PMCID: PMC8740565 DOI: 10.1044/2020_ajslp-19-00198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 04/16/2020] [Accepted: 07/15/2020] [Indexed: 05/29/2023]
Abstract
Purpose Enhanced Conversational Recast treatment is an effective intervention for remediating expressive grammatical deficits in preschool-age children with developmental language disorder, but not all children respond equally well. In this study, we sought to identify which child-level variables predict response to treatment of morphological deficits. Method Predictor variables of interest, including pre-intervention test scores and target morpheme production, age, and mother's level of education (proxy for socio-economic status) were included in analyses. The sample included 105 children (M = 5;1 [years;months]) with developmental language disorder who participated in 5 weeks of daily Enhanced Conversational Recast treatment. Classification and regression tree analysis was used to identify covariates that predicted children's generalization of their trained grammatical morpheme, as measured by treatment effect size d. Results Our analysis indicates that the Structured Photographic Expressive Language Test-Preschool 2 (SPELT-P 2) scores and the Peabody Picture Vocabulary Test-Fourth Edition scores significantly predicted the degree of benefit a child derived from Enhanced Conversational Recast treatment. Specifically, a SPELT-P 2 score above 75 (but still in the impaired range, < 87) combined with a high Peabody Picture Vocabulary Test-Fourth Edition score (> 100) yielded the largest treatment effect size, whereas a SPELT-P 2 score below 75 predicted the smallest treatment effect size. Other variables included in the model did not significantly predict treatment outcomes. Conclusions Understanding individual differences in response to treatment will allow service providers to make evidence-based decisions regarding how likely a child is to benefit from Enhanced Conversational Recast treatment and the expected magnitude of the response based on the child's background characteristics.
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Affiliation(s)
- Leah L. Kapa
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson
| | | | - Elena Plante
- Department of Speech, Language, and Hearing Sciences, The University of Arizona, Tucson
| | - Kevin Doubleday
- Department of Epidemiology and Biostatistics, The University of Arizona, Tucson
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Harvey S, Carragher M, Dickey MW, Pierce JE, Rose ML. Dose effects in behavioural treatment of post-stroke aphasia: a systematic review and meta-analysis. Disabil Rehabil 2020; 44:2548-2559. [PMID: 33164590 DOI: 10.1080/09638288.2020.1843079] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Aphasia is a debilitating chronic acquired language disorder that impacts heavily on a person's life. Behavioural treatments aim to remediate language processing skills or to enhance communication between the person with aphasia and others, and a number of different treatments are efficacious. However, it is unclear how much of a particular treatment a person needs in order to optimise recovery of language and communication skills following stroke. MATERIALS AND METHODS Systematic search for and meta-analysis of experimental studies that directly compared different amounts of the same behavioural aphasia treatment, following PRISMA guidelines. RESULTS Treatment dose research in aphasia is an emerging area. Just six studies comparing different doses of the same intervention met all criteria for inclusion. Evidence from these studies was synthesised and meta-analysed, where possible. Meta-analyses were inconclusive due to limited data; however, there are indications that suggest increased dose may confer greater improvement on language and communication measures, but with diminishing returns over time. Aphasia severity and chronicity may affect dose-response relationships. CONCLUSIONS There is currently insufficient evidence to determine the effect of dose on treatment response. A dedicated and coordinated research agenda is required to systematically explore dose-response relationships in post-stroke aphasia interventions.A video abstract is available in the Supplementary Material.Implications for rehabilitationThe investigation of the effect of dose on treatment outcomes in post-stroke aphasia is an emerging research area with few studies reporting comparison of different amounts of the same intervention.In the acute phase of recovery following stroke, higher doses of treatment provided over short periods may not be preferable, tolerable, or superior to lower doses of the same treatment.In the chronic phase, providing additional blocks of treatment may confer additional benefit for some people with aphasia but with diminishing returns.People with chronic aphasia can achieve and maintain significant gains in picture naming after a relatively brief period of high-dose treatment.
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Affiliation(s)
- Sam Harvey
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia
| | - Marcella Carragher
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia
| | - Michael Walsh Dickey
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia.,Geriatric Research Education and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.,Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA, USA
| | - John E Pierce
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia
| | - Miranda L Rose
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Australia
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Kucheria P, Moore Sohlberg M, Machalicek W, Seeley J, DeGarmo D. A single-case experimental design investigation of collaborative goal setting practices in hospital-based speech-language pathologists when provided supports to use motivational interviewing and goal attainment scaling. Neuropsychol Rehabil 2020; 32:579-610. [PMID: 33153386 DOI: 10.1080/09602011.2020.1838301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The study investigated the impact of the electronic Goal Attainment Scaling (eGAS) process on medical speech-language pathologists' (SLPs) interviewing and goal setting. The process was trained via the eGAS app, designed to facilitate motivational interviewing and goal attainment scaling. The study utilized a single-case, nonconcurrent, multiple-baseline design replicated across three clinicians and their 27 respective clients. We observed client-clinician dyads engaged in setting rehabilitation goals pre and post eGAS training. The clients had neurogenic conditions and were being treated for cognitive, communication and/or swallowing challenges in an outpatient setting. Two measures were used to collect data on the clinician's interviewing and goal-setting behaviors: (1) Assessment of Client-Centeredness when Interviewing and Goal Setting (ACIG) scale, and (2) a task analysis, i.e., the Clinician Interview Behavior scale (CIB). Training with eGAS had a strong effect on clinicians' collaborative interviewing behaviors, an inconsistent effect on their ability to adhere to a three-phase interview structure, and a strong effect on their ability to generate valid goal attainment scales. This study provides preliminary support that the eGAS process provides a feasible framework for training hospital-based SLPs engaged in neurorehabilitation to use collaborative interviewing behaviors and produce valid person-centered rehabilitation goals.
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Affiliation(s)
- Priya Kucheria
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, OR, USA
| | - McKay Moore Sohlberg
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, OR, USA
| | - Wendy Machalicek
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, OR, USA
| | - John Seeley
- Department of Education Methodology, Policy and Leadership, University of Oregon, Eugene, OR, USA
| | - David DeGarmo
- Department of Education Methodology, Policy and Leadership, University of Oregon, Eugene, OR, USA
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