Semantic Feature Analysis (SFA) in the Treatment of Naming Deficits: Evidence from a Malay Speaker with Non-Fluent Aphasia

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Event Abstract Back to Event A Comparison of Two Treatment Approaches for Agrammatic Broca's Aphasia: Script Therapy vs. Verb Network Strengthening Treatment Maureen Costello-Yacono1, 2* and Venugopal Balasubramanian1* 1 Seton Hall University, Speech Language Pathology, United States 2 La Salle University, Communication Sciences and Disorders, United States Background/Introduction: Individuals with agrammatic Broca’s aphasia frequently are treated at single word level, verb priming, or simple sentence structure treatments. In this study, an impairment specific treatment such as Verb Network Strengthening Treatment (VNeST) was explored as well as a social functional approach such as Script Therapy. These two approaches were assessed by the outcome measures of rate of speech, subject-verb-object production, and error rates during probe tasks. Objective: To examine the impact of two treatment approaches: Script Therapy and Verb Network Strengthening Treatment for two individuals with chronic agrammatic Broca’s aphasia. Method: The method used in this study was a single subject multiple baseline alternating treatment across participants’ design. Each participant received each therapy for 9 weeks and both treatments were counterbalanced. Generalization probes were administered on the second session of each treatment per week to assess pre-to-post outcome measures including rate of speech, subject- verb-object production (SVO), and error rate. Effect sizes were calculated for baseline through maintenance outcome measures. To analyze the inter-therapeutic effects of the two treatment, the Percentage of data Exceeding the Median (PEM) was used. Results: Both participants improved over the 18 weeks on rate of speech and subject verb-object (SVO) production during probe tasks. For P1, Error rates decreased from baseline to maintenance phases. Effect sizes were calculated for the baseline to maintenance phases using the Busk & Serlin’s d2 formula (1992). The effects size calculations were compared using the Beeson & Robey (2006) benchmarks for lexical and syntactic metanalyses for aphasia. For the baseline to maintenance effects, small effect sizes were found for both participants for rate of speech. For P1, a medium to large effect was noted for SVO production. P2’s effect size for SVO production revealed no effect. Error rates for P1 revealed no effect. P2’s error rate produced a small unfavorable effect. Conclusions: Both participants benefitted from the two treatment approaches in individual ways. It is possible that the multi-modal nature of the training between VNeST and Script that engaged functional sentence production and a linguistic approach for sentence production contributed to a positive language change for these participants. 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Levin (Eds.), Single Case Research Design and Analysis: New directions for psychology and education. Hillsdale, N.J.: Lawrence Erlbaum Associates Cameron, R.M., Wambaugh, J.L., & Mauszycju, S.C. (2010). Individual Variability on Discourse Measures over Repeated sampling times in persons with aphasia. Aphasiology, 24, 6-8, 671-684. Capilouto, G. J., Wright, H. H., & Wagovich, S. A. (2006). Reliability of main event measurement in the discourse of individuals with aphasia. Aphasiology, 20(2-4), 205-216. doi:10.1080/02687030500473122 Cherney, L. (2010). Oral Reading for Language in Aphasia: Impact of Aphasia Severity on Cross-Modal Outcomes in Chronic Nonfluent Aphasia. Seminars in Speech and Language, 31(1), 42-51. Cherney, L. , Halper, A., Holland, A., & Cole, R. (2008). Computerized script training for aphasia: Preliminary results. American Journal of Speech - Language Pathology, 17(1), 19-34. Cherney, L., Halper, A., & Kaye, R. (2011). Computer-based script training for aphasia: Emerging themes from post- treatment interviews. Journal of Communication Disorders, 44(4), 493-501. doi:http://dx.doi.org/10.1016/j.jcomdis.201 Cherney, L. R., Halper, A. S., Holland, A. L., Lee, J. B., Babbitt, E., & Cole, R. (2007). Improving conversational script production in aphasia with virtual therapist computer treatment software. Brain and Language, 103, 246-247. Clark, D. G., Charuvastra, A., Miller, B. L., Shapira, J. S., & Mendez, M. F. (2005). Fluent versus nonfluent primary progressive aphasia: A comparison of clinical and functional neuroimaging features. Brain and Language, 94(1), 54-60. Cohen J. (1988). Statistical Power Analysis for the Behavioral Sciences. New York, NY: Routledge Academic Connell P. & Thompson, C. (1986). Flexibility of using single subject designs. Part III. Using flexibility to modify or design experiements. Journal of speech and hearing disorders, 51, 214-225 Cruice, M, Worrall L.,. Hickson L., Murison R. (2003) Finding a focus for quality of life with aphasia: Social and emotional health, and psychological well-being. Aphasiology, 17(3), 333-353. Dickey, M. W., Milman, L. H., & Thompson, C. K. (2008). Judgment of functional morphology in agrammatic aphasia. Journal of Neurolinguistics, 21(1), 35–65. http://doi.org/10.1016/j.jneuroling.2007.08.001 Edmonds, L. A., & Babb, M. (2011). Effect of verb network strengthening treatment in moderate-to-severe aphasia. American Journal of Speech - Language Pathology (Online), 20(2), 131-145A. Retrieved from http://search.proquest.com/docview/868261347?accountid=11999 Edmonds, L. A., Nadeau, S. E., & Kiran, S. (2009). Effect of verb network strengthening treatment (VNeST) on lexical retrieval of content words in sentences in persons with aphasia. Aphasiology, 23(3), 402-424. doi:10.1080/02687030802291339. Edmonds,L.,Mammino, K, & Ojeda,J. Effects of Verb Network Strengthening Treatment in persons with aphasia: Extension and replication of previous findings. American Journal of Speech-Language Pathology, 23 (2), S312-S329. Ellis, C., Lindrooth, RC., Horner, J., (2014). Retrospective cost-effectiveness analysis of treatments for aphasia: an approach using experimental data. American Journal of Speech Language Pathology, 23, (2), 186-195. Elman, R. J. and Bernstein-Ellis, E. (1999). The efficacy of group communication treatment in adults with chronic aphasia. Journal of Speech, Language, and Hearing, 20(1), 65-72. Edmonds,L.,Mammino, K., & Ojeda,J. Effects of Verb Network Strengthening Treatment in persons with aphasia: Extension and replication of previous findings. American Journal of Speech-Language Pathology 23 (2), S312-S329. Elman, R. J. and Bernstein-Ellis, E. (1999). The efficacy of group communication treatment in adults with chronic aphasia. Journal of Speech, Language, and Hearing, 20(1), 65-72. Engelter, S., Gostynski, M., Papa, S., Frei, M., Born, C., Ajdacic-Gross, V., Gutzwiller, F., Lyrer, P. (2006) Epidemiology of Aphasia Attributable to First Ischemic Stroke: Incidence, Severity, Fluency, Etiology, and Thrombolysis. Stroke, 37, 1379-1384. Friedmann, N., & Shapiro, L. (2003) Agrammatic comprehension of OSV and OVS sentences in Hebrew. Journal of Speech, Language, and Hearing Research, 46: 288-297. Furnas, D.W. & Edmonds, L.A. (2014). The effect of computerized verb network strengthening treatment on lexical retrieval in aphasia. Aphasiology, 28 (4), 988-1012. Galletta, E.E., & Barrett A.M., (2014). Impairment and Function Interventions for Aphasia: Having it all. Current Physical Medicine and Rehabilitation Reports, 2 (2), 114-120. Gierut, J., Morrisette, M., Dickinson, S. (2015). Effect size for single-subject design in phonological treatment. Journal of speech, language, and hearing research, 58 (5), 1464-1481. Gordon,J. (1998). The Fluency Dimension in Aphasia. Aphasiology, 12, 7-8, 675-688. Helm-Estabrooks, N. (2002). Cognition and aphasia: A discussion and a study. Journal of Communication Disorders, 35, 171-186. Holland, A., Halper, A., & Cherney, L. (2010). Tell me your story: Analysis of script topics selected by persons with aphasia. American Journal of Speech-Language Pathology, 19(3), 198-203. Howards, D., Best, W., & Nickels, F. (2015). Optimising the design of intervention studies :critiques and ways forward. Aphasiology, 29, 185-198. Jacobs B, Thompson CK. Cross-modal generalization effects of training noncanonical sentence comprehension and production in agrammatic aphasia. Journal of Speech, Language, and Hearing Research, 2000;43:5–20. Kagan, A. (1998). Supported conversation for adults with aphasia: Methods and resources for training conversation partners. Aphasiology , 12(9), 816-838 Kagan, A., Mackie, N., Rowland, B.A., Kagan, J., Huijbregts, Shumay, N., McEwen, S., Sharp, S. (2008). Counting what counts: A framework for capturing real-life outcomes of aphasia intervention. Aphasiology, 22 (3), pp. 258-280 Katz, R., & Wertz, R.(1997). The efficacy of computer-provided reading treatment for chronic aphasic adults. Journal of Speech, Language, and Hearing Research, 40(3), 493. Lee, J., Kaye, R., & Cherney, L. (2009). Conversational script performance in adults with non-fluent aphasia: Treatment and intensity and aphasia severity, Aphasiology, 27, (7-8), 885-997. Lomas, J., Pickard, L., Bester, S., Elbard, H., Finlayson, A., & Zoghaib, C. (1989). The Communicative Effectiveness Index: Development and Psychometric Evaluation of a Functional Communication Measured for Adult Aphasia. Journal of Speech and Hearing Disorders, 54,113-124. McReynolds, L. & Thompson, C. (1986). Flexibility of Single subject experimental designs:Part 1. Review the basics of single Subject designs. Journal of speech and hearing disorders, 51, 194-203. Miller, J. F., & Iglesias, A. (2012). Systematic Analysis of Language Transcripts (Version 12.0) [Computer software]. Middleton, WI; SALT Software, LLC). Ma, H. (2006). An alternative method for quantitative synthesis of single-subject researches: Percentage of data points exceeding the median. Behavior modification, 30(5), 598-617. Martin, N., Fink, R., Laine, M. (2004). Treatment of word retrieval with contextual priming. Aphasiology, 18, 457-471. Nicholas, L. & Brookshire, R. (1993). A System for Quantifying the Informativeness and Efficiency of the Connected Speech of Adults with Aphasia. Journal of Speech and Hearing Research, 36, 338-350. Nickels, L. (2002). Therapy for naming disorders: Revisiting, revising, and reviewing. Aphasiology, 16(10), 935-979. Peach, R., & Reuter, K. (2010). A discourse-based approach to semantic feature analysis for the treatment of aphasic word retrieval failures. Aphasiology, 24(9), 971-990 Peach, R., & Wong, P. C. (2004). Integrating the message level into treatment for agrammatism using story retelling. Aphasiology, 18(5-7), 429-441. Retrieved from http://search.proquest.com/docview/85329796?accountid=11999 Olswang, L. B. (1993). Treatment efficacy research: A paradigm for investigating clinical practice and theory. Journal of Fluency Disorders, 18(2-3), 125-131. Plowman, E., Hentz, B., & Ellis, C. (2012). Post-stroke aphasia prognosis: A review of patient-related and stroke-related factors. Journal of Evaluation in Clinical Practice, 18(3), 689-694. doi:10.1111/j.1365-2753.2011.01650.x Raymer, A. M., & Ellsworth, T. A. (2002). Response to contrasting verb retrieval treatments: A case study. Aphasiology, 16(10), 1031-1045. doi:10.1080/026870401430000609 Raymer, A. M., & R Keywords: agrammatic aphasia, Script Therapy, Verb network strengthening treatment, impairment specific approach, social conversation approach Conference: Academy of Aphasia 56th Annual Meeting, Montreal, Canada, 21 Oct - 23 Oct, 2018. Presentation Type: poster presentation Topic: not eligible for a student prize Citation: Costello-Yacono M and Balasubramanian V (2019). A Comparison of Two Treatment Approaches for Agrammatic Broca's Aphasia: Script Therapy vs. Verb Network Strengthening Treatment. Conference Abstract: Academy of Aphasia 56th Annual Meeting. doi: 10.3389/conf.fnhum.2018.228.00020 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 16 Apr 2018; Published Online: 22 Jan 2019. * Correspondence: Dr. Maureen Costello-Yacono, Seton Hall University, Speech Language Pathology, South Orange, NJ, 07079, United States, costellom3@lasalle.edu Dr. Venugopal Balasubramanian, Seton Hall University, Speech Language Pathology, South Orange, NJ, 07079, United States, balasuve@shu.edu Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Maureen Costello-Yacono Venugopal Balasubramanian Google Maureen Costello-Yacono Venugopal Balasubramanian Google Scholar Maureen Costello-Yacono Venugopal Balasubramanian PubMed Maureen Costello-Yacono Venugopal Balasubramanian Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Event Abstract Back to Event Verb-production treatment in multilingual aphasia: Cross-linguistic generalization or inhibition? Monica I. Knoph1, 2*, Marianne Lind1, 2 and Hanne G. Simonsen1 1 University of Oslo, MultiLing, Department of Linguistics and Scandinavian studies, Norway 2 Statped, Department of Speech and Language Disorders, Norway Previous research on language intervention in multilingual aphasia shows equivocal results of cross-linguistic transfer and inhibition. Despite the fact that many speakers with non-fluent aphasia suffer greater retrieval impairment of verbs than nouns (Mätzig et al., 2009), most of the studies focus on noun retrieval. The present study aims to explore whether verb-retrieval treatment can lead to improvement of verbs and narrative production across the languages in two multilingual speakers with non-fluent aphasia. Both participants, females in their 50s, sustained left CVAs resulting in non-fluent aphasia at least 6 months prior to the study. P1 was quadrilingual, and P2 trilingual, but tested in only two of her languages. The interventions, Semantic Feature Analysis (Wambaugh & Ferguson, 2007) and a communication-based treatment, were provided in two intensive blocks over four weeks each. Both protocols focused on the production of verbs in connected speech and were provided in the participants’ latest acquired language: Norwegian. The order of the interventions was counterbalanced across the participants. The participants were tested in all or both their languages pre and post each of the interventions. Results of two tasks are reported: an action-description task and production of semi-spontaneous narratives. For P1 the action-naming task shows significant improvement of verbs in the treated language and also in one of her untreated languages. Analyses of the narrative production in the treated language show an increase in the total number of words and correct information units (CIUs) (Nicholas & Brookshire, 1993) and in the percentage of words that were CIUs. The percentage of grammatical sentences also increased, as well as the number of complex sentences. The relative amount of verb and noun tokens did not change. Concerning cross-language transfer, the analysis of the narratives in the untreated languages show mixed results. For P2 the action-naming task shows significant improvement in both the treated and the untreated language. In narrative production, P2 shows an increase in verbs and nouns (types and tokens), an increase in the amount of complex sentences, as well as in the total number of words and CIUs and in speech rate. In the untreated language there are increases in verbs and nouns (types and tokens), in complex and grammatical sentences, as well as in the total number of words and CIUs and in speech rate. The results thus show that treatment of verb production in a late acquired language can generalize to the untreated language(s) in multilingual speakers with non-fluent aphasia. Moreover, no signs of inhibition of the untreated languages were found. The study supports prior suggestions that treatment of verbs in sentence contexts is beneficial (e.g. Bastiaanse et al., 2006; Links et al., 2010), furthermore indicating that this method may also be fruitful for cross-linguistic transfer. The results from these two single case studies will be compared and discussed in light of theories of the verb’s impact on sentence production, structural differences between the languages involved and inhibition of untreated languages. Acknowledgements We thank the two multilingual speakers with aphasia for taking part in this study. References Bastiaanse, R., Hurkmans, J., & Links, P. (2006). The training of verb production in Broca’s aphasia: A multiple-baseline across-behaviours study. Aphasiology, 20(2/3/4), 298-311. doi: 10.1080/02687030500474922 Links, P., Hurkmans, J., & Bastiaanse, R. (2010). Training verb and sentence production in agrammatic Broca's aphasia. Aphasiology, 24(11), 1303-1325. doi: 10.1080/02687030903437666 Mätzig, S., Druks, J., Masterson, J., & Vigliocco, G. (2009). Noun and verb differences in picture naming: Past studies and new evidence. Cortex, 45(6), 738-758. doi: 10.1016/j.cortex.2008.10.003 Nicholas, L. E., & Brookshire, R. H. (1993). A System for Quantifying the Informativeness and Efficiency of the Connected Speech of Adults With Aphasia. Journal of Speech and Hearing Research, 36(2), 338-350. doi: 10.1044/jshr.3602.338 Wambaugh, J. L., & Ferguson, M. (2007). Application of semantic feature analysis to retrieval of action names in aphasia. Journal of Rehabilitation Research & Development, 44(3), 381-394. doi: 10.1682/jrrd.2006.05.0038 Keywords: cross-linguistic transfer, inhibition, verb treatment, multilingual, Aphasia Conference: 54th Annual Academy of Aphasia Meeting, Llandudno, United Kingdom, 16 Oct - 18 Oct, 2016. Presentation Type: Poster Sessions Topic: Academy of Aphasia Citation: Knoph MI, Lind M and Simonsen HG (2016). Verb-production treatment in multilingual aphasia: Cross-linguistic generalization or inhibition?. Front. Psychol. Conference Abstract: 54th Annual Academy of Aphasia Meeting. doi: 10.3389/conf.fpsyg.2016.68.00006 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 20 Apr 2016; Published Online: 15 Aug 2016. * Correspondence: Dr. Monica I Knoph, University of Oslo, MultiLing, Department of Linguistics and Scandinavian studies, OSLO, Norway, monica.norvik@iln.uio.no Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Monica I Knoph Marianne Lind Hanne G Simonsen Google Monica I Knoph Marianne Lind Hanne G Simonsen Google Scholar Monica I Knoph Marianne Lind Hanne G Simonsen PubMed Monica I Knoph Marianne Lind Hanne G Simonsen Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Background: Semantic feature analysis (SFA) is a treatment for lexical retrieval impairment in which participants are cued to provide semantic information about concepts they have difficulty naming in an effort to facilitate accurate lexical retrieval (Boyle, 2004b). The majority of studies of SFA have concentrated on single‐word training, with inconsistent generalisation of improved lexical retrieval to connected speech. Expansion of SFA training in discourse has yielded modest success in the context of individual treatment, but has not been examined in the context of group treatment. Aims: The aim of the current study was to investigate training of SFA in connected speech during group aphasia treatment, which provides a natural context for analysing the effectiveness of discourse production, as well as representing an increasingly popular model of service delivery for aphasia treatment. It was hypothesised that lexical retrieval during discourse would improve, as would overall communication informativeness. Methods & Procedures: Three individuals with aphasia participated in biweekly group treatment during which SFA was trained during discourse production tasks. Two of the three individuals participated in the entire course of treatment. Discourse of these two participants was analysed such that effect sizes could be calculated for measures of overall communication informativeness and efficiency (Nicholas & Brookshire, 1993), and for item‐specific lexical retrieval (Mayer & Murray, 2003). Outcomes & Results: The two individuals who participated in the full treatment protocol both demonstrated improved lexical retrieval in discourse, with additional improvements observed in either general communication informativeness or efficiency. Conclusions: Results provide preliminary support for the hypotheses that SFA administered during group aphasia treatment can be used successfully to facilitate word retrieval during discourse. Furthermore, results suggest that individuals with differing mechanisms of anomia may derive benefits from participation in this treatment protocol.

Background: Semantic feature analysis (SFA) is a treatment for lexical retrieval impairment in which participants are cued to provide semantic information about concepts they have difficulty naming, in an effort to facilitate accurate lexical retrieval (Boyle, 2004a). Previous work has provided preliminary evidence that persons with aphasia who participated in SFA-focused group aphasia treatment demonstrate improved lexical retrieval in discourse, with additional improvements observed in either general communication informativeness or efficiency (Antonucci, 2009). Furthermore, results suggested that individuals with differing mechanisms of anomia could derive benefits from participation in SFA-focused group treatment. Aims: The aim of the current study was to investigate further training of SFA in connected speech during group aphasia treatment. This study expanded and extended previous work (Antonucci, 2009), through the addition of participants with more varied aetiologies and severities of aphasia, and through the introduction of home practice. It was hypothesised that lexical retrieval during discourse would improve, as would overall communicative informativeness and/or efficiency. Methods & Procedures: Four individuals with aphasia participated in biweekly group treatment during which SFA was trained through connected speech tasks. Three participants presented with stroke aphasia, while one demonstrated aphasia consequent to traumatic brain injury. Discourse measures included those for overall communicative informativeness and efficiency (Nicholas & Brookshire, 1993) and for word-class-specific lexical retrieval (Mayer & Murray, 2003). Effect sizes were calculated for all discourse measures. Pre- and post-treatment performance on the spontaneous speech portion of the Western Aphasia Battery-Revised was also analysed relative to discourse measures, to corroborate findings from more frequently repeated probes. Outcomes & Results: All four participants demonstrated improvement to communicative informativeness and/or efficiency in connected speech tasks. Conclusions: Results provide additional support for the hypothesis that SFA administered during group aphasia treatment can be used successfully to facilitate improvement of communicative effectiveness. These results also support previous findings that individuals with differing aetiologies and natures of word retrieval impairment may benefit from participation in the same SFA-focused group aphasia treatment. Future work proceeding from this study may be directed towards differentiating which aspects of the treatment are most effective across participants with varied naming impairment, what is the optimal group composition and size, and towards discerning the most effective methods for facilitating and monitoring home practice.

Event Abstract Back to Event Agrammatic Aphasia following Right versus Left Basal Ganglia Lesions: case reports and review of the literature VENUGOPAL BALASUBRAMANIAN1*, Maureen Costello1, Maha Aldera1 and Judith Koebli1 1 Seton Hall University, United States Introduction. The controversies surrounding the clinical entity of agrammatic Broca’s aphasia can be traced to the multiple perspectives on its cognitive, linguistic and neurological bases (Baastianse & Thompson, 2012; D’Esposito & Alexander, 1998; Lieberman, 2002). A currently brewing issue is about Broca’s aphasia’s alleged causal connections with the subcortical basal ganglia (BG). Early clinical studies have argued that permanent Broca’s aphasia does not occur without subcortical lesions (Dronkers et al, 1992; Stuss & Benson, 1986). In this context, the objectives of the current study include the following: to present data from two chronic Broca’s aphasics, to provide a comprehensive review of the literature on the left versus right BG lesions to discuss the agrammatic characteristics of our subjects, and to discuss the implications for subcortical models of language. Method. Subjects. LK, a 45-year-old male high school teacher suffered a stroke and consequently developed right hemiplegia and moderate non-fluent aphasia. A CT scan evaluation revealed infarcts involving the left temporal region extending up to a portion of the frontal lobe and BG of the left hemisphere (Figure 1). Clinical language evaluation indicated the presence of agrammatic Broca’s aphasia. He received language therapy for five years post-stroke. SE, a 69-year-old right-handed female with a stroke-induced lesion to the right frontal lobe under the anterior horn of the lateral ventricle, the head of caudate and putamen of the right hemisphere (Figure 1). Periodic assessment over a duration of eleven years since onset had yielded a persistent profile of agrammatic Broca’s aphasia, apraxia of speech, and left hemiplegia. Procedure. A large array of data was gathered from LK and SE using Boston Diagnostic Aphasia Examination, Token Test (only LK) Discourse Analyses (Conversation & narrative), Discourse Comprehension Test, Psycholinguistic Assessment of Language Performance in Aphasia (PALPA), Reversible Sentence Comprehension Test (SE only), Linguistic Ambiguity Comprehension Test, and Grammaticality & Semantic acceptability assessment. Results and Discussion LK and SE evidenced deficits in both language production and comprehension. LK had problems in inflectional morphology as well as sentence constructions. SE’s language comprehension was moderately impaired as her performance on Reversible Sentence Comprehension Test revealed. Story recall task brought out features of agrammatic and apraxic speech. Test results of both SE and LK are summarized in a series of figures. The involvement of BG lesions in both LK and SE support the clinical observation that permanent Broca’s aphasia does not occur without subcortical lesions. According to the circuit models, BG forms part of cortical-striatal-cortical circuit that sub-serves complex systems such as grammars (Liebermann, 2002; Mesulam, 1990), hence agrammatism following BG lesions in these two cases. An alternative explanation is that the BG structures are involved in a sequential cognitive process that underlies behaviors including language (Chan, Ryan, & Bever, 2013). Hence agrammatic aphasia occurs following BG lesions. SE’s lesion in the right BG can be explained on the basis of the observation that language lateralization is less striking at the subcortical level (Galaburda & Eidelberg, 1982). Figure 1 References Bastiaanse, R., & Thompson, C. (2012). Perspectives on agrammatism. New York: Psychology Press. Chan, S., Ryan, L., & Bever, T. (2013). Role of the striatum in language: Syntactic and conceptual sequencing. Brain & Language, 125, 283-294. D’Esposito, M., & Alexander, M.P. (1995). Subcortical aphasia: distinct profiles following left putaminal hemorrhage. Neurology, 45, 38-41. Dronkers, N.F., Shapiro, J.K., Redfern, B., Knight, R.T. (1992). The role of Broca’s area in Broca’s aphasia. Journal of Clinical and Experimental Neuropsychology, 14, 198. Galaburda, A.M., & Eidelberg, D. (1982). Symmetry and asymmetry in the human posterior thalamus. Archives of Neurology, 39, 325-336. Lieberman, P. (2002). On the nature and evolution of the neural bases of human language. Am J Phys Anthropol., 35, 36-62. Mesulam, M.M. (1990). Large-scale neurocognitive networksand distributed processing for attention, language, and memory. Annals of Neurology, 28, 597-613. Stuss, D.T., & Benson, D.F. (1986). The frontal lobes. New York: Raven. Keywords: Subcortical aphasia, Basal Ganglia, agrammatic aphasia, cortical-striatal-cortical circuitry, Broca's Aphasia Conference: 54th Annual Academy of Aphasia Meeting, Llandudno, United Kingdom, 16 Oct - 18 Oct, 2016. Presentation Type: Poster Sessions Topic: Academy of Aphasia Citation: BALASUBRAMANIAN V, Costello M, Aldera M and Koebli J (2016). Agrammatic Aphasia following Right versus Left Basal Ganglia Lesions: case reports and review of the literature. Front. Psychol. Conference Abstract: 54th Annual Academy of Aphasia Meeting. doi: 10.3389/conf.fpsyg.2016.68.00103 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 30 Apr 2016; Published Online: 15 Aug 2016. * Correspondence: Dr. VENUGOPAL BALASUBRAMANIAN, Seton Hall University, South Orange, NJ, United States, venugopal.balasubramanian@shu.edu Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers VENUGOPAL BALASUBRAMANIAN Maureen Costello Maha Aldera Judith Koebli Google VENUGOPAL BALASUBRAMANIAN Maureen Costello Maha Aldera Judith Koebli Google Scholar VENUGOPAL BALASUBRAMANIAN Maureen Costello Maha Aldera Judith Koebli PubMed VENUGOPAL BALASUBRAMANIAN Maureen Costello Maha Aldera Judith Koebli Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

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Background: Semantic feature analysis (SFA) is a treatment approach aimed at enhancing lexical retrieval by improving access to the semantic network in speakers with aphasia. Although there are promising results on trained items, previous studies exploring the impact of SFA on verb production in monolingual speakers have shown mixed results for generalisation to untrained items and discourse. There are few published studies investigating SFA and action naming in multilingual speakers.Aims: The study explores the impact of SFA on trained and untrained verbs, semantics and syntax, and narrative production in the trained and untrained languages of a multilingual speaker (Japanese–English–German–Norwegian) with moderate non-fluent aphasia. Treatment was conducted in a late-acquired language (Norwegian).Methods & Procedures: SFA was provided during an intensive schedule of about 22 hr of therapy, with approximately 10 hr per week over two and a half weeks. The treatment focused on the production of verbs in sentence contexts.Outcomes & Results: Outcome measures include the Bilingual Aphasia Test, an action-naming test, and production of semi-spontaneous narratives.Outcomes in the treated language: Overall, the participant responded positively to the SFA treatment. The trained verbs improved significantly, but no transfer was observed to untrained verbs. There were no changes in the formal testing of semantics or syntax, but improvements were noted in narrative production.Cross-linguistic outcomes: Transfer to verbs in untreated German was evident. There were significant increases in the semantics and syntax in both English and German. The participant showed an improvement in discourse in English and German, although not in Japanese.Conclusions: SFA treatment in a late-acquired language can lead to gains in the treated language and transfer to both stronger and weaker languages, with different patterns for the various languages. This indicates that SFA may be a promising method for treating multilingual speakers with aphasia. The authors further advocate the use of narratives as an assessment tool. In addition to enhancing the ecological validity of the findings, the narratives provided information not obtainable from the other assessment tools for within- and cross-linguistic therapy gains for the participant.

Background: Semantic feature analysis (SFA) is a prominent treatment for the word retrieval deficits of aphasia. Generalisation of improved word retrieval on picture naming to discourse production has been an important factor for evaluating the effectiveness of SFA treatment. Unfortunately, generalisation of word retrieval improvements to discourse production following SFA has been modest. Aims: Because of the previous, albeit limited, success of SFA in producing improved word retrieval for discourse we further examined the utility of SFA for reducing noun and verb retrieval failures in aphasic discourse. Rather than use SFA as a means for improving generalisation of picture naming or as a compensatory strategy for lexical failures during discourse, we applied SFA as an a priori means to reduce the frequency of word retrieval failures in discourse. Methods & Procedures: Semantic feature analysis was applied to object and action word retrieval failures appearing during picture descriptions and procedural questions by two participants with anomic aphasia. A single case time-series design across behaviours with replication was used to assess changes in discourse production as well as generalisation of treatment effects to untrained pictures resulting from SFA. Outcomes & Results: Increases were observed in verbal productivity for both participants, while the informativeness of the participant's discourse, as measured by correct information unit analyses, also improved. Minimal changes were observed in the frequency and type of word-finding behaviours evinced by the participants; this finding was attributed to a masking effect arising from the participants' increased quantity of verbal output. Evidence was also found that targeting word finding behaviours in connected speech generalised to naming of untrained object and action pictures. Conclusions: The changes effected by this discourse-based approach to SFA were as robust and as consistent as has been achieved previously with SFA treatment. The choice to use a discourse-based versus a picture-based approach to SFA treatment might be based on the ecological validity of the discourse-based approach.

Background: A new phonologically based treatment that we developed for addressing naming deficits in aphasia—the phonological components analysis (PCA) treatment—is presented. The PCA was modelled after the semantic feature analysis (SFA) approach (Boyle & Coelho, 1995). The SFA approach was chosen as a model for two reasons. First, results from the semantic therapies that have used SFA have been encouraging (e.g., Boyle, 2004; Boyle & Coelho, 1995; Coelho, McHugh, & Boyle, 2000; Conley & Coelho, 2003; Lowell, Beeson, & Holland, 1995). Second, SFA incorporates the principle of choice, a factor that has been identified by some as being important in producing longer‐lasting effects of treatment (e.g., Hickin, Best, Herbert, Howard, & Osborne, 2002). The PCA was developed to serve as a comparable phonological comparison for the SFA approach with the future goal of comparing the relative effects of both types of therapies. Portions of this work were presented at the Academy of Aphasia meetings in New York, October 2002 (Rochon, Leonard, & Laird, 2002) and Victoria, October 2006 (Rochon et al., 2006a), at the American Speech and Hearing Association meeting, Philadelphia, November 2004, and at the Rotman Research Conference, Toronto, March 2006 (Rochon et al., 2006b). This project was supported by grant number 44069 from the Canadian Institutes of Health Research and by grant number NA 5379 from the Heart and Stroke Foundation of Ontario. The authors are grateful to the North York Aphasia Institute, the York Durham Aphasia Centre, and the Aphasia Centre of Ottawa‐Carleton for allowing us to recruit participants from their institutions, and to all the individuals who participated in this research. James Andrews, Eleanor Arabia, Jennifer Cupit, Kit Flynn, Heather McCallum, Lauren Reznick, and Patty Vlachos, provided valuable assistance on this project. Thank you also to two anonymous reviewers for their helpful comments. Aims: The primary aim of this investigation was to document the effectiveness of PCA treatment for the remediation of naming deficits in aphasia. In addition, we wished to examine potential maintenance and generalisation effects associated with this treatment. Methods & Procedures: The PCA treatment followed the protocol of Coelho et al. (2000). The target picture was presented in the centre of a chart and the participant was asked to name it. Irrespective of his/her ability to name the picture, the participant was asked to identify five phonological components related to the target item (i.e., rhymes with, first sound, first sound associate, final sound, number of syllables). For each component targeted, if a participant could not spontaneously provide a response, he/she was asked to choose one from a list. A single‐subject multiple‐baseline across behaviours design was employed, with maintenance effects examined 4 weeks post‐treatment. Generalisation effects were examined by comparing pre‐ and post‐treatment scores on the Philadelphia Naming Test (Roach, Schwartz, Martin, Grewal, & Brecher, 1996). Ten individuals with aphasia participated. Outcomes & Results: Of the 10 individuals, 7 demonstrated notable treatment effects. Follow‐up testing indicated maintenance of treatment gains over a 4‐week period, with some generalisation to untreated items. Conclusions: This investigation was successful in demonstrating the effectiveness of a new phonological approach to the remediation of naming deficits in aphasia and in supporting the notion that a components analysis treatment protocol (similar to a semantic feature based treatment) is useful in strengthening activations within the lexical system with the potential result of longer‐lasting effects.

This event-related functional magnetic resonance imaging (fMRI) study reports on the impact of semantic feature analysis (SFA) therapy on the neural substrate sustaining the recovery from severe anomia in two patients: one participant was diagnosed with primary progressive aphasia (PPA) 2 years before this study; the other participant acquired aphasia 8 years before this study. The participant with PPA showed severe progressive nonfluent aphasia (PNFA), the language profile being similar to a Broca's aphasia; the stroke patient presented with Broca's aphasia and a severe apraxia of speech (AOS). To examine the neural substrate allowing for recovery, both patients received brief and intensive therapy with SFA; behavioral and event-related (ER)-fMRI measures during oral picture naming were obtained pre- and post-therapy. Both patients benefitted from SFA to improve their naming performance. Functional MRI performances on trained and correct pretraining items were contrasted. Adaptive brain plasticity appeared to operate differently in each patient, despite the similarity of naming recovery profiles.

Background: Up to 60% of people with aphasia experience persistent word-finding difficulties into the chronic stage, starting six months after the stroke. Semantic Feature Analysis (SFA) and Phonological Components Analysis (PCA) are two common word-finding interventions that use the generation of semantic features for SFA (e.g. category) and phonological features for PCA (e.g. first sound) to improve naming. Despite inconsistent support for the generalization to untreated items, studies have shown improvements on probe word naming for treated items. However, research concerning within-intervention effects and generalization to alternative contexts has been limited. Aim: This study investigated the effect of treatment for SFA and PCA probe word naming as well as their within-intervention effects in four individuals with chronic post-stroke aphasia. Methods & Procedures: Baseline and follow-up measures included standardized assessments and image naming tasks. The image naming task was used to generate three lists: an SFA treated list, a PCA treated list, and an untreated list. One SFA session and one PCA session per week were then provided concurrently to each participant for a period of six weeks. Outcomes & Results: While only one participant experienced significant gains on treated probe word naming, these gains were maintained four weeks after the intervention. Exploratory results suggested that effects could transfer to two types of generalization items: different pictures of the same items and pictures of items shown in a natural context. Furthermore, while generalization to untreated items did not reach significance for any participant, some generalization of gains to standardized assessments was observed. Although rarely equivalent for SFA and PCA interventions, all participants also experienced some degree of within-intervention improvement over the progression of sessions. These improvements included a reduction in the number of forced choices required for feature generation and/or a reduction in the number of words never named during intervention sessions. Conclusion: The results support additional avenues of investigation for SFA and PCA therapies for individuals with post-stroke aphasia, namely within intervention effects and the potential for generalization to different contexts.

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<b>PB-PG-0609-18074 – NIHR Research for Patient Benefit Programme – Final report</b><br /> <br /> <b>Project title: </b>SemaFoRe: Semantic Feature and Repetition therapy in aphasia: A pilot RCT<br /> <br /> <b>Authors: </b>Dr Julie Morris - Newcastle University<br /> Professor David Howard - Newcastle University&nbsp;<br /> Mrs Frauke Buerk - Newcastle upon Tyne Hospitals Trust<br /> <br /> <b>Plain language summary</b><br /> This project focused on therapy for word finding difficulties in aphasia, an acquired communication problem, often following stroke . The project was designed as a pilot study to inform future research, looking at whether the research was feasible and acceptable. It examined two treatments to improve word finding: ‘Semantic Feature Analysis’ (SFA) and ‘Repetition in the Presence of a Picture’ (RIPP). In SFA, you generate ideas around a particular word. RIPP involves repeating words. Participants’ communication was assessed before and after therapy, including the ability to retrieve words via naming and describing pictures. Participants’ views of their communication and therapy were collected.<br /> <br /> In terms of findings about feasibility and acceptability of the research, we considered recruitment to the study, retention and acceptability (whether people stayed in the study and what they thought about it). We had 41 people referred to the study with 25 suitable. We aimed to recruit 30 in total. Recruitment was slightly slower than we had anticipated at the start. Of the 25 who took part, 23 completed every aspect of the study; this is a major achievement given the commitment (8-9 month period). The 2 people who did not complete were unable to because of ill health. Participants reported favourably about therapy; they liked both therapies with little they would change. It therefore appears that the research is feasible and acceptable to participants.<br /> <br /> In terms of more specific results, though this is a pilot study, our results do not completely replicate previous findings. Importantly, both treatments appear only to have an effect on the words treated; previous evidence suggested that SFA would improve word finding generally but this study did not find that, certainly in correct retrieval of words. Additionally, participants appear to benefit from either both or neither treatment.<br /> The implications of our research is that the methods used are acceptable to participants and it was possible to recruit and retain participants. The findings, whilst a pilot study, are based on results from 23 people; this is a larger sample than typical when such well defined therapies are investigated. Results suggest effects of these therapies are restricted to treated items; if this is the case, this has important implications for selection of treatment words. Further research in this area is warranted and we are currently developing a proposal to take to funders.<br /> <br /> <b>Keywords</b><br /> Aphasia, Anomia, Word-finding, Semantic feature analysis, Therapy, Treatment, Rehabilitation<br /> <br /> <b>Summary of research findings</b><br /> BACKGROUND<br /> This study aims to contribute to the development of research and the evidence base about treatment for word retrieval in aphasia. Aphasia is an acquired communication problem, usually after stroke or head injury. One of the most frequent difficulties experienced is a problem with word retrieval; this is therefore a frequent goal of intervention. One of the treatments in clinical use is Semantic Feature Analysis (SFA). In SFA the person is shown a picture and asked to retrieve semantic information about it (e.g. what it is used for). This treatment is of interest as some evidence suggests that treatment effects generalise to words not worked on in therapy. This is in contrast to other word retrieval therapies where effects have been shown to be restricted to treated words. If working on one word can effect change in another (untreated) word, this is an attractive treatment option; the impact of treatment is maximised. However, although widely used, there is a limited evidence base for SFA (limited by number of participants and items as well as other aspects of methodology). The evidence base also describes a set of word retrieval interventions which are more phonological in nature, involving pairing of phonology with meaning, often involving repeating the word. We have called this Repetition in the Presence of a Picture (RIPP). In RIPP, treatment effects are restricted to words seen in treatment. This study involved both treatment approaches, within a pilot cross over randomised control trial.&nbsp;<br /> <br /> AIMS AND OBJECTIVES<br /> This study is a pilot RCT which aimed:<br /> 1. To determine the approximate effect size for the primary outcome measure to inform the power calculation for a trial.<br /> 2. To assess whether the randomised crossover design is an appropriate trial design in this context.<br /> 3. To establish patterns of recruitment, consent and retention, including whether the burden of data collection required by multiple assessments in a cross-over design is acceptable.<br /> 4. To evaluate whether all planned assessment points are necessary to inform the study.<br /> 5. To evaluate overall satisfaction for the people with aphasia with the delivery of therapy.<br /> <br /> METHODS<br /> Participants were recruited by speech and language therapists (SLTs) across several hospital trusts. Participants were at least 3 months post stroke and had word retrieval difficulties, scoring 10%-60% on a naming test. They had no other significant cognitive difficulties. Participants stopped SLT for the study period, though could attend support groups. Following consent, a brief screen of speech production, comprehension and cognitive skills took place. Eligible participants were randomly assigned to one of two treatment orders; SFA followed by RIPP or RIPP followed by SFA. The random allocation was generated via an external randomisation service (Newcastle Clinical Trials Unit).&nbsp;<br /> Each therapy took place twice weekly over a 6 week period with sessions of 1 hour, either in University rooms or the participant’s home. Treatment protocols were established based on literature and discussion with the primary authors in each field. The person administering therapy worked with another SLT to refine the protocols and then to ensure adherence to the protocols.<br /> The items used in therapy were subsets of a 150 item word/picture set. In each phase of therapy, one sub-set of 50 items was treated. The sub-sets were specific to participants; the division into sets A (used in therapy A), B (used in therapy B) and C (control; never treated) was on pre-therapy performance and matched for word frequency and length. Within these constraints, items were randomly allocated to the three sets.&nbsp;<br /> An SLT administered therapy, with assessments carried out by a different SLT who was both blind to treatment condition (SFA vs. RIPP) and item set (set A, B, C). It was not possible for participants to be blind to condition since this was obvious during therapy. For analysis of connected speech, the person transcribing and analysing the samples was completely blinded using anonymised, time referent free samples. Participants’ performance was assessed after each treatment phase, with a gap between the two phases of therapy (of equivalent duration to a therapy period). This led to seven assessment points (Ax.1 &amp; Ax.2 prior to any therapy, Ax.3 following therapy A, Ax.4 prior to therapy B, Ax.5 following therapy B, Ax.6 six weeks and then Ax.7 ten weeks after all treatment ended), with approximately equal gaps between assessments 1-6.&nbsp;<br /> The primary outcome measure was the percentage of the 150 words named correctly. Secondary outcome measures were a comprehension task involving the 150 words, measures of connected speech and a measure of the participant’s perception of change in their communication.&nbsp;<br /> <br /> KEY FINDINGS<br /> There are two aspects to the findings from this study. The first relates to the pilot nature of the study and concerns the feasibility of the methods and design. The second concerns the findings in relation to the treatment effects. Taking the pilot aspects first and considering recruitment: of the 41 people recruited to the study, 25 people were appropriate. Reasons for not being included in the study were typically that word retrieval abilities were above or below the 10-60% criteria. Rates of recruitment were therefore reasonable, with a relatively high referral to consent to participation ratio (i.e. appropriate people were referred). Recruitment was slightly slow in the initial phases and improved. In terms of retention, of the 25 people recruited to the study, there was excellent retention. Only 2 participants were lost to the study due to ill health. 23 participants completed therapy and took part in assessment at all 7 points (spanning approx. 8-9 months), representing a significant commitment. Participants completed an aphasia friendly post-therapy questionnaire (at assessment time points 3 and 5). Participants were overwhelmingly positive about therapy, with very little that they would change. Within the questionnaire, 13 participants stated they had no preference for one therapy, 9 preferred SFA and 1 preferred RIPP.<br /> <br /> In terms of participants’ response to treatment, we found an average effect size (primary outcome measure) for treatment of 11.0 extra items with RIPP (95% CI 16.5-5.4, d=0.49), and 3.3 with SFA (7.7-1.0, d=0.15). The difference was highly significant (CI: 12.5-2.8, d=0.34). Across all 23 participants there was a significant overall improvement: a linear trend (z=8.79, p&lt;&lt;.0001). We also saw differences between people: homogeneity test χ2 (22) = 197.4, p&lt;&lt;0.0001 (which is unsurprising given the variation within aphasia). When the treatment effect was examined by therapy period and considering whether items had been within the treated set or not, the results demonstrated that both treatments were effective; however there was significantly larger effect of treatment for RIPP than for SFA. For both treatments the effect was seen for those items seen within treatment (contrary to predictions for SFA). Analysis of this pilot data also suggests that participants benefited from both or neither therapy. The predictor variables available to us in this study (background language, wider cognitive and demographic variables) did not allow us to predict the benefit.<br /> In considering the secondary outcome measures, there was small but significant change for the semantic verification task and also for the participant rating measure (COAST) over time. We are continuing to analyse the data from the connected speech measures, with a focus on the picture description task from the Comprehensive Aphasia Test, which was completed across each assessment point and for which there is data on the reliability and validity of scoring.<br /> <br /> All seven assessment points appear important and feasible to deliver on. The two pre therapy assessments facilitated item selection to treatment sets, it is essential to have pre and post therapy assessment to allow comparison of performance and the final post-therapy measurements are clearly important both to the clinical community and to participants (with questions at dissemination events about the longer term benefits of treatment).&nbsp;<br /> <br /> EXPECTED IMPACT AND CONCLUSION<br /> This study demonstrates the feasibility of a crossover RCT of specific aphasia therapies. Referral to a study of this type is feasible; our experience suggests that in future, the recruitment drive needs to start before the study is ready to recruit to facilitate consultation with potential participants. This study only used SLT recruiters; it was not possible to utilise the resources of the (then) Stroke Research Network. Strong support was given to the study, but referrers needed to know in detail about potential participants’ aphasia and about other therapy needs. Retention within the study and acceptability to participants were both excellent, suggesting the design and methods are appropriate. However, it is important to remember that one therapist delivered all intervention, with one research site and so participants had a great deal of consistency and this may have contributed to this success.&nbsp;<br /> The study, whilst a pilot, also generated interesting results regarding the two treatments. Both were effective, but RIPP more so; neither treatment showed generalisation to untreated items on the primary outcome measure (contrary to predictions). This has a potential impact on treatment choices for word retrieval; if the more complex SFA treatment cannot be demonstrated to have an advantage, then RIPP may be the treatment of choice for this specific aspect of aphasia rehabilitation. Results from this pilot study suggest we need to better understand the impact of treatment on everyday communication and confidence in communication, whether we can get generalisation of treatment effects, what might predict benefit and also explore whether there is a more efficient way to deliver the repetition therapy.&nbsp;<br /> <br /> <b>Patient and public involvement</b><br /> Involvement of patients has grown with this project and spread beyond this project to influence subsequent projects (from PhD studies to project grants). In developing the original project proposal, a small Aphasia Research User Group (ARUG) was set up, and has discussed (in varying depth) this project on 6 occasions. Aphasia adds a challenge to involvement of patients; people have communication difficulties which can affect their understanding of spoken and written communication and their ability to convey their ideas. This has meant meetings need to be facilitated; both in terms of understanding (of spoken and written material) and expression of ideas. Meetings have been small (typically 4-5 members with 2 facilitators who are qualified SLTs). Over time, we have developed our skills in ensuring members are able to truly contribute their views, but importantly members have gained experience and the confidence to put forward their ideas. We have also recently invited a family member to join the group, to widen consultation. We have also worked with one member, a gentleman with aphasia and with a scientific background, who has been able to comment on specific queries via e-mail (this project, and others) and this has been useful. He has commented on the lay summary of this report and has been sent the full report. We remain mindful of ensuring people with aphasia themselves are able to fully contribute. The importance of considering what to consult about, and what amount has been important as has building on information over time. The group appears to have a sense of ownership of this particular project.<br /> <br /> ARUG has gone on to be involved with other projects (e.g. Reading Comprehension in Aphasia) and to shape ideas within that project. We also encourage students (PhD, UG) who are completing projects involving people with aphasia, to present to and consult with ARUG as part of their research training (e.g. Fiona Menger, Stroke Association Fellow).&nbsp;<br /> We are now looking at ways to ensure ARUG is sustainable over time. This is both in terms of members but also in terms of the researchers' time involved. Ideally there needs to be some consistency of faciltitator and/or overall coordinator. We are looking to a model where in future these costs might be met by funded grants (by having a costing model for any future grants). The aim would be to enable ARUG to continue consultation in the very early stages (when there is no identified funding stream) into a funded role in funded projects. ARUG members have not wanted remibursement for their time to date, but this, along with other principles, would need revisiting over time. ARUG would like to develop a web presence and a set of guidelines for researchers, drawing on its experience.<br /> <br /> The project also held a wider PPI event in November 2014, inviting participants, family members and referring speech and language therapists to a dissemination and future plans event. Results of the project were discussed and then small groups discussed their views on possible future directions for the research (summary available on request). These are being taken forward as we consider the next stages.&nbsp;<br /> As seen in the ResearchFish submission, there has been on-going engagement of the SLT profession, particularly regionally, who have been engaged in discussion about this project since the outset.<br /> &nbsp;<br /> <b>Data sharing statement</b><br /> See link <a href="https://www.nihr.ac.uk/documents/nihr-position-on-the-sharing-of-research-data/12253">[https://www.nihr.ac.uk/documents/nihr-position-on-the-sharing-of-research-data/12253</a>] for the NIHR position of the sharing of research data.&nbsp; The NIHR strongly supports the sharing of data in the most appropriate way, to help deliver research that maximises benefits to patients and the wider public, the health and care system and which contributes to economic growth in the UK.&nbsp; All requests for data should be directed to the award holder and managed by the award holder.<br /> <br /> <b>Disclaimer</b><br /> This project is funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0609-18074). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.<br /> <br /> This project was carried out between March 2011 and November 2014. This final report has not been peer-reviewed. The report was examined by the Programme Director at the time of submission to assess completeness against the stated aims.

Introduction: Semantic Feature Analysis (SFA) therapy is a widely used approach for single-word naming treatment in monolingual and bilingual persons with aphasia (BiPWAs). There is evidence that SFA leads to naming improvements in both treated and untreated languages of BiPWAs. However, research on the generalization effects of SFA on narrative production is scarce. This study investigated the within- and cross-language generalization effects of SFA on narrative production and its relationship to naming gains in a group of L1-Russian-L2-Hebrew chronic-stage BiPWAs. Methods: The study included two groups of BiPWAs. In the experimental group, ten individuals received one or two blocks of SFA, while ten participants who did not receive therapy served as a control group. We compared the changes in narrative production between the experimental and control groups and examined whether the narrative changes in the experimental group were related to naming gains. Results: The results indicated that SFA generalized to narrative production in the experimental group. Within-language generalization was observed following SFA in L1, while cross-language generalization was found following SFA in both L1 and L2. Conclusion: Although SFA has the potential to generalize to narrative production in BiPWAs, this effect did not consistently align with the therapy gains in naming. To achieve greater within- and cross-language generalization effects, we recommend providing SFA in the L1 of BiPWAs.