Treating naming impairments in aphasia: Findings from a phonological components analysis treatment

Abstract

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.