Sentence Production In Aphasia Research Articles

Telerehabilitation with Verb Network Strengthening Treatment (VNeST) in two participants with mild-to-moderate and moderate-to-severe aphasia: A single-case experimental design study

ABSTRACT Background Verb Network Strengthening Treatment (VNeST) is a verb-centred aphasia treatment that targets the semantic relationships between a verb (e.g., dig) and related content words (e.g., gardener, hole), aiming to promote word retrieval and sentence production in aphasia. Previous research shows promising results of VNeST in several participants. Aims This study investigates the effects of VNeST through telerehabilitation on word retrieval and sentence production with treated and semantically related untreated verbs, as well as the possible generalisation to confrontation naming and connected speech. Further, functional communication, communicative participation, health-related quality of life and client satisfaction are explored. Methods and Procedures A single-case experimental design study with multiple baselines was conducted with two participants with stroke-induced mild-to-moderate Broca’s aphasia or moderate-to-severe Wernicke’s aphasia who received VNeST through telerehabilitation. Percentage of non-overlapping data, Baseline Corrected Tau and d-index effect size were used to measure improvement in word retrieval and sentence production elicited through video-clip stimuli. The study is registered with ClinicTrials.gov, number NCT05152979. Outcomes and Results The participant with Wernicke’s aphasia improved in word retrieval in sentences with trained and untrained verbs and showed some – albeit limited – generalisation to confrontation naming of nouns and verbs. The participant with Broca’s aphasia withdrew after half of the planned dosage, as he did not consider VNeST suitable for his needs. He did not improve in word retrieval or sentence production. Conclusions VNeST shows promise when it comes to improving word retrieval in trained and semantically related untrained stimuli in moderate-to-severe Wernicke’s aphasia. This study adds to the existing literature by showing potential improvement in VNeST through telerehabilitation.

TelePriming sentence production in aphasia.

The application of videoconferencing to the assessment and treatment of aphasia has been rapidly increasing; however, there is a need to develop treatments targeting sentence production in persons with aphasia (PWA) that can be delivered through videoconferencing. Structural priming has received recent attention as a potential training method for PWA. We investigated the feasibility and efficacy of a collaborative structural priming task delivered via the internet, TelePriming, in facilitating sentence production in PWA and healthy adults. In Study 1, young adults (YA), older adults (OA), and PWA participated in a collaborative dialogue-like priming task through videoconferencing, taking turns with an interlocutor (experimenter) to describe transitive action pictures with the goal of finding matching pictures. We measured whether participants produced more passive sentences to describe their picture after hearing their interlocutor produce passive compared to active sentences (primes). In Study 2, we compared the data from the OA and PWA of Study 1 (TelePriming) to different groups of OA and PWA, who completed the same priming task in person. All three groups showed robust priming effects in Study 1, producing more passive sentences to describe target pictures after hearing the experimenter produce passive versus active sentences. In Study 2, when controlling for demographic information (age, education) and aphasia severity, TelePriming resulted in larger priming effects for OA and PWA, compared to the in-person priming task. Survey results revealed that both OA and PWA experienced increased comfort and satisfaction with using technology following the task. Interactive message-structure alignment processes remain largely intact in PWA, and the positive effects of structural priming in a collaborative communicative task are not diminished by remote delivery. The findings demonstrate the feasibility and validity of TelePriming in OA and PWA, laying experimental groundwork for future use of TelePriming in the assessment and treatment of clinical populations with limited access to face-to-face sessions.

Planning sentence production in aphasia: evidence from structural priming and eye-tracking

BackgroundGrammatical encoding is impaired in many persons with aphasia (PWA), resulting in deficits in sentence production accuracies and underlying planning processes. However, relatively little is known on how these grammatical encoding deficits can be mediated in PWA. This study aimed to facilitate off-line (accuracy) and real-time (eye fixations) encoding of passive sentences through implicit structural priming, a tendency to better process a current sentence because of its grammatical similarity to a previously experienced (prime) sentence.MethodSixteen PWA and Sixteen age-matched controls completed an eyetracking-while-speaking task, where they described a target transitive picture preceded by a comprehension prime involving either an active or passive form. We measured immediate and cumulative priming effects on proportions of passives produced for the target pictures and proportions of eye fixations made to the theme actor in the target scene before speech onset of the sentence production.Results and conclusionBoth PWA and controls produced cumulatively more passives as the experiment progressed despite an absence of immediate priming effects in PWA. Both groups also showed cumulative changes in the pre-speech eye fixations associated with passive productions, with this cumulative priming effect greater for the PWA group. These findings suggest that structural priming results in gradual adaptation of the grammatical encoding processes of PWA and that structural priming may be used as a treatment component for improving grammatical deficits in aphasia.

Longitudinal changes in connected speech over a one-year span in the nonfluent/agrammatic variant of Primary Progressive Aphasia

ABSTRACT Background Connected speech assessment is essential to characterize the language features in primary progressive aphasia (PPA). This is especially true for the non-fluent/agrammatic variant (nfvPPA) in which one of the core features is agrammatism. Identification of agrammatism typically involves the analysis of sentence production, as in connected speech, in order to detect syntactic deficits. However, little is known about the longitudinal changes occurring in connected speech of individuals with non-fluent PPA. Aim The aim of this study was to assess changes in connected speech over a one-year span in participants with nfvPPA using semi-structured interviews. Methods and procedures We conducted a prospective group study including participants with nfvPPA (n=9) and age- and education-matched healthy controls (n=9). For each individual, connected speech was obtained using topic-directed interviews at two testing rounds, each approximately one year apart. Production on each task was recorded, transcribed and analyzed according to the Quantitative Production Analysis (QPA) protocol, a tool developed by Berndt and colleagues (2000) for the analysis of sentence production in aphasia. For each group, the probability of deterioration between the two testing rounds was estimated using Bayesian analysis. Results and outcomes For individuals with nfvPPA, statistical evidence of deterioration from the first testing round to the second was found for five variables, namely the proportion of pronouns, the proportion of verbs, the proportion of closed class words, the inflection index and the proportion of well-formed sentences. Conclusions Results from the present study suggest that variables relating to word-finding and morphology are more vulnerable to time and therefore may be relevant potential targets for intervention.

Description of connected speech across different elicitation tasks in the logopenic variant of primary progressive aphasia.

Despite its importance, in-depth analysis of connected speech is often neglected in the diagnosis of primary progressive aphasia (PPA) - especially for the logopenic variant (lvPPA) for which unreliable differential diagnosis has been documented. Only a few studies have been conducted on this topic in lvPPA. The aim of this study was to describe and compare lexico-semantic and morphosyntactic features of connected speech in participants with lvPPA, in comparison with healthy controls, using three different elicitation tasks (i.e., picture description, story narration and semi-structured interviews). In addition to a number of discourse features, we were particularly interested in the presence or absence of syntactic deficits in this PPA variant in line with recent findings. A prospective group study was conducted to compare lvPPA participants (n = 13) to age- and education-matched healthy controls (n = 13). For each individual, connected speech was obtained using three tasks: (1) The Cookie Theft picture description; (2) Cinderella Story; (3) Topic-directed interview. Production on each task was recorded, transcribed and analysed according to the Quantitative Production Analysis (QPA) protocol, a tool developed by Berndt etal. (2000) for the analysis of sentence production in aphasia. Differences between lvPPA and healthy controls and among elicitation tasks were analysed using repeated measures multilevel mixed-effects regression, separately for each outcome. Four measures were significantly different between lvPPA participants and healthy controls across all elicitation tasks. Specifically, lvPPA participants produced a reduced proportion of open-class words, a higher proportion of verbs, a higher proportion of pronouns and fewer well-formed sentences. For these measures, the difference between lvPPA and healthy controls was consistent among elicitation tasks, except for the proportion of well-formed sentences, where the difference between the two groups was significantly greater in the story narration task than in the other tasks. Across elicitation tasks that used the same analysis protocol (i.e., QPA), a similar pattern of deficits in connected speech emerged in lvPPA patients. Importantly, the findings replicate previous studies, which used different elicitation tasks and analysis protocols. Especially in relation to the documented syntactic deficits, these findings provide implications for differential diagnosis in PPA. What is already known on the subject Connected speech analysis can provide an important contribution to the language assessment for the logopenic variant of primary progressive aphasia (lvPPA). However, only a few studies have been conducted with this population. What this paper adds to existing knowledge This study highlights differences between patients with lvPPA and healthy controls regarding the proportion of open-class words, nouns, verbs and well-formed sentences. What are the potential or actual clinical implications of this work? Importantly, our results highlight syntactic deficits in the same group of individuals with lvPPA, using the same analysis protocol and across various elicitation tasks, which has implications for differential diagnosis.

Effects of working memory demands on sentence production in aphasia

Abstract The purpose of the study was to investigate the effects of task demands on sentence production and their relation to working memory (WM) capacity in people with aphasia using a verb-final language. The current study manipulated the WM loads on the sentence production tasks by varying the following three factors: task type (syntactic priming vs. sentence completion), sentence type (active vs. passive), and canonicity (canonical vs. noncanonical word order). Task type and word order canonicity were related to individual differences in WM capacity in both people with aphasia and their normal controls.

The effect of static versus dynamic depictions of actions in verb and sentence production in aphasia

ABSTRACTBackground: There is a shortage of material for the treatment of verb and sentence production in persons with aphasia (PWAs). In therapy, pictures or photographs depicting actions are often used, even though the meaning of certain verbs clearly involves movement. This aspect of movement is difficult to depict on static material. In a case study, Druks, J., & Shallice, T. (2000). Selective preservation of naming from description and the “Restricted Preverbal Message”. Brain and Language, 72, 100–128. doi:10.1006/brln.1999.2165 reported a patient who had difficulties naming actions. However, when the actions were performed, the patient was better at naming performed actions compared to naming actions depicted in still pictures.Aims: In the current study, we tested the hypothesis that PWAs are more accurate in naming verbs in isolation as well as in sentence context in a dynamic condition rather than in a static condition. In a second experiment, we examined whether the use of verbs that express specific types of movement has any influence on the production of verbs when using static and dynamic depiction. Verbs in three semantic categories were included, namely action verbs relating to arm, leg and face movements.Methods & Procedures: In the first experiment, verb production was examined in a static (photographs) condition and a dynamic (videos) condition. An action-naming task and a sentence production task of 20 items each were administered to 18 PWAs. In the second experiment, an action-naming task of 60 items was administered to 13 PWAs.Outcomes & Results: PWAs scored significantly better in the dynamic condition compared to the static condition on both the action-naming task and the sentence-production task in Experiment 1. Considering the three semantic categories that were considered in Experiment 2, PWAs only scored significantly better on the category “arm” in the dynamic condition as compared to the static condition.Conclusions: These results suggest that semantic information of an action’s specific aspects, such as movement, is activated while watching an action. We assume that PWAs profit from this depiction of movement. This study implicates that in clinical practice, dynamic material, rather than static material, should be used in diagnosis and therapy involving action naming and sentence production.

Testing the interplay of structure and meaning in aphasic sentence production

Background: Improving aphasic sentence production is a challenging endeavour, both for the speaker who must recover the linguistic skill and for the therapist who attempts to guide the process. Studies have demonstrated that treatment can often improve the sentence production ability of aphasic speakers, but with limited generalisation to new lexical content and untrained sentence structure. One factor that limits the outcome of production therapy may be the complexity of the relationship between the form and the meaning of a sentence. This is confounded by a limited array of diagnostic approaches for revealing what linguistic resources remain available to the aphasic speaker. Aims: In this study we tested a new format for eliciting sentence production in aphasia. Our goal was to reveal whether or not individual aphasic speakers were sensitive to certain semantic and syntactic elements of sentences that are believed to influence the sentence production process. Methods & Procedures: Using a modified sentence repetition format we explored the sentence production abilities of five fluent aphasic speakers under different conditions of lexical and/or structural manipulations. Lexical manipulations required substitution of a semantically related verb; structural manipulations required reordering of the post‐verbal arguments in different dative constructions (double object and prepositional) that express essentially the same message. Outcomes & Results: Response patterns obtained from the five aphasic participants revealed individual patterns of skill and sensitivity based on residual language ability. The implications of these results are discussed with reference to the potential for revealing elements of normal production patterns in aphasic speech, and the assumption that such information is important for developing more effective therapy for individuals with aphasia. Conclusions: Patterns of sentence production elicited in a modified sentence repetition task may reveal syntactic flexibility and residual syntactic knowledge in speakers with aphasia.

Verbs and Sentence Production in Aphasia: Evidence-Based Intervention

Verbs and Sentence Production in Aphasia: Evidence-Based Intervention

Canonical structure without access to verbs?

Agrammatic sentence production in aphasia has been connected to disturbances of verbs and the role played by verbs in determining the structural expression of thematic roles assumed by other words in the sentence. Apparently contradictory data are presented from an aphasic patient, who had difficulties in retrieving verbs in spite of a relatively well preserved use of canonical structure in written sentence production, where he frequently left a blank or dash between agent and theme to signal that a word was missing. A therapy study is reported where the focus was on differentiating verb meanings and integrating verbs in sentence production. After therapy the patient showed significant improvement in verb production, but only for trained items. He also showed a significant increase in use of canonical sentence structure on trials with trained, but not untrained verbs. It is suggested that the patient was relying on a general schema for canonical sentence structure which may interact with verb-specific knowledge in normal processing.

Verb Retrieval and Sentence Production in Aphasia

This paper presents a subject with a selective verb retrieval deficit. Nouns were produced more successfully than verbs in spontaneous speech, picture naming and when naming to definition. The word class effect was not observed in comprehension tasks, reading aloud or writing. This indicated that it was due to a specific problem in accessing verbs' phonological representations from semantics. The second part of the paper explores the implications of the verb deficit for sentence production. Analyses of narrative speech revealed a typically agrammatic profile, with minimal verb argument structure and few function words and inflections. Two investigations suggested that the sentence deficit was at least partly contingent upon the verb deficit. In the first, the subject was asked to produce a sentence with the aid of a provided noun or verb. The noun cues were not effective in eliciting sentences, whereas verb cues were. The second investigation explored the effects of therapy aiming to improve verb retrieval. This therapy resulted in better verb retrieval and improved sentence production with those verbs. These findings suggest that an inability to access verbs' phonological representations can severely impair sentence formulation. Implications for models of sentence production are considered.

Some aspects of sentence production in aphasia

Abstract In this paper, we address the question of whether aphasic patients can produce complete predicate-argument structures. We present a descriptive framework for analyzing this particular aspect of output, and identify different patterns of deficit. We argue that specific output analyses along these lines are a necessary first step in the assessment and treatment of sentence production deficits.