ORCID Profile
0000-0002-4653-0782
Current Organisations
University of Tasmania
,
Curtin University
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Publisher: FapUNIFESP (SciELO)
Date: 09-2014
DOI: 10.1590/S1980-57642014DN83000005
Abstract: The Conversation Analysis Profile for People with Aphasia (CAPPA) provides specific information about strengths and weaknesses of the communication between people with aphasia and their family caregiver within a conversational context.OBJECTIVE:The aim of this paper was to present the results of the first stages of cross-cultural adaptation of the CAPPA for the European Portuguese language.METHODS:This methodology study describes the translation and back-translation processes, following the recommended steps to that end. In addition, following the consent of one of the original authors, the process of content validation of the CAPPA commenced. The instrument was submitted for assessment before a panel of experts in the area, who constituted the population of this study.RESULTSAfter the translation and back-translation processes, a panel of experts was convened to adapt the Delphi technique. Some questions were excluded on the basis of ambiguity, relevance and potential repetition. Suggestions made by the expert panel were included in a revised version of the tool. 159 items obtained a 100% consensus in relevance, and 157 items were considered suitable by the expert panel, validating the content of the instrument.CONCLUSIONThe final version will now be applied to the target population in order to carry out the psychometric validation.
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.BANDL.2019.03.001
Abstract: The use of sentence repetition tasks to distinguish dementia syndromes, particularly variants of primary progressive aphasia (PPA), is receiving growing attention. Impaired sentence repetition is a core feature of logopenic variant PPA, although the underlying cognitive mechanisms of this impairment and its significance as a diagnostic criterion remain poorly understood. Sentence repetition abilities of 12 people with dementia, using an adapted error classification schema, were analyzed, along with digit span abilities, a measure frequently used to assess working memory capacity, to explore error patterns and correlations. Participants with semantic variant PPA showed the greatest performance on sentence repetition and digit span in comparison to the logopenic variant PPA and Alzheimer's disease participants. Sentence repetition errors were characterized by middle omissions for semantic variant PPA, ending omissions and phonological errors for logopenic variant PPA, and ending omissions and unrelated word substitutions for Alzheimer's disease. Significant correlations were found between sentence repetition and digit span abilities. Findings are discussed in relation to working memory capacity theories, specifically, the dual-component model.
Publisher: Informa UK Limited
Date: 08-03-2018
DOI: 10.1080/17549507.2018.1442498
Abstract: Using connected speech to assess progressive language disorders is confounded by uncertainty around whether connected speech is stable over successive s ling, and therefore representative of an in idual's performance, and whether some contexts and/or language behaviours show greater stability than others. A repeated measure, within groups, research design was used to investigate stability of a range of behaviours in the connected speech of six in iduals with primary progressive aphasia and three in iduals with Alzheimer's disease. Stability was evaluated, at a group and in idual level, across three s les, collected over 3 weeks, involving everyday monologue, narrative and picture description, and analysed for lexical content, fluency and communicative informativeness and efficiency. Excellent and significant stability was found on the majority of measures, at a group and in idual level, across all genres, with isolated measures (e.g. nouns use, communicative efficiency) showing good, but greater variability, within one of the three genres. Findings provide evidence of stability on measures of lexical content, fluency and communicative informativeness and efficiency. While preliminary evidence suggests that task selection is influential when considering stability of particular connected speech measures, replication over a larger s le is necessary to reproduce findings.
Publisher: Wiley
Date: 30-12-2022
Abstract: Evidence‐based recommendations for a core outcome set (COS minimum set of outcomes) for aphasia treatment research have been developed (the Research Outcome Measurement in Aphasia—ROMA, COS). Five recommended core outcome constructs: communication, language, quality of life, emotional well‐being and patient‐reported satisfaction/impact of treatment, were identified through three international consensus studies. Constructs were paired with outcome measurement instruments (OMIs) during an international consensus meeting (ROMA‐1). Before the current study (ROMA‐2), agreement had not been reached on OMIs for the constructs of communication or patient‐reported satisfaction/impact of treatment. To establish consensus on a communication OMI for inclusion in the ROMA COS. Research methods were based on recommendations from the Core Outcome Measures in Effectiveness Trials (COMET) Initiative. Participants with expertise in design and conduct of aphasia trials, measurement instrument development/testing and/or communication outcome measurement were recruited through an open call. Before the consensus meeting, participants agreed on a definition of communication, identified appropriate OMIs, extracted their measurement properties and established criteria for their quality assessment. During the consensus meeting they short‐listed OMIs and participants without conflicts of interest voted on the two most highly ranked instruments. Consensus was defined a priori as agreement by ≥ 70% of participants. In total, 40 researchers from nine countries participated in ROMA‐2 (including four facilitators and three‐panel members who participated in pre‐meeting activities only). A total of 20 OMIs were identified and evaluated. Eight short‐listed communication measures were further evaluated for their measurement properties and ranked. Participants in the consensus meeting ( n = 33) who did not have conflicts of interest ( n = 29) voted on the top two ranked OMIs: The Scenario Test (TST) and the Communication Activities of Daily Living—3 (CADL‐3). TST received 72% ( n = 21) of ‘yes’ votes and the CADL‐3 received 28% ( n = 8) of ‘yes’ votes. Consensus was achieved that TST was the preferred communication OMI for inclusion in the ROMA COS. It is currently available in the original Dutch version and has been adapted into English, German and Greek. Further consideration must be given to the best way to measure communication in people with mild aphasia. Development of a patient‐reported measure for satisfaction with/impact of treatment and multilingual versions of all OMIs of the COS is still required. Implementation of the ROMA COS would improve research outcome measurement and the quality, relevance, transparency, replicability and efficiency of aphasia treatment research. International consensus has been reached on five core constructs to be routinely measured in aphasia treatment studies. International consensus has also been established for OMIs for the three constructs of language, quality of life and emotional well‐being. Before this study, OMIs for the constructs of communication and patient‐reported satisfaction/impact of treatment were not established. We gained international consensus on an OMI for the construct of communication. TST is recommended for inclusion in the ROMA COS for routine use in aphasia treatment research. The ROMA COS recommends OMIs for a minimum set of outcomes for adults with post‐stroke aphasia within phases I–IV aphasia treatment research. Although not intended for clinical use, clinicians may employ the instruments of the ROMA COS, considering the quality of their measurement properties. The systematic inclusion of a measure of communication, such as TST, in clinical practice could ultimately support the implementation of research evidence and best practices.
Publisher: Springer Science and Business Media LLC
Date: 28-08-2012
Publisher: Informa UK Limited
Date: 04-2013
Publisher: Georg Thieme Verlag KG
Date: 23-12-2020
Abstract: Everyday discourse is a common context for the difficulties experienced by people with acquired neurogenic communication disorders. While evidence is present for effective manualized interventions that directly improve the discourse skills in aphasia, this remains limited for people with cognitive–communication disorders. This proof of concept study used an in-depth case series approach to trial the NARNIA discourse intervention used successfully in aphasia to explore transferability of the protocol and effectiveness in people with cognitive–communication impairments. Four female participants with mild to moderate cognitive–communication difficulties (mean age: 52.8 years)—two following traumatic brain injury and two following vascular episodes—were recruited. Modifications were made to the protocol to accommodate the participant group. Cognitive-linguistic abilities, self-perceptions of communicative behavior and psychosocial recovery, and repeated discourse measures were assessed pre-, immediately post, and at 4 weeks following intervention, to measure treatment effectiveness. Significant gains were observed in quantity of output, informativeness, and efficiency of information across both everyday and narrative discourse genres for all participants. However, in contrast to previous studies, minimal change was observed in discourse macrostructure elements. Significant improvements were also observed in memory or working memory for two participants. This study provides preliminary evidence for the effectiveness of using an adapted protocol with people with cognitive–communication disorders, highlighting how adaptations may address the cognitive needs of this erse clinical group.
Publisher: SAGE Publications
Date: 06-10-2020
Abstract: Effectiveness of early intensive aphasia rehabilitation after stroke is unknown. The Very Early Rehabilitation for SpEech trial (VERSE) aimed to determine whether intensive aphasia therapy, beginning within 14 days after stroke, improved communication recovery compared to usual care. Prospective, randomized, single-blinded trial conducted at 17 acute-care hospitals across Australia/New Zealand from 2014 to 2018. Participants with aphasia following acute stroke were randomized to receive usual care (direct usual care aphasia therapy), or one of two higher intensity regimens (20 sessions of either non-prescribed (usual care-plus or prescribed (VERSE) direct aphasia therapy). The primary outcome was improvement of communication on the Western Aphasia Battery-Revised Aphasia Quotient (AQ) at 12 weeks after stroke. Our pre-planned intention to treat analysis combined high intensity groups for the primary outcome. Among 13,654 acute stroke patients screened, 25% (3477) had aphasia, of whom 25% (866) were eligible and 246 randomized to usual care ( n = 81 33%), usual care-plus ( n = 82 33%) or VERSE ( n = 83 34%). At 12 weeks after stroke, the primary outcome was assessed in 217 participants (88%) 14 had died, 9 had withdrawn, and 6 were too unwell for assessment. Communication recovery was 50.3% (95% CI 45.7–54.8) in the high intensity group ( n = 147) and 52.1% (95% CI 46.1–58.1) in the usual care group ( n = 70 difference −1.8, 95% CI −8.7–5.0). There was no difference between groups in non-fatal or fatal adverse events ( p = 0.72). Early, intensive aphasia therapy did not improve communication recovery within 12 weeks post stroke compared to usual care.
Publisher: Wiley
Date: 21-10-2003
Publisher: Georg Thieme Verlag KG
Date: 02-2010
Abstract: In chronic aphasia, maximizing generalization of improved language abilities from clinical tasks to everyday communication can require the same systematic planning process as the early stages of therapy, often drawing on additional areas of knowledge and successes from other clinical populations. The use of narrative structure is shown here to be a useful framework for building on the developments within sentence processing impairments in aphasia and creating a bridge to more real-life language tasks. An intervention based on narrative structure is described with two people with different language profiles and at different stages of the chronic aphasia spectrum. The insights gained in assessing language ability, underpinning intervention, and capturing therapeutic changes are demonstrated.
Publisher: Informa UK Limited
Date: 06-2023
Publisher: Informa UK Limited
Date: 07-10-2021
Publisher: Frontiers Media SA
Date: 2018
Publisher: SAGE Publications
Date: 11-01-2022
DOI: 10.1177/02656590211071003
Abstract: In contrast to the large body of research investigating intervention for poor decoding skills, far fewer studies have evaluated interventions for reading comprehension. There is even less research on children with more specific difficulties with reading comprehension, often referred to as “poor comprehenders”. Levels of effectiveness have varied for interventions targeting lower- and higher-level language, including inference making, on trained measures, with little transfer to generalised reading comprehension measures in both skilled and less-skilled readers. Outcomes have been more positive for poor comprehenders, however findings have been inconsistent as to which programme components have led to gains in reading comprehension. This pilot study utilised a case series design to explore whether a novel intervention targeting oral inference making and comprehension monitoring was effective in improving the targeted skills and reading comprehension of 11 children, aged 9 –12 years, with average-for-age phonological and lower-level language skills but weak inferencing. All participants improved on the primary inference subtest post-intervention and continued to score higher at maintenance than at pre-intervention. Results on the remaining higher-level language tasks were more varied, as were the results for reading comprehension, with fewer participants demonstrating generalisation to these tasks, particularly the nonfiction texts. While the results are preliminary and descriptive, they suggest that improvements can be made in higher-level language in a 10-session intervention, and provide directions for future research.
Publisher: Informa UK Limited
Date: 06-1993
Publisher: Informa UK Limited
Date: 02-01-2021
Publisher: Informa UK Limited
Date: 31-03-2015
Publisher: Wiley
Date: 07-1995
DOI: 10.3109/13682829509021450
Abstract: This paper describes two assessment tools developed to assist in characterising certain anomias that may be best understood within a sentence-processing paradigm. Although sentence-processing models promise to contribute much to our understanding of a range of aphasic deficits, the lack of available tools to measure and monitor sentence behaviour has been a limiting factor both theoretically and clinically. Based on proposals that the process of thematic role assignment may be influential in some anomias, two tools were developed to profile thematic role realisation across elicited and spontaneous speech conditions. The first measure provides an opportunity to contrast word retrieval across elicited single-word and sentence contexts, whereas the second measure permits an examination of thematic role realisation in spontaneous output. The data from two case studies are presented to demonstrate application of the tools.
Publisher: Informa UK Limited
Date: 16-03-2015
DOI: 10.3109/02699206.2015.1020450
Abstract: Understanding the structure of discourse in healthy adults is fundamental to the assessment and diagnosis of discourse level impairments in clinical populations and the development of effective treatment regimes. Exploring discourse genre in healthy speakers that extend beyond the traditional narrative is equally paramount in facilitating maximum impact of clinical interventions in everyday speaking contexts. This study aimed to characterise the discourse of 30 healthy adult speakers across three age groups (20-39, 40-59 and 60+ years) and four discourse genres (recount, procedural, exposition and narrative), drawing on discourse frameworks used in classroom teaching. A clinically useful discourse protocol and analytic procedure using SALT was developed that profiled the macrostructure and key aspects of linguistic microstructure of the different genres, exploring coherence and cohesion within and across genre in a systematic manner. Analyses considered whether there were differences in coherence and cohesion among the different age groups, different genres and specific topics. Results showed that, while in idual variability was present, healthy adults structured their discourse consistently, adhering to the frameworks described in the developmental literature, across all four genres. Significant age differences were only seen in the amount of information contained in the body of the discourse (i.e. events, steps or statements offered) with older participants offering less information. This dataset will enable comparisons to be drawn with clinical populations to determine the utility and the feasibility of the use of this framework for diagnosis and intervention.
Publisher: SAGE Publications
Date: 10-2018
Abstract: Limited evidence exists to support very early intensive aphasia rehabilitation after stroke. VERSE is a PROBE trial designed to determine whether two types of intensive aphasia therapy, beginning within 14 days of acute stroke, provide greater therapeutic and cost-effectiveness than usual care. To publish the detailed statistical analysis plan for the VERSE trial prior to unblinding. This statistical analysis plan was based on the published and registered VERSE trial protocol and was developed by the blinded steering committee and management team, led by the trial statistician. This plan was developed using outcome measures and trial data collection forms. The VERSE statistical analysis plan is consistent with reporting standards for clinical trials and provides for clear and open reporting. Publication of a statistical analysis plan serves to reduce potential trial reporting bias and outlines transparent pre-specified analyses. Australian New Zealand Clinical Trials Registry (ANZCTR) Registration number: ACTRN12613000776707 Universal Trial Number (UTN) is U1111-1145-4130.
Publisher: Informa UK Limited
Date: 07-2006
Publisher: Informa UK Limited
Date: 21-05-2015
Publisher: Informa UK Limited
Date: 29-10-2021
Publisher: Psychology Press
Date: 15-08-2005
Publisher: Wiley
Date: 18-07-2012
DOI: 10.1111/J.1460-6984.2012.00174.X
Abstract: In recent years there has been significant interest in the differential processing of nouns and verbs in people with aphasia, but more limited consideration about whether the differences have implications for therapy. It remains unclear whether verbs can be treated in a similar way to nouns or should be treated using approaches that recognize the relationship between verb retrieval and sentence production. This paper reviews studies focusing on therapy for spoken verb retrieval, considering the impact of therapy on treated and untreated verbs, sentence production and connected speech. It explores whether there are differential gains across therapy paradigms and whether verbs respond to therapy in the same way as nouns. Studies were identified using a systematic search. A total of 26 studies were reviewed and classified under four headings: (1) studies that treated verbs in a single-word context, (2) studies that compared treatment for nouns and verbs, (3) studies that treated verbs in a sentence context, and (4) studies that treated verb retrieval and argument structure. Findings from the review demonstrate that verb therapy, irrespective of whether verbs are treated within a single-word or sentence context, is effective in improving the retrieval of treated verbs, but with limited generalization to untreated verbs. Verbs respond very similarly to nouns when treated using the same techniques, but improving verb retrieval may be harder to achieve than improving noun retrieval. The impact on sentence production is more varied. The gains in sentence production are discussed in relation to the different therapy types, the rationale for therapy and the presence of co-occurring sentence difficulties. The review highlights the need for more systematic evaluation of different types of verb therapy, measuring the impact of therapy on verb retrieval, sentence production and connected speech. Only through the judicious assessment and monitoring of change across different contexts will an understanding of how verbs respond to therapy be developed and what generalization patterns can be predicted. This will lead to increased confidence in the selection of therapy approaches for people with verb difficulties in aphasia.
Publisher: Wiley
Date: 23-05-2012
DOI: 10.1111/J.1460-6984.2012.00153.X
Abstract: Despite recognition of the need for increased long-term support for people with aphasia following stroke, there remains limited evidence for effective service-level interventions. To evaluate the outcomes and experiences of people participating in the Communication Hub for Aphasia in North Tyneside (CHANT), a 2-year partnership project between health, local authority and third-sector services, shaped by people with aphasia, which provided a coordinated programme of support and interventions for people with long-term aphasia following stroke. Quantitative and qualitative methods were used in the evaluation. Thirty-nine participants with aphasia were recruited to the 12-month study as they became part of CHANT, with 20 completing all measures at the end of the study. Participants had no other speech and language therapy during the study. Quantitative measures (before and after intervention) were used for quality of life, self-report outcomes and goal attainment. Three of the participants with aphasia and three further people involved in the service (carer, volunteer, public sector worker) each agreed to a series of five semi-structured interviews over a 9-month period. A total of 28 interviews were collected using neutral interviewers these were transcribed and analysed by a team within NVivo8 software, based on interpretive principles from grounded theory. Thematic analysis of the narratives explored the experience of engaging with CHANT, and the barriers and facilitators affecting quality of life. People with aphasia made significant gains in quality of life (in particular, in communication and psychosocial adjustment to stroke) and self-report measures of change. A total of 82% of real-life goals set as part of intervention were fully or partially achieved at follow-up. Five core themes emerged from the narratives: 'Quality of life', 'Barriers', 'Facilitators', 'Types of CHANT activity' and 'Effectiveness'. The intervention was evaluated through the theme of 'Effectiveness' in relation to the other themes, encapsulating emerging participant views (including the type and timeliness of activity, expectations of outcomes, resources and perceived value). The impact of the intervention was also analysed in terms of identifying barriers and providing facilitators. The quantitative and qualitative (narrative) findings were complementary in demonstrating the effectiveness of the CHANT service delivery model. Moreover, the narratives, through a longitudinal perspective, provided evidence about people's experience of intervention for long-term aphasia. The findings provide foundations for further work into long-term recovery, intervention and adjustment to aphasia post-stroke.
Publisher: Informa UK Limited
Date: 03-03-2021
Publisher: Informa UK Limited
Date: 30-09-2010
Publisher: Wiley
Date: 14-06-2016
Abstract: Given the integral role that verbs play in sentence production, understanding verb deficits is critical to clinical practice. Difficulties in sentence production are often directly related to an inability to retrieve argument structure information which, according to most theoretical accounts, is specified at a lexical level as part of the semantic representation of the verb. The presence of an argument complexity effect when retrieving verbs in isolation, i.e. increased difficulty with increasing number of arguments required by the verb, is considered evidence of the integral link between verbs and the ensuing structure. Recent reports, however, of relatively intact verb retrieval and impaired argument structure suggest that difficulties with verbs and argument structure may not always co-occur. One explanation for this is that lexical-syntactic information may be stored separately to lexical-semantic information at the lemma level and then differentially impaired. To determine whether the presence of difficulties creating argument structure in a group of people with aphasia with verb-retrieval deficits consistently aligned with the underlying nature of their impairment, where semantic involvement resulted in argument structure difficulties and post-semantic impairment resulted in intact argument structure. This would provide evidence either to support or to challenge the view that argument structure is lexically specified. The presence of an argument complexity effect within the participants' single verb naming was also investigated to examine the relationship between verb argument information and any subsequent difficulties creating argument structure for sentence production. Verb retrieval and argument structure production were investigated in 12 people with aphasia with verb-retrieval deficits on single-word and sentence-production measures. Eight of the 12 participants presented with a semantic verb deficit (five semantic and three mixed semantic and phonological) and had difficulties in creating argument structure. Four participants presented with a phonological verb deficit. Of these, two had intact argument structure while two had impaired argument structure. An argument complexity effect in verb naming was seen in both groups. Semantic verb-retrieval deficits consistently resulted in argument structure production difficulties, supporting the view that syntactic information is stored within the lemma. The presence of argument structure difficulties in two participants with phonological deficits however, lends support for the separate coding of lexical-syntactic from lexical-semantic information at the lemma level, a factor that has both theoretical and clinical implications with respect to diagnosis and management.
Publisher: Wiley
Date: 2009
Publisher: SAGE Publications
Date: 06-08-2015
DOI: 10.1111/IJS.12584
Publisher: Wiley
Date: 04-03-2010
Publisher: Informa UK Limited
Date: 11-2012
Publisher: Informa UK Limited
Date: 06-2006
Publisher: Informa UK Limited
Date: 24-10-2016
DOI: 10.1080/02699052.2016.1202450
Abstract: To further examine the proposed relationship between executive impairments in inhibitory control and social communication difficulties reflecting poor inhibition following TBI. Inhibitory control was assessed in 14 adults with TBI on the Hayling Sentence Completion Test (HSCT). Errors on Part B (failed inhibition) and Part B-Part A response latencies (delayed inhibition) were examined. A relative, friend or frequent communication partner of each participant with TBI completed the La Trobe Communication Questionnaire (LCQ) on the communication difficulties of the person with TBI. The Inhibitory Control Factor (ICF) score of the LCQ based on seven items relating to poor inhibition was specifically analysed against performance on the HSCT. Multiple regression analysis indicated that 58% (51% adjusted) of the variance in LCQ ICF scores was accounted for by measures on the HSCT. Only B-A response latencies on the HSCT explained a significant proportion of the variability in LCQ ICF scores. Reduced inhibition speed may more strongly contribute to disinhibited communication behaviours than failures in inhibition. These findings contribute to understanding of the cognitive processes underlying social communication and have the potential to support and inform the use and development of management practices for in iduals following TBI.
Publisher: Informa UK Limited
Date: 12-01-2017
DOI: 10.1080/17549507.2016.1265588
Abstract: A variety of dysphagia management options are available for the treatment of dysphagia following a stroke, however, it is unknown which of these approaches are most commonly utilised by Australian speech-language pathologists (SLPs) and whether particular factors influence decision-making. The aim of this study was to investigate, through an online survey, the treatment practices of SLPs in Australia for the treatment of dysphagia post-stroke and identify the factors influencing treatment decisions. A total of 118 SLPs completed the online survey. Descriptive statistics identified large variability in the dysphagia treatments utilised, with all 24 therapies listed in the online survey reported as being routinely used. Compensatory therapies were ranked as being utilised more frequently than rehabilitative approaches, with six of the seven highly utilised therapies being compensatory in nature. A client's cognitive capacity was the most prominent factor influencing SLPs' treatment decisions. This study provides insight into the practices of SLPs in Australia for the treatment of dysphagia following stroke and discusses potential for shifts in practice. It highlights the complexity involved in the decision-making process and that clinicians consider evidence, as well as client, clinician and service factors, when selecting between the range of options available.
Publisher: Informa UK Limited
Date: 26-07-2018
Publisher: Informa UK Limited
Date: 22-04-2020
Publisher: Psychology Press
Date: 15-04-2013
Publisher: Informa UK Limited
Date: 17-06-2019
Publisher: Informa UK Limited
Date: 02-09-2015
Publisher: Elsevier BV
Date: 1998
Publisher: Informa UK Limited
Date: 24-08-2016
Publisher: Informa UK Limited
Date: 04-1999
Publisher: SAGE Publications
Date: 28-09-2022
Publisher: Elsevier BV
Date: 2018
DOI: 10.2139/SSRN.3251502
Publisher: Informa UK Limited
Date: 06-1983
Publisher: Figshare
Date: 2016
Publisher: SAGE Publications
Date: 05-05-2016
Abstract: The efficacy of rehabilitation therapy for aphasia caused by stroke is uncertain. The Very Early Rehabilitation of Speech (VERSE) trial aims to determine if intensive prescribed aphasia therapy (VERSE) is more effective and cost saving than non-prescribed, intensive (usual care-plus) and non-intensive usual care (UC) therapy when started within 15 days of stroke onset and continued daily over four weeks. We hypothesize that aphasia therapy when started very early after stroke and delivered daily could enhance recovery of communication compared with UC. A total of 246 participants (82 per arm) will provide 80% power to detect a 4.4% improvement on aphasia quotient between VERSE and UC plus at a significance level of α = 0.05. Acute-care hospitals and accompanying rehabilitation services throughout Australia, 2014–2017. Three-arm, prospective, randomized, parallel group, open-label, blinded endpoint assessment (PROBE) trial. Acute stroke in previous 14 days and aphasia diagnosed by aphasia quotient (AQ) of the Western Aphasia Battery (WAB). Computer-generated blocked randomization procedure stratified by aphasia severity according to Western Aphasia Battery, to one of three arms. All participants receive UC—usual ward-based aphasia therapy. Arm 1: UC—no additional therapy Arm 2: UC-plus usual ward-based therapy Arm 3: VERSE therapy—a prescribed and structured aphasia therapy program. Arms 2 and 3 receive a total of 20 additional sessions (45–60 min, provided daily) of aphasia therapy. The additional intervention must be provided before day 50 post stroke. The aphasia quotient of Western Aphasia Battery at 12 weeks post stroke. Secondary outcomes include discourse measures, the Stroke and Aphasia Quality of Life Scale-39 and the Aphasia Depression Rating Scale at 12 and 26 weeks. Incremental cost-effectiveness ratios at 26 weeks will be reported. This trial is designed to test whether the intensive and prescribed VERSE intervention is effective in promoting maximum recovery and preventing costly health complications in a vulnerable population of survivors of stroke. It will also provide novel, prospective, aphasia specific cost-effectiveness data to guide future policy development for this population.
Publisher: Figshare
Date: 2018
Publisher: Springer Science and Business Media LLC
Date: 07-02-2011
DOI: 10.3758/S13428-010-0051-Y
Abstract: The aim of the present study was to expand the scope of category norm and typicality data to include verbs for use when investigating semantic memory in fields such as linguistics, psychology, and aphasiology. Two experiments were conducted. In the first, participants were asked to list verbs within 10 semantic categories (e.g. breaking, cleaning, cooking, etc.) and 10 noun categories (e.g. animals, fruit, tools, etc.). In the second experiment, participants were asked to rate the typicality of verbs within 8 of the previously investigated verb categories. Although participants listed fewer verbs in verb categories than nouns in noun categories, the overall patterns with regard to correlation analyses between production frequency, mean rank of responses, lexical frequency, and typicality were consistent with those observed in noun categories. These patterns are also consistent with those observed in previous research. Potential similarities and differences between nouns and verbs, as well as future applications of such data, are discussed.
Publisher: Informa UK Limited
Date: 04-05-2023
Publisher: Informa UK Limited
Date: 02-11-2017
Publisher: Springer Science and Business Media LLC
Date: 16-06-2022
DOI: 10.1186/S13063-022-06433-3
Abstract: Treatment fidelity is inconsistently reported in aphasia research, contributing to uncertainty about the effectiveness of types of aphasia therapy following stroke. We outline the processes and outcomes of treatment fidelity monitoring in a pre-specified secondary analysis of the VERSE trial. VERSE was a 3-arm, single-blinded RCT with a 12-week primary endpoint comparing Usual Care (UC) to two higher intensity treatments: Usual Care-Plus (UC-Plus) and VERSE, a prescribed intervention. Primary outcome results were previously reported. This secondary analysis focused on treatment fidelity. Video-recorded treatment sessions in the higher intensity study arms were evaluated for treatment adherence and treatment differentiation. Treatment components were evaluated using a pre-determined fidelity checklist. Primary outcome: prescribed amount of therapy time (minutes) secondary outcomes: (i) adherence to therapy protocol (%) and (ii) treatment differentiation between control and high intensity groups. Two hundred forty-six participants were randomised to Usual Care ( n =81), Usual Care-Plus ( n =82), and VERSE ( n =83). One hundred thirty-five (82%) participants in higher intensity intervention arms received the minimum prescribed therapy minutes. From 10,805 (UC 7787 UC-Plus 1450 VERSE 1568) service events, 431 treatment protocol deviations were noted in 114 participants. Four hundred thirty-seven videos were evaluated. The VERSE therapists achieved over 84% adherence to key protocol elements. Higher stroke and aphasia severity, older age, and being in the UC-Plus group predicted more treatment deviations. We found high levels of treatment adherence and differentiation between the intervention arms, providing greater confidence interpreting our results. The comprehensive systems for intervention fidelity monitoring and reporting in this trial make an important contribution to aphasia research and, we argue, should set a new standard for future aphasia studies. ACTRN 12613000776707
Publisher: Informa UK Limited
Date: 06-01-2021
Publisher: Informa UK Limited
Date: 04-04-2016
DOI: 10.3109/17549507.2016.1151936
Abstract: Within the current literature, positive intervention effects demonstrate the significant potential for people with Primary Progressive Aphasia (PPA) to learn/relearn words. Generalisation of intervention effects to other words and/or other contexts, however, remains unclear. This multiple baseline, case-series design investigated the effects of a self-cueing lexical retrieval intervention across word classes (nouns, verbs and adjectives) on four in iduals with PPA, three suggestive of the semantic variant and one of the logopenic variant. The intervention integrated semantic, phonological and orthographic levels of language production and drew on autobiographical memory. Changes in accuracy in retrieving treated and untreated items (pre-intervention, post-intervention and 4-weeks maintenance) were determined using the Cochran's Q test, with follow-up McNemar pairwise comparisons. All participants showed significant improvements in naming treated items, across all word classes. Different patterns of generalised improvement to untreated words were found for each participant. In discourse, the semantic variant participants demonstrated a significant increase in correct information units, in contrast to the participant with the logopenic variant who remained stable. This study provides evidence that people with PPA can show improved lexical retrieval following intervention. The findings suggest possible differences in generalisation across word classes and according to underlying deficit.
Publisher: SAGE Publications
Date: 10-2020
Abstract: Poor comprehenders are a significant subgroup of poor readers who, due to their ability to read aloud accurately, are often difficult to identify. This study aimed to determine whether assessment using two oral language tasks, mapped onto the two components of the Simple View of Reading, would provide an efficient approach to identification. Children ( N = 218) from School Years 3 to 6 (ages 7 8–12 1) attending two schools in Australia were assessed, and 45 identified as potential poor comprehenders, based on a profile of average phonological awareness but poor listening comprehension. Subsequent assessment of decoding and text reading comprehension confirmed 24 of these children to be poor comprehenders, consistent with reported prevalence rates. Five of these children were judged to be weak readers by their classroom teacher. The oral tasks alone overidentified this group however, the findings suggest that using the tasks as an initial phase, followed up with a reading assessment, could be effective in identifying poor comprehenders, and reduce time spent in testing as this would only involve at-risk children.
Publisher: Informa UK Limited
Date: 08-2011
Publisher: SAGE Publications
Date: 08-03-2022
DOI: 10.1177/14713012211057414
Abstract: This study examined the impact of a Montessori mealtime intervention for people living with dementia to support the mealtime experience of residents and mealtime care practices of staff in a memory support unit. The mealtime intervention was part of a broader culture change project. An observational research design was used to evaluate changes in the mealtime experience and care practices across three time points (baseline, post-implementation, maintenance), spanning 30 months. Five video recordings of the lunch time service (range: 19–32 min) were analysed. The coding protocol comprised pre-determined indicators related to accepted dimensions of person-centred care. Resident and staff behaviours were quantified across four categories: providing choice and preferences, promoting the social side of eating, supporting independence and showing respect towards residents. Staff behaviours that reflected personal enhancing actions and personal detractors were also coded during each mealtime service. A significant increase in staff providing residents with the opportunity for choice and a subsequent significant increase in residents demonstrating choice behaviours was evident. Staff and residents both significantly increased their interactional behaviours, with greater social interaction between staff and residents. Staff further demonstrated greater support for mealtime independence that reached and maintained significance during the final two s ling points. Significant gains observed post implementation were largely maintained and, on specific measures, further increased over time. A significant increase in staff use of personal enhancing actions during mealtime care was also evident. Variability in in idual staff and resident behaviour highlighted the complexity of mealtime care and culture change processes. The study provides novel evidence to support the use of a Montessori mealtime intervention to achieve more person-centred mealtime care, and which resulted in a more respectful, enabling and social dining experience. Clinical implications and direction for future research are presented to build on these findings.
Publisher: American Speech Language Hearing Association
Date: 26-03-2021
DOI: 10.1044/2020_AJSLP-20-00019
Abstract: Positive intervention effects following lexical retrieval interventions are increasingly reported with people with progressive language impairments however, generalization of therapy gains are less frequently evident and less well understood. This study sought to explore the impact of specific therapy ingredients on generalization outcomes. Twelve participants with progressive lexical retrieval deficits (four each with semantic variant primary progressive aphasia, logopenic variant primary progressive aphasia, and Alzheimer's disease, amnestic presentation) and their family members participated in a 6-week intervention that aimed to increase access to different word classes (nouns, verbs, and adjectives) through a strategic self-cueing approach. Generalization was actively facilitated through strategy practice in connected speech. Repeated baselines of picture naming and connected speech were conducted prior to intervention and repeated immediately post and at 6 weeks following intervention. All three diagnostic groups showed significant improvements in naming performance post-intervention for all word classes and for both treated and untreated items, demonstrating consistent treatment effectiveness and generalization at the word level. No changes in the informativeness or efficiency of connected speech were found. Despite heterogeneity across participants, widespread evidence of both treatment effects and generalization to untreated items was found for all diagnostic groups and word classes. The consistent within-level generalization across all groups is explored here in relation to optimization of strategy use through incorporation of cognitive scaffolds, strategic practice at the connected speech level, and the inclusion of family members. The absence of across-level generalization to connected speech is also explored. 0.23641/asha.14219771
Publisher: Informa UK Limited
Date: 18-10-2017
Publisher: Informa UK Limited
Date: 04-05-2017
Publisher: SAGE Publications
Date: 05-05-2016
Abstract: The efficacy of rehabilitation therapy for aphasia caused by stroke is uncertain. The Very Early Rehabilitation of Speech (VERSE) trial aims to determine if intensive prescribed aphasia therapy (VERSE) is more effective and cost saving than non-prescribed, intensive (usual care-plus) and non-intensive usual care (UC) therapy when started within 15 days of stroke onset and continued daily over four weeks. We hypothesize that aphasia therapy when started very early after stroke and delivered daily could enhance recovery of communication compared with UC. A total of 246 participants (82 per arm) will provide 80% power to detect a 4.4% improvement on aphasia quotient between VERSE and UC plus at a significance level of α = 0.05. Acute-care hospitals and accompanying rehabilitation services throughout Australia, 2014–2017. Three-arm, prospective, randomized, parallel group, open-label, blinded endpoint assessment (PROBE) trial. Acute stroke in previous 14 days and aphasia diagnosed by aphasia quotient (AQ) of the Western Aphasia Battery (WAB). Computer-generated blocked randomization procedure stratified by aphasia severity according to Western Aphasia Battery, to one of three arms. All participants receive UC—usual ward-based aphasia therapy. Arm 1: UC—no additional therapy Arm 2: UC-plus usual ward-based therapy Arm 3: VERSE therapy—a prescribed and structured aphasia therapy program. Arms 2 and 3 receive a total of 20 additional sessions (45–60 min, provided daily) of aphasia therapy. The additional intervention must be provided before day 50 post stroke. The aphasia quotient of Western Aphasia Battery at 12 weeks post stroke. Secondary outcomes include discourse measures, the Stroke and Aphasia Quality of Life Scale-39 and the Aphasia Depression Rating Scale at 12 and 26 weeks. Incremental cost-effectiveness ratios at 26 weeks will be reported. This trial is designed to test whether the intensive and prescribed VERSE intervention is effective in promoting maximum recovery and preventing costly health complications in a vulnerable population of survivors of stroke. It will also provide novel, prospective, aphasia specific cost-effectiveness data to guide future policy development for this population.
Publisher: Informa UK Limited
Date: 02-11-2017
Publisher: American Speech Language Hearing Association
Date: 09-03-2023
DOI: 10.1044/2022_AJSLP-22-00122
Abstract: Speech-language pathologists (SLPs) assess people with primary progressive aphasia (PPA) through measurements of speech, language, communication, and well-being, with the aims of identifying challenges and strengths, monitoring change, and informing treatment directions and supports. The purpose of this clinical focus article is to highlight the necessity for person-centered assessment specific to PPA and to conceptualize a framework that acknowledges the multifaceted nature of assessment for this population. In this framework, the unique challenges posed by a diagnosis of PPA are addressed with the aim to provide practical guidance for clinicians and to support reflection on current practices. In clinical and research practice, assessment of people with PPA requires an ever-evolving approach that is centered on the client. In this clinical focus article, a discussion-based consensus process was used to synthesize authentic longitudinal experiences of people with PPA to explore assessment approaches, tools, and philosophies. This analysis of person-centered assessment identifies seven essential components of assessment in PPA that set the foundation for the five steps of the R.A.I.S.E. Assessment framework. These components each contribute to a clear definition of assessment that reveals clients' competencies with a strengths-based focus prioritizes the reciprocity of benefits promotes dynamic assessment and recognizes the complexity, evolution of assessment over time, and advocacy. This clinical focus article takes a novel look at assessment in PPA by stepping away from assessment practices that focus on revealing deficits and decline and, instead, provides practical recommendations through the conceptualization of a PPA-specific assessment framework. The R.A.I.S.E. Assessment framework is grounded in principles of uplifting clients through person-centered assessment, keeps pace with best practice in PPA intervention, and contributes to a supportive experience for clients and families in the face of a progressive diagnosis over time.
Publisher: Informa UK Limited
Date: 11-07-2018
Publisher: Figshare
Date: 2017
Publisher: Informa UK Limited
Date: 02-09-2015
Publisher: Wiley
Date: 20-05-2018
Abstract: Cognitive impairment, particularly of executive functioning, has been implicated in deficits in spoken discourse production following acquired brain injury (ABI). However, due to variation in the methodologies and heterogeneity of findings across studies, the nature and extent of this association is not well understood. This review aims to synthesize the literature investigating associations between cognitive deficits and discourse impairment after ABI. It is reported in accordance with guidelines of The Preferred Reporting Items of Systematic Reviews and Meta-Analyses. Searches were conducted of a variety of databases including Medline, PsycINFO, EMBASE, CINAHL, ProQuest, Cochrane and ERIC. Additional studies were identified via reference harvesting. Studies were included if they reported data on participants with ABI, assessed spoken discourse production and cognitive function, and performed statistical analyses to determine the association between discourse and cognitive variables. This review excluded non-English sources and those not published in peer-reviewed journals. Meta-analyses were not conducted due to variability across tools and terminology used to describe participant injury- and non-injury-related characteristics and outcomes. Twenty-five observational studies were included in the review. Findings revealed significant associations between multiple cognitive functions and discourse across micro-linguistic to super-structural measures. Methodological and terminological inconsistencies were identified across studies, which limited systematic comparison of the results. This review revealed present, yet heterogeneous, relationships between cognitive and discourse deficits in speakers with ABI. Associations were interpreted in light of a well-established model of discourse processing. Greater comparison across studies would have been facilitated by a standard nomenclature in relation to cognitive constructs and standardized discourse assessment. Future research should explore the influence of injury- and participant-related factors on discourse-cognitive relationships. The lack of information on conversational discourse and paediatric ABI limits the generalizability of this review to daily interaction following ABI. While applicable across the lifespan, in-depth investigation of discourse following ABI in childhood and adolescence is a priority due to complex changes in language and cognition, and the potential for impairments profoundly impact social, emotional and academic progression into adulthood. Given the centrality of remediating cognitive-communication difficulties in ABI, the interrelationships between discourse and cognition should retain a critical focus of research. This will inform clinical management and future research with this population. Findings have implications for our theoretical understanding of discourse and the nature of its breakdown in ABI.
Publisher: BMJ
Date: 02-2001
Abstract: To test the hypothesis that semantic impairment is present in both patients with dementia with Lewy bodies (DLB) and those with dementia of Alzheimer's type (DAT). A comprehensive battery of neuropsychological tasks designed to assess semantic memory, visuoperceptual function, verbal fluency, and recognition memory was given to groups of patients with DLB (n=10), DAT (n=10) matched pairwise for age and mini mental state examination (MMSE), and age matched normal controls (n=15). Both DLB and DAT groups exhibited impaired performance across the range of tasks designed to assess semantic memory. Whereas patients with DAT showed equivalent comprehension of written words and picture stimuli, patients with DLB demonstrated more severe semantic deficits for pictures than words. As in previous studies, patients with DLB but not those with DAT were found to have impaired visuoperceptual functioning. Letter and category fluency were equally reduced for the patients with DLB whereas performance on letter fluency was significantly better in the DAT group. Recognition memory for faces and words was impaired in both groups. Semantic impairment is not limited to patients with DAT. Patients with DLB exhibit particular problems when required to access meaning from pictures that is most likely to arise from a combination of semantic and visuoperceptual impairments.
Publisher: Cambridge University Press
Date: 24-10-2013
Publisher: Informa UK Limited
Date: 03-09-2019
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Anne Whitworth.