Browsing by Subject "afasia"

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  • Firon, Csilla (Helsingin yliopisto, 2019)
    Tavoitteet. Tutkimuksen tavoitteena oli tarkastella uudenlaisen afasian kuntoutukseen suunnatun kuorolauluintervention subjektiivisesti koettua hyötyä. Interventio oli osa Helsingin yliopiston Kognitiivisen aivotutkimuksen yksikön Laulun sanoin -hanketta ja se koostui kuorolaulusta, ryhmämuotoisesta MIT (melodinen intonaatioterapia) -kuntoutuksesta sekä laulun harjoittelusta tablettitietokoneella. Interventioon osallistui afasiaa sairastavia henkilöitä sekä heidän läheisiään. Aiemmissa tutkimuksissa on havaittu, että musiikilla ja laululla voi olla kuntoutuksellisia vaikutuksia muun muassa kielellisiin toimintoihin. Afasian kuntoutuksessa on eniten tutkittu MIT-menetelmää, mutta myös uusia musiikkia sisältäviä kuntoutusmuotoja kehitetään aktiivisesti. Subjektiivisesti koettua kuntoutuksesta saatua hyötyä ei ole afasian osalta erityisesti tutkittu, vaikka oman kokemuksen tiedetään vaikuttavan kuntoutuk- sen lopputulokseen. Tässä tutkimuksessa tarkastellaan, minkälainen subjektiivinen arvio afaattisilla henkilöillä ja heidän läheisillään oli interventiosta. Lisäksi tarkastellaan, oliko afasian vaikeusasteella, harjoittelumäärällä tai demografisilla tai kliinisillä taustatiedoilla yhteyttä koettuun hyötyyn sekä erosivatko afaattisten henkilöiden ja läheisten kokemukset toisistaan. Menetelmät. Aineiston muodosti osallistujien intervention jälkeen täyttämät kyselylomakkeet subjektiivisista kokemuksista, interventiojakson aikana toteutuneet harjoittelumäärät sekä osallistujien demografiset ja kliiniset taustatiedot. Kyselylomakkeeseen vastasi 23 afaattista henkilöä sekä 11 läheistä. Aineistoa analysoitiin tilastollisesti Friedmanin testillä, Mann–Whitney U-testillä, Spearmanin järjestyskorrelaatioanalyysilla, Wilcoxonin merkittyjen sijalukujen testillä sekä yhden otoksen t-testillä. Avointen kysymysten vastauksia analysoitiin tyypittelemällä vastauksia teemoittain ja laskemalla esiintymisfrekvenssejä. Tulokset ja johtopäätökset. Afaattiset henkilöt kokivat intervention hyödylliseksi ja myös läheiset kokivat, että interventio oli afaattisille henkilöille hyödyllinen. Afaattisten henkilöiden ja läheisten kokemukset intervention hyödyllisyydestä eivät eronneet toisistaan, eikä harjoittelumäärän, kliinisten tai musiikillisten taustatietojen ja koetun hyödyn välillä havaittu tilastollisesti merkitsevää yhteyttä. Erityisesti mielialan kohoaminen, uusiin ihmisiin tutustuminen ja vertaistuen saaminen nousivat esiin kvalitatiivisissa vastauksissa. Näiden tulosten perusteella voidaan ehdottaa, että ryhmämuotoinen kuoro- laulukuntoutus, jossa on MIT:n elementtejä, vaikuttaa positiivisesti afaattisten henkilöiden mielialaan, sekä heidän itse arvioimana että läheisten arvioimana. Interventiosta voi jatkotutkimuksen avulla ke-hittää afasian ryhmämuotoisen laulukuntoutusmuodon.
  • Pohjansuo, Jaana (Helsingin yliopisto, 2020)
    Aims of the study. Aphasia is a linguistic-cognitive disorder that occurs after language learning and affects the processing of linguistic knowledge. Measuring the health-related quality of life of people with aphasia is part of evaluating the effectiveness of health care interventions. However, some patients are unable to respond to quality of life surveys on their own due to cognitive or communication disorders. There is a need for proxies to answer for them. Proxies may also respond on behalf of the most severely aphasic patients who would otherwise be excluded from quality of life studies altogether. Often, proxies rate the quality of life of people with aphasia lower than the people themselves. The aim of this study was to investigate whether proxies can reliably answer a quality of life survey on behalf of a person with aphasia. Methods. 12 people with aphasia responded to the Stroke and Aphasia Quality of Life Scale - 39 (SAQOL-39) and named a proxy, 11 of whom responded on behalf of the person with aphasia to the same survey. Their responses were compared using the Wilcoxon signed rank test. In addition, the Spearman rank correlation coefficient test was used to examine whether the communication domain of SAQOL-39 correlates with the overall mean and other domains. Results and conclusions. Assessments of the quality of life of people with aphasia by people with aphasia themselves and their proxies did not differ statistically. No correlation was found between the domain of communication and other domains in the results of people with aphasia. Instead, a correlation was found between all domains in the estimates of proxies. The most significant correlation was found between the communication domain and the psychosocial domain and the overall mean. According to this study, proxies can reliably answer a quality of life survey on behalf of a person with aphasia. However, the data were very small, so the result cannot be generalized. Clinically, a speech language pathologist should ask a proxy to answer a quality of life questionnaire if the person with aphasia is unable to do so on their own. In this way, the effectiveness of speech therapy rehabilitation can be measured.
  • Jussila, Anu (Helsingin yliopisto, 2020)
    Background. Aphasia is a linguistic disorder that occurs after language acquisition and is most commonly caused by stroke. Research on novel word acquisition can contribute to the development of aphasia rehabilitation because it helps understand the relearning of words lost due to aphasia. Novel word acquisition has been researched mainly in chronic aphasia, in which learning is possible but shows large individual variation. There is initial evidence that novel word learning is also possible in non-chronic aphasia. Aims. The objective of this thesis is to study recovery and novel word learning in the subacute and chronic stages of aphasia. The thesis will also look into possible connections between learning in subacute aphasia and learning in chronic aphasia. These connections have not been previously explored. Methods. The multiple case study included four aphasic participants who were examined 0–3 months after stroke and again 12 months after stroke. The examination consisted of cognitive-linguistic background tests, questionnaires and a computer-based novel word learning task. In the latter, the participant was tasked with learning the associations between given pseudo-words and images through feedback and repetition. Research data was analyzed case by case. Results and conclusions. Recovery and novel word learning in subacute and chronic aphasia varied among the participants. In both stages, some participants learned new vocabulary and were able to transfer it into their long-term memory. The changes in novel word learning from subacute to chronic aphasia also varied among the subjects. These changes were not systematically connected with the severity of the participants’ aphasia, their baseline learning ability or an alleviation of cognitive-linguistic symptoms. Learning ability in subacute aphasia does therefore not always appear to predict learning ability in chronic aphasia, but novel word learning is possible in both subacute and chronic aphasia. Aphasia recovery shows considerable individual variation.
  • Suni, Mari (Helsingfors universitet, 2016)
    Background and aims: Aphasia is commonly associated with deficits in all linguistic modalities.In mild, chronic aphasia syndromes difficulties in reading can interfere with tasks of everyday life. The rehabilitation of reading difficulties caused by a general linguistic deficit is closely related to the rehabilitation of spoken language, especially in the early stages. Partly due to the limited resources granted to speech therapy, rehabilitation seldom proceeds to reading in its own right. Research has shown that rehabilitation of reading as such can however be beneficial to more general linguistic abilities. In this study, the quality and responsiveness to treatment of a sublexical reading deficit related to mild, chronic conduction aphasia were examined. The aim was to investigate, whether a sublexical therapy method and in particular text-level reading practice were effective in enhancing the fluency of reading or more general linguistic abilities. Methods: A 37-year-old man with mild, chronic conduction aphasia and resulting phonological alexia participated in the study. The intervention consisted of 17 training sessions (total of40 hours) of speech therapy, during which independent practice of repetitive reading that lasted for 11 weeks was started. Therapy consisted of phonological and word-level repetition and naming tasks combining the auditive and written modalities. Data consisted of linguistic tasks collected before, during and after the practice period. The effects of the intervention were evaluated by examining oral reading speed and accuracy of connected text and nonwords. More general phonological and linguistic abilities were examined through auditive repetition and auditive memory tasks. Results and discussion: The reading deficit reflected a more general linguistic difficulty that seemed to originate in auditive processing. Difficulties in reading seemed to arise from weakened phonological activation of word forms. No clinically significant changes were observed after the rehabilitation period. Still, positive changes were noted that imply the rehabilitation can be efficient when carried out through a longer period. Reading speed increased in nonword reading task, but speed of reading connected text increased steadily through the whole study period. A positive change in oral reading speed was observed in first readings of practice texts that might imply a more consistent enhancement during a longer training interval. No rehabilitative effect was apparent in auditive repetition or auditive memory, even though individual tasks improved. The results of this case study imply that repetitive reading ought to be further investigated as a reading rehabilitation method for persons with mild phonological reading deficits. Considering more general phonological rehabilitation, systematic methods could enhance the effectiveness of practice.
  • Partanen, Elina (Helsingfors universitet, 2015)
    Aims: Embodied practices among people with aphasia remain relatively little known until now. The aim of this study was to describe free conversation interaction between a seriously aphasic speaker and his wife. This study aims to explore what kinds of nonverbal elements appear during the conversation of the aphasic person, and how the nonverbal elements arise in different conversational turns. The main focus of this study is on the substitutive and the complementary gestures of the speech. Earlier studies on aphasia interaction suggest that gestures are an important resource to construct meanings in turns of an aphasic speaker. Data and methods: This is a qualitative study where conversational analysis is used as a research method. Data consists of two videotaped recordings of the couples' free conversation at home settings. Results and conclusions: Several nonverbal elements, which had a significant influence for the conversation interaction of this couple, appeared in the data of this study. The wife interpreted aphasic person's nonverbal elements in the conversation as meaningful elements. The wife gave time and space for the aphasic person to participate in conversation. The aphasic speaker took advantage of the gestures in order to compensate speech loss. In fact, he almost completely relied on the substitutive and complementary gestures in conversation. He used the gestures in many ways and combined gestures skillfully to his limited verbal elements. A significant result in the study was that the aphasic speaker hardly showed any signs for verbal word search before expressing nonverbal elements. He started gesturing often seamlessly just before of his typical turn initiator verbal expressions yeah yes and yeah but or simultaneously with them. Aphasic person's expression were built fast and effortlessly despite the loss of speech. It can be said that aphasic person had adapted to his handicap caused by aphasia by taking advantage from gesturing.
  • Nylander, Niina (Helsingfors universitet, 2014)
    Aims. Improved quality of life is considered to be the overarching goal of aphasia rehabilitation based on the social model. Around the world research has been done on the factors that affect the quality of life with people with aphasia. Different kinds of structured quality of life measurements have been developed that aim to enable people with aphasia to self-report quality of life. In Finland research on the subject has been scarce. The aim of this study was to explore the views of Finnish speech and language therapists (SLT) on the quality of life in aphasia rehabilitation and the prevailing clinical practices as well as to investigate how they compare internationally. Methods. For the purposes of this study a questionnaire composed by the Aphasia Committee of the International Association of Logopedics and Phoniatrics (IALP) was translated into the Finnish language. 64 questionnaires were filled out. The Finnish data was analysed by using descriptive statistics and content analysis. The data collected in this survey formed Finland's part of an international survey conducted by IALP, which allowed the comparison between the Finnish and international results. The international survey contained 581 respondents from 16 countries including Finland. The Finnish and international data were compared by cross tabulation and Chi Squared -test. Results and conclusions. According to Finnish SLTs it is important to incorporate into practice with aphasia several quality of life domains, such as communication, affect, in/dependence, social activities, personal outlook and in addition to consider life satisfaction, social support and environment. Almost all of the Finnish SLTs used interviewing as their primary method for assessing the quality of life, only four used structured quality of life measures. Internationally there were mentioned many different structured quality of life assessments. This study indicates explicitly that there is a demand for structured quality of life assessments in Finland. The results can be applied in developing education, research and clinical practice.
  • Huotari, Salla-Maaria (Helsingfors universitet, 2015)
    Aims. The purpose of this single-case study was to investigate the effects of intensive tablet-based treatment in overall language performance level and in reading and writing processes in mild aphasia. The communicative effectiveness and task performances on the tablet software were also studied. The tablet software included tasks where semantic, syntactic and phonological processing were required; written naming, sentence writing and reading comprehension. Previous studies have indicated improvements in language skills after computer-based treatment (Katz & Wertz, 1997; Wade, Mortley & Enderby, 2003). Especially reading and writing skills can be treated by the computer-based softwares (Katz, 2008). Methods & Procedures. In this single subject research the ABA design was used. The participant in this study was a 47 year old man who had a stroke 2.5 years earlier. He had a mild chronic aphasia with difficulties in writing, reading and naming. The data of this study was formed by linguistic tests and by a self-assessment method as the participant evaluated his communicative effectiveness (CETI). The methods used in the analysis of written and read narratives included assessing rate, authenticity and the types of errors. The analysis of written narratives also included assessing word classes and type-token –ratio. Based on the data by the tablet-based software the rate and the share of errors of task performances were assessed. Results & Conclusions. Based on the Western Aphasia Battery (WAB) results, the severity of the aphasia decreased but the change was not clinically significant. Naming improved but the change wasn't stable until the follow-up. The participant showed positive development in his written and reading production; he made less spelling and reading errors after the treatment. At the same time reading and writing processes became slower. The share of lexical verbs, adjectives, pronouns and numerals increased in written narratives. The communicative effectiveness improved. The task performance on the tablet software was faster during the fourth week compared to the first week. Also the amount of incorrect performances decreased or remained the same. Based on the results, an intensive self-monitored tablet-based language treatment was effective to the subject.
  • Rantakangas, Tuula (Helsingin yliopisto, 2017)
    Aims. Verbal apraxia might occur with aphasia. Apraxia may impact on person`s ability to be in talk-in-interaction with. Little is known about how apraxia of speech might influence talk-in-interaction and a person`s use of gestures. Even the less is known how these communication strategies will change by time. In addition, a person with apraxia must find new communication strategies. To help a person with apraxia of speech to communicate better with their significant others there is a need for information: how one can support a person with verbal apraxia the most effective way. The aim of this study is to explore how the sequential organization of conversation is constructed with a person with apraxia of speech and non-fluent aphasia and a speech therapist and how gestures are used by person with verbal apraxia for one year. Methods. The participant was a 78-year-old woman who had a verbal apraxia and aphasia. The qualitive data consisted of 3 videotaped conversations with person with apraxia and non-fluent aphasia and a speech therapist (58 minutes, 50 seconds of raw data). The data was collected for one year. Focus of the analysis was on changes in the conversation organization and the use of semiotic resources in conversation for one year. The method of conversation analysis is utilized in this study. Results and conclusions. The qualitive analysis in this study showed that conversation between the speakers were typically consisted of `hint and guess` sequences. The first data (videotaped 3 weeks after the stroke) revealed that the participant was almost speechless and her use of gestures was fussy. The lack of speech and fussy gesturing made her utterances difficult to understand and conversation consisted of long negotiation turns. After six months, the participant`s utterances and the use of gestures were more detailed and she showed more active role in interaction. After one year, the participant`s utterances and gestures were even more detailed. According to these improvements, the length of negotiation turns decreased and conversation started to go along more fluent. The way how the participant used iconic gestures and pantomime were different when comparing to other studies. One potential hypothesis is that the apraxia might influence negatively one's ability to use gestures for compensatory strategies. According to these results, it is important to research more about apraxia and talk-in-interaction.
  • Holopainen, Jonna (Helsingin yliopisto, 2021)
    Aphasia is a linguistic-cognitive disorder that impedes the understanding and production of speech and is often accompanied by disorders in non-linguistic cognitive functioning, such as working memory (WM). WM has a key role in supporting on-going linguistic processing. Earlier research shows that the impairments caused by aphasia can be alleviated with speech therapy but it is still unclear which amount of therapy is most effective, at which stage of the illness and with which intensity. Some research suggests that greater amount of therapy within a shorter time span yields greater outcome. However, research findings on the matter are difficult to synthesize as the definition of ‘intensity’ varies across studies. Language Enrichment Therapy (LET) is a systemic and developmental therapy programme for aphasia rehabilitation. LET aims to restore linguistic-cognitive functioning. LET also enables rehabilitation of working memory with “brain-jogging”. As there is hardly any prior research on the LET system, the aim of this thesis is to investigate its effectiveness as an intensive aphasia therapy programme and the role of working memory in rehabilitation and, further, to identify possible background factors predicting rehabilitation outcome. The data for this thesis was collected for a research project between 1987 and 2010. The data consists of 24 persons with aphasia (PWA) who suffered a first-time stroke and whose time post-onset at baseline was 2 to 8 months. Linguistic functioning was assessed six times within the research frame with Tsvetkova’s Speech Dynamics Test, Western Aphasia Battery and the Token test. The data was analysed statistically using Friedman’s test to analyse the change in understanding and producing speech, linear regression to analyse possible factors predicting outcome and linear correlation to analyse the connection between working memory and rehabilitation outcome. The findings show that intensive rehabilitation with the LET system improves the understanding and production of speech with PWA. LET is the most effective in ameliorating speech understanding for those PWA with greater impairment and lesser time post-onset. No factors predicting the outcome of speech production were found which might be due to the developmental nature of the LET system in which rehabilitation of understanding always precedes that of production. WM had no predictive value for rehabilitation outcome. These findings must be interpreted with caution but can still be used for clinical decision making.
  • Jormanainen, Sanna (Helsingfors universitet, 2015)
    Aims. In the last few years there have been studies that use multi-level approaches in the analysis of narrative language in aphasia. In Finland there is no established method for assessing the narration of aphasic persons. The literature provides different models but there is not commonly approved system. The purpose of this study was to examine how aphasic persons perform in cartoon story description tasks and to apply a multi-level method for assessing their narrative speech. The aim is to find an appropriate model that discovers change in narrative speech. Method. Six aphasic persons participated in this research where they received transcranial magnetic stimulation or the placebo version of it and ILAT rehabilitation. The narrative speech of the participants was assessed by using to picture sequence tasks in four different times during the research: before the rehabilitation, during it, immediately after it and after 3 months. The analysis focused on 1) productivity, 2) lexical and grammatical processing and 3) informativeness. In addition their performance in narrative task was compared to performance scores in Western Aphasia Battery. The methods of analysis were adapted from methods used by Marini et al. (2011). Results and conclusions. In five out of the six persons who participated in this study there was some positive change in narration at least in one aspect of the analysis. Only one participant showed overall improvement. The participants who had fluent aphasia, had more clear changes in the results that the subjects who had non-fluent aphasia. The definition of the analyzing method was challenging but it is important to unravel these multi-level analyzing methods in Finland in future. The picture sequence task is a functional means to elicit narrative speech but instead of using sequences with small number of pictures sequences with more pictures should perhaps be used. It would also be important to collect normative data from Finnish speaking people using these multi-level methods. It would enable the comparison of aphasic person's narratives to the normative data.
  • Sepänmäki, Pauliina (Helsingfors universitet, 2017)
    The Objective. According to many studies, social isolation, decreased quality of life and psychosocial problems such as depression are some of the most difficult consequences of aphasia. The aim of this study was to explore the amount and the quality of aphasic peoples' social participation. The questions of the study were how much and what kind of social events did the participants have and also how happy they were with the quality of the participation. In addition, one aim of this study was to find out what kind of thoughts did the participants have about the impact of aphasia on their social life. The further goal was to survey the importance of aphasia groups. Data and Methods. Four chronically aphasic people were included in the study. They all took part in an aphasia group in an adult education center. The participants kept a diary for two weeks, marked all of their social occasions and gave a satisfaction-score for each of them. Later the participants took part in a semi-structured interview where their views and experiences on social life were examined. In addition, the participants filled the Communication Activity Log to evaluate the amount and the quality of their daily communication Results. The participants participated in different social events every day despite of the severity of the aphasia. The quality of the communication did not seem to have effect on the amount of the communication. The satisfaction in social events was reasonably high with only a few exceptions. Overall, the participants thought that they had succeed to adapt to live with aphasia. Despite the difficulties in communication, they felt that they could participate in social life although they had some limitations. They all avoided occasions with a lot of people because they felt that it was difficult to participate in conversations. All of the participants took regularly part in activities that were targeted for aphasic people because they felt that such occasions were easy to participate in. All of the participants had lost friends after the stroke, and hoped they could participate more in social occasions. Severe solitude or social isolation wasn't, however reported. All of the participants had regular contact with the people that were important for them. The participants felt that the general knowledge about aphasia was quite low, which made it more difficult to communicate with strangers. It was easier to communicate with familiar people, but even the closest family members didn't always understand the consequences of aphasia.
  • Venäläinen, Sirje (Helsingfors universitet, 2016)
    Background and aims. The most common and persistent symptom of aphasia is word retrieval deficit, anomia. There is evidence of selective verb retrieval problems amongst non-fluent aphasic speakers. Training verbs in sentence context increases verb naming accuracy in naming tests and enhances verb usage and the use of well-formed syntactic structures in connected speech. Especially intensive interventions in which training takes place in communicative contexts may be beneficial. The aim of this study was to investigate whether a sentence-level verb intervention affects verb naming and the structures and vocabulary of the connected speech of Finnish non-fluent aphasic speakers. Methods. Two speakers with chronic Broca's aphasia participated in this study. Markku, a 35-year-old man, and Annikki, a 72-year-old woman, had both become aphasic due to a single stroke in the left hemisphere. The intervention programme lasted 6–7 weeks and consisted of 15 training sessions of 90 minutes (a total of 22,5 hours). In six different speech production tasks the participants were trained to place obligatory and optional sentence elements around a verb. The target was to promote verb usage in narratives. The effects of the intervention were evaluated by examining verb naming accuracy and speed in a naming test, by calculating the mean length of utterances and the proportion of empty speech in connected speech, and analysing the syntax and the vocabulary of narratives. Results. Markku's aphasia quotient (WAB) increased by 20 points after the intervention as his speech became more fluent and informative. There were no changes in Annikki's aphasia quotient. The intervention had no effect on verb naming in a verb naming test. Both participants produced longer narratives after the intervention, but at the same time the proportion of empty speech increased in Annikki's speech. The mean lengths of utterances didn't change after the intervention. The proportion of utterances including a finite verb increased slightly in Markku's narratives. Simultaneously, the proportion of clauses with an incomplete verb phrase or no verb phrase decreased slightly. The intervention had no effect on syntactic structures in Annikki's case. The number of different verbs increased in both participants' picture description narratives, although the change was much smaller in Annikki's case. There was some evidence in Markku's case that the intervention had a small effect on the vocabulary of personal narratives and descriptions of event sequences. Discussion. The results of this study provide preliminary support for the usefulness of sentence-level verb interventions in aphasia rehabilitation in Finland. The results indicate that this intervention can have a positive effect on the number of different verbs and the number of finite verbs used in non-fluent narratives. However, the response to the intervention seems to be highly individual. The next step would be to examine the efficacy of the intervention method in a larger scale study. The intervention could be modified by increasing the intensity of training and increasing the amount of training without picture support. The intervention method is applicable in the clinical world. In addition, an aphasic speaker and their significant other can train at home using the intervention tasks, so that possible intervention results could be better maintained after the intervention is withdrawn.
  • Sunervo, Ilona (Helsingfors universitet, 2015)
    Aim. Aphasia impacts not only the aphasic person, but also the significant others. There has been a largely grown interest on different types of intervention and services directed to significant others. However, there is little evidence how SLPs implement these practices in the clinical rehabilitation process. The aim of this study was to investigate how significant others participate in the rehabilitation process for people with aphasia in the SLPs point of view. Also, the resources and the causes behind these practices were studied. Methods. This study was carried out as a survey for Finnish speech and language therapists working with people with aphasia. The questionnaire was conducted in e-form and sent via the Finnish Association of Speech Therapists to its members. A total of 56 SLPs participated in the survey. The closed questions of the questionnaire were analyzed quantitatively, by representing percentages and frequencies of the answers. The qualitative analysis was based on the classification of recurring themes in the open-ended questions. Results and conclusions. According to 60 % of the respondents, significant others were part of the evaluation process frequently or always. In planning the rehabilitation, significant others were involved frequently or always according to 68 % of the respondents. Significant others were frequently or always part of the rehabilitation according to 58 % of the respondents. SLPs used varying methods working with significant others, although structured methods described in the literature were seldom used. The participation of significant others was considered fairly important. SLPs recognized the importance of significant others in supporting communication and overall progress in rehabilitation. Structural/organizational constraints were often mentioned and SLPs also felt that significant others weren't always motivated to participate in the rehabilitation process. Time, therapy materials and education were among the resources that were needed more. As a conclusion, this study shows that practices concerning participation of significant others in the aphasia rehabilitation process are somewhat unestablished in Finland, and that communication partner training hasn't quite yet reached clinicians. There are no clinical guidelines concerning aphasia therapy and significant others participation in it, which based on the results, would be needed.
  • Jokinen, Milla (Helsingin yliopisto, 2020)
    Aims. One of the most common symptoms in aphasia is anomia, or word-finding difficulty. When retrieving words, that one has already learned causes a challenge, it is understandable that learning new ones can be difficult for people with aphasia. Studies have proven, though, that the ability to learn novel words doesn’t necessarily disappear in aphasia, but there is a wide individual variation in the learning ability. Because the ability to learn has been found to correlate with the response to therapy in aphasic individuals, researching learning and understanding it better is important from the clinical point of view. There are a lot of factors that affect learning, and modality could be one of them. In some previous studies, it has been noted that aphasic individuals were only able to learn novel words if they were in a written format. The aim of this study was to find out more about the effect of modality on learning novel words in chronic aphasia, and to compare the learning results of the aphasic individuals with those of healthy control participants. Methods. Two aphasic (AFA1 and AFA2) and two healthy control participants were recruited for this study. The learning experiment consisted of four learning conditions with different input-output modality combinations, meaning that the participants first either read or heard the words, and then either said them out loud or wrote them down. In each condition, there were 15 word-picture pairs to learn. The words were pseudowords and the pictures were black-and-white drawings of ancient farming equipment. Results and conclusions. The results of this study support the earlier results that suggest that even in chronic aphasia, learning novel words is still possible, but there is a lot of variation. In this experiment, AFA1 could learn words well, but AFA2 didn’t really learn them at all. Modality was found to be significant as well, since the learning results even for AFA1 were poor in two of the four learning conditions. Unlike in the previous studies, AFA1’s learning wasn’t dependent on reading the words but on writing them. Though her performance was most successful in the condition where the words were read and then written. In this condition, she learned all the 15 words and her learning was on the level of the healthy control participant. As of now, only few studies have been done on the effect of modality on learning in aphasia, but the results from this study and the previous ones encourage to do more research on this subject. Because a link has been found between learning ability and response to therapy, figuring out the best way to learn for each aphasic individual might also affect the treatment outcomes.
  • Elo, Laura (Helsingin yliopisto, 2020)
    Background and aims. Aphasia is a linguistic disorder most commonly caused by stroke. Aphasia manifests itself as difficulties in understanding and producing spoken or written language. Rehabilitation from aphasia requires the ability to learn. Previous studies have shown that individuals with chronic aphasia are able to learn and remember novel vocabulary in varying degrees. In addition, studies have shown that self-repair of speech is interrelated with linguistic recovery. However, the relationship between self-repair of connected speech and novel word acquisition in the non-chronic and chronic stages of aphasia has not previously been studied. The objective of this thesis is to describe the self-repair of connected speech and novel word learning ability in aphasic individuals and to determine whether self-repair and the ability to learn novel words are interrelated in the subacute (0–3 months) and chronic (12 months) stages of aphasia. Participants and methods. Four aphasic individuals were examined 0–3 months and again 12 months post-stroke within the Opi Sanoja research project at the University of Helsinki. Participants completed a computer-assisted learning experiment in which their aim was to learn the associations between novel words and images. Connected speech was collected from participants’ speech samples in a picture narration task, a stroke narrative and a thematic interview. The speech samples were transcribed according to the conventions used in conversation analysis and self-repairs were analyzed qualitatively and quantitatively at both points in time. The relationship between self-repair and novel word acquisition was analyzed on a case-by-case basis and a group-level basis using scatter graphs and regression plots. Results and conclusions. Self-repairs of connected speech decreased and changed during the first year after stroke for all participants. The ability to learn novel words varied among the participants, but some participants were able to learn new words in the subacute and chronic stages of aphasia. On a case-by-case basis, no relationship was found between self-repair of connected speech and the ability to learn novel words in the subacute or chronic stages of aphasia. The learning ability in the subacute stage did not appear to predict the amount of self-repairs, nor the length of non-repaired problem sequences in the chronic stage. At the group level, in the subacute stage, there was a weak positive correlation between learning ability and self-correction rates, which turned negative in the chronic stage. There appeared to be a weak negative correlation between the length of non-repaired problem sequences and the ability to learn in the subacute stage, which disappeared in the chronic stage. However, group-level results were unreliable due to small sample size.
  • Virtanen, Tarja (Helsingfors universitet, 2015)
    Objective: Previous studies suggest that outcomes in aphasia therapy are not often routinely measured in the clinical practice. On the other hand, there has been little research on the views of speech and language therapists (SLT) on the outcome evaluation. The objective of this study was to gather information about the opinions of SLT's when it comes to the role, need and value of the outcome evaluation in the clinical practice. Methods: A conceptual framework called theory of alignment was used in this study. The data were collected by interviewing ten SLTs practicing aphasia therapy. The interviews were transcribed and the data were analyzed using qualitative content analysis. Results and conclusions: According to the results SLTs evaluate the outcomes of aphasia therapy for themselves, for the patients and their significant others and for external stakeholders. The role of the outcome evaluation is different depending on the stakeholder needing evaluation. SLTs may consider routine evaluation of the outcomes unnecessary since the different stakeholders do not always create a need for the outcome evaluation. When it comes to the outcomes of aphasia therapy, STLs found it important to get information on their patient's improvement in different contexts. SLTs also valued other persons' opinions of the outcomes as well as information on the patient's symptoms and their further need for aphasia therapy. Furthermore, SLTs considered that the extent and form of information were important when assessing outcomes. Acknowledging the views of SLTs on the outcome evaluation may help to develop the evaluation practices by resolving some problems relating to the evaluation. In case the routine evaluation of outcomes is desired nationally in aphasia therapy, the SLTs should find that there are different stakeholders needing evaluation for a certain reason. When new tests and assessment tools are developed and translated into Finnish language, it should be considered that they will provide information SLTs find worth collecting.
  • Heikkilä, Anna (Helsingin yliopisto, 2021)
    Aphasia is a linguistic disorder that occurs after language acquisition and can lead to difficulties with expressive and receptive language. Aphasia is most often caused by a stroke. The inability to retrieve words, also known as anomia, is the most common symptom of aphasia and it is most often assessed with object-naming tasks. It is acknowledged that in aphasia learning is fundamental aspect of the recovery process and this has led to increasing interest to study novel word learning ability in aphasia. So far, word learning ability in people with aphasia has been studied mainly in chronic stage. The aim of this study was to examine novel word learning ability in subacute aphasia using recognition and naming task and to investigate the possible connection between recognition and naming ability. Additionally, the possible connection between naming of familiar objects and new objects was investigated. The sample of this study was part of the Opi sanoja research project and included ten adults with subacute aphasia (maximum 3 months post-stroke). Participants completed a learning task on computer and their aim was to learn six pseudoword-picture pairings. The novel word learning ability of the participants was assessed using recognition and confrontation naming task. The tasks were administered on two different occasions one week apart from each other. The ability to name familiar objects was assessed using Boston Naming Test. Participants’ ability to name novel objects wasn’t correlated with their ability to recognize the novel objects. Furthermore, participants’ ability to name familiar objects didn’t correlate with the ability to name novel objects. However, there was considerable inter-individual variability in learning performance. Some of the participants were able to recognize novel objects at the statistically significant level immediately after the learning task and one week later. However, some of the participant’s couldn’t recognize the objects either immediately after the learning task or one week later. At the group level participants’ performance on the novel object naming task was poor and was virtually at floor. However, consideration of individual participant results revealed that one of the participants was able to name some of the novel objects correctly. Based on the results, people in subacute aphasia recognize novel targets better than name them. The results are in line with previous studies that have investigated ability to learn new words in chronic aphasia and support the initial evidence that people with subacute aphasia can learn novel words. The findings of this study also provide preliminary understanding of the ability to name novel objects in subacute aphasia.
  • Martinsuo, Maija (Helsingin yliopisto, 2019)
    Background. Aphasia refers to a disability in the processing of linguistic information. It is most typically due to a stroke. Aphasia impairs a person's ability to understand, produce and use language. Recovery from aphasia is generally divided into three main stages: acute, subacute and chronic. So far, the ability to learn new words in aphasia has only been studied in chronic aphasia. Learning new words is a complex process. In natural language learning, the relationship between a word and its meaning is often not unambiguous, but the words and their possible meanings are numerous, and the connections are complex. The learning of new words can take place by hearing or by reading. The prerequisite for rehabilitation from aphasia is the ability to learn new things, but aphasia research typically uses familiar and everyday words. However, the use of familiar words in research makes it difficult to interpret the results. In order to assess whether a person with aphasia is able to learn new vocabulary, research must be done on a vocabulary that was not available to the person before aphasia. Objectives. The aim of this thesis is to determine, whether people with subacute aphasia can learn novel vocabulary in a situation that imitates natural language learning. This thesis also investigates how the learning ability of people with aphasia compares to the learning ability of healthy matched controls in the same task and how the matched controls learn compared to healthy young adults. Methods. The participants of the study consisted of three groups: young controls, matched controls and aphasic participants. The aphasic participants were examined at HUS Hospital District in Laakso Hospital in Helsinki and in Hyvinkää Hospital. The word learning task consisted of six 3-syllable nonwords that were practiced using a computer program. The task was to combine a spoken and written novel word with the correct novel image, choosing from two different images. Results and conclusions. Learning novel words is possible in subacute aphasia. However, there was great variability in the ability to learn between the aphasic participants. Some learned the words well, others learned some words, and some did not seem to learn the words at all. In addition, some of aphasic participants in the subacute stage were able to maintain the vocabulary they learned for at least a week after learning. Some of the aphasic participants learned the words on par with matched controls but for some the learning was significantly weaker. Both young adults and matched controls performed well on the learning task, but young adults learn the words faster than matched controls.