Browsing by Subject "sujumaton afasia"

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  • 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.
  • Tikka, Marjo (Helsingfors universitet, 2015)
    The Objective. Two persons with severe chronic non-fluent aphasia had received repetitive transcranial magnetic stimulation (rTMS) and Intensive language action therapy (ILAT) interventions. The aim of this multiple-case study was to analyze if their possibly improved language skills also improved social-functional communication abilities in every day life. Another objective of the study was to analyze the adaptation to impaired speech by a person with aphasia and the significant other. Previous research has shown that aphasic people communicate better with their close relatives than their success in clinical tests may predict. Several studies have shown that persons with aphasia and the significant others can give reliable assessment of aphasic speaker's linguistic and communicative skills in every day life. Even though the mutual adaptation to impaired speech aims at improving the interaction, it can in fact cause asymmetry between aphasic speaker and his/her significant one. Data and Methods.The participants comprised two persons with aphasia and their significant others. The first participant was a 52 year old man who had had a stroke 2 years earlier and another 72 years old man, 4 years after stroke onset. Both participants had a chronic severe Broca's aphasia. The quantitative data of the study consisted of Communicative Activity Log (CAL) ratings of patients and their significant others given before and after the interventions. The qualitative data consisted of 20 videotaped conversations (about 7 hours of raw data). Focus of the analysis was on changes in communicative activity of the participants and there were identified through conversation analysis (e.g. initiating new topics or how different kinds of repair initiatives were used). Also signs of asymmetry between a person with aphasia and the significant other were identified. Results and Conclusions. The CAL evaluations revealed that 52 year old participant's performance in everyday life situations improved significantly. The participant reported a significant increase of 38% in the quality and 14% in the amount of communication in everyday life after the interventions. Consistent with this result, his significant other reported also increase of 33% in the quality and 38% in the amount of his communication. Also signs of changes in his communication into more symmetric direction were identified in conversation analysis. He aimed at producing more detailed and lengthier utterances, asking questions and initiating new topics in conversation. For the 72 year old participant the self evaluating index revealed a qualitative improvement of 27% and quantitative improvement of 38% in communicative activities. Conversely, his significant other reported hardly any improvement in his quality of communication and decrease of 9% in the amount of his communication. Changes in 72 year old participant's communication weren't that clear in conversation analysis data either. He however showed more active role in interaction initiating new topics in conversation, and producing lengthier utterances and details like names. Some noteworthy changes in both participants' repair initiatives were identified after the interventions: both participants made repair initiations to their conversation partners, they also expressed the trouble source if they could't hear or understand their conversation partner's turn. Both of the participants also made self-repairs after unsuccessful attempt to articulate the missing word. Self-repair was non-existent feature in their conversation before. These changes reveal e.g. that the linguistic competence of the participants had improved and the interaction with their significant others appeared more symmetric and harmonic compared to conversations before the interventions.