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1.
  • Ahlsén, Elisabeth, 1951, et al. (författare)
  • Activity-based communication analysis - focusing on context in communication partner training
  • 2018
  • Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 32:10, s. 1145-1165
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: There is an increased awareness of contextual influence on communication involving persons with aphasia (PWA) and there is a need for frameworks addressing how to analyse contextual factors and address them in, for example, communication partner training (CPT). Activity-based communication analysis (ACA) is a theoretically based method providing a vocabulary and a structure for analysing the influence of context in interaction and how it relates to communication. Aims: The purpose of this paper is to present the framework of ACA as a means of stimulating further enrichment of CPT practices. Methods and Procedures: The paper provides a brief background to the ACA approach, including examples, as well as a checklist and a model for analysis and assessment of intervention addressing communication involving PWA. Outcomes and Results: This approach enables an explicit account of different contextual factors and how they relate to communication and may, thus, guide the design of CPT for particular participants and motivate behavioural change. Conclusions: ACA is a framework that addresses the influence of context on communicative interaction and provides a way of including contextual factors in a systematic way when analysing communication involving PWA. In this way, it can contribute to a richer analysis and intervention and is clearly applicable for CPT
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3.
  • Ali, M, et al. (författare)
  • Protocol for the development of the international population registry for aphasia after stroke (I-PRAISE)
  • 2022
  • Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 36:4, s. 534-554
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: We require high-quality information on the current burden, the types of therapy and resources available, methods of delivery, care pathways and long-term outcomes for people with aphasia.Aim: To document and inform international delivery of post-stroke aphasia treatment, to optimise recovery and reintegration of people with aphasia.Methods & Procedures: Multi-centre, prospective, non-randomised, open study, employing blinded outcome assessment, where appropriate, including people with post-stroke aphasia, able to attend for 30 minutes during the initial language assessment, at first contact with a speech and language therapist for assessment of aphasia at participating sites. There is no study-mandated intervention. Assessments will occur at baseline (first contact with a speech and language therapist for aphasia assessment), discharge from Speech and Language Therapy (SLT), 6 and 12-months post-stroke. Our primary outcome is changed from baseline in the Amsterdam Nijmegen Everyday Language Test (ANELT/Scenario Test for participants with severe verbal impairments) at 12-months post-stroke. Secondary outcomes at 6 and 12 months include the Therapy Outcome Measure (TOMS), Subjective Index of Physical and Social Outcome (SIPSO), Aphasia Severity Rating Scale (ASRS), Western Aphasia Battery Aphasia Quotient (WAB-AQ), stroke and aphasia quality of life scale (SAQoL-39), European Quality of Life Scale (EQ-5D), lesion description, General Health Questionnaire (GHQ-12), resource use, and satisfaction with therapy provision and success. We will collect demography, clinical data, and therapy content. Routine neuroimaging and medication administration records will be accessed where possible; imaging will be pseudonymised and transferred to a central reading centre. Data will be collected in a central registry. We will describe demography, stroke and aphasia profiles and therapies available. International individual participant data (IPD) meta-analyses will examine treatment responder rates based on minimal detectable change & clinically important changes from baseline for primary and secondary outcomes at 6 and 12 months. Multivariable meta-analyses will examine associations between demography, therapy, medication use and outcomes, considering service characteristics. Where feasible, costs associated with treatment will be reported. Where available, we will detail brain lesion size and site, and examine correlations with SLT and language outcome at 12 months.Conclusion: International differences in care, resource utilisation and outcomes will highlight avenues for further aphasia research, promote knowledge sharing and optimise aphasia rehabilitation delivery. IPD meta-analyses will enhance and expand understanding, identifying cost-effective and promising approaches to optimise rehabilitation to benefit people with aphasia.
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4.
  • Aronsson, Fredrik, et al. (författare)
  • Is cognitive impairment associated with reduced syntactic complexity in writing? Evidence from automated text analysis
  • 2021
  • Ingår i: Aphasiology. - : ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD. - 0268-7038 .- 1464-5041. ; 35:7, s. 900-913
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Written language impairments are common in Alzheimers disease and reduced syntactic complexity in written discourse has been observed decades before the onset of dementia. The validity of average dependency distance (ADD), a measure of syntactic complexity, in cognitive decline needs to be studied further to evaluate its clinical relevance. Aims: The aim of the study was to determine whether ADD is associated with levels of cognitive impairment in memory clinic patients. Methods & procedures: We analyzed written texts collected in clinical practice from 114 participants with subjective cognitive impairment, mild cognitive impairment, and Alzheimers disease during routine assessment at a memory clinic. ADD was measured using automated analysis methods consisting of a syntactic parser and a part-of-speech tagger. Outcomes & results: Our results show a significant association between ADD and levels of cognitive impairment, using ordinal logistic regression models. Conclusion: These results suggest that ADD is clinically relevant with regard to levels of cognitive impairment and indicate a diagnostic potential for ADD in cognitive assessment.
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5.
  • Bauer, Malin, 1990, et al. (författare)
  • Complex oral semantic verbal fluency in non-brain-damaged adults and individuals with multiple sclerosis and subjective anomia
  • 2020
  • Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 34:12, s. 1471-1486
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Many neurologic conditions, for example multiple sclerosis (MS), are associated with subtle communication and language difficulties. To detect such difficulties, there is a need for valid and reliable methods. While standard aphasia test batteries have been found insufficient, more complex language tasks are believed to be able to distinguish more subtle language difficulties from normal variation in communicative ability. Aims: The aim of this study was to: (1) explore the influence of demographic variables on the results of a novel complex oral semantic fluency task with multiple restrictions in non-brain-damaged (NBD) adults, (2) investigate the construct validity and reliability of the method, and (3) compare the results of NBD individuals and individuals with MS. Method and procedure: One hundred and ten NBD individuals performed the complex task and three standard fluency tasks with single restrictions. Regression analyses were run to assess the influence of demographic factors. Furthermore, 16 individuals with MS and subjective anomia performed the complex task and the results were compared with those for a matched group of NBD individuals. Outcome and results: Age and education influenced the NBD individuals’ scores on the complex task. The NBD individuals’ results on the complex task correlated with those on the three standard fluency tasks. Furthermore, the subgroup of 16 pair-matched NBD individuals produced statistically significantly more adequate responses in the complex task than the group of individuals with MS. However, on an individual level some of the participants with MS performed at level with, or even better than the pair-matched NBD individuals. Provision of scoring guidelines yielded high interrater-reliability. Conclusions: The results illustrate the challenge in attempts to provide formal measures of subtle language disorders. Still, the complex task is a promising assessment tool which may be a complement to existing standard word fluency tasks, although future studies are required to establish the validity and ability to detect subtle language difficulties in different clinical groups.
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6.
  • Behrns, Ingrid, 1961, et al. (författare)
  • Aphasia and Computerised Writing Aid Supported Treatment
  • 2009
  • Ingår i: Aphasiology. - London : Psychology Press. - 0268-7038 .- 1464-5041. ; 23:10, s. 1276-1294
  • Tidskriftsartikel (refereegranskat)abstract
    • Background:Individuals with aphasia often experience difficulties in writing. Word processors with a spell checker and a grammar checker can compensate for some of the writing difficulties associated with aphasia.Aims:To determine if writing difficulties associated with aphasia may be reduced by the use of a computerised writing aid when training patients.Methods & Procedures:The writing aids used in this study were originally designed specifically for persons with developmental reading and writing difficulties and are based on statistics of frequent misspellings and phonotactic rules. Three participants with aphasia selected one of two offered writing aids. Written production during treatment and evaluation was recorded and analysed by keystroke logging. The study had a single-subject ABA design replicated across three participants. The baseline (A) was established by measuring four dependent variables. During a 9-week intervention phase (B) the dependent variables were measured once a week. A follow-up (A) was done 10 months after the training was finished. The dependent variables were: total number of words in a writing task; proportion of correctly written words; words per minute; proportion of successful edits. The results were analysed both visually and by statistical calculations. Outcomes & Results:All participants experienced a positive improvement in their writing ability. Results showed individual differences; after completed training the first participant made more successful edits, the second wrote more words, had a larger proportion of correctly written words, and made more successful edits. The third participant's results did not show any improvement that could be statistically supported.Conclusions:This study showed that the computerised training facilitated the generating process and made the revision process more efficient for the participants. The results are important in that they indicate possible ways of designing writing treatment. However, they also show the need for careful analyses when evaluating different treatment strategies and in discussing what improved writing ability may be.
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7.
  • Blom Johansson, Monica, 1965-, et al. (författare)
  • A multiple-case study of a family-oriented intervention practice in the early rehabilitation phase of persons with aphasia
  • 2013
  • Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 27:2, s. 201-226
  • Tidskriftsartikel (refereegranskat)abstract
    • Background:Having a family member with aphasia severely affects the everyday life of the significant others, resulting in their need for support and information. Family-oriented intervention programmes typically consist of support, information, and skill training, such as communication partner training (CPT). However, because of time constraints and perceived lack of skills and routines, such programmes, especially CPT, are not common practice among speech-language pathologists (SLPs).Aims:To design and evaluate an early family-oriented intervention of persons with stroke-induced moderate to severe aphasia and their significant others in dyads. The intervention was designed to be flexible to meet the needs of each participant, to emotionally support the significant others and supply them with information needed, to include CPT that is easy to learn and conduct for SLPs, and to be able to provide CPT when the persons with aphasia still have access to SLP services.Methods & Procedures:An evaluative multiple-case study, involving three dyads, was conducted no more than 2 months after the onset of aphasia. The intervention consisted of six sessions: three sessions directed to the significant other (primarily support and information) and three to the dyad (primarily CPT). The intervention was evaluated both qualitatively and quantitatively based on video recordings of conversations and self-assessment questionnaires.Outcomes & Results:The importance of emotional support as well as information about stroke/aphasia was clearly acknowledged, especially by the significant others. All significant others perceived increased knowledge and understanding of aphasia and related issues.Communicative skills (as manifested in the video recordings) showed improvements from pre- to post-intervention.Conclusions:The results corroborate the need for individualised and flexible family-oriented SLP services that are broad in content. Furthermore, the results support the early initiation of such services with recurrent contact. The usefulness of CPT this early in the rehabilitation process was indicated but is yet to be proved.
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8.
  • Blom Johansson, Monica, 1965-, et al. (författare)
  • Communication changes and SLP-services according to significant others of persons with aphasia
  • 2012
  • Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 26:8, s. 1005-1028
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Significant others are important to persons with aphasia. For several reasons they should be involved in speech-language pathology (SLP) services, including acquiring facilitating communicative strategies and receiving support. In order to further adapt SLP services there is a need to know the perceptions and views of the significant others. Little is known about how they perceive changes in communication as well as received SLP services and in what way they want to be involved in these services.Aims: The study aimed to investigate which communicative changes significant others of persons with aphasia had experienced after a stroke event and to what extent these changes were experienced. A further aim was to describe the significant others’ experiences of SLP services and their motivation to participate in these services. Finally, the significant others’ experiences were compared in terms of sex, age, type of relationship, time since stroke onset, and type and severity of aphasia.Methods & Procedures: An 80-item study-specific questionnaire was answered by 173 significant others of persons with aphasia living throughout Sweden (response rate 69%). Of these, 33% were male and 67% female. Mean age was 64.2 years (range 33–87 years) and 85.5% of the participants were a cohabiting partner to a person with aphasia.Outcomes & Results: A total of 64% of participants perceived their conversations as being less stimulating and enjoyable compared with conversations before stroke onset. Aphasia was considered a substantial or very substantial problem by 64%. The participants took on an increased communicative responsibility, and 70% had changed their communicative behaviour in order to facilitate conversations. A total of 75% (n = 130) had met with the SLP of the person with aphasia. Of those, 63% perceived their own support from SLP services to be adequate; 87% considered language ability training as the most important SLP service. Type and severity of aphasia were especially related to the communicative experiences of the participants and their motivation to be involved in SLP services.Conclusions: The substantial decrease from pre- to post-stroke regarding enjoyment and meaningfulness of conversations suggests the need to further improve SLP services in order to help the people in question communicate at an optimal level. We suggest that clinicians should put more emphasis on explaining the benefits and availability of different kinds of aphasia rehabilitation services, such as functional communication training and communication partner training in addition to language ability training.
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9.
  • Blom Johansson, Monica, 1965-, et al. (författare)
  • Self-reported changes in everyday life and health of significant others of people with aphasia : a quantitative approach
  • 2022
  • Ingår i: Aphasiology. - : Taylor & Francis. - 0268-7038 .- 1464-5041. ; 36:1, s. 76-94
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Changes in the everyday life and health of the significant others (SOs) of people living with stroke sequalae have been widely investigated. However, information regarding the frequency of the changes in daily life and the variables most associated with these perceived life changes is limited. Aims: To examine the extent to which SOs of persons with aphasia (PWAs) experience changes in everyday life and health after the stroke event and how they evaluate these changes and to identify which variables are associated with these perceived life changes. Methods & Procedures: A study-specific questionnaire about perceived changes in everyday life and health was completed by 173 SOs of PWAs living in Sweden (response rate 67.8%). The items concerned the SO’s working and financial situation, leisure time and social life, relationship with the PWA, household work and responsibility, and health and quality of life. Outcomes & Results: The everyday life and health of the SOs were greatly affected by the stroke event. The changes the SOs experienced were mainly appraised negatively. The relationships with the PWA and immediate family were least affected by the stroke. The perceived existence and severity of physical, cognitive, and language impairments of the PWA were the variables most strongly associated with the everyday life situation of the participants. The sex and age of the participants and the nature of the relationship with the PWA were only marginally associated with the experience of the situation. Conclusions: SOs’ perceptions of the PWA’s stroke-related disabilities and need for assistance may be a key factor in identifying SOs who may require support and guidance to help them cope with their new life situation.
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