| 1. |
- Ahlsén, Elisabeth, 1951, et al.
(författare)
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Activity-based communication analysis - focusing on context in communication partner training
- 2018
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Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 32:10, s. 1145-1165
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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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| 2. |
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| 3. |
- Ali, M, et al.
(författare)
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Protocol for the development of the international population registry for aphasia after stroke (I-PRAISE)
- 2022
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Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 36:4, s. 534-554
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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)
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Is cognitive impairment associated with reduced syntactic complexity in writing? Evidence from automated text analysis
- 2021
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Ingår i: Aphasiology. - : ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD. - 0268-7038 .- 1464-5041. ; 35:7, s. 900-913
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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)
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Complex oral semantic verbal fluency in non-brain-damaged adults and individuals with multiple sclerosis and subjective anomia
- 2020
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Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 34:12, s. 1471-1486
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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)
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Aphasia and Computerised Writing Aid Supported Treatment
- 2009
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Ingår i: Aphasiology. - London : Psychology Press. - 0268-7038 .- 1464-5041. ; 23:10, s. 1276-1294
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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)
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A multiple-case study of a family-oriented intervention practice in the early rehabilitation phase of persons with aphasia
- 2013
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Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 27:2, s. 201-226
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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)
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Communication changes and SLP-services according to significant others of persons with aphasia
- 2012
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Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 26:8, s. 1005-1028
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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)
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Self-reported changes in everyday life and health of significant others of people with aphasia : a quantitative approach
- 2022
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Ingår i: Aphasiology. - : Taylor & Francis. - 0268-7038 .- 1464-5041. ; 36:1, s. 76-94
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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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| 10. |
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| 11. |
- Cruice, Madeline, et al.
(författare)
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Reporting Interventions in Communication Partner Training : A Critical Review and Narrative Synthesis of the Literature
- 2018
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Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 32:10, s. 1135-1166
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Tidskriftsartikel (refereegranskat)abstract
- Background: Communication partner training (CPT) is an umbrella term for a complex behavioural intervention for communications partners (CPs) of people with aphasia (PWA) and possibly PWA themselves, with many interacting components, deployed in flexible ways. Recent systematic reviews (Simmons-Mackie, Raymer, Armstrong, Holland, & Cherney, 2010; Simmons-Mackie, Raymer, & Cherney, 2016) have highlighted the effectiveness of CPT in addressing the skills of conversation partners and the communicative participation of people with aphasia but have suggested that CPT has been variably delivered, with no clear picture of what the essential elements of CPT are and how CPT is expected to achieve its results through hypothesised mechanisms of change (Coster, 2013).Aim: This paper aims broadly to consider specification of CPT and describes how CPT has been conducted overall and in relation to treatment recipients. Recommendations for CPT and areas for future research are considered.Methods & Procedures: A critical review and narrative synthesis was carried out through: (i) the systematic application of the 12-item TIDieR checklist (Hoffmann et al., 2014) to the 56 studies appraised in the Simmons-Mackie et al. (2010, 2016)) reviews, providing a quantitative overview of the completeness of CPT intervention reporting; and (ii) a qualitative synthesis of the reviewed CPT literature according to TIDieR items.Outcomes & Results: Half of the TIDieR checklist items were reported by 71% or more of the studies, and the rest of the items were reported by 0–63% of studies. TIDieR items relating to the treatment (goal, rationale or theory of essential elements, materials and procedures) and provision (provider, mode, timing, dose) were more frequently reported; however, the level of detail provided was often inadequate or incomplete. The interventions were insufficiently specified to enable replication for most of the studies considered. The most infrequently reported items were: name, location, intervention tailoring and modification, and planned and actual intervention adherence/fidelity.Conclusion: For a better understanding of an intervention, it is necessary to identify and describe potentially central elements and perhaps especially in complex interventions as CPT, where it is likely also more difficult. Whilst the reviewed CPT studies are on average reporting on slightly more than half of the TIDieR items, they are overall insufficiently detailed. Some items appear easier to report on, whereas other items have not been attended to, are too complex in nature to give a full report on, or simply have not been relevant for the individual study to include.
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| 12. |
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| 13. |
- Grönberg, Angelina, et al.
(författare)
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Long-term prognosis and health-related quality of life for people with Aphasia in Sweden
- 2024
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Ingår i: Aphasiology. - 0268-7038 .- 1464-5041.
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Tidskriftsartikel (refereegranskat)abstract
- Background: People with aphasia (PWA) after ischemic stroke often have difficulties in communication and social participation. To individualise rehabilitation and optimise recovery, there is a need for knowledge regarding prevalence of aphasia, and language functions in relation to long-term recovery and health-related quality of life (HRQoL). In this study, we examined these issues in a Swedish setting. Methods: We screened consecutive persons with first-ever ischemic stroke admitted to Skåne University Hospital, Sweden, at baseline (median day 4 post stroke onset) for aphasia with the Language Screening Test (LAST). We then performed a detailed follow-up of PWA at 1, 3, and 12months after stroke onset with the Swedish version of the Comprehensive Aphasia Test (CAT) for evaluation of cognition and language, and with the self-reported Aphasia Impact Questionnaire (AIQ) for evaluation of HRQoL. We analysed aphasia recovery and potential associations between aphasia severity, language functions, stroke severity according to National Institutes of Health Stroke Scale (NIHSS), and HRQoL. Results: Initial aphasia was present in 27% (n=60 of 221) of stroke persons in the acute phase. At 1month after stroke onset, 74% (n=40 of 54 survivors with initial aphasia) had remaining aphasia, at 3months 67% (n=34 of 51) had aphasia and at 12months post stroke 61% (n=30 of 49) had remaining aphasia. Improvement of aphasia was greatest during the first months after onset, with significant improvement regarding naming (p=0.01), repetition (p=0.03) and comprehension of written language (p=0.01). HRQoL remained significantly associated with aphasia severity after adjusting for stroke severity and age. At 3months, 87% (n=26) of PWA reported that aphasia affected their ability to communicate with the environment, had negative consequences on level of participation (73%, n =22), and their emotional well-being (87%, n =26). There were no significant temporal changes regarding HRQoL between 3 and 12months post stroke. Conclusion: Chronic aphasia was observed in 61% of all alive persons presenting with baseline aphasia after ischemic stroke. Aphasia has negative consequences on HRQoL for PWA and aphasia severity impacts HRQoL regardless of stroke severity.
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| 14. |
- Haley, Katarina L., et al.
(författare)
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Life activity choices by people with aphasia: repeated interviews and proxy agreement
- 2019
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Ingår i: Aphasiology. - : Taylor & Francis. - 0268-7038 .- 1464-5041. ; 33:6, s. 710-730
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Tidskriftsartikel (refereegranskat)abstract
- Background: Person-centered rehabilitation requires that meaningful life activities are identified on a case-by-case basis, but the discovery process can be inaccessible for clients with aphasia. Card-sorting methodology addresses core barriers and help clients communicate their preferences.Aims: To characterize life activities that people with aphasia want to do, to estimate consistency in selections over time, and to replicate previous findings about the ability of family members and friends to identify their loved ones’ activity preferences.Methods & Procedures: We administered the Life Interests and Values (LIV) Cards to 26 people with aphasia, asking them which of 95 depicted life activities they wanted to do more in their lives. Half the activity cards were presented again one to ten weeks later. Twenty family members or friends responded as proxies by selecting from a questionnaire with the same items.Outcomes & Results: Participants with aphasia selected diverse activities, though as a group they identified significantly more activities from the “social” activity category than from the “home and community”, “creative and relaxing”, or “physical” categories. Across the repeated interviews, they selected identical activities on average 78% of the time. Item-to-item agreement between people with aphasia and their proxy responders was significantly lower at 69%.Conclusions: People with aphasia have diverse activity interests and are reliable informants about their preferences. Because significant others have limited ability to predict these choices, their impressions are inadequate substitutes for direct interviews.
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| 15. |
- Henriksson, Ingrid, 1961, et al.
(författare)
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Public awareness of aphasia – results of a Swedish sample
- 2019
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Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 33:1
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Tidskriftsartikel (refereegranskat)abstract
- © 2018 Informa UK Limited, trading as Taylor & Francis Group Background: Public awareness of a condition like aphasia may affect service provision and everyday life communication for people affected by the condition. Nevertheless, studies have shown that the public awareness of aphasia is low in many countries. Aims: This study explores awareness and knowledge of aphasia among the general public in Sweden. Methods & Procedures: We describe two surveys on the public awareness of aphasia undertaken using convenience samples in four different cities in southern Sweden. The questionnaire was closely based on those used in previous studies of aphasia awareness around the world. A total of 372 participants were recruited. Results are presented in terms of whether participants had heard of aphasia or not, and in the case that they had heard of it, whether they had a basic knowledge of the condition. Further analyses were undertaken on these three groups of participants: their gender and age distributions, educational background, what they knew about aphasia, and where they had learnt about it. Outcomes & Results: The results are discussed in comparison with similar surveys elsewhere, and we note the comparatively high percentage of participants who have heard of aphasia in our survey though, mirroring previous surveys, the amount of knowledge was often limited or incorrect. Unlike in other surveys, no clear relation was found between gender and awareness of aphasia, or education and awareness of aphasia. Age profiles and the source of participants’ information about aphasia were similar to earlier studies: that is, older people seem to have more aphasia awareness than younger people do. Further, media like TV, radio, newspapers, and magazines were the most often reported source for knowledge of aphasia. Conclusions: There is a need for further work to increase public awareness of aphasia and different forms of public media may play an important role in this endeavour.
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| 16. |
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| 17. |
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| 18. |
- Kristensson, Joana, 1972, et al.
(författare)
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Effects on communication from intensive treatment with Semantic Feature Analysis in aphasia
- 2015
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Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 29:4, s. 466-487
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Tidskriftsartikel (refereegranskat)abstract
- Background: Anomia, a persistent and frequent symptom of aphasia after stroke, obstructs the transfer of information in conversation, which can have serious consequences for participation in everyday social interaction with significant others and in society. Aims: This study aimed to replicate the findings of Coelho and his colleagues, as well as Boyle, and Wambaugh and Ferguson regarding the use of semantic feature analysis (SFA) for individuals with aphasia after stroke. Its main purpose was to explore whether intervention could (1) increase the ability to participate in conversation and (2) lead to positive changes in functional communication as perceived by the participants themselves and their significant others. Methods & Procedures: In this multiple-baseline across-subjects-design study, three participants with chronic aphasia were treated with intensive training using SFA. Treatment outcome was assessed with repeated measures of confrontation naming of actions and objects and with quantitative ratings of the quality of speech as well as communicative participation in conversation. The ratings were made by independent assessors blinded as to what phase of the study the data were obtained from. In addition, a questionnaire measuring perceived functional communication as reported by the participants and their significant others was administered before and after the training as well as at a follow-up session 10–12 weeks after the training was completed. Outcome & Results: Only minor treatment outcomes were apparent in this study. Visual inspection of the results showed a slight increase in the ability to participate in conversation for two of the three participants as well as a fall in the number of complex paraphasias for one of them and an increase in self-corrections for two. There was no improvement in the participants’ confrontation-naming ability. Two of the three participants rated their own functional communication skills higher at follow-up than before training while the third participant reported no change. As regards the ratings by significant others at follow-up versus before training, there was one slight decrease, one slight increase, and one considerable increase. Conclusions: Treatment with SFA might improve communicative skills and increase participation in everyday conversation despite not having a measurable effect on confrontation-naming ability in a formal assessment situation. Further research is needed to identify the individuals with aphasia who can benefit from treatment with SFA and to determine the nature of its impact on communicative participation.
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| 19. |
- Kristensson, Joana, 1972, et al.
(författare)
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Evaluation of treatment effects of semantic feature analysis on mild anomia in multiple sclerosis
- 2022
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Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 36:6, s. 706-731
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Tidskriftsartikel (refereegranskat)abstract
- Background: Multiple sclerosis (MS) commonly includes anomia and other communicative deficits that affect communicative participation and quality of life. Anomia treatment in MS is currently unexplored. Owing to the degenerative nature of MS, compensatory treatment might be preferable to restorative treatment. Semantic feature analysis (SFA) has been reported to have a treatment effect in aphasia and traumatic brain injury, and it can also be used as a compensatory word-finding strategy. SFA might therefore be effective on anomia in MS. Aims: The aim of this study was to evaluate the treatment effects of SFA on mild anomia in MS. Hypotheses were that, if used as a strategy, SFA may improve word-retrieval ability in connected speech, reduce self-perceived word-finding difficulties and increase communicative participation. Methods & Procedures: Two participants (one with relapsing-remitting MS, one with progressive MS) experiencing anomia and reduced communicative participation took part in this early-phase study with a single-case experimental design (SCED). Outcome measures included accuracy and speed in confrontation naming of treated items, correct information units (CIUs) in a re-telling task, self-reported strategy use in everyday communication, self-reported occurrence of anomia and related nuisance, and self-reported communicative participation. Measurements were carried out before treatment, at the beginning of every third treatment session, once directly after treatment, repeatedly during a maintenance phase, and once at a follow-up session ten weeks after treatment. Outcomes & Results: No treatment effects on confrontation-naming ability, re-telling ability or self-reported measures were evident in either participant after treatment with SFA. Effects of repeated measures appeared as reduced response time in confrontation naming. Conclusions: SFA as the sole element of treatment may not be sufficient to obtain treatment effects on mild anomia in MS. Further research is warranted. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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| 20. |
- Myrberg, Karin, et al.
(författare)
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Different approaches in aphasia assessments: a comparison between test and everyday conversations
- 2018
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Ingår i: Aphasiology. - : ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD. - 0268-7038 .- 1464-5041. ; 32:4, s. 417-435
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Tidskriftsartikel (refereegranskat)abstract
- Background: When it comes to aphasia assessments, many speech and language pathologists (SLPs) rely heavily on norm-referenced language tests, even though they are aware that certain important language skills can only be evaluated by analysis of conversational discourse. The formalized aphasia test situation is a typical example of institutional interaction, which differs in systematic ways from everyday conversations. This article examines conversations between persons with aphasia (PWAs) and SLPs in the two different contexts, a topic where previous research is limited. Aims: The aim is to compare the interactions between PWAs and SLPs in test conversations and in more everyday-like conversations and to relate the interactional data to the participants performance on the aphasia test battery. Methods amp; Procedures: Ten PWAs and three SLPs participated in the study. Each PWA participated in two conversations with an SLP, a test conversation, while performing tasks targeting the ability to produce sentences and narratives from an aphasia test battery, and a more everyday-like conversation. The conversations were audio and video recorded and thereafter transcribed. Three main observations considered to be important mechanisms for interaction organization were identified and calculated in the transcriptions. The test results were summarized and analyzed. Outcomes amp; results: The results demonstrated that there were a larger number of turns produced by the PWAs in the everyday conversations compared to the test conversations. Furthermore, there were more communicative initiatives and nonverbal contributions in the everyday conversations. The number of repairs initiated by the PWAs were equivalent, but looking at repair characteristics, it was found that repairs resolved within the same turn were found in the test conversations while repairs stretching over several turns were more frequent in the everyday conversations. Conclusions: The results of the present study demonstrated differences of the interaction between PWAs and SLPs in test conversations and in more everyday-like conversations. Furthermore, there seemed to be no obvious relationship between the participants actual test scores on the aphasia test battery and aspects of conversation that can be related to being a competent speaker.
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| 21. |
- Myrberg, Karin, et al.
(författare)
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Instances of trouble in aphasia and dementia : an analysis of trouble domain and interactional consequences
- 2022
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Ingår i: Aphasiology. - : Taylor & Francis. - 0268-7038 .- 1464-5041. ; 36:11, s. 1333-1350
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Tidskriftsartikel (refereegranskat)abstract
- Background Language problems in dementia resemble the symptoms of aphasia in many respects. Persons with aphasia (PWA) and persons with dementia (PWD) present rather similar results on standardised language tests and cognitive screening tools. There is limited research that compares PWA's and PWD's language abilities, and a particularly small number of studies have an interactional focus. Aims In this study, we will contribute to the emergent discussion about interaction in aphasia and dementia. The aim was to investigate instances of trouble in conversations involving PWD, PWA and speech and language pathologists (SLPs), with a particular focus on trouble domain and interactional consequences. Methods & Procedures Ten PWD and 10 PWA were video-recorded during informal conversations with SLPs. Ten minutes of each conversation were transcribed thoroughly according to Conversation Analytical principles and instances of trouble were identified and calculated throughout the data. Thereafter, the instances of trouble were categorised by trouble domain: as connected to either primarily linguistic or cognitive issues. Outcomes & results At first glance, the conversations between the PWD and PWA seemed rather similar when looking at the number of turns and the number of instances of trouble. The analyses, however, reveal that significantly more turns were spent on trouble solving in the conversations involving the PWA. The vast majority of the troubles involving the PWA were categorised as being connected primarily to linguistic issues, whereas trouble among the PWD were more evenly distributed between the trouble domains. The SLPs took a more active role in supporting the conversations of the PWA than for the PWD. Conclusions The results indicate that many conversational troubles involving PWD are connected to primarily linguistic issues. However, PWD seem to have less severe linguistic problems compared to PWA. The analyses also reveal that many of the language problems described in PWD might be a direct consequence of cognitive issues, and that SLPs may take a more passive role in trouble solving in conversations involving PWD. The lack of personal common ground and preconceived notions about the medical conditions are discussed as potential motives for the SLPs' behaviour. The analysis of instances of trouble in informal conversations might contribute to both research and clinical assessment of language abilities in PWA and PWD.
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| 22. |
- Olsson, Camilla, 1971-, et al.
(författare)
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Relations between executive function, language, and functional communication in severe aphasia
- 2019
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Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 33:7, s. 821-845
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Tidskriftsartikel (refereegranskat)abstract
- Background: Intervention in severe aphasia often means aiming for access to meaningful social interaction in spite of linguistic barriers that might not be treatable. This demands knowledge about the different factors that influence functional communication. Apart from linguistic ability, executive functions are thought to play an important role.Aims: To expand the understanding of the relations of executive functions and linguistic ability to functional communication in severe aphasia.Methods and Procedures: Executive functions, linguistic ability, and functional communication were assessed in 47 participants with severe aphasia. The results were analysed for the total sample and for a verbal and a nonverbal subgroup.Outcomes and Results: Impairment of executive function was found in 79% of the participants. There were moderate to strong correlations between all subtests of executive functions and linguistic ability. In the total sample, significant partial correlation was found between functional communication and verbal output. In the nonverbal subgroup, there was a significant partial correlation between executive function and functional communication, when controlling for linguistic ability. In the verbal subgroup, no relations were found between executive functions or language and functional communication.Conclusions: Impairments of executive functions are common in people with severe aphasia, and executive function and linguistic ability are closely related. The ability to produce verbal output is strongly related to functional communication, but in people with extreme limitation or total absence of verbal output, executive functions seem to be an important factor for functional communication. There is a large variation of executive functions and functional communication in people with severe aphasia, especially in the nonverbal subgroup. It is important that people with severe aphasia are given a complete and proper evaluation of their abilities, and that the possible importance of executive function to communication is considered in communication intervention.
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| 23. |
- Persson, Klara Josefina, et al.
(författare)
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Do best practice recommendations align with current aphasia practices in the Swedish care context : a national survey
- 2022
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Ingår i: Aphasiology. - : Routledge. - 0268-7038 .- 1464-5041. ; 36:8, s. 903-920
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Tidskriftsartikel (refereegranskat)abstract
- Background: For healthcare professionals, decision-makers and taxpayers, clinical guidelines and recommendations are tools for implementing interventions supported by research evidence. To ensure efficient, safe, and equal care for people with aphasia (PWA) in Sweden, it is vital that speech and language pathologists (SLPs) can work in accordance with evidence-based practice.Aim: To investigate to which degree the Best practice recommendations for aphasia (BPRA) are already well aligned with current practice in the management of aphasia and to what extent they would require adjustment to fit the Swedish care contexts.Methods and procedures: The BPRA were translated from English to Swedish according to steps 1 and 2 in the translation method recommended by the World Health Organization (WHO). A web-based questionnaire was used for data collection. All healthcare regions in Sweden were represented, and the study included a total of 109 SLPs. The participants' perceived knowledge and application of the recommendations and whether the recommendations can serve as a basis for national clinical guidelines were summarized quantitatively. The participants' comments on the applicability of the BPRA were analyzed with qualitative content analysis according to an established model.Outcomes and results: Only a few participants indicated they had good knowledge of the BPRA. The responses additionally showed that the application of the BPRA varied between the participants and across clinical settings. Lacking SLP resources was stated to be the main perceived barrier for complying with the recommendations. The participants also stated that the BPRA requires adjustment to provide a partial basis for national clinical guidelines for aphasia and the need for national clinical guidelines to be adjusted to prevalent SLP resources.Conclusions: There are challenges in following up on some of the interventions that, according to both multinational recommendations and Swedish guidelines, should be given priority in the care of PWA. The barriers that are stated to complicate Swedish SLPs' compliance with some of the multinational recommendations are similar to the barriers posed by SLPs in other national studies on the uptake of aphasia rehabilitation recommendations. In Sweden, SLPs experience a lack of resources of various kinds to be able to fully comply with the BPRA.
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| 24. |
- Saldert, Charlotta, 1966, et al.
(författare)
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An interaction-focused intervention approach to training everyday communication partners: A single case study
- 2015
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Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 29:3, s. 378-399
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Tidskriftsartikel (refereegranskat)abstract
- Background: Communication partner training appears to be a growing area within aphasiology. Much of the work carried out so far has focused on training volunteers to have conversations with people with aphasia in order to improve communication and the person with aphasia’s (PWA’s) psychosocial well-being and/or improving the ability of significant others to communicate information with the PWA within clinical tasks. In this paper we present the results of a single-case intervention study which used an interaction-focused approach to target the conversational behaviours of the significant other of a PWA with the aim of improving the dyad’s everyday conversations within the home environment. Aims: To discuss the targeting, implementation and evaluation of an interaction-focused intervention programme for a significant other of a person with aphasia. Methods & Procedures: Conversation Analysis was used both to guide choice of individualised target behaviours for the intervention and to explore changes in the conversational interaction between a woman with mild-moderate aphasia and her life partner. Three samples of video-recorded natural conversational interaction from before and after the partner took part in a six session long group intervention were analysed. The evidence for change that emerged from qualitative analysis of the conversational data was further analysed by an independent, blinded, assessor doing quantitative comparisons. Outcomes & Results: There was qualitative and quantitative evidence that two of three targeted conversational behaviours had changed following the intervention programme. Following the completion of the intervention the dyad spent significantly less time in pedagogic activities. Furthermore, the significant other showed an increased attention towards PWA’s conversational contributions. The combination of qualitative and quantitative analyses also revealed that post-intervention the communication partner displayed changes in an interactional behaviour which was not targeted in the intervention i.e. dismissive language towards the person with aphasia. Conclusions: This study adds to the existing literature in presenting positive results from an intervention which used an interaction-focused approach, here targeted towards the everyday communication partner of a PWA. Notably, this study supplemented qualitative outcomes with blinded and statistical quantitative analyses. Also, the fact that no transcriptions were used during the intervention process and that therapy was delivered via group intervention shows the feasibility of this form of communication partner training in clinical settings. Furthermore, the study suggests that intervention programmes targeting the behaviours of a communication partner may produce positive change in conversational behaviours that have not been directly targeted in the intervention.
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| 25. |
- Saldert, Charlotta, 1966, et al.
(författare)
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Complexity in measuring outcomes after communication partner training: Alignment between goals of intervention and methods of evaluation
- 2018
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Ingår i: Aphasiology. - : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 32:10, s. 1167-1193
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Tidskriftsartikel (refereegranskat)abstract
- Background: Researchers are currently discussing the need for consensus on a core set of outcome measures to assess interventions in aphasia. For indirect, environmental approaches to aphasia intervention, such as communication partner training (CPT), the roadmap to obtaining consensus on core outcome measures seems especially complex. While the purpose of CPT is to improve communication for people with communication disorders, the intervention is aimed at the communication partner. There is also a variety of goals, activities, and possible settings for CPT. This complexity increases the risk of a mismatch between the goals and content of the intervention and measures used to evaluate the outcome.Aims: The purpose of this paper is to describe the complexity of measuring outcomes from CPT. The aim is to enable clinicians and researchers to reflect on the outcomes to be measured and also on how different types of measures may or may not be aligned with the goals and content of a specific CPT intervention.Main contribution: The current proliferation of outcome measures used in CPT is considered in the light of a survey of general factors to be considered in evaluating intervention outcomes. The complexity of measuring outcomes in CPT is illustrated and the importance of alignment of main objectives, intervention tasks, and projected outcomes is exemplified by referencing two common types of CPT approaches. Objectives relating to knowledge of aphasia, interactional behaviour, and feelings and attitudes are considered in relation to specific outcome measurements. It is suggested that both study-specific and more general measures are needed for capturing and comparing outcomes. The measurement of relevant outcome in CPT is discussed along with implications for future research and clinical practice.Conclusions: Different CPT approaches share the same purpose of facilitating communication in aphasia, but their application in research studies or in the clinic, is specific to the particular context. Special care must thus be taken in both clinical practice and research to safeguard the alignment between objectives, tasks, and projected intervention outcomes and the actual measures used. Further, it is concluded that there is a need for the development of new measures based on a consensus on key outcomes to be measured in CPT.
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| 26. |
- Saldert, Charlotta, 1966, et al.
(författare)
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Conversation partner training with spouses of persons with aphasia : A pilot study using a protocol to trace relevant characteristics
- 2013
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Ingår i: Aphasiology. - Abingdon : Routledge. - 0268-7038 .- 1464-5041. ; 27:3, s. 271-292
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Tidskriftsartikel (refereegranskat)abstract
- Background: Conversation partner training can be effective in improving communication in aphasia. However, there is a need for further research about effects of specific training programmes as well as about the relevant characteristics of the conversation partners who are to be candidates for training.Aims: This pilot study explores the applicability of an adaptation of a conversation partner training programme. In addition, a protocol for assessment of variables relating to the person with aphasia and the conversation partner that may be involved in changes in conversational interaction is examined.Methods & Procedures: Three dyads with persons with aphasia and their spouses participated in this explorative study with a case-series design. The training outcome was monitored with measures of perceived functional communication and analysis of multiple video-recorded natural conversations obtained at baseline, post intervention, and at a 12-week follow-up. Repeated measures of comprehension, word fluency, and psychological well-being were obtained as well as descriptive measures of the executive function and a profiling of attitudes and behaviour in communication in the spouses.Outcomes & Results: All three persons with aphasia and two of the spouses reported a slight improvement in the measure of perceived functional communication. This perception of improvement was also reflected in blinded, independent assessments of ability to support communication in conversations for the two spouses who reported improvement. The profiling of the third spouse indicated problems in attitudes to communication and also in aspects of executive function, and may account for the lack of intervention effects seen in the third dyad.Conclusions: The results show that intervention with the adapted training programme may be effective. It might be argued that the outcome measures as well as other measures fulfil their purpose. The profiling of relevant traits in the conversation partner may be useful, although the prognostic validity of the instruments needs to be further evaluated. © 2013 Copyright Taylor and Francis Group, LLC.
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| 27. |
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| 28. |
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| 29. |
- Taubner, Helena, 1977-, et al.
(författare)
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Still the same?–Self-identity dilemmas when living with post-stroke aphasia in a digitalised society
- 2020
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Ingår i: Aphasiology. - Abingdon : Informa UK Limited. - 0268-7038 .- 1464-5041. ; 34:3
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Tidskriftsartikel (refereegranskat)abstract
- © 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Background: Self-identity construction through “stories of self” is highly relevant for people with aphasia, not only because the onset entails a “biographical disruption” but also since their ability to keep their “stories of self” going is reduced. Three dilemmas (constancy/change, sameness/difference and agency/dependency) are known to be central to identity. In a digitalised society like Sweden, self-identity construction, including the navigation of these dilemmas, takes place both online and offline. Nevertheless, research combining aphasia, identity and online issues is scarce. Aim: This qualitative study aims, in termsidentity dilemmas, to investigate self-identityconstruction in working-agepersons living with post-strokeaphasia in adigitalised society (i.e. Sweden). Are the dilemmas relevant to the participants, and if so, how do they navigate them online and offline? Methods and Procedures: Nine individuals (three men and six women, aged 24–54 at onset) with mild or moderate post-stroke aphasia participated. The data comprises nine individual audio-recorded interviews and 1,581 screenshots from online observations. Qualitative analyses were performed (vertically and horizontally), combining inductive and deductive approaches. Outcomes and Results: All three dilemmas are relevant to the participants. They construct their self-identity as both the same as they were pre-stroke and changed. They are both the same and different in relation to other stroke survivors (with or without aphasia), i.e. both “disabled” and “normal”. They display both dependency and agency. Thus, they navigate the dilemmas by constantly negotiating what to include in their stories of self. In addition, telling one story of self offline does not imply telling the same story online. Conclusion: The dilemmas are intertwined and highly relevant to the participants. Offline and online settings evoke different ways for them to navigate the dilemmas. Increased awareness of the possible struggle with self-identity dilemmas in people with aphasia, and the possible difference between their online and offline self-identities, should be of value to family members, clinicians and researchers. Further research based on a larger sample is suggested.
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| 30. |
- Torinsson, Malin, et al.
(författare)
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Telerehabilitation with Verb Network Strengthening Treatment (VNeST) in two participants with mild-to-moderate and moderate-to-severe aphasia: A single-case experimental design study
- 2024
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Ingår i: APHASIOLOGY. - 0268-7038 .- 1464-5041.
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundVerb Network Strengthening Treatment (VNeST) is a verb-centred aphasia treatment that targets the semantic relationships between a verb (e.g., dig) and related content words (e.g., gardener, hole), aiming to promote word retrieval and sentence production in aphasia. Previous research shows promising results of VNeST in several participants.AimsThis study investigates the effects of VNeST through telerehabilitation on word retrieval and sentence production with treated and semantically related untreated verbs, as well as the possible generalisation to confrontation naming and connected speech. Further, functional communication, communicative participation, health-related quality of life and client satisfaction are explored.Methods and ProceduresA single-case experimental design study with multiple baselines was conducted with two participants with stroke-induced mild-to-moderate Broca's aphasia or moderate-to-severe Wernicke's aphasia who received VNeST through telerehabilitation. Percentage of non-overlapping data, Baseline Corrected Tau and d-index effect size were used to measure improvement in word retrieval and sentence production elicited through video-clip stimuli. The study is registered with ClinicTrials.gov, number NCT05152979.Outcomes and ResultsThe participant with Wernicke's aphasia improved in word retrieval in sentences with trained and untrained verbs and showed some - albeit limited - generalisation to confrontation naming of nouns and verbs. The participant with Broca's aphasia withdrew after half of the planned dosage, as he did not consider VNeST suitable for his needs. He did not improve in word retrieval or sentence production.ConclusionsVNeST shows promise when it comes to improving word retrieval in trained and semantically related untrained stimuli in moderate-to-severe Wernicke's aphasia. This study adds to the existing literature by showing potential improvement in VNeST through telerehabilitation.
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