Effects of syntactic cueing therapy on picture naming and connected speech in acquired aphasia

Abstract

Language therapy for word-finding difficulties in aphasia usually involves picture naming of single words with the support of cues. Most studies have addressed nouns in isolation, even though in connected speech nouns are more frequently produced with determiners. We hypothesised that improved word finding in connected speech would be most likely if intervention treated nouns in usual syntactic contexts. Six speakers with aphasia underwent language therapy using a software program developed for the purpose, which provided lexical and syntactic (determiner) cues. Exposure to determiners with nouns would potentially lead to improved picture naming of both treated and untreated nouns, and increased production of determiner plus noun combinations in connected speech. After intervention, picture naming of treated words improved for five of the six speakers, but naming of untreated words was unchanged. The number of determiner plus noun combinations in connected speech increased for four speakers. These findings attest to the close relationship between frequently co-occurring content and function words, and indicate that intervention for word-finding deficits can profitably proceed beyond single word naming, to retrieval in appropriate syntactic contexts. We also examined the relationship between effects of therapy, and amount and intensity of therapy. We found no relationship between immediate effects and amount or intensity of therapy. However, those participants whose naming maintained at follow-up completed the therapy regime in fewer sessions, of relatively longer duration. We explore the relationship between therapy regime and outcomes, and propose future considerations for research.

Keywords:

• Anomia
• Therapy
• Syntax
• Determiner
• Connected speech

Acknowledgments

This study was supported by funding from: Sheffield University Proof of Commercial Concept Fund, Yorkshire Concept Proof of Commercial Concept Fund, and Sheffield University Enterprises Limited. Thank you to the participants with aphasia who gave their time to the study so enthusiastically.

 A version of the software program (STAR: Sheffield Therapy for Anomia Rehabilitation) used in this study is currently undergoing testing prior to obtaining a commercial licence.

Notes

¹Wisenburn and Mahoney (2009) recommend less conservative effect sizes. We elected to use these values however, as the magnitude mapped logically onto statistical significance values derived from the McNemar tests.