Semantic Feature Analysis Treatment for Aphasic Word Retrieval Problems:

1. Semantic Feature Analysis Treatment for Aphasic Word Retrieval Problems: The Challenge of Moving from Naming to Discourse Production Mary Boyle, Ph.D., CCC-SLP, BC-ANCDS Montclair State University CHSS Brown Bag Seminar 2/25/11

2. Acknowledgements Burke Rehabilitation Hospital Montclair State University Separately Budgeted Research Awards Graduate Assistants Participants with Aphasia

3. Semantic Feature Analysis Treatment • Organized method of activating semantic networks • Based on models of lexical retrieval that conceive of the semantic system as a network of concepts (Caramazza, 1997; Collins & Loftus, 1975; Gordon & Dell, 2003; Levelt, 2001; Oppenheim et al., 2010; Lombardi & Sartori, 2007; McRae et al., 2005)

4. Semantic Features grows on trees red fruit APPLE has skin used for cider has seeds has a core

5. Semantic networks: pear cherry banana apple radish lettuce celery pie cake

6. Used for cider has a core red fruit grows on trees has skin has seeds cherry APPLE radish (After Dell et al, 1997; Levelt, 2000, 2001)

7. PWA actively attempts retrieval of feature for each target in each treatment session • Therapist • Initially plays primary role • Gradually fades prompts, shifting burden to patient • Emphasized importance of using structured procedure consistently until pt. needs minimal/no cueing • Hypothesis: persistent practice with procedure would lead to more organized word retrieval without deliberate use of compensatory strategies

8. Results of C-SFA • 7 participants with mild or moderate aphasia secondary to L CVA or TBI benefited from C-SFA • Broca’s (N=2) • Anomic (N=2) • Conduction (N=1) • Wernicke’s (N=1) • fluent aphasia secondary to TBI (N=1) • (Boyle, 2004; Boyle & Coelho, 1995; Coelho, McHugh, & Boyle, 2000; Conley & Coelho, 2003)

9. Results of C-SFA

10. Generalization to discourse Macro versus micro discourse analysis Proxy measures versus direct measures Direct measures – what do neurologically normal adults do?

11. Results of C-SFA (continued)

12. Discourse Semantic Feature Analysis (D-SFA)

13. Variation: D-SFA PWA tells a story about wordless comic strip

14. 3 single subject designs • 52 yo female with conduction aphasia • 61 yo male with Broca’s aphasia • 61 yo male with Broca’s aphasia • 2 60-min sessions/wk for 12 sessions

15. Results: • Improved confrontation naming for treated Ns • Generalized to untreated Ns (including semantically unrelated) • Fewer word-finding behaviors in discourse • Participants with Broca’s aphasia improved in informativeness of discourse • Naïve listeners only judged one of the 3 participants to be better at word retrieval after treatment

16. Variability of word finding behaviors day-to-day • Test of Word Finding in Discourse • German, 1991; Boyle, 2004

17. Elicitation procedures described by Nicholas & Brookshire (1993) • 3 sessions, 2 to 7 days apart • Audio recorded • Transcript analysis (German, 1991): • Segmented into T-units • Total T-units calculated • Percentage of T-units with evidence of ANY word-finding behavior (%TWFB) • Percentage of T-units with each specific word-finding behavior

18. Summary Global measure of WFB in discourse, %TWFD, stable across sessions Distribution of specific WFBs changed across sessions for most participants

19. Video Retells • More like everyday discourse for adults • Word retrieval changes in normal aging • More empty words • Longer pauses • More incorrect object labels • Hedging about names • Compared 10 neurologically normal adults to 3 PWA retelling two episodes from “I Love Lucy”

20. Results • Empty words and delays were not most common word-finding behaviors in neurologically normal adults; reformulations and repetitions were • Reformulations and repetitions also most common for PWA • NN adults rarely produced word-finding behaviors in fragments • For PWA, fragments always associated with word-finding behaviors