Therapy for word-finding in aphasia : effects on picture naming and conversation
Therapy for word finding deficits in aphasia have taken two forms: semantic and phonological, with relatively more examples of the former in the literature. Criticisms levelled against such therapies focus on the fact that in most reported cases treatment effects are limited to treated items, and there is very little evidence of real functional change in terms of improvement in everyday speech for the person with aphasia. Behaviour in conversation can vary and for this reason it is important to establish reliability and stability of the aspects of conversation under scrutiny. This was carried out in the work reported here in order to identify aspects of conversation which might be used as outcome measures for therapy. The analysis of inter and intra-rater reliability and of test retest stability produced a measure which was used to identify the effects of two forms of therapy. The two forms of therapy were presented consecutively to three people with aphasia. In the first phase phonological and orthographic cues were used. In the second phase participants were encouraged to use the set of treatment words in speech situations, ranging from naming to definition to use in conversation. The effect of each form of therapy on picture naming and on conversation was measured. The results showed a positive effect of the phonological and orthographic cues for two of the participants in terms of gains in picture naming. For the third participant this therapy was ineffective. The second phase of therapy was effective for all three in terms of gains in items only treated in that phase of therapy. The analysis of the conversation data showed unstable baselines for a number of aspects for all three participants. Nevertheless there were some aspects which were stable for a given individual and some evidence of positive changes after therapy.