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Results for Adults Aphasia Book 1
Ages: 16-Adult   Grades: 11-Adult

Treat a wide range of clients with aphasia and adjust the tasks quickly within the therapy session with this book.

Outcomes

  • Progress in auditory comprehension ranging in difficulty from picture identification to following verbal directions
  • Progress in verbal expression ranging from word imitation to verbal reasoning/problem solving
  • Improve word retrieval, specifically nouns
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Clients respond to your prompts while looking at items pictured individually and in scenes.  The picture stimuli and verbal prompts are adaptable to a variety of treatment approaches, including linguistic stimulation, semantic features, and phonological treatment.

The book is divided into two difficulty levels, and each level includes pictures and prompts for auditory comprehension and verbal expression tasks.

Level 1 presents six items pictured individually on a page. 

  • The auditory comprehension tasks include:
    • picture identification
    • two and three item series
    • one-item descriptions
    • two-item descriptions
    • yes/no questions
  • The verbal expression tasks include:
    • word imitation
    • automatic completion
    • sentence completion
    • sentence imitation
    • sentence stimulation
    • naming by semantic association
    • confrontational naming

Level 2 uses simple, everyday scenes. 

  • The auditory comprehension tasks include:
    • yes/no questions
    • sentence comprehension
    • listening for words in sentences
    • following directions
  • The verbal expression tasks include:
    • open sentence completion with a noun
    • open sentence completion with a phrase
    • sentence formulation with verb/noun cues
    • sentence formulation with noun cues
    • expanding expression
    • verbal reasoning/problem solving

Copyright © 2009

Components
176 pages
  • Subjects benefitted maximally when training combined comprehension tasks with word production.  Comprehension training is most effective when semantic and phonologic processing are incorporated (Raymer, 2005).
  • According to Goodglass and Wingfield (as cited in Raymer, 2005), individuals with anomic aphasia have greater difficulty with nouns than with other grammatical categories (Raymer, 2005).
  •  ". . . carefully controlled studies have demonstrated that factors such as imageability, length, familiarity, and especially age of acquisition have a more potent effect on noun and verb naming abilities than word frequency."  Stimulus materials for naming tasks need to incorporate these variables that can influence naming performance (Raymer, 2005).
  • Clinicians should probe and explore each patient's responses to a variety of stimuli and changes in task parameters to form successful approaches to aphasia treatment (Helm-Estabrooks & Albert, 2004).
  • The ability to retrieve words in picture naming and in conversation are related (Holland, Fromm, DeRuyter, & Stein, 1996).
  • There is evidence that individuals with aphasia who receive speech and language treatment have significantly better outcomes than those individuals with aphasia who do not receive treatment (Hickin, Best, Herbert, Howard, & Osborn, 2003).
  • Individuals with aphasia can often overcome word retrieval difficulties if the listener supplies them with a simple cue.  Cueing hierarchies may be useful for individuals with a variety of naming impairments (Raymer, 2005).  

Results for Adults Aphasia Book 1 incorporates these principles and is also based on expert professional practice.

References

Helm-Estabrooks, N. & Albert, M.L. (2004). Manual of aphasia and aphasia therapy (2nd ed., p. 167). Austin, TX: Pro-Ed.  

Hickin, J., Best, W., Herbert, R., Howard, D., & Osborn, F. (2003). Therapy for word finding difficulties in aphasia: Measuring the impact on real-life communication. Proceedings of the Fifth European Congress of CPLOL.  

Holland, A.L., Fromm, D.S., DeRuyter, F., & Stein, M. (1996). Treatment efficacy: Aphasia. Journal of Speech and Hearing Research, 39, S27-S36.  

Raymer, A.M. (2005). Naming and word-retrieval problems. In L.L. LaPointe (Ed.), Aphasia and related neurogenic language disorders (3rd ed.). New York: Thieme.

Author(s)

Christine Johnson

Biography

Christine Johnson, M.S., CCC- SLP, worked as a speech-language pathologist in healthcare for over 20 years in inpatient, outpatient, home-based, and skilled nursing settings.  She has a special interest in stroke treatment and has helped develop a day rehab program, a stroke support group, community education programs, and care paths for individuals with strokes.  She enjoys country living in west-central Illinois as well as playing the piano, reading, and visiting family.  She is currently a marketing coordinator at LinguiSystems.  Results for Adults Aphasia Book 1 is Christine's first publication with LinguiSystems.

Introduction

I've worked in various healthcare settings for over 20 years and have had the privilege of treating many clients with aphasia.  The complexity of language and language-based cognition are both intriguing and challenging.

Current research confirms that the injured brain is flexible and capable of change, and in fact, neuroimagining studies provide evidence of a significant relationship between neuroplastic changes and language recovery (Raymer et al., 2008).  In terms of aphasia therapy, research continues to show that aphasia treatment is much more effective compared to spontaneous recovery alone; however, more data is needed to determine whether different types of treatment help different forms of aphasia and different language behaviors (Raymer et al., 2008).  As clinicians, we know that different types of strokes and brain injuries require different treatment approaches, which is why it's vital to evaluate each client's performance prior to treatment and then match appropriate therapy techniques to the individual client.

Results for Adults Aphasia Book 1 is a flexible, adaptable resource with two levels of difficulty designed to help you treat a wide range of clients at various levels of care.  The lessons are organized alphabetically by category or topic area, and the tasks are presented in general order of difficulty according to auditory comprehension and verbal expression skills.  Noun naming is heavily emphasized since individuals with anomic aphasia have greater difficulty with nouns than with other grammatical categories (Raymer, 2005).  In some cases, the stimuli are constrained by the semantic category.

This book is unique in that pictured items are presented with a hierarchical sequence of written/verbal stimuli.  This format allows you to easily adjust the level of difficulty during the therapy session.

 

Instructions
The lessons in Results for Adults Aphasia Book 1 are grouped by semantic categories and are divided into two levels, picture grids and scenes.  Each two-page lesson includes a picture page with corresponding verbal stimulus items.  Level 1 lessons contain a picture page with six individual pictures and a task page with auditory comprehension and verbal expression stimuli.  Level 2 lessons include a simple, everyday scene with functional tasks that require increasingly more complex auditory comprehension and verbal expression.  The lessons do not need to be presented sequentially; rather, choose lessons that meet your individual client's interests and needs.

Level 1—Picture Grids

  • Auditory Comprehension Tasks
    • Picture Identification—The client points to each picture as you name it.  To make the task easier, you can limit the number of choices.  Some clients benefit from having only two choices initially.  To add difficulty, increase the number of choices in subsequent trials.
    • Two- and Three-Item Series—The client points to the two or three pictures you name.
    • One-Item Descriptions—The client points to the picture you describe using a carrier phrase for each item.  Some clients with auditory comprehension difficulties may require a shorter auditory stimulus, so a simpler stimulus is also provided.
    • Two-Item Descriptions—The client points to two pictures you describe using the stimuli from the previous task.
    • Yes/No Questions—The client responds to questions about the pictured items.  Since clients with aphasia frequently perseverate on a verbal yes/no response, you may want to allow the client to point to a written yes or no or to respond using a head nod or shake.
  • Verbal Expression Tasks
    • Phonological Cue—Rhyming words and nonsense words are provided and can be given as cues if the client has difficulty formulating a response during any of the verbal expression tasks.
    • Word Imitation—The client repeats the name of each picture.
    • Automatic Completion—The goal of this task is to stimulate word retrieval at the automatic level.  The length of the stimuli varies from a two- or three-word phrase to a short sentence, depending on the linguistic context of the item group.
    • Sentence Completion—The client listens to the starter words and provides a noun to complete each sentence.
    • Sentence Imitation—The client repeats a sentence about each picture.
    • Sentence Stimulation—The client listens to a question and supplies the answer, imitating the syntax presented in the question.  This task could also be adapted to train for pronouns.
    • Naming by Semantic Association—The client gives the semantic features of each stimulus word with your cues.
    • Confrontational Naming—The client names each picture as you point to it.  To make the task easier, allow the client to point to each picture in the order he chooses and name it.  Some pictures include labels for recognition purposes.  For a true measure of confrontational naming, photocopy the picture page and white-out the labels.

Level 2—Scenes

  • Auditory Comprehension Tasks
    • Yes/No Questions—The client answers questions about items in the scene.
    • Sentence Comprehension—The client listens to each sentence description and identifies the item(s) in the scene.
    • Listening for Words in Sentences—The client points to the picture he hears in each sentence.
    • Following Directions—The client follows directions related to items in the scene.
  • Verbal Expression Tasks
    • Open Sentence Completion with a Noun—The client listens to the starter words and provides a noun to complete each sentence.
    • Open Sentence Completion with a Phrase—The client formulates a phrase-length response to complete each sentence.
    • Sentence Formulation with Verb/Noun Cues—The client uses each verb/noun pair in a complete sentence.  To make the task easier, point to the noun in the scene when giving each cue.
    • Sentence Formulation with Noun Cues—The client uses each noun in a complete sentence.  To make the task easier, point to the picture in the scene when giving each cue.
    • Expanding Expression—The client gives a two- or three-sentence response for each prompt.  Encourage the client to draw on his own experiences as he formulates his responses.
    • Reasoning/Problem Solving—The client answers questions that require higher-level thinking.  This task is appropriate for clients working on cognition and advanced verbal expression using abstract language and reasoning.

Since the presentation of aphasia varies among individuals, my goal is to provide you with stimulus items arranged in a hierarchy that are flexible and adaptable to a variety of treatment approaches and settings.  I encourage you to change the order of the tasks and to adjust them to meet your individual client's needs.  I hope this book helps you provide meaningful and valuable therapy to your diverse caseload of clients with aphasia.

Christine