Event Abstract

A Comparison of Two Treatment Approaches for Agrammatic Broca's Aphasia: Script Therapy vs. Verb Network Strengthening Treatment

  • 1 Seton Hall University, Speech Language Pathology, United States
  • 2 La Salle University, Communication Sciences and Disorders, United States

Background/Introduction: Individuals with agrammatic Broca’s aphasia frequently are treated at single word level, verb priming, or simple sentence structure treatments. In this study, an impairment specific treatment such as Verb Network Strengthening Treatment (VNeST) was explored as well as a social functional approach such as Script Therapy. These two approaches were assessed by the outcome measures of rate of speech, subject-verb-object production, and error rates during probe tasks. Objective: To examine the impact of two treatment approaches: Script Therapy and Verb Network Strengthening Treatment for two individuals with chronic agrammatic Broca’s aphasia. Method: The method used in this study was a single subject multiple baseline alternating treatment across participants’ design. Each participant received each therapy for 9 weeks and both treatments were counterbalanced. Generalization probes were administered on the second session of each treatment per week to assess pre-to-post outcome measures including rate of speech, subject- verb-object production (SVO), and error rate. Effect sizes were calculated for baseline through maintenance outcome measures. To analyze the inter-therapeutic effects of the two treatment, the Percentage of data Exceeding the Median (PEM) was used. Results: Both participants improved over the 18 weeks on rate of speech and subject verb-object (SVO) production during probe tasks. For P1, Error rates decreased from baseline to maintenance phases. Effect sizes were calculated for the baseline to maintenance phases using the Busk & Serlin’s d2 formula (1992). The effects size calculations were compared using the Beeson & Robey (2006) benchmarks for lexical and syntactic metanalyses for aphasia. For the baseline to maintenance effects, small effect sizes were found for both participants for rate of speech. For P1, a medium to large effect was noted for SVO production. P2’s effect size for SVO production revealed no effect. Error rates for P1 revealed no effect. P2’s error rate produced a small unfavorable effect. Conclusions: Both participants benefitted from the two treatment approaches in individual ways. It is possible that the multi-modal nature of the training between VNeST and Script that engaged functional sentence production and a linguistic approach for sentence production contributed to a positive language change for these participants.

References

Ballard, K., & Thompson, C. (1999). Treatment and generalization of complex sentence production in agrammatism.
Journal of Speech, Language, and Hearing Research, 42(3), 690-707.
Basso, A (2003). Aphasia and its Therapy. New York: Oxford University Press.
Basso, A. (2010). “Natural” conversation: A treatment for severe aphasia. Aphasiology 24 (4), 466-479.
Beeson, P, & Robey R. (2006). Evaluating Single Subject Treatment Research: Lessons Learned from Aphasia Literature.
Neuropsychology Review, 16 (4), 161-169.
Bilda, K. (2011). Video-based conversational script training for aphasia: A therapy study. Aphasiology, 25(2), 191-201.
Boyle, M. (2004). Semantic feature analysis treatment for anomia in two fluent aphasia syndromes. American Journal of
Speech-Language Pathology, 13,236-249.
Busk, P. & Serlin, R. (1992). Meta analysis for single case research. In T. R. Kratochwill & J. R. Levin (Eds.), Single
Case Research Design and Analysis: New directions for psychology and education. Hillsdale, N.J.: Lawrence Erlbaum Associates
Cameron, R.M., Wambaugh, J.L., & Mauszycju, S.C. (2010). Individual Variability on Discourse Measures over Repeated sampling times in persons with aphasia. Aphasiology, 24, 6-8, 671-684.
Capilouto, G. J., Wright, H. H., & Wagovich, S. A. (2006). Reliability of main event measurement in the discourse of individuals with aphasia. Aphasiology, 20(2-4), 205-216. doi:10.1080/02687030500473122
Cherney, L. (2010). Oral Reading for Language in Aphasia: Impact of Aphasia Severity on Cross-Modal Outcomes in Chronic
Nonfluent Aphasia. Seminars in Speech and Language, 31(1), 42-51.
Cherney, L. , Halper, A., Holland, A., & Cole, R. (2008). Computerized script training for aphasia: Preliminary results.
American Journal of Speech - Language Pathology, 17(1), 19-34.
Cherney, L., Halper, A., & Kaye, R. (2011). Computer-based script training for aphasia: Emerging themes from post-
treatment interviews. Journal of Communication Disorders, 44(4), 493-501. doi:http://dx.doi.org/10.1016/j.jcomdis.201
Cherney, L. R., Halper, A. S., Holland, A. L., Lee, J. B., Babbitt, E., & Cole, R. (2007). Improving conversational script production in aphasia with virtual therapist computer treatment software. Brain and Language, 103, 246-247.
Clark, D. G., Charuvastra, A., Miller, B. L., Shapira, J. S., & Mendez, M. F. (2005). Fluent versus nonfluent primary progressive aphasia: A comparison of clinical and functional neuroimaging features. Brain and Language, 94(1), 54-60.
Cohen J. (1988). Statistical Power Analysis for the Behavioral Sciences. New York, NY: Routledge Academic
Connell P. & Thompson, C. (1986). Flexibility of using single subject designs. Part III. Using flexibility to modify or
design experiements. Journal of speech and hearing disorders, 51, 214-225
Cruice, M, Worrall L.,. Hickson L., Murison R. (2003) Finding a focus for quality of life with aphasia: Social and emotional health, and psychological well-being. Aphasiology, 17(3), 333-353.
Dickey, M. W., Milman, L. H., & Thompson, C. K. (2008). Judgment of functional morphology in agrammatic aphasia.
Journal of Neurolinguistics, 21(1), 35–65. http://doi.org/10.1016/j.jneuroling.2007.08.001
Edmonds, L. A., & Babb, M. (2011). Effect of verb network strengthening treatment in moderate-to-severe aphasia. American Journal of Speech - Language Pathology (Online), 20(2), 131-145A. Retrieved from http://search.proquest.com/docview/868261347?accountid=11999
Edmonds, L. A., Nadeau, S. E., & Kiran, S. (2009). Effect of verb network strengthening treatment (VNeST) on lexical
retrieval of content words in sentences in persons with aphasia. Aphasiology, 23(3), 402-424. doi:10.1080/02687030802291339.
Edmonds,L.,Mammino, K, & Ojeda,J. Effects of Verb Network Strengthening Treatment in persons with aphasia:
Extension and replication of previous findings. American Journal of Speech-Language Pathology, 23 (2), S312-S329.
Ellis, C., Lindrooth, RC., Horner, J., (2014). Retrospective cost-effectiveness analysis of treatments for aphasia: an
approach using experimental data. American Journal of Speech Language Pathology, 23, (2), 186-195.
Elman, R. J. and Bernstein-Ellis, E. (1999). The efficacy of group communication treatment in adults with chronic
aphasia. Journal of Speech, Language, and Hearing, 20(1), 65-72.
Edmonds,L.,Mammino, K., & Ojeda,J. Effects of Verb Network Strengthening Treatment in persons with aphasia:
Extension and replication of previous findings. American Journal of Speech-Language Pathology 23 (2), S312-S329.
Elman, R. J. and Bernstein-Ellis, E. (1999). The efficacy of group communication treatment in adults with chronic aphasia. Journal of Speech, Language, and Hearing, 20(1), 65-72.
Engelter, S., Gostynski, M., Papa, S., Frei, M., Born, C., Ajdacic-Gross, V., Gutzwiller, F., Lyrer, P. (2006) Epidemiology of
Aphasia Attributable to First Ischemic Stroke: Incidence, Severity, Fluency, Etiology, and Thrombolysis. Stroke, 37, 1379-1384.
Friedmann, N., & Shapiro, L. (2003) Agrammatic comprehension of OSV and OVS sentences in Hebrew. Journal of
Speech, Language, and Hearing Research, 46: 288-297.
Furnas, D.W. & Edmonds, L.A. (2014). The effect of computerized verb network strengthening treatment on lexical retrieval
in aphasia. Aphasiology, 28 (4), 988-1012.
Galletta, E.E., & Barrett A.M., (2014). Impairment and Function Interventions for Aphasia: Having it all. Current Physical
Medicine and Rehabilitation Reports, 2 (2), 114-120.
Gierut, J., Morrisette, M., Dickinson, S. (2015). Effect size for single-subject design in phonological treatment. Journal of speech, language, and hearing research, 58 (5), 1464-1481.
Gordon,J. (1998). The Fluency Dimension in Aphasia. Aphasiology, 12, 7-8, 675-688.
Helm-Estabrooks, N. (2002). Cognition and aphasia: A discussion and a study. Journal of Communication
Disorders, 35, 171-186.
Holland, A., Halper, A., & Cherney, L. (2010). Tell me your story: Analysis of script topics selected by
persons with aphasia. American Journal of Speech-Language Pathology, 19(3), 198-203.
Howards, D., Best, W., & Nickels, F. (2015). Optimising the design of intervention studies :critiques and ways
forward. Aphasiology, 29, 185-198.
Jacobs B, Thompson CK. Cross-modal generalization effects of training noncanonical sentence
comprehension and production in agrammatic aphasia. Journal of Speech, Language, and Hearing Research, 2000;43:5–20.
Kagan, A. (1998). Supported conversation for adults with aphasia: Methods and resources for training
conversation partners. Aphasiology , 12(9), 816-838
Kagan, A., Mackie, N., Rowland, B.A., Kagan, J., Huijbregts, Shumay, N., McEwen, S., Sharp, S. (2008).
Counting what counts: A framework for capturing real-life outcomes of aphasia intervention. Aphasiology, 22 (3), pp. 258-280
Katz, R., & Wertz, R.(1997). The efficacy of computer-provided reading treatment for chronic aphasic adults. Journal of Speech, Language, and Hearing Research, 40(3), 493.
Lee, J., Kaye, R., & Cherney, L. (2009). Conversational script performance in adults with non-fluent aphasia: Treatment
and intensity and aphasia severity, Aphasiology, 27, (7-8), 885-997.
Lomas, J., Pickard, L., Bester, S., Elbard, H., Finlayson, A., & Zoghaib, C. (1989). The Communicative Effectiveness Index:
Development and Psychometric Evaluation of a Functional Communication Measured for Adult Aphasia. Journal of Speech and Hearing Disorders, 54,113-124.
McReynolds, L. & Thompson, C. (1986). Flexibility of Single subject experimental designs:Part 1. Review the basics of single
Subject designs. Journal of speech and hearing disorders, 51, 194-203. 
Miller, J. F., & Iglesias, A. (2012). Systematic Analysis of Language Transcripts (Version 12.0) [Computer software].
Middleton, WI; SALT Software, LLC).
Ma, H. (2006). An alternative method for quantitative synthesis of single-subject researches: Percentage of data
points exceeding the median. Behavior modification, 30(5), 598-617.
Martin, N., Fink, R., Laine, M. (2004). Treatment of word retrieval with contextual priming. Aphasiology, 18, 457-471.
Nicholas, L. & Brookshire, R. (1993). A System for Quantifying the Informativeness and Efficiency of the Connected
Speech of Adults with Aphasia. Journal of Speech and Hearing Research, 36, 338-350.
Nickels, L. (2002). Therapy for naming disorders: Revisiting, revising, and reviewing. Aphasiology, 16(10), 935-979.
Peach, R., & Reuter, K. (2010). A discourse-based approach to semantic feature analysis for the treatment of aphasic word retrieval failures. Aphasiology, 24(9), 971-990
Peach, R., & Wong, P. C. (2004). Integrating the message level into treatment for agrammatism using story retelling.
Aphasiology, 18(5-7), 429-441. Retrieved from http://search.proquest.com/docview/85329796?accountid=11999
Olswang, L. B. (1993). Treatment efficacy research: A paradigm for investigating clinical practice and theory. Journal of Fluency Disorders, 18(2-3), 125-131.
Plowman, E., Hentz, B., & Ellis, C. (2012). Post-stroke aphasia prognosis: A review of patient-related and stroke-related
factors. Journal of Evaluation in Clinical Practice, 18(3), 689-694. doi:10.1111/j.1365-2753.2011.01650.x
Raymer, A. M., & Ellsworth, T. A. (2002). Response to contrasting verb retrieval treatments: A case study. Aphasiology,
16(10), 1031-1045. doi:10.1080/026870401430000609
Raymer, A. M., & R

Keywords: agrammatic aphasia, Script Therapy, Verb network strengthening treatment, impairment specific approach, social conversation approach

Conference: Academy of Aphasia 56th Annual Meeting, Montreal, Canada, 21 Oct - 23 Oct, 2018.

Presentation Type: poster presentation

Topic: not eligible for a student prize

Citation: Costello-Yacono M and Balasubramanian V (2019). A Comparison of Two Treatment Approaches for Agrammatic Broca's Aphasia: Script Therapy vs. Verb Network Strengthening Treatment. Conference Abstract: Academy of Aphasia 56th Annual Meeting. doi: 10.3389/conf.fnhum.2018.228.00020

Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters.

The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated.

Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed.

For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions.

Received: 16 Apr 2018; Published Online: 22 Jan 2019.

* Correspondence:
Dr. Maureen Costello-Yacono, Seton Hall University, Speech Language Pathology, South Orange, NJ, 07079, United States, costellom3@lasalle.edu
Dr. Venugopal Balasubramanian, Seton Hall University, Speech Language Pathology, South Orange, NJ, 07079, United States, balasuve@shu.edu