At the Shirley Ryan AbilityLab (SRALab), we recorded using functional near-infrared spectroscopy (fNIRS) during a resting-state condition and an oral reading condition to determine the reliability of graph metrics for functional connectivity data in this population.
fNIRS Setup at SRALabIn partnership with Dr. Knowles in the SONiC lab and Dr. Wolfe in the Department of Communication, we are examining communication strategies and resilience between adults with neurogenic communication impairments and their care partners in a mixed methods study.
Introduction: Many people with aphasia experience concomitant executive functioning deficits, and the literature supports a role of executive functioning in treatment response. However, the optimal executive functioning assessment for measuring this impact is unclear, as is the extent to which outcomes (e.g., acquisition, generalization) may be impacted differently. The present retrospective study aimed to determine the degree to which nonverbal fluency, one measure of executive functioning with minimal language demand, was associated with naming treatment acquisition, stimulus generalization, and response generalization in people with chronic aphasia. We hypothesized that nonverbal fluency would be positively associated with treatment acquisition and both forms of generalization, based on the existing literature.
Methods: This retrospective study included 13 participants with chronic, post- stroke aphasia from a completed clinical trial. Participants completed 2 weeks of a cued picture-naming treatment. Using linear regression, we examined the association between baseline nonverbal fluency and Tau-U treatment effect size for trained (acquisition) and untrained items (response generalization) and per- cent stimulus generalization (definition naming).
Results: Controlling for aphasia severity, nonverbal fluency was a small but sig- nificant correlate of response and stimulus generalization, but not of treatment acquisition.
Discussion: Nonverbal fluency may be associated with generalization, whereby executive functioning abilities may support generalizing aphasia interventions beyond trained items and contexts. However, more research is needed to inves- tigate the potential association between executive functioning and various treat- ment outcomes as well as its clinical utility.
Purpose: The optimal schedule for delivering a given aphasia treatment is unknown. Competing theories suggest that both intensive (i.e., massed) and distributed (i.e., spaced) treatment schedules have benefits. Moreover, studies that have begun to investigate optimal delivery schedules have emphasized treatments for single-word retrieval rather than treatments that target connected language and have greater potential for generalization. The present study compared outcomes from three conditions of a script-training treatment, varying in session frequency.
Method: Participants were 45 adults with chronic poststroke aphasia (3 months poststroke). All study activities took place at an urban freestanding rehabilitation center. This dose-controlled quasi-randomized pilot clinical trial involved six 1-hr sessions of computer-based script training in each of three conditions: standard (two sessions per week for 3 weeks; n = 15), intensive (three sessions per week for 2 weeks; n = 15), and attenuating (three sessions in the first week, two sessions in the second week, and one session in the third week; n = 15). Treatment was delivered via the AphasiaScripts software, which involved repeated practice of each sentence from a scripted conversation with a virtual clinician. Outcome measures included the proportion of correct to total possible words in the script (i.e., accuracy), duration of script production (i.e., rate), and the percentage of correct essential information units during a conversation with a novel communication partner (i.e., stimulus generalization). Outcomes were analyzed using Bayesian linear mixed-effects models for accuracy, speech rate, and generalization of essential information units.
Results: The main effects of treatment, regardless of condition, were positive between baseline and posttreatment, as well as between baseline and 1, 2, and 4 weeks posttreatment (follow-up). There were no statistical differences in the main effects of accuracy or rate between conditions and no interaction effects. The main effects of generalization, regardless of condition, were not statistically reliable between baseline and posttreatment but were positive between baseline and follow-up 4 weeks after treatment.
Conclusions: Results suggested that, given six 1-hr script-training treatment sessions, session frequency did not influence outcomes in terms of accuracy, rate, or generalization. Rather, all three frequency conditions produced statistically reliable positive treatment effects.
Figure 6. Script generalization.
Figure 2. Semantic and Phonological Regions in Older Adults.