Treatment in PPA Flashcards
T or F: There is a lack of computer based language studies for post-stroke aphasia
False - there is an abundance of studies looking at post-stroke but limited information on how to slow loss of words in individuals with NPPA
What is the rationale for using computer based language studies (MossTalk) in NvPPA?
- computer based treatment found efficacious
- cued naming found effective in Tx for anomia
- orthography found helpful in aphasia therapy
- combo of orthographic and phonological cues helpful in treatment of phonologically based anomia
In the MossTalk program, a picture of a raccoon is shown with the letter R below (orthographic clue). When is the full word ‘raccoon’ shown to the participant?
-whether they named the animal or correctly or not, the name shows up under the image
In PPA therapy, if you see _________ its great. If you see _______ this is a ‘big deal’
maintenance
improvement
From the MossTalk experiment, the 2 participants showed post-tx effects _______ later and marginal maintenance _________ post-tx
4 weeks
6 months
What are the conclusions about MossTalk for NPPA?
- both patients benefitted (to diff degrees) from a computer based treatment for anomia
- effectiveness of treatment for anomia in NPPA comparable or better to post-stroke anomia (looking at maintenance)
- computer based treatment may be viable Tx approach for patients who suffer from PPA in absence of generalized cognitive impairment
For the study looking at treatment for anomia in SvPPA, what were the 3 subsets of words
1) could name & comprehend
2) couldn’t name but could comprehend
3) couldn’t not and couldn’t comprehend
In the treatment of anomia in SPPA, what were the methods of tx?
-A card with a picture of an item AK wanted to learn, on the other side was a description of the item that was personally salient
Explain what happened to the words on the control list (words she could comprehend and name but that she wasn’t trained on).
-There was a decrease in naming accuracy of words she knew at the start (~25% decrease)
What happened to AK’s naming accuracy scores to words that she could understand and name and that were targeted during treatment?
They remained at 100%, indicating that treatment of known words can help prevent loss of words in PPA.
In the Tx of SPPA, what happened to the words that AK could understand but not name?
-went from 0% accuracy pre-tx to 60% post-tx
In the Tx of SPPA, what happened to the words that AK couldn’t’ understand and couldn’t name?
went from 0% pre-tx to 35% post-tx
Based on the results from AK’s treatment for SPPA, is it better to work on words that a patient knows but can’t name or words a patient doesn’t understand and can’t name
- words they understand but can’t name
- you only have to help them relearn the word, compared to teaching comprehension and the name
- this group of words had higher naming accuracy for AK compared to words she couldn’t understand or name
What were the conclusions from the treatment of AK’s SvPPA using pictures?
- improvement after Tx
- effects maintained six months later
- slower forgetting of treated words
What 3 factors affect success in therapy of word naming?
- personal familiarity with items (linked to patients autobiographical experience) affects remembering
- organizing words into semantic categories is more helpful than organizing them alphabetically
- partially spared semantic knowledge facilitates relearning
Describe what the procedure for errorless learning is in semantic dementia
look at the object and tell me its name only if you are 100% sure you are correct. Otherwise listen to the description nada read the written word
How was the MossTalk program used with SPPA?
- each picture presented on the screen, accompanied with a written and spoken description
- the correct name would be displayed after each trial regardless of the outcome
In the MossTalk experiment with CST who had SPPA, what were the results on the 3 lists?
- significant improvement post-tx
- effects maintained 1 month post
- effects maintained 3 months post
T or F: CST (SvPPA) was able to name 100% of the +N+C control words after 4 months of treatment
FALSE: his naming accuracy of the control words decreased by 50% as they were not treated
What are the theoretical implications of CSTs evidence from computer based errorless retraining of words in SvPPA?
- feasibility of computer-based treatments for anomia in SvPPA established
- effectiveness of errorless approach in SvPPA in re-teaching lost words
- justification for including in tx the words that patients with SvPPA still have in their vocal
Summarize the positive aspects of errorless learnign
- effective therapeutic technique
- successfully been applied to anomia in SvPPA
- effective for people with reduced explicit memory
What are some positives of effortful processing
- subject generated (effortful, elaborative) info retained better
- effortful learning improves recollection
- Effortful processing may facilitate learning in SvPPA?
Explain passive errorful learning
- Experimenter provides a list of things that don’t apply to the certain animal
- Then asks patient to name the animal
- Asks them to repeat the correct name (whether they were correct or not)
Explain active errorful learning
- Experimenter asks many questions about an animal, which patient has to answer
- Then asks patient to name the animal
- Asks them to repeat the correct name (whether they were correct or not)
Explain passive errorless learning
- experimenter lists characteristics of an animal (semantic and phonological)
- experimenter provides name
- patient repeats name
Explain active errorless learning
- experimenter asks questions about the animal (semantic and phonological) to which the answer is always YES
- experimenter asks “Is it called (correct response)”
- patient repeats name
Subject generated cues involves _____ learning
active
Experimented provided cues involves _______ learning
passive
In a true errorful approach, there needs to be _____ wrong answers
2-3
What type of approach was most effective on word re-learning for individuals with SvPPA?
errorless active (subject generated)
T or F: errorless active learning also had the best effect on post-tx word comprehension
False - no significance between all 4 learning methods and word comp
Semantic processing is thought to originate the ___________ in the brain
anterior temporal lobe
What changes in brain activation may occur as a result of naming tx for SPPA?
-increased activity of activation in anterior temporal lobe (occurred only in least impaired participant)
What things do you need to remember when providing language tx in SvPPA?
- greater success with personally relevant items
- semantically based treatment more successful
- clients involved in item selection
- more effective with partially spared semantics
- practice necessary to maintain gains
- incorporate re-trained vocal into daily language
- computer based tx is appropriate
- errorless approach > traditional errorful approach
- self-generated cues > experiment-provided cues
What are the overall benefits of language tx in PPA?
- improvement in naming
- focused activity
- possibility of re-learnign words necessary for daily functioning
- possible generalization to different items and contexts
- maintenance of gains with practice
- neuroplasticity?