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Attentive Reading with Constrained Summarization-Written (ARCS-W), a treatment to improve written and spoken discourse in people with mild aphasia.

Jessica A. Obermeyer1* and Lisa A. Edmonds1
  • 1 Teachers College Columbia University, Biobehavioral Sciences, United States

Background: This phase II study (Robey, 2004) evaluated the efficacy of Attentive Reading with Constrained Summarization-Written (ARCS-W) to improve written and spoken discourse in two people with mild aphasia and to determine if positive results reported in three participants with mild aphasia (Obermeyer & Edmonds, 2016) could be replicated. ARCS-W is adapted from Attentive Reading with Constrained Summarization (Rogalski & Edmonds, 2008) and targets multi-modality discourse production and the non-linguistic cognitive requirements of discourse. This treatment addresses two critical gaps in clinical research: mild aphasia and written discourse. Methods: P1 was a 66-year-old African-American male; P2 was a 49-year-old Asian-Pacific American male. Both presented with mild anomic aphasia, due to stroke, per the Western Aphasia Battery (WAB-AQ; Kertesz, 2006) (P1 AQ=79.3; P2 AQ=86.7). This single subject pre- to post-treatment design study included pre-treatment assessment, treatment (21-24 visits, 2-3 times/week, 1.5 hours each), post-treatment assessment and 1-month maintenance assessment (P1 only). A control task of nonword writing to dictation was administered at all testing time-points. Treatment required reading current event articles with the intent to summarize, followed by spoken and written summarization with constraints (use specific words, produce complete sentences and stay on topic). Micro- and macrolinguistic level discourse was evaluated with untrained tasks, including Nicholas and Brookshire stimuli (N&B; 1993) and story-retelling (Discourse Comprehension Test; Brookshire & Nicholas, 1997). Half of the prompts were completed in speaking, half in writing. Microlinguistic outcomes included percent correct information units (%CIUs; Nicholas & Brookshire, 1993), percent complete utterances (%CUs; Edmonds, Nadeau & Kiran, 2009) and percent grammatically complex sentences (incomplete/simple sentences scored 1-3 and complex sentences scored 4 or 5) (Altman, Goral & Levy, 2012). Macrolinguistic outcomes included percent main concepts (%MCs) and global coherence (utterances were rated 1-4, with 4 being on topic) (Wright, Capilouto, & Koutsoftas, 2013). Improvement in discourse was interpreted by an increase of ten percentage points from pre-treatment for all measures except global coherence, where a two standard deviation increase indicated improvement based on data from Wright, Koutsoftas, Capilouto and Fergadiotis (2014). Spoken and written confrontation naming was evaluated with An Object and Action Naming Battery (Druks & Masterson, 2000), with an increase of two standard deviations indicating improvement. Results: P1 improved in spoken and written naming of nouns. In written discourse, P1 conveyed higher %MCs with greater global coherence in the N&B stimuli with an increase of grammatically complex sentences and %MCs observed in story-retell. P2 increased production of grammatically complex utterances, %MCs and global coherence with written N&B stimuli. In story retelling, P2 increased %CIUs and global coherence. Neither participant improved on the control task. See Table 1. Spoken discourse was also evaluated and will be included at the conference presentation. Conclusions: The results of this study provide preliminary evidence that the top-down approach of ARCS-W can impact micro- and macro-elements of written discourse generalization measures in people with mild aphasia. Different mechanisms facilitated improvements, with P1 showing increased lexical retrieval that impacted global coherence and %MCs and P2 improving global coherence which also influenced %CIUs.

Acknowledgements

We would like to acknowledge the contributions of the people in the Aphasia Rehabilitation and Bilingualism Research Lab at Teachers College, Columbia University, especially Heather Swanson, Jaquelyn Franquez, Valeria Iturralde and Patricia Reyes who assisted on this project. We would also like to acknowledge the participants who committed their time and effort to the study.

References

Altman, C., Goral, M., & Levy, E. S. (2012). Integrated narrative analysis in multilingual aphasia: The relationship among narrative structure, grammaticality, and fluency. Aphasiology, 26(8), 1029-1052.
Brookshire, R. H., & Nicholas, L. E. (1997). Discourse comprehension test: Test manual (2nd ed.). Minneapolis, MN: BRK Publishers.
Druks, J., & Masterson, J. (2000). An object & action naming battery. Hove, United Kingdom: Psychology Press.
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.
Goodman, R. A., & Caramazza, A. (1986). Johns Hopkins Dyslexia and Dysgraphia Batteries. In R. Chapey (Ed.), Language intervention strategies in adult aphasia and related neurogenic communication disorders (4th ed) (pp. 596-603). Baltimore, MD: Lippincott, Williams & Wilkins.
Kertesz, A. (2006). Western Aphasia Battery (Revised). San Antonio, Tx: PsychCorp.
Nicholas, L. E., & Brookshire, R. H. (1993). A system for quantifying the informativeness and efficiency of the connected speech of adults with aphasia. Journal of Speech, Language, and Hearing Research, 36(2), 338-350.
Obermeyer, J. & Edmonds, L. A. (2016, May). Attentive Reading with Constrained Summarization-Written in people with mild aphasia. Presented at Annual Clinical Aphasiology Conference, Charlottesville, VA.
Robey, R. R. (2004). A five-phase model for clinical-outcome research. Journal of communication disorders, 37(5), 401-411.
Rogalski, Y., & Edmonds, L. A. (2008). Attentive Reading and Constrained Summarisation (ARCS) treatment in primary progressive aphasia: A case study. Aphasiology, 22(7-8), 763-775.
Wright, H. H., Capilouto, G. J., & Koutsoftas, A. (2013). Evaluating measures of global coherence ability in stories in adults. International Journal of Language & Communication Disorders, 48(3), 249-256.
Wright, H. H., Koutsoftas, A. D., Capilouto, G. J., & Fergadiotis, G. (2014). Global coherence in younger and older adults: Influence of cognitive processes and discourse type. Aging, Neuropsychology, and Cognition, 21(2), 174-196.

Keywords: Mild aphasia, Aphasia treatment, discourse, written discourse, Multi-modality treatment

Conference: Academy of Aphasia 55th Annual Meeting , Baltimore, United States, 5 Nov - 7 Nov, 2017.

Presentation Type: poster presentation

Topic: General Submission

Citation: Obermeyer JA and Edmonds LA (2019). Attentive Reading with Constrained Summarization-Written (ARCS-W), a treatment to improve written and spoken discourse in people with mild aphasia.. Conference Abstract: Academy of Aphasia 55th Annual Meeting . doi: 10.3389/conf.fnhum.2017.223.00056

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Received: 27 Apr 2017; Published Online: 25 Jan 2019.

* Correspondence: Ms. Jessica A Obermeyer, Teachers College Columbia University, Biobehavioral Sciences, New York, New York, 10027, United States, jao2158@tc.columbia.edu