The effect of facilitation of lexical retrieval on verb phrase production in Primary Progressive Aphasia.
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1
Macquarie University, Australia
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2
NSW Government, Australia
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3
University of Sydney, Australia
Lexical retrieval treatment is a preferred intervention for word finding difficulties in Primary Progressive Aphasia (PPA). Evidence demonstrates that it can improve naming of trained items and gains can be maintained with ongoing practice (Croot, 2018). Evidence of generalisation of treatment gains to connected speech tasks, such as sentence production, however, is sparse (Cadorio et al., 2017). It is theoretically and clinically important to understand whether facilitating the availability of a lexical target affects meaningful connected speech in PPA, as this will indicate whether treatments that improve single word retrieval could generalise to connected speech contexts. Using a case series design, we therefore tested the assumption underlying lexical retrieval treatment that improved access to target verbs and object nouns will increase success in verb phrase production.
Method. Eleven participants with PPA were asked to produce a sentence in response to each of 60 pictures depicting people engaged in everyday activities, in three conditions: (1) No Facilitation: an action picture alone was presented; (2) Noun Facilitation: written and spoken noun presented with the picture; (3) Verb Facilitation: written and spoken verb presented with the picture. We analysed the difference in the number of correct productions of target verb-object verb phrases (i.e. where both the target verb and the target object noun were present) between conditions using Binomial Tests at the individual case level and Stouffer’s method across participants.
Results. Combined across the case series, there was a significantly improved production of correct target verb phrases in both the noun and the verb facilitation conditions (Noun: z=-4.746, p<.001; Verb: z=-6.801, p<.001), but verb facilitation resulted in significantly more improvement than noun facilitation (z=-2.624, p=.004). At an individual level, in the noun facilitation condition, the increase in correct verb phrases ranged from 10-22% (see Table 1), a significant increase for six participants (p<.05) and trending to significant for four others (p<.1). In the verb facilitation condition, the increase in correct verb phrases ranged from 10-38% and this was a significant increase for eight participants and trending to significant for one other. Only two participants, both with non-fluent variant PPA, demonstrated no benefit for verb phrase production from verb facilitation (ELC, TEG), and ELC also failed to show significant change from noun facilitation. Two participants showed significantly more improvement from verb facilitation, and one showed a trend. TEG was close to significantly more improvement from noun than verb facilitation. However, there was no evidence of significant differences across the group in any comparison (Homogeneity tests: all H(10)<12.5, p>.26).
Discussion. This study demonstrates that provision of the lexical item improves production of a verb-object verb phrase and that generalisation to sentence production is a feasible expectation following positive gains in lexical retrieval treatment. For most individuals, and the group as a whole, verb availability was particularly helpful. While there was no statistical evidence for variability across participants, those with nfvPPA appeared to show less benefit. The association of verb facilitation with improved verb phrase production has important theoretical and clinical implications and requires further investigation.
Acknowledgements
This abstract is affiliated with the symposium "Aphasia in neurodegenerative conditions."
References
Cadorio I., Lousada, M., Martins, P., & Figueiredo, D. (2017). Generalisation and maintenance of treatment gains in primary progressive aphasia (PPA): a systematic review. International Journal of Language & Communication Disorders, 52 (5)
Croot, K. (2018) Treatment for lexical retrieval impairments in primary progressive aphasia: A research update with implications for clinical practice. Seminars in Speech and Language, 39, 242-256. doi: 10.1055/s-0038-1660783.
Keywords:
Primary Progressive Aphasia.,
lexical retrieval treatment,
generalisation,
Verb facilitation,
Noun facilitation
Conference:
Academy of Aphasia 57th Annual Meeting, Macau, Macao, SAR China, 27 Oct - 29 Oct, 2019.
Presentation Type:
Poster presentation
Topic:
Eligible for student award
Citation:
Taylor-Rubin
C,
Croot
K and
Nickels
LA
(2019). The effect of facilitation of lexical retrieval on verb phrase production in Primary Progressive Aphasia..
Front. Hum. Neurosci.
Conference Abstract:
Academy of Aphasia 57th Annual Meeting.
doi: 10.3389/conf.fnhum.2019.01.00034
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Received:
07 May 2019;
Published Online:
09 Oct 2019.
*
Correspondence:
Ms. Cathleen Taylor-Rubin, Macquarie University, Sydney, New South Wales, 2109, Australia, cathleen.rubin@students.mq.edu.au