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Contrasting therapy effects for verb and sentence processing difficulties: A discussion of what worked and why

Lookup NU author(s): Dr Janet Webster

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Abstract

Background: Over recent years there have been a number of studies investigating the effects of therapy for verb and sentence processing difficulties in people with aphasia. A variety of therapies have been described, with apparently different foci and different methods. Despite this, similarities in the outcomes reported would suggest that the therapy techniques are in fact targeting similar processes. Aims: The paper describes two periods of speech and language therapy intervention with a person with non-fluent aphasia, MV. The contrasting effects of the two therapy periods are discussed and the mechanisms underpinning the improvements seen following the second period involving “verb and noun association therapy” are considered. Methods & Procedures: A case study approach is used to evaluate the effects of two periods of intervention. The client, MV, was diagnosed with a semantic impairment resulting in a noun and verb retrieval deficit, as well as difficulties with argument structure and mapping. In the first intervention period, therapy consisted of verb-centred mapping therapy and tasks promoting divergent noun and verb retrieval. In the second intervention period, “verb and noun association” therapy was used. Therapy was preceded and followed by detailed assessment of single word and sentence comprehension and production. Outcomes & Results: The initial period of therapy resulted in no linguistic improvement. In contrast, the verb and noun association therapy resulted in item-specific improvement in verb naming and a parallel improvement in verb comprehension. Significant gains in sentence production were also seen; MV was able to produce more nouns within a sentence context and produce more thematically complete and grammatically accurate sentences. These gains were not related to her ability to produce the nouns targeted within the therapy. Conclusions: It is proposed that the gains in sentence production following the verb and noun association therapy were a consequence of the improved specification of the argument structure around verbs. It is not clear whether this resulted from improved access to lexically specified argument structure information or more generalised gains in argument structure production. The study suggests that gains in sentence production can be achieved for some clients without explicit identification or cueing of arguments and that this approach may be more beneficial for people who struggle with the demands of a more “meta-linguistic” approach.

Publication metadata

Author(s): Webster JM, Gordon B

Publication type: Article

Publication status: Published

Journal: Aphasiology

Year: 2009

Volume: 23

Issue: 10

Pages: 1231-1251

ISSN (print): 0268-7038

ISSN (electronic): 1464-5041

Publisher: Psychology Press

URL: http://dx.doi.org/10.1080/02687030802246291

DOI: 10.1080/02687030802246291

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