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Post-Stroke Language Remediation Through Constraint-Induced Aphasia Therapy

Griffith, Julie
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1415615475

Abstract Details

2014, PhD, University of Cincinnati, Allied Health Sciences: Communication Sciences and Disorders.
Purpose: The goal of this dissertation was to investigate the effect of constraint-induced aphasia therapy (CIAT) on post-stroke language remediation. Two studies were implemented for this purpose. Study 1: CIAT: Examining Linguistic Gains in Discourse, investigated the effects of a 10-day CIAT program on the content, complexity, efficiency, and communicative success of the utterances produced by people with aphasia. Study 2: CIAT: What About Shaping?, documented the types of cues provided by clinicians during CIAT and examined the cues given for changes in number, type, and power across the program. Method: The studies were performed as part of a larger randomized controlled trial (NCT00843427) with in the National Institute of Health project (NIH R01 NS048281), “fMRI of Language Recovery Following Stroke in Adults” PI: Jerzy P. Szaflarski, M.D., Ph.D. The larger investigation utilized a prospective design which consecutively enrolled nine people with aphasia whose discourse was analyzed with a repeated measures design in Study 1. The measures examined were: percent of (a) correct information units (CIUs), (b) counted words, (c) mazes, (d) true conversational units (TCunits), (e) initial successful turns as well as (f) type token ratio (TTR), (g) mean length of utterance (MLU), and (h) CIUs per utterance. The focus of Study 2 was the cueing behavior of seven clinicians trained to facilitate the treatment. The cues provided were categorized into 11 types and were assigned a level of power. The cue types included: (1) request attention, (2) reminder, (3) constraint, (4) semantic function, (5) semantic phrase completion, (6) semantic reminder, (7) phonetic cue with visual model, (8) phonetic cue first phoneme(s), (9) articulatory placement, (10) choice of two words, and (11) word imitation. Both investigations employed non-parametric statistics to detect significant differences in the dependent measures. Results: The analyses utilized in Study 1 revealed that the people with aphasia exhibited positive significant gains in the percent of CIUs, counted words, TCunits, mazes and CIUs per utterance produced. However, a significant decrease in TTR was revealed. The participants displayed a trend for increased MLU, but no significant increases were detected. No changes were detected in the initial successful requests of the people with aphasia. In Study 2, the analyses showed no significant differences in the number, type, and power of cues provided by the clinicians. Although, inspection of the raw data revealed that more cues were given at the end of the program than the beginning and no discernable pattern of change in the type and power of cues provided was determined. Conclusion: Through this dissertation, post-stroke language remediation was advanced by: (1) identifying discourse measures that detect improvements in the verbal language produced by individuals during CIAT, and (2) broadening the definition of shaping to include the specific cues clinicians give to improve the verbal abilities of people with aphasia. This dissertation presents an emerging conceptualization of CIAT that may enhance future protocols by investigating the role of shaping and promoting skills necessary for people with aphasia to become independent communicators through post-stroke communication rehabilitation.
Aimee Dietz, Ph.D. (Committee Chair)
Angel L. Ball, Ph.D. (Committee Member)
Lisa Kelchner, Ph.D. (Committee Member)
Jerzy Szaflarski, M.D. Ph.D. (Committee Member)
Jennifer Vannest, Ph.D. (Committee Member)
160 p.
Speech Therapy
Aphasia; Constraint-induced Aphasia Therapy; Discourse; Cueing; Speech Pathology

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Citations

  • Griffith, J. (2014). Post-Stroke Language Remediation Through Constraint-Induced Aphasia Therapy [Doctoral dissertation, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1415615475

    APA Style (7th edition)

  • Griffith, Julie. Post-Stroke Language Remediation Through Constraint-Induced Aphasia Therapy. 2014. University of Cincinnati, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1415615475.

    MLA Style (8th edition)

  • Griffith, Julie. "Post-Stroke Language Remediation Through Constraint-Induced Aphasia Therapy." Doctoral dissertation, University of Cincinnati, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1415615475

    Chicago Manual of Style (17th edition)

ucin1415615475
682
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This open access ETD is published by University of Cincinnati and OhioLINK.