Rehabilitation of lexical retrieval in aphasia: Evidence ...

Interim S

• Typicality effects in no
replicate existing work

• Patients with aphasia
typicality effects

– Except well defined ca

• The nature of typicality
depend upon whether
co-existing semantic im

BOSTON UNIVERSITY APHASIA
RESEARCH LABORATORY

Summary

ormal individuals
k
also sensitive to

ategories

y in aphasia appears to
r patients present with
mpairments

Typicality effect i
and in patients w

Evidence for the typicality effect

Category verification: “is robin a bird”?
Feature verification: “Does this bird fly?

Oral Naming: What kind of bird is this?

Treatment for naming deficits Kiran

BOSTON UNIVERSITY APHASIA
RESEARCH LABORATORY

in normal individuals
with aphasia

Kiran & Thompson (2003b)
Kiran, Ntorou, & Eubank (2007)

Sebastian & Kiran (submitted)

Kiran & Allison (submitted)

Kiran & Allison (submitted)

Kiran & Thompson (2003a); Kiran, (2008)
n & Johnson, (2008); Kiran et al., (in preperation),

Framework fo

Semantic repre

•Sequential: 2 stages (Levelt, 1989)
•Interactive: Bi-directional links

(Dell, 1986)

Phonological re

BOSTON UNIVERSITY APHASIA Phonem
RESEARCH LABORATORY

or lexical access

esentation •Activation of network
of features

•Influenced by
frequency, imageability,

animacy

epresentation Activation of
me level corresponding address

or

Activation of potential
nodes

Treatment for

Semantic representa

Phonological
representation
Phoneme level

BOSTON UNIVERSITY APHASIA
RESEARCH LABORATORY

naming deficits

ation
l

Treatment for

Semantic representa

Phonological
representation
Phoneme level

BOSTON UNIVERSITY APHASIA
RESEARCH LABORATORY

naming deficits

ation
l

Treatment for

Semantic representa

Phonological
representation
Phoneme level

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RESEARCH LABORATORY

naming deficits

ation •Semantic based treatment
results in improvements in
retrieval of phonological

representations

•Facilitates generalization to
trained and untrained items

(Boyle & Coehlo, 1995;
Coehlo et al., 2000; Drew &
Thompson, 1999; Kiran &

Thompson, 2003)

l

Framework f

Semantic representa

Phonological
representation
Phoneme level

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RESEARCH LABORATORY

for treatment

ation Features for the
category clothing
•Worn in warm
weather
•Has buttons
•Has zippers
•Decorative
accessory
•Optional
•Protective covering
•Worn by women

l

Kiran & Bassetto (2008)

Semantic representa

Phonological
representation

Phoneme level

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ation

/pants/
/sweater/

/suspenders/
/apron/

l

Kiran & Bassetto (2008)

Selective genera

X

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alization patterns

X
Clothing

Kiran & Bassetto (2008)

Schedule of treatmen

Pre –treatment ass

Western Aphasia Batter

Baselines: Naming exam

Treatment on one c

Session 1: Tra
SesSSseeiossSnsseiioos1nns: iTo21rn::aTTi2ner:aisnTitngeini
SesSseiosnsio1n: T2r:aTineisntging &

Session 2: Testing & T

..

Session 1: Training

Session 2: Testing & Training

BOSTON UNIVERSITY APHASIA Post treatmen
RESEARCH LABORATORY Standardized

nt for each participant

sessment:

ry, Boston Naming Test

mples across consecutive sessions No feedback provided

category-typicality

aining Week 1
genisngtgin&gT&raTinraininging Week 2
& Training Week 3
Week 4
Tr.a.ini.ng.

Until 80% accuracy achieved

g on items trained

nt assessment:
d language tests

Kiran & Bassetto (2008)

Schedule of treatmen

Pre –treatment ass

Western Aphasia Batter

Baselines: Naming exam

Treatment on one c

e.g., Session 1: Tra
SesSSseeiossSnsseiioos1nns: iTo21rn::aTTi2ner:aisnTitngeini
Train naming of SesSseiosnsio1n: T2r:aTineisntging &
atypical examples
of birds Session 2: Testing & T

Test naming of ..
atypical and
typical examples
of birds

Session 1: Training

Session 2: Testing & Training

BOSTON UNIVERSITY APHASIA Pre –treatmen
RESEARCH LABORATORY Standardized

nt for each participant

sessment:

ry, Boston Naming Test

mples across consecutive sessions No feedback provided

category-typicality

aining Week 1 No feedback
genisngtgin&gT&raTinraininging Week 2 provided regarding
& Training Week 3 accuracy
Week 4
Tr.a.ini.ng.

Until 80% accuracy achieved

g on items trained

nt assessment:
d language tests

Kiran & Bassetto (in press)

Treatment

Sorting word cards by category

Select target word (N = 15)

Patient asked to generate 5 Can b
features for target item

Unwa

Select 6 written semantic features Things
from distracters for each target Ca

Respond to 15 auditorily I
presented questions el

(5 accurate, 5 inaccurate, 5 distracter)

Word recall of trained items

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RESEARCH LABORATORY

t Protocol

Garage sale /Not in garage sale

Jewelry

become old fashioned Have too many of these

anted/Not needed Outdated
s that are passed on Personal grooming

an buy at a mall Things that get lost

Is it an Is it for Does it live in
lectronic entertainment trees?

item

What are we talking about? Jewelry

Animate c

Bird

BOSTON UNIVERSITY APHASIA

Kiran & RTEhSEoAmRCpHsoLnAB, O(2R0AT0O3R)Y

categories

Features for the
category birds:
•wings
•flies
•two legs
•lays eggs
•feathers
•builds nest
•sings
•feathers
•beak
•nocturnal
•eats insects
•eats fish
•claws
•webbed feet
•Swims

(Garrard et al., 2001; Kiran,

2002; McRae et al., 1997)

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RESEARCH LABORATORY



Participant Pre tx Time post
WAB AQ onset CVA

(months)

Animate categories (Kiran & Thompson, 200
P1 43.4 99

P2 50.9 13

P2 70 9
P4 46.4 14

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RESEARCH LABORATORY

t Category Generalization trends
A Trained
) Typical ≠› Atypical
03a) Atypical => Typical
Atypical => Typical
1. Birds Atypical => Typical
2. Vegetables Typical ≠› Atypical
Atypical => Typical
1. Birds
2. Vegetables Atypical => Typical

1. Vegetables

1. Vegetables
2. Birds

Participant Pre tx Time post
WAB AQ onset CVA

(months)

Animate categories (Kiran & Thompson, 200
P1 43.4 99

P2 50.9 13

P2 70 9
P4 46.4 14

BOSTON UNIVERSITY APHASIA
RESEARCH LABORATORY

t Category Generalization trends
A Trained
) Typical ≠› Atypical

03a) Atypical => Typical

1. Birds

2. Vegetables

1. Birds Atypical => Typical

2. Vegetables Atypical => Typical

1. Vegetables Typical ≠› Atypical

1. Vegetables Atypical => Typical
2. Birds Atypical => Typical

Participant Pre tx Time post
WAB AQ onset CVA

(months)

Animate categories (Kiran & Thompson, 200
P1 43.4 99

P2 50.9 13

P2 70 9
P4 46.4 14

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RESEARCH LABORATORY

t Category Generalization trends
A Trained
) Typical ≠› Atypical

03a) Atypical => Typical

1. Birds

2. Vegetables

1. Birds Atypical => Typical
2. Vegetables Atypical => Typical

1. Vegetables Typical ≠› Atypical

1. Vegetables Atypical => Typical
2. Birds Atypical => Typical

Clothing/F

Clothing

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RESEARCH LABORATORY

Furniture

Features for the
category clothing
•Worn in warm
weather
•Has buttons
•Has zippers
•Decorative
accessory
•Optional
•Protective covering
•Worn by women

Kiran (2008)

P1: Clothing

100 Treatment
90 BL

80

Percent Accuracy 70

60

50

40

30 Atyp
20 Typi
10

0

1 3 5 7 9 11 13 15 17 19 21

Probes

90 P1: Furniture
80 BL Treatment
70
Percent Accuracy 60
50
40 BOSTON UNIVERSITY APHASIA 17 Atyp
30 Typi
20 R3ESEARC5H LA7BORAT9ORY11 13 15
10 19 21
Probes
0
1

pical-trained Typical
ical-Untrained Atypical

23 25 27 Typical

pical-Untrained Atypical
ical-Trained
Kiran (2008)
23 25

Participant Pre tx Time post
WAB AQ onset CVA

(months)

Inanimate categories (Kiran, submitted)
P1 56.7 9

P2 72.5 7
P3 62.2 7

P4 46.4 9

P5 37 8

BOSTON UNIVERSITY APHASIA
RESEARCH LABORATORY

t Category Generalization trends
A Trained
)

1. Clothing Atypical => Typical
2. Furniture Typical ≠› Atypical

1. Furniture Typical ≠› Atypical

1. Furniture Atypical ≠› Typical
2. Clothing Typical ≠› Atypical

1. Clothing Typical ≠› Atypical
2. Furniture Atypical => Typical

1. Furniture Atypical => Typical

Kiran (2008)

Participant Pre tx Time post
WAB AQ onset CVA

(months)

Inanimate categories (Kiran, submitted)
P1 56.7 9

P2 72.5 7
P3 62.2 7

P4 46.4 9

P5 37 8

BOSTON UNIVERSITY APHASIA
RESEARCH LABORATORY

t Category Generalization trends
A Trained
)

1. Clothing Atypical => Typical

2. Furniture Typical ≠› Atypical

1. Furniture Typical ≠› Atypical

1. Furniture Atypical ≠› Typical

2. Clothing Typical ≠› Atypical

1. Clothing Typical ≠› Atypical

2. Furniture Atypical => Typical

1. Furniture Atypical => Typical

Kiran (2008)

Participant Pre tx Time post
WAB AQ onset CVA

(months)

Inanimate categories (Kiran, submitted)
P1 56.7 9

P2 72.5 7
P3 62.2 7

P4 46.4 9
8
P5 37

BOSTON UNIVERSITY APHASIA
RESEARCH LABORATORY

t Category Generalization trends
A Trained
)

1. Clothing Atypical => Typical

2. Furniture Typical ≠› Atypical

1. Furniture Typical ≠› Atypical

1. Furniture Atypical ≠› Typical
2. Clothing
Typical ≠› Atypical
1. Clothing
Typical ≠› Atypical
2. Furniture
Atypical => Typical
1. Furniture
Atypical => Typical

Kiran (2008)

Well defined categories
and clear b

Shapes

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s have a clear definition
boundaries

Features for Shapes
1. Is a closed figure
2. Has sides
3. It is round
4. Is 3 dimensional
5. Has angles
6. Has lines
7. Has curves
8. Has diameter
9. Can bisect
10. acute angles

Kiran & Johnson (2008)

P1: Shapes

100

90 Treatment
80 Baseline

70

Atypical 60

50

40

30

20

10

0

1 2 3 4 5 6 7 8 9 10 11 12 13

100Typical

90 Generalization

80
70
60
50
40
30
20
10

0
1 2 3 4 5 6 7 8 9 10 11 12 13

Probes

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Atypical

14 15 16 17 18 19

14 15 16 17 18 19 Typical

Kiran & Johnson (2008)

Participant Pre tx Time post
WAB AQ onset CVA

(months)

Well define categories (Kiran & Johnson, sub
P1 82.5 11

P2 84.3 7

P3 87.3 36

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RESEARCH LABORATORY

t Category Generalization trends
A Trained
) Atypical => Typical
Typical ≠› Atypical
bmitted) Atypical => Typical
1. Shapes

1. Shapes

1. Shapes

Kiran & Johnson (2008)