Purpose 18 11 2010 21 05 00 What did the researchers want to know or what was the research question Study effectiveness of various cues Study effectiveness of four common cues for eliciting word responses in Broca s aphasics 1 Do the cues of initial syllable stimulation sentence completion printed word and 2 Does severity of Broca s aphasia influence overall responsiveness to cues 3 Does the degree of oral apraxia vary with the severity of Broca s aphasia with varying levels of apraxia and verbal ability word imitation rank themselves in potency Does presence or severity of oral apraxia contribute significantly to apraxia of speech Number of errors on ordered and imitative subtests of Rosenbek and Moore test of oral apraxia were correlated with verbal modality response levels from PICA and overall PICA scores and Subtest IV scores o Six correlations ranged from 0 51 to 0 62 Significant at 0 05 level of confidence Indicate that verbal response levels in Broca s aphasia didn t decrease as oral apraxia increased In our sample severity of Broca s aphasia was relatively independent of oral apraxia Procedure What did they do Usually in the Methods section Subjects Twenty subjects with aphasia were drawn from mid Tennessee o 45 from Veterans Administration hospital settings o 55 from private hospitals and clinics All but one suffered an appreciable hemiparesis greater in arm than leg All presented nonfluent aphasia with no evidence of a gross comprehension deficit o Consistent with classic descriptions of a Broca s aphasia Age of subjects o Mean 54 9 years o Range 38 to 67 years Months postonset o Mean 31 24 months o Range 1 month to 106 months almost 9 years All were in therapy while study was executed Tests they had to pass Each subject passed a pure tone audiometric screening at a level of 25 dB o Ophthalmological report indicated that all subjects were free of problems of acuity and visual field defect to the extent that they could read printed stimulus material To insure a minimal level of auditory comprehension o Subtest VI of Porch Index of Communicative Ability Assesses auditory comprehension of the function of objects o Subtest X of PICA Assesses auditory comprehension for object names o No subject fell below 12 on these two subtests To screen general reading ability o Subtests V and VII of PICA Assess reading of object placement and object function or name No subject scored below 8 5 To determine severity of apraxia of speech and expressive language impairment o Use of verbal modality response levels Interpretation of verbal formulation difficulty No subject showed dysarthric symptoms as defined by clinical signs of weakness or paralysis of the speech musculature To determine presence and severity of nonspeech oral apraxia o Unpublished test developed by Rosenbek and Moore Patients were asked to perform each of the 20 items in response to command and also imitation Items were scored with plus minus categories Severity was established by totaling errors To establish a diagnosis and site of lesion in terms of cerebral lobe involvement o Obtained available medical records Reviewed by chief of neurology service at Veterans Administration Hospital Nashville o Routine neurological examinations were available on 14 subjects 10 patients etiologic classification was thrombotic or embolic 3 patients were definitely thrombotic 1 patient aneurysm 1 of 14 patients had previous cerebrovascular accidents o ALL showed left hemisphere damage with wide range of lesion sites involving frontal temporal and parietal lobes 1 had a lesion involving parietal and occipital lobes 1 had a lesion of the frontal and parietal lobes 2 patients lobe localization couldn t be determined 1 patient traditional localization of just left frontal lobe Four cues utilized Initial syllable o Combined auditory and visual stimulation and consisted of the initial consonant vowel combination of each target word Sentence completion o Utilized simple linguistic structures and often employed stereotyped phrasing Cue for ship was He is the captain of the Printed word o Identifying the pictures o In block letters one inch high Word imitation o An auditory and lip postural cue o Required subject to repeat word after examiner Naming Task Thirty black and white line drawings were constructed Words more than 3 syllables in length were not used Difficulty of the initial sound was controlled and established by utilization of the Griffith Miner Phonetic Context Inventory o Included 5 of the 9 most frequently misarticulated sounds l tf f s r Names for drawings were selected from a pool of picturable words in most frequent 6000 words of the Thorndike Lorge lists Procedure Each subject was tested individually o If he failed to name a picture he was given one and then another of the four cues until he produced an intelligible approximation of the word Pilot testing o Included randomized presentation of all four cues Indicated that word imitation was consistently effective in evoking a correct response In study itself three other cues were employed in a randomized order o word imitation cue was placed last in each cueing sequence cueing was terminated when a correct response was evoked maximum and minimum cueing group were established o to determine whether Broca s aphasics of different severity levels utilized o total number of cues that each subject required overall responsiveness was cues in a similar manner calculated those subjects who required a cue for less than 50 of the words to be named were designed as the minimal cueing group N 7 those subjects who required a cue for more than 50 of the words to be named were designated as the maximum cueing group N 13 Results 18 11 2010 21 05 00 What did they find Results 1 Cue Potency Mean of cues to which max group responded correctly are in first row of TABLE Analysis of variance ANOVA preformed to compare means o Maximum group Results were statistically significant Used Tukey s B method to identify which of the possible pairs of means were different Indicate significant difference between the initial syllable cue and the printed word cue Indicate significant difference between the initial syllable cue and sentence completeion cue Sentence completion and printed word did not prove to be significant Potency most effective to least o Word imitation o Initial syllable o Sentence completion printed word o Minimum group Results were not significant Mean of cue utilization Initial syllable cue