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What did the researchers want to know or what was the research question?Study effectiveness of various cuesStudy effectiveness of four common cues for eliciting word responses in Broca’s aphasics with varying levels of apraxia and verbal ability1. Do the cues of initial syllable stimulation, sentence completion, printed word, and word imitation rank themselves in potency?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?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 scoresSix correlations ranged from -0.51 to -0.62Significant at 0.05 level of confidenceIndicate that verbal response levels in Broca’s aphasia didn’t decrease as oral apraxia increasedIn our sample, severity of Broca’s aphasia was relatively independent of oral apraxiaWhat did they do? (Usually in the Methods section)Subjects:Twenty subjects with aphasia were drawn from mid-Tennessee45% from Veterans Administration hospital settings55% from private hospitals and clinicsAll but one suffered an appreciable hemiparesis (greater in arm than leg)All presented nonfluent aphasia with no evidence of a gross comprehension deficitConsistent with classic descriptions of a Broca’s aphasiaAge of subjectsMean – 54.9 yearsRange – 38 to 67 yearsMonths postonsetMean – 31.24 monthsRange – 1 month to 106 months (almost 9 years)All were in therapy while study was executedTests they had to passEach subject passed a pure-tone audiometric screening at a level of 25 dBOphthalmological report indicated that all subjects were free of problems of acuity and visual field defect to the extent that they could read printed stimulus materialTo insure a minimal level of auditory comprehensionSubtest VI of Porch Index of Communicative AbilityAssesses auditory comprehension of the function of objectsSubtest X of PICAAssesses auditory comprehension for object namesNo subject fell below 12 on these two subtestsTo screen general reading abilitySubtests V and VII of PICAAssess reading of object placement and object function or nameNo subject scored below 8.5To determine severity of apraxia of speech, and expressive language impairmentUse of verbal modality response levelsInterpretation of verbal formulation difficultyNo subject showed dysarthric symptoms as defined by clinical signs of weakness or paralysis of the speech musculatureTo determine presence and severity of nonspeech oral apraxiaUnpublished test developed by Rosenbek and MoorePatients were asked to perform each of the 20 items in response to command and also imitationItems were scored with plus-minus categoriesSeverity was established by totaling errorsTo establish a diagnosis and site of lesion in terms of cerebral lobe involvementObtained available medical recordsReviewed by chief of neurology service at Veterans Administration Hospital, NashvilleRoutine neurological examinations were available on 14 subjects10 patients – etiologic classification was thrombotic or embolic3 patients – were definitely thrombotic1 patient – aneurysm1 of 14 patients had previous cerebrovascular accidentsALL showed left-hemisphere damage with wide range of lesion sites involving frontal, temporal, and parietal lobes1 had a lesion involving parietal and occipital lobes1 had a lesion of the frontal and parietal lobes2 patients – lobe localization couldn’t be determined1 patient – traditional localization of just left frontal lobeFour cues utilizedInitial syllableCombined auditory and visual stimulation and consisted of the initial consonant-vowel combination of each target wordSentence completionUtilized simple linguistic structures and often employed stereotyped phrasingCue for ship was “He is the captain of the…”Printed wordIdentifying the picturesIn block letters one inch highWord imitationAn auditory and lip postural cueRequired subject to repeat word after examinerNaming TaskThirty black and white line drawings were constructedWords more than 3 syllables in length were not usedDifficulty of the initial sound was controlled and established by utilization of the Griffith-Miner Phonetic Context InventoryIncluded 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 listsProcedureEach subject was tested individuallyIf 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 wordPilot testingIncluded randomized presentation of all four cuesIndicated that word imitation was consistently effective in evoking a correct responseIn study itself, three other cues were employed in a randomized orderword imitation cue was placed last in each cueing sequencecueing was terminated when a correct response was evokedmaximum and minimum cueing group were establishedto determine whether Broca’s aphasics of different severity levels utilized cues in a similar mannertotal number of cues that each subject required (overall responsiveness) was calculatedthose 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)What did they find? (Results)Cue PotencyMean % of cues to which max. group responded correctly are in first row of TABLE 1Analysis of variance (ANOVA) preformed to compare meansMaximum groupResults were statistically significantUsed Tukey’s B method to identify which of the possible pairs of means were differentIndicate significant difference between the initial syllable cue and the printed word cueIndicate significant difference between the initial syllable cue and sentence completeion cueSentence completion and printed word did not prove to be significantPotency, most effective to leastWord imitationInitial syllableSentence completion = printed wordMinimum groupResults were not significantMean % of cue utilizationInitial syllable cue, 22.61%Sentence completion cue, 43.49%Printed word cue, 52.53%Support contention that cues are effective and can be ranked


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UMD HESP 202 - Lecture notes

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