phonomotor treatment for anomia - · pdf filephonomotor treatment for anomia diane l. kendall,...
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![Page 1: Phonomotor treatment for anomia - · PDF filePhonomotor treatment for anomia Diane L. Kendall, PhD Associate Professor, Department of Speech and Hearing Sciences Research Scientist,](https://reader031.vdocuments.site/reader031/viewer/2022022423/5a9e183e7f8b9ada718daef7/html5/thumbnails/1.jpg)
Phonomotor treatment
for anomia
Diane L. Kendall, PhD
Associate Professor, Department of Speech and Hearing Sciences
Research Scientist, VAMC Puget Sound
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TODAY
• Describe study
• Treatment
• Results
• Future
![Page 3: Phonomotor treatment for anomia - · PDF filePhonomotor treatment for anomia Diane L. Kendall, PhD Associate Professor, Department of Speech and Hearing Sciences Research Scientist,](https://reader031.vdocuments.site/reader031/viewer/2022022423/5a9e183e7f8b9ada718daef7/html5/thumbnails/3.jpg)
• Veterans Affairs (VA) grant
• 2010-2013
• $850,000
• Provide treatment to 30 individuals
– aphasia and anomia
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• Currently,
– Data collection finished!!!!!
– November 2012
• Analysis of ALL data
– Finish June 2013
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TODAY
• Describe study
• Treatment
• Results
• Future
![Page 6: Phonomotor treatment for anomia - · PDF filePhonomotor treatment for anomia Diane L. Kendall, PhD Associate Professor, Department of Speech and Hearing Sciences Research Scientist,](https://reader031.vdocuments.site/reader031/viewer/2022022423/5a9e183e7f8b9ada718daef7/html5/thumbnails/6.jpg)
Participants • N=28
• Chronic aphasia
(>6mos)
• Left CVA
• 18 right-handed, 2
left-handed
• 18 Monolingual
English
• 2 Bilingual (English dominant
language since childhood)
• Included: – Aphasia
– Word retrieval deficits
– Impaired phonologic processing
• Excluded – Significant (severe) speech
apraxia
– Depression
– Degenerative disease
– Chronic medical illness
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N=28 Age
(years)
Education Months
post
stroke
onset
AVE 56 16 47
Range 26-78 12-23 10-211
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Western Aphasia
Battery (WAB-AQ) (out of 100)
Boston
Naming Test
(BNT) (spontaneous correct out
of 60)
Standardized Assessment
of Phonology in Aphasia
(SAPA) (raw score out of 151)
AVE 79/100 36/60 96/151
General language test
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Western Aphasia
Battery (WAB-AQ) (out of 100)
Boston
Naming Test
(BNT) (spontaneous correct out
of 60)
Standardized Assessment
of Phonology in Aphasia
(SAPA) (raw score out of 151)
AVE 79/100 36/60 96/151
![Page 10: Phonomotor treatment for anomia - · PDF filePhonomotor treatment for anomia Diane L. Kendall, PhD Associate Professor, Department of Speech and Hearing Sciences Research Scientist,](https://reader031.vdocuments.site/reader031/viewer/2022022423/5a9e183e7f8b9ada718daef7/html5/thumbnails/10.jpg)
Western Aphasia
Battery (WAB-AQ) (out of 100)
Boston
Naming Test
(BNT) (spontaneous correct out
of 60)
Standardized Assessment
of Phonology in Aphasia
(SAPA) (raw score out of 151)
AVE 79/100 36/60 96/151
Test of ‘sounds”
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Immediate treatment
Immediately post treatment
Testing
Pre-treatment
Testing
Treatment
Phase
3-month post treatment testing
1-week 1-week 1-week 6-weeks
Delayed treatment
Immediately post treatment testing
Pre-treatment
Testing
Usual care
control phase
3-months post treatment testing
1-week 1-week 1-week 6-weeks
Treatment
Phase
6-weeks
Post usual care testing
1-week
N=14
N=14
1-year post testing
1-week
1-week
1-year post testing
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TODAY
• Describe study
• Treatment
• Results
• Future
![Page 13: Phonomotor treatment for anomia - · PDF filePhonomotor treatment for anomia Diane L. Kendall, PhD Associate Professor, Department of Speech and Hearing Sciences Research Scientist,](https://reader031.vdocuments.site/reader031/viewer/2022022423/5a9e183e7f8b9ada718daef7/html5/thumbnails/13.jpg)
TWO PHASES OF TREATMENT
1) Phonemes in Isolation
2) Phoneme Sequences
1-, 2- and 3-syllables
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How can you tell if
treatment works?
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Research
Questions
Measures
1. Acquire (learn) Phonology
Naming pictures
2. Does what you learn
in therapy generalize
to something else??
Naming pictures
Conversation
3. What about at 3
months and 1 year?
Phonology
Naming pictures
Conversation
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TODAY
• Describe study
• Treatment
• Results
• Future
![Page 17: Phonomotor treatment for anomia - · PDF filePhonomotor treatment for anomia Diane L. Kendall, PhD Associate Professor, Department of Speech and Hearing Sciences Research Scientist,](https://reader031.vdocuments.site/reader031/viewer/2022022423/5a9e183e7f8b9ada718daef7/html5/thumbnails/17.jpg)
Research aim
Outcome measure
Acquisition (pre- vs imm post-)
N=20
3-mo (pre- vs 3 mo)
N=16
1-yr (pre- vs 1-yr
N=8
Learn
Trained nouns P=.000 Pre 64% (SD 26) Post 82% (SD 17)
P=.000 Pre 66% (SD 25) Post 79% (SD 22)
P=.016 Pre 70% (SD 18) Post 86% (SD 7)
Generalize to
phonology
Standardized Assessment of Phonology in Aphasia
P= .000 Pre 97 (25)
Post 106 (24)
P=.000 Pre 97 (25)
Post 106 (26)
P=.010 Pre 100 (23) Post 115 (15)
Generalize to
words not seen in therapy
Untrained nouns P=.001
Pre 64% (SD 25) Post 70% (SD 25)
P=.033 Pre 66% (SD 25) Post 71% (SD 26)
P=.033 Pre 68% (SD 20) Post 81% (SD 19)
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Nouns
0
10
20
30
40
50
60
70
80
90
100
Pre n=20 Imm n=20 3 mo n=16 1 year n=8 Pre n=20 Imm n=20 3 mo n=16 1 year n=8
Real words Trained Real words Untrained
* *
*
* *
*
Perc
ent
accu
racy
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Conversation n=3
• VIDEO
• Productivity (# of clauses, # verbal units, # words): – 2 of 3 more verbal output following therapy
– twice the number of clauses, more verbal units, and more words when compared with before
treatment output.
• Grammar (% grammatical clauses): – 0 of 3
• Relevance (% of clauses containing new information, relevance of
response to each prompt): – 2 of 3 improved
• Efficiency (self corrections, interjections, irrelevant words): – there was no change in the overall efficiency
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Discussion
• Results support our hypothesis
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word
“flower”
Idea!
sounds
F + L + OW + R
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TODAY
• Describe study
• Treatment
• Results
• Future
![Page 23: Phonomotor treatment for anomia - · PDF filePhonomotor treatment for anomia Diane L. Kendall, PhD Associate Professor, Department of Speech and Hearing Sciences Research Scientist,](https://reader031.vdocuments.site/reader031/viewer/2022022423/5a9e183e7f8b9ada718daef7/html5/thumbnails/23.jpg)
New Grant
N=40 Phonomotor
treatment
N=40 Traditional treatment
(standard of care)
VS.
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Acknowledgements • YOU!!!!!
• VA RR&D Merit Review Grant #C6572R
• UW Aphasia Lab – Liz Brookshire, MA
– Megan Oelke, MA
– JoAnn Silkes, PhD
– Irene Minkina, BS
– Lauren Bislick, MA
– Rebecca Pompon, PhC