Enhancing communication in jargon aphasia: a small group study of writing therapy

Abstract

People with jargon aphasia have severely disordered and incomprehensible speech that may be resistant to therapeutic intervention. In this study, we treated written output and examined whether it assisted communication for these clients. In stage one of the study, anagram sorting, delayed copying and lexical decision tasks were used to investigate the residual knowledge of written words in a group of ten people with jargon aphasia. Evidence of the presence of orthographic knowledge was taken as an indication that writing might be a useful focus for therapy. This hypothesis was explored in stage two with six clients. A personally useful vocabulary was selected for each, and copying, word completion and written picture-naming tasks were used in therapy to improve written production of these words. The clients made progress in written naming. However, they showed little change on a 'message' assessment that tested their ability to use the written words to convey messages. Stage three targeted communicative writing. Here, three of the clients received 'message therapy', which encouraged them to relate treated words to functional messages and to communicate them to a partner. The clients improved on the message assessment and observation of their communication and reports from relatives suggested that they made functional use of writing in a range of communication settings.

Combining treatment for written and spoken naming

“…The underlying cause of naming impairment may be damage to semantics, phonology, or orthography-or the links among these central components of language processing that are depicted in Figure 1. Treatments for lexical retrieval may be variously directed toward semantic knowledge and lexical-semantic relations (e.g., Boyle, 2004;Kiran & Thompson, 2003), phonological processing and speech production (e.g., Franklin et al, 2002;Hillis & Caramazza, 1994;Miceli et al, 1996), or orthographic representations and writing (e.g., Aliminosa et al, 1993;Beeson et al, 2003a;Robson et al, 2001). Behavioral treatments also may stimulate interactive use of residual knowledge across semantic, phonologic, and orthographic domains.…”

Learning‐in‐interaction: Resourceful work by people with aphasia and therapists in the course of language impairment therapy

“…Best, Herbert, Hickin, Osborne, and Howard (2002), for example, in a small group study of facilitation in aphasia, found that in pre-therapy trials participants did not respond to cueing methods in the same ways, and that this was possibly, but not necessarily, predictably dependent on the type of aphasic impairment. While it could be argued that applying flexible approaches to the process of enacting aphasia language therapy might make group studies or replications in the conventional sense problematic, Robson and Horton (2007) argue that, as in the group study of writing therapy for people with jargon aphasia (Robson, Marshall, Chiat, & Pring, 2001), therapy may be defined in terms of ''processing goals'', i.e., the nature of the processing the therapy is intended to promote. In the case of Robson et al (2001) this was to enable access to stored semantic and orthographic information about target items and therefore to reinforce target-related representations.…”

“…While it could be argued that applying flexible approaches to the process of enacting aphasia language therapy might make group studies or replications in the conventional sense problematic, Robson and Horton (2007) argue that, as in the group study of writing therapy for people with jargon aphasia (Robson, Marshall, Chiat, & Pring, 2001), therapy may be defined in terms of ''processing goals'', i.e., the nature of the processing the therapy is intended to promote. In the case of Robson et al (2001) this was to enable access to stored semantic and orthographic information about target items and therefore to reinforce target-related representations. This allowed tasks to be devised in terms of their potential to realise these processing goals, and therefore to be flexibly adaptable to each participant in the group study.…”

Treatment of Underlying Forms in a discourse context

“…This focus on verbal output is consistent with the aphasia treatment literature at large, in which spoken language protocols vastly outnumber those available for remediating writing problems. This is unfortunate, given that many patients with aphasia must exploit writing to augment or replace their speech because writing is their most intact output modality, their spoken language deficits are resilient to treatment, or concomitant motor speech symptoms limit their intelligibility (Beeson, Rising, & Volk, 2003;Murray & Karcher, 2000;Robson, Marshall, Chiat, & Pring, 2001). Of the available, empirically evaluated, writing protocols, few address writing beyond the isolated word level.…”