Processing proper nouns in aphasia: Evidence from assessment and therapy

Abstract

Background: Dissociations between proper and common names following brain damage have frequently been reported (see Yasuda, Nakamura, & Beckman, 2000, for review) and suggest that these different word classes are processed by distinct mechanisms. The dissociations are often observed in people with relatively pure impairments, but might also be expected more generally in aphasia. There is the further possibility that the different vocabulary groups require different therapy approaches. Yet, to our knowledge, no study has explored whether treatments that are known to be successful with common nouns are also successful with proper nouns. Aims: This study had two main aims: to compare the comprehension and production of common and proper nouns in 20 people with aphasia; and to investigate whether semantic naming therapy is equally effective for common and proper nouns. Methods & Procedures:A total of 20 people with aphasia were tested in their ability to comprehend and produce matched sets of proper and common nouns. The stimuli comprised: 20 famous people, 20 famous places, 20 high-familiarity common nouns, and 20 lowfamiliarity common nouns. Participants were also tested with personally relevant proper names, such as the names of family members. In the second phase of the study 10 of the original participants were given semantic therapy for both common and proper nouns. Experimental measures explored effects on treated and untreated words. Outcomes & Results: Initial testing found that comprehension scores were generally high, with no word class effect. In production, proper nouns were significantly more difficult to name than the matched common nouns. However, this finding excluded personally relevant proper nouns, which were the most successfully named items. Results from the second phase showed that semantic therapy was equally effective in improving naming of both common and proper nouns. As in many previous studies, effects were almost entirely confined to treated items. Conclusions: Our findings suggest that proper nouns induce more naming failures in aphasia than common nouns. However, despite this, they seem equally amenable to therapy. Clinical and theoretical implications are discussed.

Functionally relevant items in the treatment of aphasia (part I): Challenges for current practice

“…However, when we calculated names manually from amongst the 1000 most frequent words, we found 11 names for places (e.g., London, Europe and Africa) and three first names (John, Peter and Michael). Again, only a handful of published treatment studies have focused on proper names (e.g., Robson, Marshall, Pring, Montagu, & Chiat, 2004;Semenza & Sgaramella, 1993) despite the fact that some people with aphasia have special problems with proper names (e.g., Harris & Kay, 1995;Semenza, Zettin, & Borgo, 1998). In addition, according to our clinical experience, many people with aphasia want to improve their ability to produce people's names in particular.…”

Leveraging the test effect to improve maintenance of the gains achieved through cognitive rehabilitation.

“…A few studies probed maintenance beyond 1 month (Bastiaanse, Hurkmans, & Links, 2006; Drew & Thompson, 1999; Edwards & Tucker, 2006; Furnas & Edmonds, 2014; Thompson, Kearns, & Edmonds, 2006), although none of these examined maintenance of item-specific gain. Many more studies assessed performance only up to 1 month following treatment (Boo & Rose, 2011; Edmonds & Kiran, 2006; Fillingham, Sage, & Lambon Ralph, 2005; Law, Wong, Sung, & Hon, 2006; Leonard, Rochon, & Laird, 2008; Milman, Clendenen, & Vega-Mendoza, 2014; Raymer, Kohen, & Saffell, 2006; Raymer et al, 2012; Robson, Marshall, Pring, Montagu, & Chiat, 2004; Sage, Snell, & Lambon Ralph, 2011; Schneider & Thompson, 2003; van Hees, Angwin, McMahon, & Copland, 2013), and many studies with encouraging language rehabilitation findings in PWA simply did not collect follow-up data that measure the retention of performance gains (Denes, Perazzolo, Piani, & Piccione, 1996; Harnish, Neils-Strunjas, Lamy, & Eliassen, 2008; Hickin, Mehta, & Dipper, 2015; Hinckley & Carr, 2005; Lee, Kaye, & Cherney, 2009; Pulvermüller et al, 2001). Evidence that treatment strategies can lead to improved language abilities is certainly important, but the ultimate goal should be long-term improvement.…”

Using Phonemic Cueing of Spontaneous Naming to Predict Item Responsiveness to Therapy for Anomia in Aphasia

“…In other words, the elusive finding of generalized improvement in word retrieval skills, for example, as indicated by greater accuracy scores on treated and untreated sets of target words, has been the exception rather than the rule in published studies. 26 This has led to several studies in which the primary goal has been improved reliability of production for purposefully trained items, for example, usually vocabulary items, which are agreed to be communicatively relevant to an individual participant, 5,[27][28][29] where generalized improvement in word retrieval skills was taken to be a possible but not a probable therapy outcome. Such studies have negotiated target words for training on the basis of likely everyday use in conversation or general interaction; proper names of family members and friends are one example.…”

“…Such studies have negotiated target words for training on the basis of likely everyday use in conversation or general interaction; proper names of family members and friends are one example. 29 Successful minimal cueing could constructively serve as a screening tool within this therapy approach, alongside personal communicative relevance, in terms of determining items likely or not likely to respond to naming therapy. Therefore, the extent to which a corpus of words assessed for baseline (preintervention) naming accuracy is easily cueable, as a readily included method within confrontation naming would be predictive of likely success in naming therapy for an individual participant with aphasia.…”