In this month's edition of aphasiatoolbox, we focus on the importance of canonical sentences and sentence stucture in aphasia recovery.
Look at the sentences below.
What do you notice? Do you or your client sound or write like
the "bubble" on the far left or the near left?
In the aphasia conversational cafes that I lead, we begin with conversation; some of the participants can generally say one word, perhaps a short sentence or make a gesture (
Level One cafe); In the
Level Two cafe, we move into self-generated thoughts and ideas creating canonical sentences - ie subject - verb - object. Here, we work on different sentence structures - compound, complex, cataphors, etc and different parts of speech - ie adjectives, prepositions, conjunctions, etc.
In this way, we build our sentences - from a 2 or 3 word sentence into a rich and dynamic exchange of ideas.
From my own experience, I know that aphasia recovery does not happen by naming or copying a word, using isolated drills or an app; recovery takes place in a robust environment where propositional speech and sentence flow occur. The hallmark of aphasia recovery is the ability to create
your own adult ideas and sentences, whether saying that or typing that.
Intent refers to what a person is planning or wants to communicate prior to speaking or writing. That is, it's the person's underlying message.
Propositional speech is self-generated speech; for the person with aphasia, this requires conscious mental effort to manipulate specific linguistic segments, in order to assemble them into express meaningful ideas independently.
Bill Connors discusses: Recursive Sentences
In this month's edition, Bill Connors discusses and explains recursion in sentences - and, most importantly, its innovative use in aphasia practice and treatment.
Apps for Sentence Generation
As we mentioned, conventional therapy - ie naming, imitation, copying, using an app, cannot take the place of robust, neuroplastic self-generated propositional speech. Here we discuss some available apps for sentence generation. The apps listed here are primarily for adults with aphasia.
Teachers With Apps brings you 33 super speech and language iPad apps for home, classroom, and/or the therapist's office. Speech and language is one area of educational apps that has exploded with smashing success. The prices range anywhere from free to expensive.
Background: Mild reading difficulties are a pervasive symptom of aphasia. While much research in aphasia has been devoted to the study of single word reading, little is known about the process of (silent) sentence reading. Reading research in the non-brain-damaged population has benefited from the use of eye-tracking methodology, allowing inferences on cognitive processing without participants making an articulatory response. This body of research identified two factors, which strongly influence reading at the sentence level: word frequency and contextual predictability (influence of context).
Conclusions: Consistent with compensatory processing theories, these findings indicate that decreased reading efficiency may trigger a more interactive reading strategy that aims to compensate for poorer reading by putting more emphasis on a sentence context, particularly for low-frequency words. For those individuals who have difficulties applying the strategy automatically, using a sentence context could be a beneficial strategy to focus on in reading intervention.
Abstract: Exploring generalisation following treatment of language deficits in aphasia can provide insights into the functional relation of the cognitive processing systems involved. In the present study, we first review treatment outcomes of interventions targeting sentence processing deficits and, second report a treatment study examining the occurrence of practice effects and generalisation in sentence comprehension and production. In order to explore the potential linkage between processing systems involved in comprehending and producing sentences, we investigated whether improvements generalise within (i.e., uni-modal generalisation in comprehension or in production) and/or across modalities (i.e., cross-modal generalisation from comprehension to production or vice versa). Two individuals with aphasia displaying co-occurring deficits in sentence comprehension and production were trained on complex, non-canonical sentences in both modalities. Two evidence-based treatment protocols were applied in a crossover intervention study with sequence of treatment phases being randomly allocated. Both participants benefited significantly fromtreatment, leading to uni-modal generalisation in both comprehension and production. However, cross-modal generalisationdid not occur. The magnitude of uni-modal generalisation in sentence production was related to participants' sentence comprehension performance prior to treatment. These findings support the assumption of modality-specific sub-systems for sentence comprehension and production, being linked uni-directionally from comprehension to production.
Abstract: The relationship between recursive sentence embedding and theory-of-mind (ToM) inference is investigated in three persons with Broca's aphasia, two persons with Wernicke's aphasia, and six persons with mild and moderate Alzheimer's disease (AD). We asked questions of four types about photographs of various real-life situations. Type 4 questions asked participants about intentions, thoughts, or utterances of the characters in the pictures ("What may X be thinking/asking Y to do?"). The expected answers typically involved subordinate clauses introduced by conjunctions or direct quotations of the characters' utterances. Broca's aphasics did not produce answers with recursive sentence embedding. Rather, they projected themselves into the characters' mental states and gave direct answers in the first person singular, with relevant ToM content. We call such replies "situative statements." Where the question concerned the mental state of the character but did not require an answer with sentence embedding ("What does X hate?"), aphasics gave descriptive answers rather than situative statements. Most replies given by persons with AD to Type 4 questions were grammatical instances of recursive sentence embedding. They also gave a few situative statements but the ToM content of these was irrelevant. In more than one third of their well-formed sentence embeddings, too, they conveyed irrelevant ToM contents. Persons with moderate AD were unable to pass secondary false belief tests. The results reveal double dissociation: Broca's aphasics are unable to access recursive sentence embedding but they can make appropriate ToM inferences; moderate AD persons make the wrong ToM inferences but they are able to access recursive sentence embedding. The double dissociation may be relevant for the nature of the relationship between the two recursive capacities. Broca's aphasics compensated for the lack of recursive sentence.