Comparing the effectiveness of orthographic and phonological cues in the treatment of anomia....

Comparing the effectiveness of orthographic and phonological cues

in the treatment of anomia.

Lyndsey Nickels1, Antje Lorenz1,2,

1 Macquarie Centre for Cognitive Science (MACCS), Macquarie University

2 Institut für Linguistik, Potsdam University

Introduction: phonological cues

• Phonological cues have strong effects on spoken word retrieval (e.g. Pease & Goodglass, 1978)

• early studies: phonological cues produce only short-lasting effects on naming success

- Patterson et al., 1983 (NO effects: 25 min. later) - Howard et al., 1985a (NO effects: 10 min. later)

• more recent studies: phonological cues may produce long-lasting effects

e.g. Best et al., 2002 (effects still present: 10 min. later), Barry & McHattie, 1991 (20 min.)

Introduction: orthographic cues

• relatively little research on the effects of written cues on spoken word retrieval

• orthographic cues may have strong effects (e.g. Howard & Harding, 1998: single-case study)

•orthographic cue-effects might be long-lasting (Best et al., 2002: 10 min. Later)

Introduction: phonological vs. orthographic cues

- little research looking at phonological vs. orthographic cues in the same participants

- both phonological and orthographic cues may have similar effects on word retrieval in anomic aphasia (Best et al., 2002)

- orthographic cues may produce longer lasting effects than phonological cues / tasks in language-unimpaired subjects and aphasic people

(e.g. Basso et al., 2001)

AIM of this study

...to compare the effects of phonological and orthographic

cues with a specific focus on:

1. duration of effects (immediate vs. delayed effects: 20 min. vs. 24 h)

2. predictability of cueing-effects from underlying functional deficits

3. underlying mechanism of effectiveness of phonological vs. orthographic cues

Material: Black & white line drawings of objects (N=224)

Phonological cues (N=56) Orthographic cues (N=56)

UNCUED SETS (N=112)

CUED SETS (N=112)

seen (N=56)(presented for uncued namingin all sessions)

unseen (N=56)(only in pre- and post-assessments)

Material: Black & white line drawings of objects (N=224)

MATCHING

- matching of sets for each participant individually:

for naming-accuracy in the pre-assessment (N=224)

further factors:

word frequency (comb. spoken + written, log.); word-length (nb. phonemes);

articulatory complexity (consonant clusters); animacy; OPC-regularity

pre-assessments

Design

Phase 1: 24 hr post-assessment

PHASE 1

PICTURE NAMING

sound cues

letter cues

no cues

(n=28 each set)

3 sessions

pseudorandomized order of pictures within each set

order of presentation of different sets counterbalanced across different sessions

Phase 2: 24 hr post-assessment

PHASE 2

PICTURE NAMING

sound cues

letter cues

no cues

(n=28 each set)

3 sessions

Preparation of experiments

Prestimulation-paradigm:

SOUNDS (wav-files)

initial sound

break: 300 ms

target picture

(time-out: 6 sec.)

break: 200 ms

LETTERS (bmp-files)

initial letter: 600 ms

break: 300 ms

target picture

break: 200 ms

NO CUES

after 300 ms:

target picture

break: 200 ms

(Universal Data Acquisition Program, UDAP, Zierdt, 2002)

20 minutes later all pictures are named again with NO CUES

Participants

- no (severe) apraxia of speech

- auditory discrimination of single sounds unimpaired (or mildly impaired)

- unimpaired in object decision task (BORB, Riddoch & Humphreys, 1993)

- impaired word retrieval in conversation and spoken naming

- predominantly post-semantic anomia in all participants

Initials GenderAge

(years)

Time post

onset (years; months)

AetiologySpeech output

Auditory discrimination: single sounds

% correct(n=50)

Spoken naming

% correct (n=224)

DRS F 56 5;11 L CVA Fluent 90 55.8

JUE F 33 4;9 L CVA Nonfluent 96 64.8

MCB F 63 3;2 L CVA Fluent 96 48.7

KCC M 66 6;0 L CVA NonFluent 92 33.5

Cue effects in first session: immediate effects

* p < .05, McNemar-test (2-tailed): pre-assessment vs. naming immediately after cue

-10

0

10

20

30

40

50

DRS MCB JUE KCC

% e

ffec

t si

ze (

cued

nam

ing

- pr

e)

phoneme

grapheme

no cue

**

n.s.n.s.

n.s.

n.s.

n.s.

n.s.

n.s.

n.s.

n.s.

n.s.

-10

0

10

20

30

40

50

DRS MCB JUE KCC

% e

ffec

t si

ze (

cued

nam

ing

- pr

e)

phoneme

grapheme

no cue

**

n.s.n.s.

n.s.

n.s.

n.s.

n.s.

n.s.

n.s.

n.s.

n.s.

Cue effects in first session

* p < .05, McNemar-test (2-tailed): pre-assessment vs. naming after cue

Immediate 20 mins later

-10

0

10

20

30

40

50

DRS MCB JUE KCC

% e

ffec

t si

ze (

cued

nam

ing

- pr

e)

phoneme

grapheme

no cue

**

n.s.n.s.

n.s.

n.s.

n.s.

n.s.

n.s.

n.s.

n.s.

n.s.

Cue effects in first session


-10

0

10

20

30

40

50

DRS MCB JUE KCC

* *

**

Immediate 20 mins later

Cue effects in third sessionthird session: cumulative effects

-10

0

10

20

30

40

50

DRS MCB JUE KCC

% e

ffec

t si

ze (

cued

nam

ing

- pr

e)

phoneme

grapheme

no cue


*

Immediate

* **

**

-10

0

10

20

30

40

50

DRS MCB JUE KCC

3rd session: 20 mins after cue

* ***

**

*


-10

0

10

20

30

40

50

DRS MCB JUE KCC


* ***

**

*

Post-test: 1 day after 3rd session


-10

0

10

20

30

40

50

DRS MCB JUE KCC

*

Immediate


* **

** * **

*

**

*

-10

0

10

20

30

40

50

DRS MCB JUE KCC

% e

ffe

ct

siz

e (

de

lta

)

phoneme

grapheme

no cue

unseen control

Post-test: 1 day after 3rd session

* **

***

Summary of results: JUE & KCC

• did not improve with seen or unseen control pictures

• graphemic cue effective

• stable effect (20 min., 24 hours later)

How do letter cues help SPOKEN naming?

phonological output lexicon

phonological output buffer

semantic

system

speech

target picture

How might letter cues work?

tomato

/t/ /ə/ /m/ /a:/ /t/ /əʊ/

“tomato”



semantic

system

speech

target picture


tomato



semantic

system

speech

target picture


tomato

/t/

“tomato”

orthographic-phonological conversion

T

initial grapheme cue

tomato

/t/ /ə/ /m/ /a:/ /t/ /əʊ/

Nonword reading route

JUE & KCC: Reading aloud

reading, non-

words PALPA (n=40)

initial phoneme correct in erroneous responses

JUE 0 87.5

KCC 5 42.1

Nonword reading impaired - is there another

mechanism by which cues might be effective?



semantic

system

speech

target picture

How might letter cues work? Direct lexical theory

tomato


T


orthographicinput lexicon



semantic

system

speech

target picture

How might letter cues work? Direct lexical theory

tomato

“tomato”


T


tomato

/t/ /ə/ /m/ /a:/ /t/ /əʊ/

orthographicinput lexicon[tomato][toy] [tent] [tea]

Summary of results: JUE & KCC

• did not improve with seen or unseen control pictures

• graphemic cue effective

• stable effect (20 min., 24 hours later)

• Poor nonword reading – but some ability – is it enough?• Further investigation with words with irregular initial letters (e.g.

Knife) will determine whether this is the cueing mechanism

• Good (concrete) word reading – means a direct lexical mechanism may be a possibility (cf Best et al.)

Summary of results: DRS

• DRS

– improved with seen control pictures (no cues, help, feedback)

– unseen control pictures remained stable

ie trying to name pictures (with no feedback) helps naming on a subsequent occasion

Conclusions

• Orthographic cues can be effective in improving naming

- BUT NOT for all individuals

- further investigation required to determine the mechanism

- Orthographic cues may be effective via a direct-lexical route in some people.

• Trying to name the same set of pictures in different sessions without help or feedback can result in an improved naming of those pictures for some individuals

Thank you!

Comparing the effectiveness of orthographic and phonological cues in the treatment of anomia....

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