Treating naming impairments in aphasia: Findings from a phonological components analysis treatment

Abstract

Background: A new phonologically based treatment that we developed for addressing naming deficits in aphasia—the phonological components analysis (PCA) treatment—is presented. The PCA was modelled after the semantic feature analysis (SFA) approach (Boyle & Coelho, 1995 Boyle, M. and Coelho, C. A. 1995. Application of a semantic feature analysis as a treatment for aphasic dysnomia.. American Journal of Speech‐Language Pathology, 4: 135–138. [Crossref] , [Google Scholar]). The SFA approach was chosen as a model for two reasons. First, results from the semantic therapies that have used SFA have been encouraging (e.g., Boyle, 2004 Boyle, M. 2004. Semantic feature analysis treatment for anomia in two fluent aphasia syndromes.. American Journal of Speech‐Language Pathology, 13: 236–249. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]; Boyle & Coelho, 1995 Boyle, M. and Coelho, C. A. 1995. Application of a semantic feature analysis as a treatment for aphasic dysnomia.. American Journal of Speech‐Language Pathology, 4: 135–138. [Crossref] , [Google Scholar]; Coelho, McHugh, & Boyle, 2000 Coelho, C. A., McHugh, R. E. and Boyle, M. 2000. Semantic feature analysis as a treatment for aphasic dysnomia: A replication.. Aphasiology, 14(2): 133–142. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]; Conley & Coelho, 2003 Conley, A. and Coelho, C. A. 2003. Treatment of word retrieval impairment in chronic Broca's aphasia.. Aphasiology, 17(3): 203–211. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]; Lowell, Beeson, & Holland, 1995 Lowell, S., Beeson, P. M. and Holland, A. L. 1995. The efficacy of a semantic cueing procedure on naming performance in adults with aphasia.. American Journal of Speech‐Language Pathology, 4: 109–114. [Crossref] , [Google Scholar]). Second, SFA incorporates the principle of choice, a factor that has been identified by some as being important in producing longer‐lasting effects of treatment (e.g., Hickin, Best, Herbert, Howard, & Osborne, 2002 Hickin, J., Best, W., Herbert, R., Howard, D. and Osborne, F. 2002. Phonological therapy for word‐finding difficulties: A re‐evaluation.. Aphasiology, 16(10/11): 981–999. [Taylor & Francis Online] , [Google Scholar]). The PCA was developed to serve as a comparable phonological comparison for the SFA approach with the future goal of comparing the relative effects of both types of therapies. Aims: The primary aim of this investigation was to document the effectiveness of PCA treatment for the remediation of naming deficits in aphasia. In addition, we wished to examine potential maintenance and generalisation effects associated with this treatment. Methods & Procedures: The PCA treatment followed the protocol of Coelho et al. (2000 Coelho, C. A., McHugh, R. E. and Boyle, M. 2000. Semantic feature analysis as a treatment for aphasic dysnomia: A replication.. Aphasiology, 14(2): 133–142. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]). The target picture was presented in the centre of a chart and the participant was asked to name it. Irrespective of his/her ability to name the picture, the participant was asked to identify five phonological components related to the target item (i.e., rhymes with, first sound, first sound associate, final sound, number of syllables). For each component targeted, if a participant could not spontaneously provide a response, he/she was asked to choose one from a list. A single‐subject multiple‐baseline across behaviours design was employed, with maintenance effects examined 4 weeks post‐treatment. Generalisation effects were examined by comparing pre‐ and post‐treatment scores on the Philadelphia Naming Test (Roach, Schwartz, Martin, Grewal, & Brecher, 1996 Roach, A., Schwartz, M. F., Martin, N., Grewal, R. S. and Brecher, A. 1996. The Philadelphia Naming Test: Scoring and rationale.. Clinical Aphasiology, 24: 121–133. [Google Scholar]). Ten individuals with aphasia participated. Outcomes & Results: Of the 10 individuals, 7 demonstrated notable treatment effects. Follow‐up testing indicated maintenance of treatment gains over a 4‐week period, with some generalisation to untreated items. Conclusions: This investigation was successful in demonstrating the effectiveness of a new phonological approach to the remediation of naming deficits in aphasia and in supporting the notion that a components analysis treatment protocol (similar to a semantic feature based treatment) is useful in strengthening activations within the lexical system with the potential result of longer‐lasting effects.