Year: 2011
Type: dissertation
Abstract: Rationale: Aphasia and anomia affect the communication abilities of thousands of South \nAfrican stroke survivors. Therapy provision in South Africa is a challenging endeavour. \nClinicians must provide therapy to clients who speak languages which have rarely, if \never, been the focus of clinical study. Models developed for use with clients who speak \nEnglish or related languages may not be suitable for speakers of other, parametricallydiverse \nlanguages. Bilingualism is widespread in South Africa, yet therapeutic insights on \nhow best to treat bilingual speakers are only beginning to inform clinical research and \npractice. Time and financial support are also lacking in many clinical settings. \nAim: This study represents an attempt to establish which of four treatment conditions \n(initial phoneme cueing, codeswitch1 cueing, true phonemic cueing and prosodic cueing) \nis most effective at facilitating improved naming performance in two Sesotho-English \nbilingual speakers with post-stroke anomia. \nMethodology: Commercially-available tests of naming ability were found to be \nstatistically invalid since they seemed to assess familiarity with Western culture and \nartifacts rather than naming ability. Working in conjunction with ten neurologically \nunimpaired Sesotho speakers living in the Northern Free State, community-referenced \nwords lists were developed for use in this study. \nTwo bilingual Sesotho-English speakers with post-stroke anomia participated in this \nstudy. T. was assessed and found to present with classical anomia, while S. presented \nwith output anomia. T.’s word finding difficulties are characterized by pauses, use of \nvocalizers and part-whole productions, while S. tends to produce semantic paraphasias \nduring anomic moments. \n1 In keeping with trends present in research literature (e.g. Auer, 1999), codeswitching will be designated \nby a single, unhyphenated word. \nxi \nEach treatment condition (initial phoneme cueing, codeswitch cueing, true phonemic \ncueing and prosodic cueing) were allocated a word list. Pre-- and post-intervention scores \nof naming ability on these treatment lists and four lists of semantically related words \nwere compared. The treatment conditions were evaluated in terms of three constructs \ncommonly employed in anomia literature: potency (the degree to which a technique helps \na speaker relearn words directly targeted in therapy), semantic generalizability (the \ndegree to which a technique helps a speaker relearn words semantically related to those \ndirectly targeted in therapy) and persistence (the degree to which therapy effects are longlived.). \nThe sign-test was used to determine statistical significance or otherwise. \nResults and discussion: Neither initial phoneme cueing nor codeswitch cueing were \nassociated with statistically significant potency in either participant. Both true phonemic \ncueing and prosodic cueing were associated with statistically significant levels of potency \nin both participants. None of the treatment conditions were associated with statistically \nsignificant semantic generalizability in either participant. In the case of S., codeswitch \ncues appeared lead to an increase in the number and complexity of semantic paraphasias. \nNo significant decrease in any of the gains made during the intervention portion of the \nstudy were noted one month after the conclusion of the study. Explanations for these \nresults, informed by cognitive neuropsychology, are provided. Possible refinements to \nmodels of lexical retrieval in monolingual and bilingual speakers are postulated. \nConclusion: The results of this study suggest that speech-language pathologists in South \nAfrica should not rely solely on therapy approaches developed for use with Englishspeakers. \nInstead, a parametrically informed approach, which draws heavily on cognitive \nneuropsychological understandings of bilingual functioning, may be helpful in furnishing \nspeech-language pathologists in South Africa with the tools they need to provide \nservices. The local community needs to play a role in developing materials for use in \ntherapy and assessment in challenging environments. New therapy techniques should be \nweighed against commonly used measures of therapy efficacy to determine the best \ncourse of treatment.
Author: Brent Archer
Language: English
Subfield: Cognitive Neuroscience
Field: Neuroscience
Domain: Life Sciences
Open Access status: green
OpenAlex ID: W2242616074