Grassly, J; (2013) Facilitating word retrieval in people with aphasia: an exploration of the relationship between language and neuropsychological processing. Doctoral thesis , UCL (University College London).

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Abstract

Background: The challenge of understanding word retrieval is one that has long been the subject of investigation in aphasia therapy research, and has been confounded by the finding that people with similar patterns of language impairment can respond in different ways to the same therapy approach. Consideration has now turned to factors other than just language processes when planning intervention, including extra-linguistic cognitive processes, and the provision, and type, of feedback given. Aims: To investigate the language and neuropsychological processing abilities of people with aphasia, and to examine how these abilities relate to response to facilitation and feedback. Methods & Procedures: Eight adults with aphasia, aged between 25 and 81, participated in a case series design. A novel battery of language and neuropsychological assessments was administered. Five facilitation studies were carried out, in which the effect on word retrieval at a later point in time was investigated for different linguistic cues and use of feedback. Outcomes & Results: The differences in participants’ profiles enabled significant theoretically-motivated correlations to be identified between several aspects of processing within the areas under investigation: language, facilitation, neuropsychology and feedback. Conclusions & Implications: Assessments of memory and attention show potential for use within a wider battery administered by clinicians. Measures of executive function were less straightforward, due in part to its multifaceted nature; assessments of this domain should therefore be considered on an individual basis with regards to the underlying processes measured. Language skills alone are not able to predict response to facilitation. Facilitation was found to be a robust and valid tool and it is suggested that it may be used as a reliable probe tool to identify appropriate therapy techniques. Clinician-delivered feedback can improve word retrieval for responses that were initially incorrect; promoting self-feedback following correct responses can result in superior delayed naming.

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