Does Naming Therapy Make Ordering In a Restaurant Easier 2

Experiment 1: Results Correlations between ASHA FACS Communication Independence scores and measures of cognitive-linguistic ability Social Communication Basic Needs Reading, Writing & Number Concepts Daily Planning Overall Communication Independence n = 72 WAB-LQ .789*** .525*** .787*** .740*** .829*** WAB-CQ .802*** .518*** .773*** .742*** .822*** WAB-AQ .782*** .393** .688*** .650*** .736*** CLQT: Attention .351** .239 (p = .054) .575*** .612*** .576*** CLQT: Memory .743*** .464*** .721*** .693*** .780*** CLQT: Executive Functions .379** .326** .615*** .646*** .617*** CLQT: Language .758*** .441*** .722*** .704*** .786*** CLQT: Visuospatial .243 (p = .050) .211 (p = .089) .484*** .537*** .480*** CLQT: Composite .621*** .387** .782*** .775*** .797*** CLQT: Clock Drawing .560*** .437*** .646*** .655*** .692*** BNT .679*** .367** .651*** .681*** .726*** PAPT .543*** .415*** .605*** .640*** .659*** * = p significant at < .05 ** = p significant at < .01 *** = p significant at < .001 Correlation Strength: Green = Strong (1.00 - .700); Yellow = Moderate (.699 - .400); Red = Weak (.399 - .100) Experiment 1: Results Correlations between ASHA FACS Communication Independence scores and measures of cognitive-linguistic ability Social Communication Basic Needs Reading, Writing & Number Concepts Daily Planning Overall Communication Independence n = 72 WAB-LQ .789*** .525*** .787*** .740*** .829*** WAB-CQ .802*** .518*** .773*** .742*** .822*** WAB-AQ .782*** .393** .688*** .650*** .736*** CLQT: Attention .351** .239 (p = .054) .575*** .612*** .576*** CLQT: Memory .743*** .464*** .721*** .693*** .780*** CLQT: Executive Functions .379** .326** .615*** .646*** .617*** CLQT: Language .758*** .441*** .722*** .704*** .786*** CLQT: Visuospatial .243 (p = .050) .211 (p = .089) .484*** .537*** .480*** CLQT: Composite .621*** .387** .782*** .775*** .797*** CLQT: Clock Drawing .560*** .437*** .646*** .655*** .692*** BNT .679*** .367** .651*** .681*** .726*** PAPT .543*** .415*** .605*** .640*** .659*** * = p significant at < .05 ** = p significant at < .01 *** = p significant at < .001 Correlation Strength: Green = Strong (1.00 - .700); Yellow = Moderate (.699 - .400); Red = Weak (.399 - .100) Experiment 1: Results Correlations between ASHA FACS Qualitative Dimensions scores and measures of cognitive-linguistic ability Overall Adequacy Appropriateness Promptness Qualitative Dimensions n = 70† WAB-LQ .800*** .488*** .530*** .700*** .792*** WAB-CQ .787*** .501*** .532*** .717*** .796*** WAB-AQ .767*** .438*** .534*** .756*** .780*** CLQT: Attention .445*** .566*** .429*** .284* .497*** CLQT: Memory .756*** .526*** .478*** .688*** .752*** CLQT: Executive Functions .484*** .610*** .447*** .335** .543*** CLQT: Language .744*** .449*** .437*** .678*** .718*** CLQT: Visuospatial .364** .544*** .401** .206 (n.s.) .424*** CLQT: Composite .705*** .614*** .537*** .513*** .710*** CLQT: Clock Drawing .544*** .576*** .434*** .451*** .602*** BNT .679*** .412** .371** .585*** .638*** PAPT .565*** .476*** .315** .407*** .546*** ** = p significant at < .01 *** = p significant at < .001 * = p significant at < .05 Correlation Strength: Green = Strong (1.00 - .700); Yellow = Moderate (.699 - .400); Red = Weak (.399 - .100) † QDC scores not available for two PWA within the sample Communication Sharing Experiment 1: Results Correlations between ASHA FACS Qualitative Dimensions scores and measures of cognitive-linguistic ability Overall Adequacy Appropriateness Promptness Qualitative Dimensions n = 70† WAB-LQ .800*** .488*** .530*** .700*** .792*** WAB-CQ .787*** .501*** .532*** .717*** .796*** WAB-AQ .767*** .438*** .534*** .756*** .780*** CLQT: Attention .445*** .566*** .429*** .284* .497*** CLQT: Memory .756*** .526*** .478*** .688*** .752*** CLQT: Executive Functions .484*** .610*** .447*** .335** .543*** CLQT: Language .744*** .449*** .437*** .678*** .718*** CLQT: Visuospatial .364** .544*** .401** .206 (n.s.) .424*** CLQT: Composite .705*** .614*** .537*** .513*** .710*** CLQT: Clock Drawing .544*** .576*** .434*** .451*** .602*** BNT .679*** .412** .371** .585*** .638*** PAPT .565*** .476*** .315** .407*** .546*** * = p significant at < .05 ** = p significant at < .01 *** = p significant at < .001 Correlation Strength: Green = Strong (1.00 - .700); Yellow = Moderate (.699 - .400); Red = Weak (.399 - .100) † QDC scores not available for two PWA within the sample Communication Sharing Experiment 1: Summary All but four correlations between measures of impairment and functional communication were significant and more than 90% were moderate or strong Functional Communication Skills Functional Communication Skills Cognitive-Linguistic Skills Cognitive-Linguistic Skills Experiment 2: General Overview What is the effect of treatment? Age vs. Time Post-Onset of Aphasia 1 Experiment 2 Participants: 72 n = 39 60.9 yrs Mean age: 63.6 Mean time post4.7 yrs onset: 5.1 Time Post-Onset (in years) 35 30 Baseline Testing Treatment • Standardized Assessments 20 • Study-specific nonstandardized screener • Max of 10-12 weeks • 1-2 sessions/week 25 Post-Treatment Testing • Standardized Assessments • Study-specific nonstandardized screener 15 10 5 0 0 20 40 60 Age (in years) 80 100 Experiment 2: Correlation results Reading, Writing Overall & Number Daily Planning Communication Concepts Independence n = 37† WAB-LQ .906*** .595*** .871*** .807*** .893*** WAB-CQ .920*** .598*** .853*** .825*** .891*** WAB-AQ .904*** .484** .799*** .760*** .834*** CLQT: Attention .495** .591*** .625*** .630*** .644*** CLQT: Memory .849*** .542** .774*** .754*** .819*** CLQT: Executive Functions .558*** .719*** .687*** .698*** .727*** CLQT: Language .850*** .502** .737*** .743*** .797*** CLQT: Visuospatial .421* .603*** .561*** .585*** .590*** CLQT: Composite .765*** .666*** .825*** .811*** .846*** CLQT: Clock Drawing .623*** .604*** .648*** .711*** .715*** BNT .803*** .518** .692*** .773*** .779*** PAPT .614*** .737*** .664*** .681*** .747*** * = p significant at < .05 ** = p significant at < .01 *** = p significant at < .001 Correlation Strength: Green = Strong (1.00 - .700); Yellow = Moderate (.699 - .400); Red = Weak (.399 - .100) † Data not available for two PWA within the sample Social Communication Basic Needs • Strong and highly significant correlations between cognitivelinguistic and functional communication skills at baseline in the subset of PWA who underwent therapy Overall Qualitative Dimensions n = 35†† WAB-LQ .817*** .529** .606*** .826*** .829*** WAB-CQ .813*** .526** .597*** .838*** .829*** WAB-AQ .799*** .487** .578*** .843*** .817*** CLQT: Attention .581*** .560*** .444* .379* .570*** CLQT: Memory .798*** .533** .473** .775*** .778*** CLQT: Executive Functions .659*** .664*** .532*** .519** .697*** CLQT: Language .722*** .428* .442* .754*** .712*** CLQT: Visuospatial .528** .566*** .394* .374* .538** CLQT: Composite .813*** .644*** .559*** .587*** .772*** CLQT: Clock Drawing .544** .662*** .420* .494** .613*** BNT .668*** .395* .395* .636*** .639*** PAPT .560*** .484** .268 (n.s.) .434* .532** * = p significant at < .05 ** = p significant at < .01 *** = p significant at < .001 Correlation Strength: Green = Strong (1.00 - .700); Yellow = Moderate (.699 - .400); Red = Weak (.399 - .100) †† Data not available for two additional PWA Adequacy Appropriateness Promptness Communication Sharing Experiment 2: Intervention and Response Slope analysis of accuracy and response time on trained tasks indicated 35/39 PWA improved significantly on at least one task Naming Reading Writing Problem Solving Memory • PWA significantly improved from pre- to post-therapy on WAB-R CQ and AQ and CLQT Attention and Visuospatial Skills • No significant changes in ASHA FACS domain or dimension scores were noted following therapy • Change-score calculation = post-tx score – pre-tx score Scores (%) Experiment 2: Results in Pre- to Post-Treatment Outcome Measures 74 72 70 68 66 64 62 60 58 56 ** * WAB-R CQ * p < .05 **p < .01 * ** WAB-R AQ Pre-Tx CLQT: CLQT: Attention Visuospatial Skills Post-Tx Experiment 2: Change Score Correlations Correlations between ASHA FACS Communication Independence and cognitive-linguistic measure change scores Social Communication Basic Needs Reading, Writing & Number Concepts Daily Planning Overall Communication Independence n = 37† WAB-LQ .245 (n.s.) .063 (n.s.) .261 (n.s.) .027 (n.s.) .215 (n.s.) WAB-CQ .251 (n.s.) .132 (n.s.) .261 (n.s.) -.030 (n.s.) .200 (n.s.) WAB-AQ .303 (n.s.) .235 (n.s.) .256 (n.s.) .069 (n.s.) .267 (n.s.) CLQT: Attention .076 (n.s.) .034 (n.s.) .160 (n.s.) -.207 (n.s.) .008 (n.s.) CLQT: Memory .181 (n.s.) .090 (n.s.) .148 (n.s.) -.015 (n.s.) .090 (n.s.) CLQT: Executive Functions .103 (n.s.) .131 (n.s.) -.005 (n.s.) -.028 (n.s.) .077 (n.s.) CLQT: Language .164 (n.s.) -.056 (n.s.) .181 (n.s.) .075 (n.s.) .154 (n.s.) CLQT: Visuospatial .067 (n.s.) .177 (n.s.) .074 (n.s.) -.191 (n.s.) -.001 (n.s.) CLQT: Composite .204 (n.s.) .188 (n.s.) .219 (n.s.) -.147 (n.s.) .054 (n.s.) CLQT: Clock Drawing -.218 (n.s.) -.045 (n.s.) -.102 (n.s.) -.040 (n.s.) -.170 (n.s.) BNT .293 (n.s.) .261 (n.s.) .280 (n.s.) .249 (n.s.) .337 (n.s.) PAPT .193 (n.s.) .061 (n.s.) .143 (n.s.) .143 (n.s.) .181 (n.s.) * = p significant at < .05 ** = p significant at < .01 *** = p significant at < .001 Correlation Strength: Green = Strong (1.00 - .700); Yellow = Moderate (.699 - .400); Red = Weak (.399 - .100) † Data not available for two PWA within the sample Experiment 2: Change Score Correlations Correlations between ASHA FACS Qualitative Dimensions and cognitive-linguistic measure change scores Adequacy Appropriateness Promptness Communication Sharing Overall Qualitative Dimensions n = 35†† WAB-LQ .086 (n.s.) .399 (n.s.) .403 (n.s.) .136 (n.s.) .475 (n.s.) WAB-CQ .082 (n.s.) .446 (n.s.) .352 (n.s.) .210 (n.s.) .476 (n.s.) WAB-AQ .147 (n.s.) .600* .325 (n.s.) .283 (n.s.) .570* CLQT: Attention -.093 (n.s.) .330 (n.s.) .238 (n.s.) .245 (n.s.) .303 (n.s.) CLQT: Memory .141 (n.s.) .175 (n.s.) .128 (n.s.) -.142 (n.s.) .193 (n.s.) CLQT: Executive Functions .116 (n.s.) .313 (n.s.) .086 (n.s.) .087 (n.s.) .228 (n.s.) CLQT: Language .067 (n.s.) -.032 (n.s.) -.043 (n.s.) -.239 (n.s.) -.042 (n.s.) CLQT: Visuospatial -.025 (n.s.) .359 (n.s.) .165 (n.s.) .222 (n.s.) .282 (n.s.) CLQT: Composite .065 (n.s.) .568 (n.s.) .106 (n.s.) .161 (n.s.) .356 (n.s.) CLQT: Clock Drawing -.226 (n.s.) .035 (n.s.) -.313 (n.s.) -.332 (n.s.) -.192 (n.s.) BNT .201 (n.s.) .246 (n.s.) .040 (n.s.) -.069 (n.s.) .145 (n.s.) PAPT .325 (n.s.) .247 (n.s.) -.194 (n.s.) -.009 (n.s.) .053 (n.s.) * = p significant at < .05 ** = p significant at < .01 *** = p significant at < .001 Correlation Strength: Green = Strong (1.00 - .700); Yellow = Moderate (.699 - .400); Red = Weak (.399 - .100) †† Data not available for two additional PWA Experiment 2: Interim Conclusions Highly significant, strong Following therapy, PWA positive associations between improved significantly on cognitive-linguistic skills and several tests of cognitivefunctional communication at a linguistic skills but not on any single time point ASHA FACS domains Only two significant correlations between change scores on measures of cognitive-linguistic skills and change scores on ASHA FACS Why is change not related? • The most obvious possibility… • In Experiment #2, scores improved only on cognitive-linguistic measures, NOT on the ASHA FACS • Did all PWA really not change in functional communication? Inter-Individual Variability in PWA Change Scores Impairment Change Scores 40 35 30 25 20 15 10 5 0 -5 -10 Functional Communication Change Scores 2.5 2 1.5 1 0.5 0 -0.5 -1 -1.5 Baseline WAB-R AQ: PWA 1: 93.7 (mild); PWA 2: 48 (moderate); PWA 3: 31.3 (severe) What is the severity of the sample? • Frattali et al.’s field test included only PWA with WAB AQ <93.8 • Our sample included 9 PWA who were perceptibly aphasic but had WAB AQ >93.8 Severity Level based on WAB AQ Frattali et al. (n=131) 38.2% 26.7% 35.1% Revised Present sample (n=39) (n=30) 23.1% 30.0% 33.3% 26.7% 43.6% 43.3% Follow-Up Analysis: Results in Pre- to PostTreatment Outcome Measures 65 Scores (%) • PWA significantly improved from pre- to post-therapy on WAB-R AQ and CLQT: Attention • Improvement approached significance for WAB-R CQ and BNT * 75 ** 55 45 35 25 WAB CQ * p < .05 **p < .01 WAB AQ Pre-Tx CLQT Attention Post-Tx BNT Follow-Up Analysis: Results in Pre- to PostTreatment Outcome Measures 5.5 AVG Scores • PWA significantly improved from pre- to post-therapy on Social Communication and Daily Planning • Improvement approached significance for Reading, Writing & Number Concepts, Overall CI, and Overall Qualitative Dimensions * 5 * 4.5 4 3.5 3 Social Reading, Writing Daily Planning Communication & Number Concepts * p < .05 **p < .01 Pre-Tx Overall CI Post-Tx Overall Qualitative Dimensions Follow-Up Analysis: Results in Change Correlations Correlations between ASHA FACS Communication Independence and cognitive-linguistic measure change scores Social Communication Basic Needs Reading, Writing & Number Concepts Daily Planning Overall Communication Independence n = 28† WAB-LQ .372 (n.s.) .050 (n.s.) .239 (n.s.) .053 (n.s.) .295 (n.s.) WAB-CQ .349 (n.s.) .129 (n.s.) .231 (n.s.) -.042 (n.s.) .253 (n.s.) WAB-AQ .284 (n.s.) .186 (n.s.) .202 (n.s.) .029 (n.s.) .230 (n.s.) CLQT: Attention .183 (n.s.) .099 (n.s.) .206 (n.s.) -.146 (n.s.) .096 (n.s.) CLQT: Memory .295 (n.s.) .196 (n.s.) .263 (n.s.) .043 (n.s.) .208 (n.s.) CLQT: Executive Functions .231 (n.s.) .198 (n.s.) .0370 (n.s.) -.013 (n.s.) .134 (n.s.) CLQT: Language .338 (n.s.) .039 (n.s.) .323 (n.s.) .132 (n.s.) .279 (n.s.) CLQT: Visuospatial .107 (n.s.) .271 (n.s.) .067 (n.s.) -.217 (n.s.) .031 (n.s.) CLQT: Composite .311 (n.s.) .269 (n.s.) .255 (n.s.) -.133 (n.s.) .124 (n.s.) CLQT: Clock Drawing -.275 (n.s.) -.134 (n.s.) -.160 (n.s.) -.071 (n.s.) -.220 (n.s.) BNT .285 (n.s.) .143 (n.s.) .216 (n.s.) .084 (n.s.) .278 (n.s.) PAPT .193 (n.s.) .122 (n.s.) .059 (n.s.) .335 (n.s.) .267 (n.s.) * = p significant at < .05 ** = p significant at < .01 *** = p significant at < .001 Correlation Strength: Green = Strong (1.00 - .700); Yellow = Moderate (.699 - .400); Red = Weak (.399 - .100) † Data not available for two PWA within the sample Follow-Up Analysis: Results in Change Correlations Correlations between ASHA FACS Qualitative Dimensions and cognitive-linguistic measure change scores Adequacy Appropriateness Promptness Communication Sharing Overall Qualitative Dimensions n = 27†† WAB-LQ .083 (n.s.) .443 (n.s.) .462 (n.s.) .134 (n.s.) .572 (p = .094) WAB-CQ .042 (n.s.) .451 (n.s.) .431 (n.s.) .205 (n.s.) .567 (p = .094) WAB-AQ .014 (n.s.) .648* .366 (n.s.) .224 (n.s.) .596 (p = .079) CLQT: Attention -.108 (n.s.) .353 (n.s.) .312 (n.s.) .235 (n.s.) .370 (n.s.) CLQT: Memory .205 (n.s.) .198 (n.s.) .252 (n.s.) -.168 (n.s.) .336 (n.s.) CLQT: Executive Functions .209 (n.s.) .354 (n.s.) .153 (n.s.) .078 (n.s.) .346 (n.s.) CLQT: Language .152 (n.s.) .021 (n.s.) .117 (n.s.) -.268 (n.s.) .103 (n.s.) CLQT: Visuospatial -.108 (n.s.) .335 (n.s.) .237 (n.s.) .160 (n.s.) .286 (n.s.) CLQT: Composite .042 (n.s.) .546 (n.s.) .185 (n.s.) .113 (n.s.) .422 (n.s.) CLQT: Clock Drawing -.294 (n.s.) -.022 (n.s.) -.386 (n.s.) -.393 (n.s.) -.287 (n.s.) BNT .110 (n.s.) .175 (n.s.) -.029 (n.s.) -.255 (n.s.) .077 (n.s.) PAPT .307 (n.s.) .087 (n.s.) -.178 (n.s.) -.096 (n.s.) -.101 (n.s.) * = p significant at < .05 ** = p significant at < .01 *** = p significant at < .001 Correlation Strength: Green = Strong (1.00 - .700); Yellow = Moderate (.699 - .400); Red = Weak (.399 - .100) †† Data not available for one additional PWA Follow-Up Analysis Conclusions The subsample of PWA with more severe aphasia improved significantly on several tests of cognitivelinguistic skills Unlike the full treatment group, this more impaired group also improved on domains/dimensions of the ASHA FACS BUT…there was only ONE significant correlation between change scores on measures of impairment and the ASHA FACS Discussion: Why is change not related? Correlations between ASHA FACS Communication Independence scores and measures of cognitive-linguistic ability Pre-Treatment Post-Treatment Reading, Writing Overall Basic Needs Daily Planning Communication & Number n = 28 † Concepts Independence WAB-LQ .847*** .563** .833*** .717*** .852*** WAB-CQ .872*** .563** .805*** .733*** .849*** WAB-AQ .880*** .463* .752*** .669*** .785*** CLQT: Attention .565** .578** .706*** .726*** .756*** CLQT: Memory .797*** .476* .702*** .608** .745*** CLQT: Executive Functions .509** .645*** .655*** .677*** .723*** CLQT: Language .810*** .466* .677*** .611*** .732*** CLQT: Visuospatial .458* .572** .617** .678*** .683*** CLQT: Composite .686*** .564** .781*** .785*** .821*** CLQT: Clock Drawing .542** .454* .557** .665*** .660*** BNT .788*** .550** .702*** .699*** .784*** PAPT .473* .706*** .552** .578** .672*** * = p significant at < .05 ** = p significant at < .01 *** = p significant at < .001 Correlation Strength: Green = Strong (1.00 - .700); Yellow = Moderate (.699 - .400); Red = Weak (.399 - .100) † Data not available for two PWA within the sample Reading, Writing Overall & Number Basic Needs Daily Planning Communication Concepts Independence n = 28 † WAB-LQ .799*** .582** .807*** .674*** .786*** WAB-CQ .824*** .603** .813*** .686*** .802*** WAB-AQ .870*** .513** .766*** .639*** .754*** CLQT: Attention .462* .528** .661*** .705*** .742*** CLQT: Memory .718*** .474* .734*** .617** .710*** CLQT: Executive Functions .327 (n.s.) .542** .641*** .684*** .713*** CLQT: Language .764*** .502* .802*** .647*** .759*** CLQT: Visuospatial .319 (n.s.) .520** .552** .627** .648*** CLQT: Composite .554** .589** .783*** .741*** .808*** CLQT: Clock Drawing .284 (n.s.) .483* .706*** .582** .666*** BNT .726*** .472* .761*** .696*** .772*** PAPT .379 (n.s.) .505* .600** .670*** .682*** * = p significant at < .05 ** = p significant at < .01 *** = p significant at < .001 Correlation Strength: Green = Strong (1.00 - .700); Yellow = Moderate (.699 - .400); Red = Weak (.399 - .100) † Data not available for two PWA within the sample Social Communication Social Communication