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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
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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.)
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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)
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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)
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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
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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)
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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
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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
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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
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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
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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.
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-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
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-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
-10
0
10
20
30
40
50
DRS MCB JUE KCC
* *
**
Immediate 20 mins later
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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
* p < .05, McNemar-test (2-tailed): pre-assessment vs. naming after cue
*
Immediate
* **
**
-10
0
10
20
30
40
50
DRS MCB JUE KCC
3rd session: 20 mins after cue
* ***
**
*
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* p < .05, McNemar-test (2-tailed): pre-assessment vs. naming after cue
-10
0
10
20
30
40
50
DRS MCB JUE KCC
3rd session: 20 mins after cue
* ***
**
*
Post-test: 1 day after 3rd session
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* p < .05, McNemar-test (2-tailed): pre-assessment vs. naming after cue
-10
0
10
20
30
40
50
DRS MCB JUE KCC
*
Immediate
3rd session: 20 mins after cue
* **
** * **
*
**
*
-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
* **
***
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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?
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phonological output lexicon
phonological output buffer
semantic
system
speech
target picture
How might letter cues work?
tomato
/t/ /ə/ /m/ /a:/ /t/ /əʊ/
“tomato”
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phonological output lexicon
phonological output buffer
semantic
system
speech
target picture
How might letter cues work?
tomato
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phonological output lexicon
phonological output buffer
semantic
system
speech
target picture
How might letter cues work?
tomato
/t/
“tomato”
orthographic-phonological conversion
T
initial grapheme cue
tomato
/t/ /ə/ /m/ /a:/ /t/ /əʊ/
Nonword reading route
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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?
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phonological output lexicon
phonological output buffer
semantic
system
speech
target picture
How might letter cues work? Direct lexical theory
tomato
orthographic-phonological conversion
T
initial grapheme cue
orthographicinput lexicon
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phonological output lexicon
phonological output buffer
semantic
system
speech
target picture
How might letter cues work? Direct lexical theory
tomato
“tomato”
orthographic-phonological conversion
T
initial grapheme cue
tomato
/t/ /ə/ /m/ /a:/ /t/ /əʊ/
orthographicinput lexicon[tomato][toy] [tent] [tea]
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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.)
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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
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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
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Thank you!