Refereed article in conference proceedings (A4)

Do we treat functionally relevant items in aphasia therapy? – Current challenges and new tools

Subtitle: Current challenges and new tools

List of Authors: Renvall K, Nickels L, Davidson B

Publication year: 2013

Book title *: 29th World Congress of the IALP: Where practice meets science


Aphasiologists aim to select “functional”, “relevant” and “useful” items for use in therapy, yet the field lacks clear definitions of these terms. Strategies and tools to enable identification of items that are truly “functionally relevant” are also lacking. The purpose of this paper is to present a brief review of the meaning of “functionally relevant” for aphasiology, to discuss challenges in identifying functionally relevant items, and to provide guidance in the selection of these items for treatment of acquired language disorders and word retrieval disorders (anomia) in particular. This study includes a literature review, analyses of existing language databases, and provision of new tools that may be used to guide selection of therapy items at two levels: vocabulary and topics of conversations.

Review of the aphasia literature shows that the field lacks clear definitions, thus in order to clarify the meaning of “functional”, we define two types of functionally relevant items: “generally frequent” and “personally chosen” vocabulary. By reviewing the aphasia literature and studies from related fields including Augmentative and Alternative Communication (AAC), we determine strengths and weaknesses of these approaches. We show that one of the major challenges is that aphasiologists typically aim to treat items which are intuitively the most common for people in general but have no tools to objectively identify frequent words. A related challenge is that most reported therapy studies are directed at concrete nouns and verbs although, as confirmed by our analyses, the most common words in everyday use are abstract and include words from other word classes (e.g., pronouns, conjunctions, adjectives, and adverbs). There is also a lack of instructions and published materials to guide selection of other, more personally relevant items.

This paper reports on reanalysis of existing datasets of adult speakers’ everyday conversations and the use of a large psycholinguistic database to provide four new resources for making selection of therapy items easier and more objective in the future. The first resource provides evidence of the most frequent topics in older adults’ conversations. The second is another topic-related resource drawn from the everyday conversations of both healthy and aphasic older people. The third resource is a collation of the most frequent words used by older adults as part of their everyday conversations extracted from three separate studies. The fourth resource represents the 1000 most frequent words retrieved from a large psycholinguistic database.

Considering that most aphasia treatment studies have reported item-specific effects without generalisation to untreated items, careful selection of target items is important. Use of frequency-based topic and vocabulary lists can be one way to increase the number of items that are potentially relevant for many people. They can also guide selection of more individual vocabularies. Our proposal should not be interpreted as recommending rigid use of pre-determined stimulus lists but rather as providing informed guidance for selecting functionally relevant therapy items. The agenda for future research is to identify vocabulary within the most common topics and to determine effective methods of treatment for word classes other than nouns and verbs.

Last updated on 2021-24-06 at 09:51