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Background: Stroke rehabilitation interventions are routinely personalized to address individuals' needs, goals, and challenges based on evidence from aggregated randomized controlled trials (RCT) data and meta-syntheses. Individual participant data (IPD) meta-analyses may better inform the development of precision rehabilitation approaches, quantifying treatment responses while adjusting for confounders and reducing ecological bias., Aim: We explored associations between speech and language therapy (SLT) interventions frequency (days/week), intensity (h/week), and dosage (total SLT-hours) and language outcomes for different age, sex, aphasia severity, and chronicity subgroups by undertaking prespecified subgroup network meta-analyses of the RELEASE database., Methods: MEDLINE, EMBASE, and trial registrations were systematically searched (inception-Sept2015) for RCTs, including ⩾ 10 IPD on stroke-related aphasia. We extracted demographic, stroke, aphasia, SLT, and risk of bias data. Overall-language ability, auditory comprehension, and functional communication outcomes were standardized. A one-stage, random effects, network meta-analysis approach filtered IPD into a single optimal model, examining SLT regimen and language recovery from baseline to first post-intervention follow-up, adjusting for covariates identified a-priori . Data were dichotomized by age (⩽/> 65 years), aphasia severity (mild-moderate/ moderate-severe based on language outcomes' median value), chronicity (⩽/> 3 months), and sex subgroups. We reported estimates of means and 95% confidence intervals. Where relative variance was high (> 50%), results were reported for completeness., Results: 959 IPD (25 RCTs) were analyzed. For working-age participants, greatest language gains from baseline occurred alongside moderate to high-intensity SLT (functional communication 3-to-4 h/week; overall-language and comprehension > 9 h/week); older participants' greatest gains occurred alongside low-intensity SLT (⩽ 2 h/week) except for auditory comprehension (> 9 h/week). For both age-groups, SLT-frequency and dosage associated with best language gains were similar. Participants ⩽ 3 months post-onset demonstrated greatest overall-language gains for SLT at low intensity/moderate dosage (⩽ 2 SLT-h/week; 20-to-50 h); for those > 3 months, post-stroke greatest gains were associated with moderate-intensity/high-dosage SLT (3-4 SLT-h/week; ⩾ 50 hours). For moderate-severe participants, 4 SLT-days/week conferred the greatest language gains across outcomes, with auditory comprehension gains only observed for ⩾ 4 SLT-days/week; mild-moderate participants' greatest functional communication gains were associated with similar frequency (⩾ 4 SLT-days/week) and greatest overall-language gains with higher frequency SLT (⩾ 6 days/weekly). Males' greatest gains were associated with SLT of moderate (functional communication; 3-to-4 h/weekly) or high intensity (overall-language and auditory comprehension; (> 9 h/weekly) compared to females for whom the greatest gains were associated with lower-intensity SLT (< 2 SLT-h/weekly). Consistencies across subgroups were also evident; greatest overall-language gains were associated with 20-to-50 SLT-h in total; auditory comprehension gains were generally observed when SLT > 9 h over ⩾ 4 days/week., Conclusions: We observed a treatment response in most subgroups' overall-language, auditory comprehension, and functional communication language gains. For some, the maximum treatment response varied in association with different SLT-frequency, intensity, and dosage. Where differences were observed, working-aged, chronic, mild-moderate, and male subgroups experienced their greatest language gains alongside high-frequency/intensity SLT. In contrast, older, moderate-severely impaired, and female subgroups within 3 months of aphasia onset made their greatest gains for lower-intensity SLT. The acceptability, clinical, and cost effectiveness of precision aphasia rehabilitation approaches based on age, sex, aphasia severity, and chronicity should be evaluated in future clinical RCTs.

Our study examines the lexical representation and processing of compounds in participants with aphasia (PWA) and language-unimpaired control speakers. Participants were engaged in primed picture-naming in German, a language that marks for grammatical gender. Gender-marked determiners served as primes (der masc , die fem , das neut [the]) and noun-noun compounds as targets (e.g., Gold neut fisch masc [goldfish]). Experiment 1 tested whether the compound's constituents are activated at a lexical-syntactic level during production. Primes were gender-congruent either with the morphological head of the target compound (e.g., der masc for the target Gold neut fisch masc ), or its modifier (das neut for Gold neut fisch masc ), or incongruent with both (die fem ). Head congruency of prime and target produced strong facilitatory effects across groups. Modifier congruent primes produced contrasting effects. Modifier congruency speeded up picture naming in the controls and PWA with isolated deficits of lexical access (PWA-lex) but they delayed picture naming in PWA with additional deficits of phonological encoding (PWA-pho). Both patterns suggest that the lemmas of both constituents of compound targets and their grammatical gender are activated during compound retrieval, in line with a multiple-lemma representation of compounds. Experiment 2 explored the nature of the observed effects compared to a gender-neutral control condition. While facilitatory effects were shown by PWA-lex and the controls, PWA-pho did not profit from congruent primes but showed inhibitory effects by incongruent primes, exclusively. Inhibitory effects were also attested for the controls but not for PWA-lex. The functional origin of determiner priming effects and their theoretical and clinical implications are discussed in the framework of current accounts., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The present study tests theories about the representation of compound nouns and grammatical gender in the mental lexicon. Comprehension and production of determiner-compound-noun phrases were examined in three aphasic native speakers of German, a language that marks grammatical gender on definite determiners of nouns. In picture naming, participants were more impaired in retrieving compounds than matched simple nouns and showed different error patterns. However, retrieving the correct determiner was equally impaired for compounds and simple nouns. Clear dissociations between impaired determiner retrieval in production and relatively preserved processing of determiner-noun phrases in comprehension were observed for existing compounds and simple nouns. In contrast, processing of novel compounds was more impaired in both modalities, and gender-mismatch effects were especially observed for novel compounds. The results support the account of decomposed word forms and holistic lemma representations of compound nouns in the mental lexicon.

Background: In picture naming, both unimpaired and impaired speakers are usually better in naming singular than plural forms of the same noun, such as cat/cats. This singular-advantage is especially present in the case of singular-dominant nouns (e.g., table has higher surface frequency compared to its corresponding plural tables). However, for plural-dominant items (e.g., eyes has a higher surface frequency compared to eye) such singular advantage disappears. Thus, the lexical representation/processing of singular-dominant and plural-dominant nouns seem to differ but the exact underlying source for this dominance effect is still a matter of debate. While most of the available data stem from English experiments, less data are available from German. Aims: This study examines the effect of plural dominance for the German - n plural, a plural form, which can be predictable or non-predictable on the basis of the ending of the singular word form and its grammatical gender. Hence, this study examines the role of dominance and predictability of plural production in aphasia. Our data will enrich the development of materials for the assessment of morpho-lexical impairments in aphasia. Methods & Procedures: In a case-series design, five people with aphasia with severe word-finding difficulties participated in two picture naming tasks with single- and multiple-depictions of objects. Materials included nouns of the German -n plural type. Exp. 1 tested for effects of number and plural dominance in naming fully predictable -n plurals and their corresponding singulars. Exp. 2 tested for effects of number and predictability, using subsets of fully predictable and non-predictable -n plurals, and their corresponding singulars. Outcomes & Results: Exp. 1 revealed a significant plural dominance effect in spoken picture naming across five German speakers with aphasia: a singular advantage was observed for singular-dominant nouns, but plural-dominant singular and plural nouns did not differ. Further, in Exp. 2, no effect of predictability for the German plural affix -n was found, but an overall singular advantage across both groups. Conclusions: We interpret the dominance pattern of Exp.1 as manifestation in the links between concept and lemma level for singular- and plural-dominant nouns. Exp. 2, confirmed the singular advantage for singular-dominant nouns for both -n plural groups, indicating that both -n plural groups follow one plural production mechanism, however, we cannot be confident about the type of mechanism. [ABSTRACT FROM AUTHOR]

This paper investigates the production of German plural nouns by two aphasic participants with non-fluent speech production. Experimental tasks included two production tasks: (1) picture naming of single and multiple objects, and (2) an elicitation task of singular and plural nouns. Materials were controlled for regularity and predictability of plural form, and for dominance of number, referring to the relative difference in word form frequency between a singular and its corresponding plural form. Both regularity and number dominance have been shown to affect plural noun production in both unimpaired and aphasic speakers, but the underlying functional origin of these effects is still a matter of debate. The results point to differences in the lexical representation and processing of regular and irregular German plural nouns. Thus, the data are in line with the dual mechanism account. [ABSTRACT FROM AUTHOR]

This study examines spoken naming of German nominal compounds in four individuals with chronic aphasia in order to test current theories about the production of morphologically complex nouns. We investigated the impact of morphological complexity, grammatical class of the modifier, and of the constituents' semantic transparency on spoken naming accuracies, error types, and position of preserved constituents in erroneous responses. The results show that most participants were specifically impaired with compounds compared to long matched simple nouns. Furthermore, the grammatical class of the modifier affected the qualitative error pattern for three participants with agrammatic aphasia who were particularly impaired in retrieving the verbal modifier constituent as compared to the nominal head. In contrast, for noun-noun compounds no head superiority effect was obtained. Finally, semantic transparency did not affect overall naming accuracies, but the occurrence of constituent errors, i.e. erroneous responses overlapping with the target in one constituent. More constituent errors were observed for transparent than opaque targets. The results are compatible with decompositional and dual route accounts. [ABSTRACT FROM AUTHOR]

Background: Plural dominance refers to the relative difference between the frequencies of a word in its singular and plural forms. Most of the evidence for theoretical accounts of plural dominance has come from psycholinguistic perception experiments (e.g., Baayen, Burani, & Schreuder, 1996; Baayen, Dijkstra, & Schreuder, 1997; Baayen, Schreuder, & Sproat, 1998). Only a few studies have investigated the production side of dominance, even in unimpaired speakers (e.g., Baayen, Levelt, Schreuder, & Ernestus, 2008). To our knowledge there is only one published neuropsychological study from Luzzatti, Mondini, and Semenza (2001) that uses reading-aloud data from an Italian brain-impaired speaker. Although findings across paradigms are inconsistent, they do indicate that plural-dominant nouns behave differently from singular-dominant nouns, and therefore suggest a difference in representation. Aims: This paper investigates processing of plural nouns in aphasia with a specific focus on effects of dominance. Methods & Procedures: We carried out two single-case studies with two women with aphasia, FME and DRS, who showed word retrieval deficits in picture naming as a result of different underlying functional impairments. The main task of interest was picture naming of single and multiple objects in order to test effects of plural dominance. In addition, word–picture matching tested number representation in comprehension. Outcome & Results: DRS showed a specific morphological impairment with plural marking, whereas FME had no specific morphological deficit. The results are discussed in the framework of current psycholinguistic accounts on the representation and processing of plural nouns (e.g., Levelt, Roelofs, & Meyer, 1999; Schreuder & Baayen, 1995). Conclusions: Different effects of plural dominance shown by both women with aphasia result from different underlying functional deficits, which indicate differences in the representation of plural dominance across processing levels. [ABSTRACT FROM AUTHOR]

Abstract: This study compared a semantic and a phonological/orthographic approach to the treatment of word-finding difficulties in a case-series of ten individuals with aphasia, using a cross-over design. The study aims to investigate whether one approach is generally more effective than the other or whether the effectiveness of the two treatments relates systematically to the nature of the underlying functional impairment within the framework of a modular single-word processing model. In both treatments, the main task was spoken naming of pictured objects with different types of cues. In the semantic approach, different aspects of the target semantic concept were used as a cue in picture naming, while in the word-form method, both phonological and orthographic information were provided as a cue. Treatment effects were assessed in terms of both short- and long-lasting effects on spoken picture naming accuracy in each participant after the end of each treatment phase. Here, both item-specific effects and a possible generalisation to untreated pictures were considered. In addition, the immediate effects of the phonological and the semantic prompts were analysed. With regard to the cue effects on immediate naming, the word-form specific cues proved stronger than the semantic cues. The semantic treatment phase on the other hand, produced more stable effects than the word-form specific phase in some participants. A direct relationship between specific treatment effects and underlying functional deficit pattern was not confirmed for all subjects, i.e. participants with post-semantic anomia benefited from the semantic approach and participants with semantic anomia benefited from the phonological/orthographic approach. In the discussion of the results different explanations are considered, including the importance of preserved functions which aphasic participants bring into the treatment, the possible acquisition of a conscious strategy, and the possible influence of order of treatment. The effects of the two treatments are interpreted with regard to their underlying functional mechanisms in a single-word processing model. [Copyright &y& Elsevier]

Background: Both orthographic and phonological information from the target word can be appropriate cues in anomia treatment. Furthermore, both types of cues are used very frequently in clinical practice, although their underlying mechanisms of effectiveness and stability are still a matter of debate (e.g., Basso, Marangolo, Piras, & Galluzzi, 2001; Best, Herbert, Hickin, Osborne, & Howard, 2002; Howard & Harding, 1998). Aims: The aim of the study was to examine the mechanisms by which orthographic cues are effective in detail. The study addresses two questions. First, what is the relationship between sublexical transcoding ability and the effectiveness of orthographic cues? And second, what is the relationship between effectiveness of orthographic cues and effectiveness of phonological cues? Methods & Procedures: Three people with chronic aphasia and moderate to severe anomia participated in facilitation of spoken naming, using either the initial phoneme or initial letter of the target word. Both immediate and delayed effects were assessed over six facilitation sessions. Orthographic and phonological cue effects were investigated with regard to regularity of orthographic-phonological conversion (OPC) of the target's initial letter, and with regard to sub-lexical and lexical reading and repetition in the participants using a multiple single-case design (cf. Howard, 2003). Outcomes & Results: In one participant both phonological and orthographic cues produced similar effects. In the other two participants, orthographic cueing effects were present in the absence of phonological cueing effects. With regard to regularity of the initial letter-phoneme conversion in the orthographic condition, a similar pattern overall was present for regular, ambiguous, and irregular target words, e.g., initial letter cues seemed to be similarly effective in words such as KNIFE (irregular OPC of initial letter) as in words such as KING or DOLL. Conclusions: Initial letter cues are appropriate cues for the effective treatment of anomia as they may produce strong and long-lasting effects. In contrast to earlier predictions (e.g., Bruce & Howard, 1988), initial letter cues may be effective even in participants where the initial phoneme cue remains totally ineffective. There are likely to be various mechanisms of effectiveness underpinning orthographic cue effects: a sub-lexical mechanism and a lexical mechanism of effectiveness. [ABSTRACT FROM AUTHOR]