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Background: One of the few studies to describe therapy specifically for phonological assembly difficulties in aphasia is a single-case study by Franklin, Buerk, and Howard (2002). Their client made a significant improvement in picture naming for both treated and untreated words after therapy comprising two phases, the first aimed at improving auditory awareness and the second aimed at improving self-monitoring. Aims: This study aimed to determine whether the treatment programme used by Franklin et al. (2002) is replicable with other people with impaired phonological assembly as the main part of their aphasia, and to explore any differences in the outcomes for participants. Methods & Procedures: A case series of four participants with aphasia with mixed impairments including phonological assembly difficulties received a replication of the treatment protocol described by Franklin et al. (2002). Outcomes & Results: None of the participants responded to therapy in the same way as Franklin et al.'s (2002) original client. Three participants improved on naming after the first, auditory discrimination, phase of therapy, but only one participant made further gains in naming following the second, monitoring, phase of therapy, and all improvements seen were for treated items only. One participant did not show any significant improvement on naming of treated or untreated items after either phase of therapy. Conclusions: Whereas Franklin et al.'s (2002) original client had a relatively pure post-lexical phonological assembly impairment, the three participants in the current study whose speech improved after therapy had a combination of lexical and post-lexical phonological impairments, and it is proposed that their item-specific improvements in picture naming occurred as a result of improved mapping between semantics and the phonological output lexicon. The participant in this study whose speech did not improve following therapy had a combination of phonological assembly difficulties and apraxia of speech. This study demonstrates that the same therapy can work at different levels for different individuals, depending on many factors, including their profile of linguistic and cognitive impairments. [ABSTRACT FROM AUTHOR]

Music groups play an important role in connecting the generations, however, little is known about the factors underpinning the longevity of such programs in a community context. This study evaluated participants’ perceptions of the factors supporting the longevity of an intergenerational community music program that had been running for more than 10 years. Semi-structured interviews were used to examine the perceptions and experiences of nine older adult volunteers and eight parent participants of the music program. Interviews were transcribed verbatim and analyzed using thematic analysis to identify factors influencing the success and longevity of the group. Three overarching themes were identified, (1) program philosophy, (2) connection with community, and (3) intergenerational relationships, with a further eight subthemes. Findings are integrated into a visual model of the intergenerational music program, reflecting core factors that have contributed to the longevity of the group. Benefits of the intergenerational music program and future directions are discussed. [ABSTRACT FROM AUTHOR]

Abstract: Background: Cognitive impairment, particularly of executive functioning, has been implicated in deficits in spoken discourse production following acquired brain injury (ABI). However, due to variation in the methodologies and heterogeneity of findings across studies, the nature and extent of this association is not well understood. Aims: This review aims to synthesize the literature investigating associations between cognitive deficits and discourse impairment after ABI. It is reported in accordance with guidelines of The Preferred Reporting Items of Systematic Reviews and Meta‐Analyses. Data sources: Searches were conducted of a variety of databases including Medline, PsycINFO, EMBASE, CINAHL, ProQuest, Cochrane and ERIC. Additional studies were identified via reference harvesting. Eligibility criteria: Studies were included if they reported data on participants with ABI, assessed spoken discourse production and cognitive function, and performed statistical analyses to determine the association between discourse and cognitive variables. This review excluded non‐English sources and those not published in peer‐reviewed journals. Meta‐analyses were not conducted due to variability across tools and terminology used to describe participant injury‐ and non‐injury‐related characteristics and outcomes. Results: Twenty‐five observational studies were included in the review. Findings revealed significant associations between multiple cognitive functions and discourse across micro‐linguistic to super‐structural measures. Methodological and terminological inconsistencies were identified across studies, which limited systematic comparison of the results. Conclusions: This review revealed present, yet heterogeneous, relationships between cognitive and discourse deficits in speakers with ABI. Associations were interpreted in light of a well‐established model of discourse processing. Greater comparison across studies would have been facilitated by a standard nomenclature in relation to cognitive constructs and standardized discourse assessment. Future research should explore the influence of injury‐ and participant‐related factors on discourse–cognitive relationships. The lack of information on conversational discourse and paediatric ABI limits the generalizability of this review to daily interaction following ABI. While applicable across the lifespan, in‐depth investigation of discourse following ABI in childhood and adolescence is a priority due to complex changes in language and cognition, and the potential for impairments profoundly impact social, emotional and academic progression into adulthood. Given the centrality of remediating cognitive‐communication difficulties in ABI, the interrelationships between discourse and cognition should retain a critical focus of research. This will inform clinical management and future research with this population. Findings have implications for our theoretical understanding of discourse and the nature of its breakdown in ABI. [ABSTRACT FROM AUTHOR]

Purpose: Speech-language pathologists (SLPs) assess people with primary progressive aphasia (PPA) through measurements of speech, language, communication, and well-being, with the aims of identifying challenges and strengths, monitoring change, and informing treatment directions and supports. The purpose of this clinical focus article is to highlight the necessity for person-centered assessment specific to PPA and to conceptualize a framework that acknowledges the multifaceted nature of assessment for this population. In this framework, the unique challenges posed by a diagnosis of PPA are addressed with the aim to provide practical guidance for clinicians and to support reflection on current practices. Method: In clinical and research practice, assessment of people with PPA requires an ever-evolving approach that is centered on the client. In this clinical focus article, a discussion-based consensus process was used to synthesize authentic longitudinal experiences of people with PPA to explore assessment approaches, tools, and philosophies. Results: This analysis of person-centered assessment identifies seven essential components of assessment in PPA that set the foundation for the five steps of the R.A.I.S.E. Assessment framework. These components each contribute to a clear definition of assessment that reveals clients’ competencies with a strengths-based focus; prioritizes the reciprocity of benefits; promotes dynamic assessment; and recognizes the complexity, evolution of assessment over time, and advocacy. Conclusions: This clinical focus article takes a novel look at assessment in PPA by stepping away from assessment practices that focus on revealing deficits and decline and, instead, provides practical recommendations through the conceptualization of a PPA-specific assessment framework. The R.A.I.S.E. Assessment framework is grounded in principles of uplifting clients through person-centered assessment, keeps pace with best practice in PPA intervention, and contributes to a supportive experience for clients and families in the face of a progressive diagnosis over time. [ABSTRACT FROM AUTHOR]

Background: Treatment fidelity is inconsistently reported in aphasia research, contributing to uncertainty about the effectiveness of types of aphasia therapy following stroke. We outline the processes and outcomes of treatment fidelity monitoring in a pre-specified secondary analysis of the VERSE trial.Methods: VERSE was a 3-arm, single-blinded RCT with a 12-week primary endpoint comparing Usual Care (UC) to two higher intensity treatments: Usual Care-Plus (UC-Plus) and VERSE, a prescribed intervention. Primary outcome results were previously reported. This secondary analysis focused on treatment fidelity. Video-recorded treatment sessions in the higher intensity study arms were evaluated for treatment adherence and treatment differentiation. Treatment components were evaluated using a pre-determined fidelity checklist.Primary Outcome: prescribed amount of therapy time (minutes); secondary outcomes: (i) adherence to therapy protocol (%) and (ii) treatment differentiation between control and high intensity groups.Results: Two hundred forty-six participants were randomised to Usual Care (n=81), Usual Care-Plus (n=82), and VERSE (n=83). One hundred thirty-five (82%) participants in higher intensity intervention arms received the minimum prescribed therapy minutes. From 10,805 (UC 7787; UC-Plus 1450; VERSE 1568) service events, 431 treatment protocol deviations were noted in 114 participants. Four hundred thirty-seven videos were evaluated. The VERSE therapists achieved over 84% adherence to key protocol elements. Higher stroke and aphasia severity, older age, and being in the UC-Plus group predicted more treatment deviations.Conclusions: We found high levels of treatment adherence and differentiation between the intervention arms, providing greater confidence interpreting our results. The comprehensive systems for intervention fidelity monitoring and reporting in this trial make an important contribution to aphasia research and, we argue, should set a new standard for future aphasia studies.Trial Registration: ACTRN 12613000776707. [ABSTRACT FROM AUTHOR]

The aim of the present study was to expand the scope of category norm and typicality data to include verbs for use when investigating semantic memory in fields such as linguistics, psychology, and aphasiology. Two experiments were conducted. In the first, participants were asked to list verbs within 10 semantic categories (e.g. breaking, cleaning, cooking, etc.) and 10 noun categories (e.g. animals, fruit, tools, etc.). In the second experiment, participants were asked to rate the typicality of verbs within 8 of the previously investigated verb categories. Although participants listed fewer verbs in verb categories than nouns in noun categories, the overall patterns with regard to correlation analyses between production frequency, mean rank of responses, lexical frequency, and typicality were consistent with those observed in noun categories. These patterns are also consistent with those observed in previous research. Potential similarities and differences between nouns and verbs, as well as future applications of such data, are discussed. [ABSTRACT FROM AUTHOR]

Deep-sea ferromanganese (Fe-Mn) nodules and crusts are rich in traditional and non-traditional metals with both current and emerging economic value. Mn(III,IV) oxides (e.g., phyllomanganates) are important host phases for these metals (e.g., Ni), which are structurally incorporated during nodule and Fe-Mn crust formation. Recrystallization of phyllomanganates can be catalyzed by aqueous Mn(II) (Mn(II) aq) during (bio)geochemical Mn redox cycling. The fate of structurally incorporated metals during such recrystallization of Mn(III,IV) oxides remains, however, poorly constrained. Here, we use a 62Ni isotope tracer to determine the exchangeability of dissolved Ni with structurally incorporated Ni in two deep-sea Fe-Mn nodules and one Fe-Mn crust. Ni exchange between solid and solution was investigated during reactions in 1 mM Mn(II) aq and in Mn(II)-free solutions under variable pH conditions (pH 5.5 and 7.5) over time. Sample characterization shows that all samples are of hydrogenetic or mixed hydrogenetic-diagenetic origin and Ni is preferentially associated with the phyllomanganates. Our Ni exchange experiments reveal that in some samples up to 25% of incorporated Ni is exchangeable with the fluid after 14 days. The prevalent reaction pathways exhibit pH-dependent behavior during phyllomanganate recrystallization and differ between sample types, with Mn(II) aq enhancing Ni exchange in the Fe-Mn crust-fluid system and Ni exchange being independent of Mn(II) aq concentrations in the Fe-Mn nodule-fluid systems. The exchangeability of structurally-incorporated Ni in Fe-Mn nodules and crusts indicates a labile behavior that potentially makes it available for biogeochemical processes in the marine environment. Unlabelled Image • Ferromanganese nodules and crust characterized by synchrotron techniques. • Exchangeability of structurally-incorporated Ni with aqueous Ni examined with isotopic tracer. • Ni exchange between solid and solution is greatest for ferromanganese crust. • Labile Ni in deep-sea ferromanganese deposits may be important for biogeochemical processes in marine environments. [ABSTRACT FROM AUTHOR]

Purpose: To establish the extent to which person-centered processes are integrated in assessment procedures, the Relationship, Assessment, Inclusion, Support, Evolve (R.A.I.S.E.) Assessment framework was used to evaluate measures that are typically used when assessing people living with primary progressive aphasia (PPA)., Method: Forty-five assessment tools were evaluated through the lens of the five R.A.I.S.E. principles: building the client-clinician R elationship, A ssessment choices, I ncluding the client and care partners, providing S upport, and E volving procedures to match client capability and progression. The principles were operationalized as questions for raters to evaluate whether a measure met this aspect of the R.A.I.S.E. Assessment framework., Results: Ten measures commonly used in the assessment of people living with PPA met all R.A.I.S.E. principles. These measures centered upon the elicitation of naturalistic discourse, conversation, client self-report, and clinician ratings. Thirteen measures did not meet any of the criteria, and represented standardized evaluation procedures do not provide the opportunity to connect to the client, elicit or provide feedback or support, nor to adapt in response to need or performance., Conclusions: Whether using standardized or informal assessment tools, a relational and qualitative approach to providing assessment is paramount to promote client success and therapeutic engagement. We provide guidance through the R.A.I.S.E. framework on practices to cultivate person-centered processes of assessment in the care of people living with PPA.

Purpose: Although discourse assessment is recommended, few tools exist for adolescent acquired brain injury (ABI) and few theories describe the contribution of cognition to discourse impairment. This study explored whether a novel discourse protocol can identify difficulties following ABI and whether a discourse processing model provides a useful account of impairment., Method: Using a case-control design, two adolescent males with moderate ABI (12 and 14 years) were compared to a neurotypical sample on a range of language and cognitive assessments. Patterns in performance were interpreted using a theoretical model. Participants completed a standardised omnibus language assessment, discourse assessment, and battery of cognitive tasks., Result: Analyses revealed significant differences in discourse and cognition between adolescents with and without ABI. No impairment was detected on a standardised language assessment. Patterns in discourse and cognition aligned with a contemporary model of discourse processing., Conclusion: Participants with ABI demonstrated discourse deficits relative to the neurotypical reference sample. The findings demonstrate the value of discourse sampling across multiple genres and analysis of microlinguistic to superstructural features. A structure-building framework (SBF) model, originating in schizophrenia, provides a promising theory with which to interpret discourse impairment and has the potential to inform intervention for discourse in ABI.

Within the educational context of identifying the critical ingredients of an effective speech-language pathologist, this paper highlights the centrality of theory in underpinning every level of our practice. A spotlight is placed on us knowing how language and communication work, what makes our interventions work, how we can make the most difference through our choices in therapy, and what makes both us and our clients respond. So, what are the critical ingredients of an effective speech-language pathologist, of an effective therapy, of an effective therapeutic alliance, and why is this so important? While there are many foundational and guiding habits upon which new graduates, early career, and experienced clinicians shape their practice, no one habit is regarded as more important than us exploring the theoretical underpinnings of what we are doing and why. To underscore the role of theory in our everyday practice, a discourse level intervention for people with aphasia is used as an exemplar to track the complex contribution of different theories to a single intervention. Discourse level interventions are relatively new on the scene in the area of acquired language disorders. Child language interventions, on the other hand, have frequently revolved around the story, aiming to bridge the oral-literate divide through the development of narrative structure. This paper will aim to weave its own story around discourse level interventions, combining the narrative genre with the everyday genres used by adults in conversation. I will highlight how this approach taps into lexical theories, sentence processing theories, discourse organisation, and the cognitive underpinnings of language, and closely examine how this multilayering of language in context may hold some of the answers to questions around generalisation, impact, and making the greatest difference to individuals.

Purpose: Guidelines recommend routine discourse assessment and treatment in paediatric acquired brain injury (ABI) but provide little guidance for clinical practice. The degree to which this has influenced the nature of discourse assessment and treatment in clinical practice has not been examined in detail., Method: Speech-language pathologists working in paediatric ABI (clients aged <18 years) in Australia, New Zealand, the UK, the USA, Canada, and the Asia Pacific region were invited to complete a survey of discourse assessment and intervention practices ( n  = 77)., Result: Clinicians from Australia and New Zealand comprised over half of a responses (53%). The largest proportion had over 10 years' experience (60%), worked in the metropolitan area (58%), and with secondary school-age children (64%). Routine discourse assessment was undertaken by 80% of respondents, focussing on a limited range of genres. No preferred intervention approach was identified. One-quarter of clinicians routinely considered holistic factors during clinical decision-making. Limited normative data and treatment evidence, insufficient time and training were identified as clinical barriers., Conclusion: Assessment practices were consistent with guidelines, yet interventions were highly variable, reflecting limited evidence, client heterogeneity, time constraints, and limited training. A biopsychosocial approach to practice was evident, yet a focus on impairment level factors was prominent. Findings support the need for standardised discourse assessment and discourse intervention methods. Translation into practice guidelines would promote consistency and confidence in clinical practice.

Background: Evidence-based recommendations for a core outcome set (COS; minimum set of outcomes) for aphasia treatment research have been developed (the Research Outcome Measurement in Aphasia-ROMA, COS). Five recommended core outcome constructs: communication, language, quality of life, emotional well-being and patient-reported satisfaction/impact of treatment, were identified through three international consensus studies. Constructs were paired with outcome measurement instruments (OMIs) during an international consensus meeting (ROMA-1). Before the current study (ROMA-2), agreement had not been reached on OMIs for the constructs of communication or patient-reported satisfaction/impact of treatment., Aim: To establish consensus on a communication OMI for inclusion in the ROMA COS., Methods & Procedures: Research methods were based on recommendations from the Core Outcome Measures in Effectiveness Trials (COMET) Initiative. Participants with expertise in design and conduct of aphasia trials, measurement instrument development/testing and/or communication outcome measurement were recruited through an open call. Before the consensus meeting, participants agreed on a definition of communication, identified appropriate OMIs, extracted their measurement properties and established criteria for their quality assessment. During the consensus meeting they short-listed OMIs and participants without conflicts of interest voted on the two most highly ranked instruments. Consensus was defined a priori as agreement by ≥ 70% of participants., Outcomes & Results: In total, 40 researchers from nine countries participated in ROMA-2 (including four facilitators and three-panel members who participated in pre-meeting activities only). A total of 20 OMIs were identified and evaluated. Eight short-listed communication measures were further evaluated for their measurement properties and ranked. Participants in the consensus meeting (n = 33) who did not have conflicts of interest (n = 29) voted on the top two ranked OMIs: The Scenario Test (TST) and the Communication Activities of Daily Living-3 (CADL-3). TST received 72% (n = 21) of 'yes' votes and the CADL-3 received 28% (n = 8) of 'yes' votes., Conclusions & Implications: Consensus was achieved that TST was the preferred communication OMI for inclusion in the ROMA COS. It is currently available in the original Dutch version and has been adapted into English, German and Greek. Further consideration must be given to the best way to measure communication in people with mild aphasia. Development of a patient-reported measure for satisfaction with/impact of treatment and multilingual versions of all OMIs of the COS is still required. Implementation of the ROMA COS would improve research outcome measurement and the quality, relevance, transparency, replicability and efficiency of aphasia treatment research., What This Paper Adds: What is already known on this subject International consensus has been reached on five core constructs to be routinely measured in aphasia treatment studies. International consensus has also been established for OMIs for the three constructs of language, quality of life and emotional well-being. Before this study, OMIs for the constructs of communication and patient-reported satisfaction/impact of treatment were not established. What this paper adds to existing knowledge We gained international consensus on an OMI for the construct of communication. TST is recommended for inclusion in the ROMA COS for routine use in aphasia treatment research. What are the potential or actual clinical implications of this work? The ROMA COS recommends OMIs for a minimum set of outcomes for adults with post-stroke aphasia within phases I-IV aphasia treatment research. Although not intended for clinical use, clinicians may employ the instruments of the ROMA COS, considering the quality of their measurement properties. The systematic inclusion of a measure of communication, such as TST, in clinical practice could ultimately support the implementation of research evidence and best practices., (© 2022 The Authors. International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.)

Purpose: The healthcare experience is a multifaceted and varied process, particularly for people living with complex conditions such as primary progressive aphasia (PPA). Different experiences influence pathways through the health system, impacting client outcomes. To our knowledge, no previous studies have directly explored the healthcare experiences of people with PPA and their families. This study aimed to explore the experiences of people living with PPA from the perspective of both the person with PPA and their families during diagnostic and post-diagnostic phases, and to identify factors influencing service access and perceptions of quality of care., Method: The study followed an Interpretive Phenomenological Analysis (IPA) approach. In-depth, semi-structured interviews were completed with three people with PPA and their primary care partner, and two further care partners of people with PPA., Result: Five superordinate themes were identified: characterising the assessment experience, getting a diagnosis, moving beyond the diagnosis, participant interactions with clinicians, and overall service provision. The five superordinate themes comprised 14 subthemes., Conclusion: The study provides preliminary insights into the complexity of the PPA healthcare journey, and the need for increased accessibility of information and supports following diagnosis. The findings inform recommendations for improving quality of care and the development of a PPA service framework or care pathway.

Purpose: This study examined the impact of a Montessori mealtime intervention for people living with dementia to support the mealtime experience of residents and mealtime care practices of staff in a memory support unit. The mealtime intervention was part of a broader culture change project., Method: An observational research design was used to evaluate changes in the mealtime experience and care practices across three time points (baseline, post-implementation, maintenance), spanning 30 months. Five video recordings of the lunch time service (range: 19-32 min) were analysed. The coding protocol comprised pre-determined indicators related to accepted dimensions of person-centred care. Resident and staff behaviours were quantified across four categories: providing choice and preferences, promoting the social side of eating, supporting independence and showing respect towards residents. Staff behaviours that reflected personal enhancing actions and personal detractors were also coded during each mealtime service., Results: A significant increase in staff providing residents with the opportunity for choice and a subsequent significant increase in residents demonstrating choice behaviours was evident. Staff and residents both significantly increased their interactional behaviours, with greater social interaction between staff and residents. Staff further demonstrated greater support for mealtime independence that reached and maintained significance during the final two sampling points. Significant gains observed post implementation were largely maintained and, on specific measures, further increased over time. A significant increase in staff use of personal enhancing actions during mealtime care was also evident. Variability in individual staff and resident behaviour highlighted the complexity of mealtime care and culture change processes., Implications: The study provides novel evidence to support the use of a Montessori mealtime intervention to achieve more person-centred mealtime care, and which resulted in a more respectful, enabling and social dining experience. Clinical implications and direction for future research are presented to build on these findings.

Purpose : Narrative is the dominant focus of traditional standardised discourse assessment, yet the complex discourse needs of adolescence has led to increased interest in profiling skills in other monologic genres for this age group. This interest is not commensurate with a robust understanding of the influence of genre on adolescent discourse across word to whole-text language features. This knowledge is important to inform context(s) for assessment to profile strengths and weaknesses in discourse-level language. Method : One hundred and sixty adolescents between 12 and 15 years ( M = 13;1, SD=  1;1, 55% female, 45% male) completed the Curtin University Discourse Protocol - Adolescent. Samples of recount, narrative, expository and persuasive discourse were coded using a multi-level analysis procedure. Result : Genre had a significant influence on language variables regardless of age. Narrative tasks citied the longest, most lexically diverse, cohesive, coherent and well-structured output. Results were consistent with the oral to literate continuum and the order in which genres are introduced in the academic curriculum. Conclusion : Structure, content and domain-specific knowledge likely influenced the genre-related differences seen in this study. It would be advantageous to sample a range of monologic genres when assessing adolescent discourse. Declarative knowledge may be an important consideration in topic selection.

Purpose Positive intervention effects following lexical retrieval interventions are increasingly reported with people with progressive language impairments; however, generalization of therapy gains are less frequently evident and less well understood. This study sought to explore the impact of specific therapy ingredients on generalization outcomes. Method Twelve participants with progressive lexical retrieval deficits (four each with semantic variant primary progressive aphasia, logopenic variant primary progressive aphasia, and Alzheimer's disease, amnestic presentation) and their family members participated in a 6-week intervention that aimed to increase access to different word classes (nouns, verbs, and adjectives) through a strategic self-cueing approach. Generalization was actively facilitated through strategy practice in connected speech. Repeated baselines of picture naming and connected speech were conducted prior to intervention and repeated immediately post and at 6 weeks following intervention. Results All three diagnostic groups showed significant improvements in naming performance post-intervention for all word classes and for both treated and untreated items, demonstrating consistent treatment effectiveness and generalization at the word level. No changes in the informativeness or efficiency of connected speech were found. Conclusions Despite heterogeneity across participants, widespread evidence of both treatment effects and generalization to untreated items was found for all diagnostic groups and word classes. The consistent within-level generalization across all groups is explored here in relation to optimization of strategy use through incorporation of cognitive scaffolds, strategic practice at the connected speech level, and the inclusion of family members. The absence of across-level generalization to connected speech is also explored. Supplemental Material https://doi.org/10.23641/asha.14219771.

Purpose: Positive outcomes following reminiscence therapy have been reported for older adults with mild cognitive impairment and dementia in cognition and quality of life and, in a small number of studies, communication. Despite the close relationship between cognition and language, the impact on communication has received limited attention. This study aimed to investigate whether the spoken discourse of older adults with mild cognitive impairment or dementia could be improved within the genre of nostalgic recounts following group reminiscence therapy, and whether change generalised to everyday discourse. Method: Four females (mean: 87 years, SD: 7.3) who lived in a residential aged care facility and were diagnosed with mild ( n  = 2) or major ( n  = 2) neurocognitive impairment were recruited to attend a group reminiscence programme delivered in eight one-hour treatment sessions over four weeks. Multiple baseline samples of discourse were obtained in the week prior to intervention to monitor stability. Macrostructure, rate, informativeness and efficiency of discourse production were measured to identify change within nostalgic recounts and monitor evidence of generalised change in everyday discourse genres. Cognitive performance and quality of life were also monitored. Result: While variability was evident, significant increases in macrostructure and richness of nostalgic recounts were found for two participants, with significant generalisation to everyday discourse. Both participants had diagnoses of mild cognitive impairment. No significant improvements were seen in cognition or quality of life with all participants. Conclusion: This study provides promising evidence for the spoken recall of memories having the potential to improve the communication of people with neurocognitive disorders, with some indication that people with milder impairment may be more amenable to this form of intervention. Nostalgic recounts may provide an explicit context in which speech-language pathologists can facilitate the planning of spoken production in people with cognitive impairment, and influence speaking in everyday contexts.

The use of sentence repetition tasks to distinguish dementia syndromes, particularly variants of primary progressive aphasia (PPA), is receiving growing attention. Impaired sentence repetition is a core feature of logopenic variant PPA, although the underlying cognitive mechanisms of this impairment and its significance as a diagnostic criterion remain poorly understood. Sentence repetition abilities of 12 people with dementia, using an adapted error classification schema, were analyzed, along with digit span abilities, a measure frequently used to assess working memory capacity, to explore error patterns and correlations. Participants with semantic variant PPA showed the greatest performance on sentence repetition and digit span in comparison to the logopenic variant PPA and Alzheimer's disease participants. Sentence repetition errors were characterized by middle omissions for semantic variant PPA, ending omissions and phonological errors for logopenic variant PPA, and ending omissions and unrelated word substitutions for Alzheimer's disease. Significant correlations were found between sentence repetition and digit span abilities. Findings are discussed in relation to working memory capacity theories, specifically, the dual-component model., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Given the integral role that verbs play in sentence production, understanding verb deficits is critical to clinical practice. Difficulties in sentence production are often directly related to an inability to retrieve argument structure information which, according to most theoretical accounts, is specified at a lexical level as part of the semantic representation of the verb. The presence of an argument complexity effect when retrieving verbs in isolation, i.e. increased difficulty with increasing number of arguments required by the verb, is considered evidence of the integral link between verbs and the ensuing structure. Recent reports, however, of relatively intact verb retrieval and impaired argument structure suggest that difficulties with verbs and argument structure may not always co-occur. One explanation for this is that lexical-syntactic information may be stored separately to lexical-semantic information at the lemma level and then differentially impaired., Aims: To determine whether the presence of difficulties creating argument structure in a group of people with aphasia with verb-retrieval deficits consistently aligned with the underlying nature of their impairment, where semantic involvement resulted in argument structure difficulties and post-semantic impairment resulted in intact argument structure. This would provide evidence either to support or to challenge the view that argument structure is lexically specified. The presence of an argument complexity effect within the participants' single verb naming was also investigated to examine the relationship between verb argument information and any subsequent difficulties creating argument structure for sentence production., Methods & Procedures: Verb retrieval and argument structure production were investigated in 12 people with aphasia with verb-retrieval deficits on single-word and sentence-production measures., Outcomes & Results: Eight of the 12 participants presented with a semantic verb deficit (five semantic and three mixed semantic and phonological) and had difficulties in creating argument structure. Four participants presented with a phonological verb deficit. Of these, two had intact argument structure while two had impaired argument structure. An argument complexity effect in verb naming was seen in both groups., Conclusions & Implications: Semantic verb-retrieval deficits consistently resulted in argument structure production difficulties, supporting the view that syntactic information is stored within the lemma. The presence of argument structure difficulties in two participants with phonological deficits; however, lends support for the separate coding of lexical-syntactic from lexical-semantic information at the lemma level, a factor that has both theoretical and clinical implications with respect to diagnosis and management., (© 2016 Royal College of Speech and Language Therapists.)

Background: In recent years there has been significant interest in the differential processing of nouns and verbs in people with aphasia, but more limited consideration about whether the differences have implications for therapy. It remains unclear whether verbs can be treated in a similar way to nouns or should be treated using approaches that recognize the relationship between verb retrieval and sentence production., Aims: This paper reviews studies focusing on therapy for spoken verb retrieval, considering the impact of therapy on treated and untreated verbs, sentence production and connected speech. It explores whether there are differential gains across therapy paradigms and whether verbs respond to therapy in the same way as nouns., Method & Procedures: Studies were identified using a systematic search. A total of 26 studies were reviewed and classified under four headings: (1) studies that treated verbs in a single-word context, (2) studies that compared treatment for nouns and verbs, (3) studies that treated verbs in a sentence context, and (4) studies that treated verb retrieval and argument structure., Main Contribution: Findings from the review demonstrate that verb therapy, irrespective of whether verbs are treated within a single-word or sentence context, is effective in improving the retrieval of treated verbs, but with limited generalization to untreated verbs. Verbs respond very similarly to nouns when treated using the same techniques, but improving verb retrieval may be harder to achieve than improving noun retrieval. The impact on sentence production is more varied. The gains in sentence production are discussed in relation to the different therapy types, the rationale for therapy and the presence of co-occurring sentence difficulties., Conclusions: The review highlights the need for more systematic evaluation of different types of verb therapy, measuring the impact of therapy on verb retrieval, sentence production and connected speech. Only through the judicious assessment and monitoring of change across different contexts will an understanding of how verbs respond to therapy be developed and what generalization patterns can be predicted. This will lead to increased confidence in the selection of therapy approaches for people with verb difficulties in aphasia., (© 2012 Royal College of Speech and Language Therapists.)

Background: Despite recognition of the need for increased long-term support for people with aphasia following stroke, there remains limited evidence for effective service-level interventions., Aims: To evaluate the outcomes and experiences of people participating in the Communication Hub for Aphasia in North Tyneside (CHANT), a 2-year partnership project between health, local authority and third-sector services, shaped by people with aphasia, which provided a coordinated programme of support and interventions for people with long-term aphasia following stroke., Methods & Procedures: Quantitative and qualitative methods were used in the evaluation. Thirty-nine participants with aphasia were recruited to the 12-month study as they became part of CHANT, with 20 completing all measures at the end of the study. Participants had no other speech and language therapy during the study. Quantitative measures (before and after intervention) were used for quality of life, self-report outcomes and goal attainment. Three of the participants with aphasia and three further people involved in the service (carer, volunteer, public sector worker) each agreed to a series of five semi-structured interviews over a 9-month period. A total of 28 interviews were collected using neutral interviewers; these were transcribed and analysed by a team within NVivo8 software, based on interpretive principles from grounded theory. Thematic analysis of the narratives explored the experience of engaging with CHANT, and the barriers and facilitators affecting quality of life., Outcomes & Results: People with aphasia made significant gains in quality of life (in particular, in communication and psychosocial adjustment to stroke) and self-report measures of change. A total of 82% of real-life goals set as part of intervention were fully or partially achieved at follow-up. Five core themes emerged from the narratives: 'Quality of life', 'Barriers', 'Facilitators', 'Types of CHANT activity' and 'Effectiveness'. The intervention was evaluated through the theme of 'Effectiveness' in relation to the other themes, encapsulating emerging participant views (including the type and timeliness of activity, expectations of outcomes, resources and perceived value). The impact of the intervention was also analysed in terms of identifying barriers and providing facilitators., Conclusions & Implications: The quantitative and qualitative (narrative) findings were complementary in demonstrating the effectiveness of the CHANT service delivery model. Moreover, the narratives, through a longitudinal perspective, provided evidence about people's experience of intervention for long-term aphasia. The findings provide foundations for further work into long-term recovery, intervention and adjustment to aphasia post-stroke., (© 2012 Royal College of Speech and Language Therapists.)

In chronic aphasia, maximizing generalization of improved language abilities from clinical tasks to everyday communication can require the same systematic planning process as the early stages of therapy, often drawing on additional areas of knowledge and successes from other clinical populations. The use of narrative structure is shown here to be a useful framework for building on the developments within sentence processing impairments in aphasia and creating a bridge to more real-life language tasks. An intervention based on narrative structure is described with two people with different language profiles and at different stages of the chronic aphasia spectrum. The insights gained in assessing language ability, underpinning intervention, and capturing therapeutic changes are demonstrated., (Thieme Medical Publishers.)