Cavanaugh, Robert
(2023)
Determinants of Multilevel Discourse Outcomes in Anomia Treatment for Aphasia.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
Communication is fundamental to the human condition but is impaired in life-altering ways for more than 2.4 million individuals with aphasia in the United States. Individuals with aphasia identify discourse-level communication (i.e. language in use) as a high priority for treatment. The central premise of most aphasia treatments is that restoring language at the phoneme, word, and/or sentence level will generalize to discourse. However, treatment-related changes in discourse-level communication are modest, poorly understood, and vary greatly between individuals with aphasia. In response, this study conducted a multilevel discourse analysis of archival, monologic discourse outcomes across two high-intensity Semantic Feature Analysis clinical trials (combined n = 60). First, we evaluated improvement on theoretically motivated discourse outcomes representing lexical-semantic processing, lexical diversity, grammatical complexity, and discourse informativeness across study enrollment, entry, exit, and 1 month follow-up. Second, we examined the potential moderating role of non-language cognitive factors (semantic memory, divided attention, and executive function) on discourse outcomes in a subsample of participants (n = 44). The present study found no evidence for meaningful or statistically reliable improvements in monologue discourse performance after Semantic Feature Analysis. There was weak and inconsistent evidence that non-language cognitive factors may play a role in moderating treatment response. While improving discourse-level communication may help to reduce the profound communication and psychosocial consequences of aphasia, these findings indicate that intentional treatment design with a focus on generalization to discourse is likely necessary to meaningfully improve discourse-level communication in aphasia in both research and clinical practice.
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Details
| Item Type: |
University of Pittsburgh ETD
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| Status: |
Unpublished |
| Creators/Authors: |
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| ETD Committee: |
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| Date: |
11 July 2023 |
| Date Type: |
Publication |
| Defense Date: |
17 April 2023 |
| Approval Date: |
11 July 2023 |
| Submission Date: |
9 May 2023 |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Number of Pages: |
148 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Health and Rehabilitation Sciences > Communication Science and Disorders |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
Aphasia Treatment Discourse |
| Date Deposited: |
11 Jul 2023 15:43 |
| Last Modified: |
11 Jul 2023 15:43 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/44233 |
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