Improvement in functional vocabulary and generalization to conversation following a self-administered treatment using a smart tablet in primary progressive aphasia.

Currently, public services in speech-language pathology for primary progressive aphasia (PPA) are very limited, although several interventions have been shown to be effective. In this context, new technologies have the potential to enable people with PPA to improve their communication skills. The main aim of this study was to investigate the efficacy of a self-administered therapy using a smart tablet to improve naming of functional words and to assess generalization to an ecological conversation task. Five adults with PPA completed the protocol. Using an ABA design with multiple baselines, naming performance was compared across four equivalent lists: (1) trained with functional words; (2) trained with words from a picture database; (3) exposed but not trained; and (4) not exposed (control). Treatment was self-administered four times a week for a period of four consecutive weeks. A significant improvement for trained words was found in all five participants, and gains were maintained two months post-treatment in four of them. Moreover, in three participants, evidence of generalization was found in conversation. This study supports the efficacy of using a smart tablet to improve naming in PPA and suggests the possibility of generalization to an ecological context.

The role of executive control in post-stroke aphasia treatment.

Executive control (EC) ability is increasingly emerging as an important predictor of post-stroke aphasia recovery. This study examined whether EC predicted immediate treatment gains, treatment maintenance and generalization after naming therapy in ten adults with mild to severe chronic post-stroke aphasia. Performance on multiple EC tasks allowed for the creation of composite scores for common EC, and the EC processes of shifting, inhibition and working memory (WM) updating. Participants were treated three times a week for five weeks with a phonological naming therapy; difference scores in naming accuracy of treated and untreated words (assessed pre, post, four- and eight-weeks after therapy) served as the primary outcome measures. Results from simple and multiple linear regressions indicate that individuals with better shifting and WM updating abilities demonstrated better maintenance of treated words at four-week follow-up, and those with better common EC demonstrated better maintenance of treated words at both four- and eight-week follow-ups. Better shifting ability also predicted better generalization to untreated words post-therapy. Measures of EC were not indicative of improvements on treated words immediately post-treatment, nor of generalization to untreated words at follow-up. Findings suggest that immediate treatment gains, maintenance and generalization may be supported by different underlying mechanisms.

A Retrospective Study of Long-Term Improvement on the Boston Naming Test.

Purpose Lexical retrieval impairment is a universal characteristic of aphasia and a common treatment focus. Although naming improvement is well documented, there is limited information to shape expectations regarding long-term recovery. This was the motivation for a retrospective study of longitudinal data on the Boston Naming Test (BNT; Kaplan, Goodglass, & Weintraub, 1983, 2000). Method BNT scores were analyzed from a heterogeneous cohort of 42 individuals with anomia associated with a range of aphasia types. The data were collected over the course of 20 years from individuals who had participated in treatment and received at least 2 BNT administrations. A linear mixed model was implemented to evaluate effects of initial BNT score, time postonset, and demographic variables. For those over 55 years of age, BNT change was evaluated relative to data from the Mayo Clinic's Older Americans Normative Studies. Results There was a significant average improvement of +7.67 points on the BNT in individuals followed for an average of 2 years. Overall, the average rate of improvement was +5.84 points per year, in contrast to a decline of 0.23 points per year in a healthy adult cohort from the Mayo Clinic's Older Americans Normative Studies. Naming recovery was approximately linear, with significant main effects of initial BNT score (i.e., initial severity) and time postonset; the greatest changes were noted in those whose initial severity was moderate. Conclusions These findings indicate a positive prognosis for naming improvement over time regardless of demographic factors and provide estimates for clinical predictions for those who seek rehabilitation during the chronic phase.

Treatment for spoken and written word retrieval in the semantic variant of primary progressive aphasia.

This study investigated whether a treatment programme for spoken word retrieval, supplemented with written naming, was beneficial for an individual with right-hemisphere dominant semantic variant of PPA (svPPA). Assessment and treatment were delivered remotely through Skype. Treatment consisted of two phases of lexical retrieval therapy (Repetition and Reading in the Presence of a Picture: RRIPP), with and without written responses (Phases 1 and 2 respectively), and a third treatment phase based on the procedures of Conceptual Enrichment (COEN) therapy. The first two phases of treatment resulted in short-lasting improvements in spoken and written word retrieval, with greater improvement in Phase 2 when written production was also required. Both treatment phases resulted in gains only for treated items, but generalised to different depictions to those treated. However, Phase 2 also resulted in significant improvement of treated items on a comprehension task. COEN treatment did not result in significant gains in word retrieval or comprehension. This study reinforces the value of a simple lexical retrieval treatment delivered remotely. It adds to the current evidence that anomia in svPPA can be responsive to treatment, but also shows that challenges remain regarding maintenance effects and the generalisation of treatment effects to connected speech.

Typicality-based semantic treatment for anomia results in multiple levels of generalisation.

This study investigated the effects of typicality-based semantic feature analysis (SFA) treatment on generalisation across three levels: untrained related items, semantic/phonological processing tasks, and measures of global language function. Using a single-subject design with group-level analyses, 27 persons with aphasia (PWA) received typicality-based SFA to improve their naming of atypical and/or typical exemplars. Progress on trained, untrained, and monitored items was measured weekly. Pre- and post-treatment assessments were administered to evaluate semantic/phonological processing and overall language ability. Ten PWA served as controls. For the treatment participants, the likelihood of naming trained items accurately was significantly higher than for monitored items over time. When features of atypical items were trained, the likelihood of naming untrained typical items accurately was significantly higher than for untrained atypical items over time. Significant gains were observed on semantic/phonological processing tasks and standardised assessments after therapy. Different patterns of near and far transfer were seen across treatment response groups. Performance was also compared between responders and controls. Responders demonstrated significantly more improvement on a semantic processing task than controls, but no other significant change score differences were found between groups. In addition to positive treatment effects, typicality-based SFA naming therapy resulted in generalisation across multiple levels.

The effect of augmented input on the auditory comprehension of narratives for people with aphasia: a pilot investigation.

Augmented input is the strategy of supplementing expressive language with visuographic images, print, gestures, or objects in the environment. The goal of augmented input is to facilitate comprehension of spoken language. The purpose of this study was to evaluate the relative effectiveness of two different augmented input conditions in facilitating auditory comprehension of narrative passages in adults with aphasia. One condition involved the communication partner (clinician) of the adult with aphasia actively pointing (AI-PP) out key content words using visuographic supports. The second condition involved no active pointing (AI-NPP) by the communication partner (i.e., attention was not drawn to the visuographic supports). All 12 participants with aphasia listened to two narratives; one in each condition. Auditory comprehension was measured by assessing participants' accuracy in responding to 15 multiple-choice cloze-type statements related to the narratives. Of the 12 participants, seven gave more accurate responses to comprehension items in the AI-PP condition, four gave more accurate responses in the AI-NPP condition, and one scored the same in both conditions. These differences were not statistically significant (p > 0.05). Communication-partner-referenced augmented input using combined high-context and PCS symbol visuographic supports improved response accuracy for some participants. Continued research is necessary to determine partner involvement with and frequency of augmented input that improve auditory comprehension.

Long-Term maintenance of anomia treatment effects in primary progressive aphasia.

This study examined the maintenance of anomia treatment effects in primary progressive aphasia (PPA). Following baseline testing, a phonological treatment and an orthographic treatment were administered over the course of six months. The treatment stimuli consisted of nouns that were consistently named correctly at baseline (Prophylaxis items) and/or nouns that were consistently named incorrectly at baseline (Remediation items). Naming accuracy was measured at baseline, and it was measured at 1 month, 8 months, and 15 months post-treatment. The change in naming accuracy from baseline to each post-treatment evaluation was calculated within each treatment condition, and within a matched untrained condition. The change in naming accuracy was then compared between the three conditions. The results of these analyses indicate that phonological and orthographic treatments are both effective in the Prophylaxis and Remediation of anomia in all three variants of PPA. For Prophylaxis items, some of the effects of each treatment can persist for as long as 15 months post-treatment. These long-term treatment effects were more robust in the orthographic treatment condition and for participants with the semantic variant of PPA.

Comparing the effects of clinician and caregiver-administered lexical retrieval training for progressive anomia.

There is a growing body of literature indicating that lexical retrieval training can result in improved naming ability in individuals with neurodegenerative disease. Traditionally, treatment is administered by a speech-language pathologist, with little involvement of caregivers or carry-over of practice into the home. This study examined the effects of a lexical retrieval training programme that was implemented first by a clinician and, subsequently, by a trained caregiver. Two dyads, each consisting of one individual with anomia caused by neurodegenerative disease (one with mild cognitive impairment and one with logopenic primary progressive aphasia) and their caregiver, participated in the study. Results indicated medium and large effect sizes for both clinician- and caregiver-trained items, with generalisation to untrained stimuli. Participants reported improved confidence during communication as well as increased use of trained communication strategies after treatment. This study is the first to document that caregiver-administered speech and language intervention can have positive outcomes when paired with training by a clinician. Caregiver-administered treatment may be a viable means of increasing treatment dosage in the current climate of restricted reimbursement, particularly for patients with progressive conditions.

Efficacy of a self-administered treatment using a smart tablet to improve functional vocabulary in post-stroke aphasia: a case-series study.

BACKGROUND: Aphasia is an acquired language disorder that occurs secondary to brain injury, such as stroke. It causes communication difficulties that have a significant impact on quality of life and social relationships. Although the efficacy of speech-language therapy has been clearly demonstrated in this population, long-term services are currently limited due to logistical and financial constraints. In this context, the potential contribution of technology, such as smart tablets, is worth exploring, especially to improve vocabulary that is relevant in daily life. AIMS: The main aim was to investigate the efficacy of a self-administered treatment using a smart tablet to improve naming of functional words in post-stroke anomia. METHODS & PROCEDURES: Four adults with post-stroke aphasia took part in the study. An ABA design with multiple baselines was used to compare naming performances for four equivalent lists: (1) trained with functional words chosen with the participant; (2) trained with words randomly chosen from a picture database; (3) exposed but not trained; and (4) not exposed (control). OUTCOMES & RESULTS: For all participants, the treatment self-administered at home (four times/week for 4 weeks) resulted in a significant improvement for both sets of trained words that was maintained 2 months after the end of treatment. Moreover, in two participants, evidence of generalization to conversation was found. CONCLUSIONS & IMPLICATIONS: This study confirms the efficacy of using smart tablets to improve naming in post-stroke aphasia. Although more studies are needed, the use of new technologies is unquestionably a promising approach to improve communication skills in people with aphasia, especially by targeting vocabulary that is relevant to them in their daily lives.

Rehabilitación neuropsicológica de un caso con sintomatología de afasia de conducción y anómica por evento isquémico / Neuropsychological rehabilitation in a case of conduction and anomic aphasia symptomatology by ischemic event

El tema de la rehabilitación de las afasias es explorado con frecuencia en la literatura de las últimas décadas, debido a que es una de las secuelas más comunes del daño cerebral y de las que más presenta variaciones dependiendo del caso, por lo cual los profesionales a cargo de los pacientes que sufren de esta condición se ven en la necesidad de buscar métodos eficaces para tratarlos. El objetivo de esta investigación es mostrar el diseño de un único caso con sintomatología de afasia de conducción y anomia pura. Se trata de un paciente masculino de 62 años de edad, con nivel académico de doctorado, diagnóstico de afasia de conducción y anomia a causa de un evento isquémico con 18 meses de evolución. Recibió tratamiento neuropsicológico en base a modelos histórico-culturales y neurocognitivos en dos periodos diferentes, una hora por semana. Se llevó a cabo una evaluación neuropsicológica antes y después del programa de rehabilitación, además se hizo uso de líneas bases en ambos periodos y se tomó en cuenta la perspectiva del paciente y su esposa. El rendimiento en la primera y segunda evaluación muestra un mejor desempeño en algunas áreas del lenguaje, mientras que en las líneas bases y en la apreciación del paciente y su esposa se observaron cambios importantes, concluyendo que el programa tuvo efectos favorables en la comunicación del paciente en el hogar.

The subject of aphasia rehabilitation is frequently explored in recent literature since it is one of the most common forms of brain damage and presents an assortment of variations depending on the specific case, making it so that professionals who are in charge of patients with this condition find themselves in need of effective treatment methods. This article aims to present the design for the single case study rehabilitation of a patient with conduction aphasia and pure anomia. The patient in question is a 62-year-old male with a P.h.D. level education, diagnosed with conduction aphasia and anomia caused by an ischemic event with an 18-month evolution, he received neuropsychological treatment following the historic-cultural and neurocognitive models, spanning two different treatment periods, one hour a week. A neuropsychological evaluation was made before and after the rehabilitation program, as well as using a baseline for both periods and taking into account the perspective of both the patient and his wife. Patient performance in the first and second evaluations shows improvement in some language areas, while the baselines, as well as the patient and his wife's assessment speak of important changes, concluding that the program had favorable effects on the patient's communication at home

The Neural and Behavioral Correlates of Anomia Recovery following Personalized Observation, Execution, and Mental Imagery Therapy: A Proof of Concept.

The impact of sensorimotor strategies on aphasia recovery has rarely been explored. This paper reports on the efficacy of personalized observation, execution, and mental imagery (POEM) therapy, a new approach designed to integrate sensorimotor and language-based strategies to treat verb anomia, a frequent aphasia sign. Two participants with verb anomia were followed up in a pre-/posttherapy fMRI study. POEM was administered in a massed stimulation schedule, with personalized stimuli, resulting in significant improvement in both participants, with both trained and untrained items. Given that the latter finding is rarely reported in the literature, the evidence suggests that POEM favors the implementation of a word retrieval strategy that can be integrated and generalized. Changes in fMRI patterns following POEM reflect a reduction in the number of recruited areas supporting naming and the recruitment of brain areas that belong to the language and mirror neuron systems. The data provide evidence on the efficacy of POEM for verb anomia, while pointing to the added value of combined language and sensorimotor strategies for recovery from verb anomia, contributing to the consolidation of a word retrieval strategy that can be better generalized to untrained words. Future studies with a larger sample of participants are required to further explore this avenue.

The Roles of Retrieval Practice Versus Errorless Learning in Strengthening Lexical Access in Aphasia.

Purpose: The purpose of this study was to determine how 2 methods known to improve naming impairment in aphasia (i.e., retrieval practice and errorless learning) affect lexical access. We hypothesized that instances of naming during retrieval practice use and strengthen item-specific connections in each of 2 stages of lexical access: Stage 1, meaning-to-word connections, and Stage 2, word-to-phonology connections. In contrast, errorless learning prioritizes opportunities for repeating words, which we expect to primarily strengthen item-specific connections in Stage 2 because repetition circumvents the need for semantically driven word retrieval. Method: We tested the outcomes of retrieval practice versus errorless learning training for items that were selected because the naming errors they elicited suggested weakened connections at Stage 1 or at Stage 2 of lexical access for each of 10 individuals with chronic aphasia. Each participant's Stage 1 items and Stage 2 items were divided evenly between the 2 training conditions. Naming tests were administered 1 day and 1 week after training to assess retention of training gains. We also examined whether the participants' pretraining naming error profiles were associated with the relative efficacy of retrieval practice versus errorless learning. Results: The posttraining naming tests showed an advantage of retrieval practice over errorless learning for Stage 1 items and an advantage of errorless learning over retrieval practice for Stage 2 items. In addition, greater percentages of phonological error naming responses prior to training were associated with greater posttraining accuracy in the errorless learning condition relative to the retrieval practice condition. Conclusions: The findings suggest that the advantage of retrieval practice for naming impairment in aphasia largely results from greater strengthening of practiced semantic-lexical connections compared with errorless learning, which prioritizes repetition and, therefore, mainly confers strengthening of practiced lexical-phonological connections. Understanding how specific training conditions improve naming can help predict the relative efficacy of each method for individuals with aphasia.

More Than a Story: My Life Came Back to Life.

Purpose: Social models of aphasia rehabilitation emphasize the importance of supporting identity renegotiation, which can be accomplished in part through personal narrative construction. The purpose of this study was to examine the experiences of persons who had engaged in a project to coconstruct personal narratives about life with aphasia. Method: Qualitative interviews were conducted with 3 participants with aphasia who completed a 4-week personal narrative coconstruction project, which included preadministration and postadministration of the Communication Confidence Rating Scale for Aphasia (Cherney & Babbitt, 2011). Results were analyzed using interpretative phenomenological analysis. Results: Three themes were revealed: (a) More than a story: It changed my life validated the idea that the narrative coconstruction process supported a positive view of identity; (b) A positive experience captured the participants' enjoyment in coconstructing and sharing their story; (c) Hope engendered by the coconstruction experience empowered participants with new levels of confidence not only in their communication skills but also in themselves. Conclusions: This study provided insight into the experience of coconstructing personal narratives using a structured protocol. Participants experienced the project as a positive, meaningful opportunity to actively contemplate their life and look forward. The study has implications for clinicians considering support of identity renegotiation in aphasia rehabilitation.

Exploring Treatment Fidelity in Persons With Aphasia Autonomously Practicing With Computerized Therapy Materials.

Purpose: Current computer technologies permit independent practice for people with cognitive-communicative disorders. Previous research has investigated compliance rates and outcome changes but not treatment fidelity per se during practice. Our aim was to examine adherence to procedures (treatment fidelity) and accuracy while persons with aphasia independently practiced word production using interactive, multimodal, user-controlled, word-level icons on computers. Method: Four persons with aphasia independently practiced single-word production after stimulation via user-initiated interactions in 3 conditions: (I) auditory stimulus with static representational drawing; (II) auditory stimulus with synchronized articulation video; and (III) users' choice between the 2 prior conditions. Sessions were video-recorded for subsequent analysis, which established emergently refined behavioral taxonomies using an iterative, mixed-methods approach. Results: In independent practice, users only sometimes adhere to modeled behaviors, other times improvising novel behaviors. The latter sometimes co-occurred with successful productions. Differences in success rates were noted between Conditions I and II across behaviors with Condition II generally favored. In Condition III, participants tended to choose the stimulus that resulted in highest success rates. Conclusions: During independent practice with technology, persons with aphasia do not necessarily comply with clinicians' practice instructions, and treatment fidelity does not determine success. Autonomy and choice in practice may reveal unanticipated dimensions for computerized aphasia treatment.

Influencia de la tarea cognitiva en el patrón cinemático de marcha en un sujeto con accidente cerebrovascular: a propósito de un caso / Influence of a cognitive task on the kinematic gait pattern in a subject with stroke: a case report

El propósito del presente estudio fue analizar las modificaciones que se producen en el patrón cinemático de marcha en un sujeto con ictus en respuesta a una tarea concurrente cognitiva. En él participó un varón de 57 años con antecedente de accidente cerebro vascular y capacidad de marcha independiente. Se le solicitó que caminara bajo 2condiciones: sin tarea cognitiva y con tarea cognitiva, basada en la resolución de operaciones matemáticas. Se analizaron los movimientos articulares de pelvis, cadera, rodilla y tobillo del lado afecto en ambas condiciones mediante VICON Motion System(R). El trabajo revela la influencia de una tarea cognitiva en el patrón cinemático de la marcha, que afecta a las articulaciones de la cadera, la rodilla y el tobillo en el periodo de apoyo y oscilación (AU)

The aim of the present study was to analyse the changes occurring in the kinematic gait pattern of a 57-year-old man with stroke in response to a concurrent cognitive task. The patient had independent walking ability. He walked under 2 conditions: without a cognitive task and with a cognitive task, based on the resolution of mathematical operations. Motion capture was performed using the VICON Motion System(R). The motion of the pelvis, hip, knee and ankle were analysed in the affected side in both conditions. The study revealed the influence of the cognitive task on the kinematic gait pattern, modifying the hip, knee and ankle pattern during the stance and the swing period (AU)

Influence of Linguistic and Nonlinguistic Variables on Generalization and Maintenance Following Phonomotor Treatment for Aphasia.

PURPOSE: Although phonomotor treatment shows promise as an effective intervention for anomia in people with aphasia, responses to this treatment are not consistent across individuals. To better understand this variability, we examined the influence of 5 participant characteristics-age, time postonset, aphasia severity, naming impairment, and error profile-on generalization and maintenance of confrontation naming and discourse abilities following phonomotor treatment. METHOD: Using retrospective data from 26 participants with aphasia who completed a 6-week phonomotor treatment program, we examined the relationships between participant characteristics of interest and change scores on confrontation naming and discourse tasks, measured pretreatment, immediately following treatment, and 3 months following treatment. RESULTS: Although the participant characteristics of aphasia severity and error profile appeared to predict generalization to improved confrontation naming of untrained items and discourse performance, a post hoc analysis revealed that no one characteristic predicted generalization across participants at 3 months posttreatment. CONCLUSIONS: Response to phonomotor treatment does not appear to be influenced by aphasia and anomia severity level, error profile, participant age, or time postonset. Other factors, however, may influence response to intensive aphasia treatment and are worthy of continued exploration.

Effect of Message Type on the Visual Attention of Adults With Traumatic Brain Injury.

PURPOSE: The purpose of this investigation was to measure the effect of message type (i.e., action, naming) on the visual attention patterns of individuals with and without traumatic brain injury (TBI) when viewing grids composed of 3 types of images (i.e., icons, decontextualized photographs, and contextualized photographs). METHOD: Fourteen adults with TBI and 14 without TBI-assigned either to an action or naming message condition-viewed grids composed of 3 different image types. Participants' task was to select/sustain visual fixation on the image they felt best represented a stated message (i.e., action or naming). RESULTS: With final fixation location serving as a proxy for selection, participants in the naming message condition selected decontextualized photographs significantly more often than the other 2 image types. Participants in the action message condition selected contextualized photographs significantly more frequently than the other 2 image types. Minimal differences were noted between participant groups. CONCLUSIONS: This investigation provides preliminary evidence of the relationship between image and message type. Clinicians involved in the selection of images used for message representation should consider the message being represented when designing supports for people with TBI. Further research is necessary to fully understand the relationship between images and message type.

Discourse Characteristics in Aphasia Beyond the Western Aphasia Battery Cutoff.

PURPOSE: This study examined discourse characteristics of individuals with aphasia who scored at or above the 93.8 cutoff on the Aphasia Quotient subtests of the Western Aphasia Battery-Revised (WAB-R; Kertesz, 2007). They were compared with participants without aphasia and those with anomic aphasia. METHOD: Participants were from the AphasiaBank database and included 28 participants who were not aphasic by WAB-R score (NABW), 92 participants with anomic aphasia, and 177 controls. Cinderella narratives were analyzed using the Computerized Language Analysis programs (MacWhinney, 2000). Outcome measures were words per minute, percent word errors, lexical diversity using the moving average type-token ratio (Covington, 2007b), main concept production, number of utterances, mean length of utterance, and proposition density. RESULTS: Results showed that the NABW group was significantly different from the controls on all measures except MLU and proposition density. These individuals were compared to participants without aphasia and those with anomic aphasia. CONCLUSION: Individuals with aphasia who score above the WAB-R Aphasia Quotient cutoff demonstrate discourse impairments that warrant both treatment and special attention in the research literature.

Influence of Cognitive Ability on Therapy Outcomes for Anomia in Adults With Chronic Poststroke Aphasia.

Purpose: The relationship between cognitive abilities and aphasia rehabilitation outcomes is complex and remains poorly understood. This study investigated the influence of language and cognitive abilities on anomia therapy outcomes in adults with aphasia. Method: Thirty-four adults with chronic aphasia participated in Aphasia Language Impairment and Functioning Therapy. A language and cognitive assessment battery, including 3 baseline naming probes, was administered prior to therapy. Naming accuracy for 30 treated and 30 untreated items was collected at posttherapy and 1-month follow-up. Multiple regression models were computed to evaluate the relationship between language and cognitive abilities at baseline and anomia therapy outcomes. Results: Both language and cognitive variables significantly influenced anomia therapy gains. Verbal short-term memory ability significantly predicted naming gains for treated items at posttherapy (ß = -.551, p = .002) and for untreated items at posttherapy (ß = .456, p = .014) and 1-month follow-up (ß = .455, p = .021). Furthermore, lexical-semantic processing significantly predicted naming gains for treated items at posttherapy (ß = -.496, p = .004) and 1-month follow-up (ß = .545, p = .012). Conclusions: Our findings suggest that individuals' cognitive ability, specifically verbal short-term memory, affects anomia treatment success. Further research into the relationship between cognitive ability and anomia therapy outcomes may help to optimize treatment techniques.

Does Naming Therapy Make Ordering in a Restaurant Easier? Dynamics of Co-Occurring Change in Cognitive-Linguistic and Functional Communication Skills in Aphasia.

PURPOSE: This study was conducted to investigate the static and dynamic relationships between impairment-level cognitive-linguistic abilities and activity-level functional communication skills in persons with aphasia (PWA). METHOD: In Experiment 1, a battery of standardized assessments was administered to a group of PWA (N = 72) to examine associations between cognitive-linguistic ability and functional communication at a single time point. In Experiment 2, impairment-based treatment was administered to a subset of PWA from Experiment 1 (n = 39) in order to examine associations between change in cognitive-linguistic ability and change in function and associations at a single time point. RESULTS: In both experiments, numerous significant associations were found between scores on tests of cognitive-linguistic ability and a test of functional communication at a single time point. In Experiment 2, significant treatment-induced gains were seen on both types of measures in participants with more severe aphasia, yet cognitive-linguistic change scores were not significantly correlated with functional communication change scores. CONCLUSIONS: At a single time point, cognitive-linguistic and functional communication abilities are associated in PWA. However, although changes on standardized assessments reflecting improvements in both types of skills can occur following an impairment-based therapy, these changes may not be significantly associated with each other.