Exploring supported conversation with familial caregivers of persons with dementia: a pilot study.

BACKGROUND: Dementia can lead to difficulties in communication between caregivers and patients. Teaching conversational strategies has been effective for a wide array of clients with acquired neurologic disorders and their caregivers. Research indicates positive results for Supported Conversation for adults with Aphasia (SCA) secondary to stroke. Applying this method to work with caregivers of individuals with dementia could prove to be a valid intervention tool. This investigation examined the applicability of SCA with individuals with dementia and their familial caregivers. METHOD: Four dyads (caregiver and individual with dementia) participated in the SCA program with some adaptation for dementia. The program was 4 weeks with a pre-training and post training assessment. The Measure of Skill in Supported Conversation (MSC) and Measure of Level of Participation in Conversation (MPC) were given to measure the overall effectiveness of SCA at teaching and improving communication, respectively. A qualitative analysis of unproductive coping mechanisms also occurred. The Zarit Burden Interview (ZBI) was given to gauge caregiver burden from pre- to post-training. RESULTS: MSC and MPC scores were significantly improved from baseline to post training, and a significant reduction in unproductive coping behaviors also occured. ZBI scores were variable across participants. CONCLUSIONS: Results suggest that the SCA has the potential to be used to improve communication between persons with dementia and their caregivers. Findings suggest that further research is warranted into the effectiveness of SCA in dementia. TRIAL REGISTRATION: Retrospectively registered 9/5/2018 ISRCTN17622451.

The Main Concept Analysis: Validation and sensitivity in differentiating discourse produced by unimpaired English speakers from individuals with aphasia and dementia of Alzheimer type.

PURPOSE: Discourse from speakers with dementia and aphasia is associated with comparable but not identical deficits, necessitating appropriate methods to differentiate them. The current study aims to validate the Main Concept Analysis (MCA) to be used for eliciting and quantifying discourse among native typical English speakers and to establish its norm, and investigate the validity and sensitivity of the MCA to compare discourse produced by individuals with fluent aphasia, non-fluent aphasia, or dementia of Alzheimer's type (DAT), and unimpaired elderly. METHOD: Discourse elicited through a sequential picture description task was collected from 60 unimpaired participants to determine the MCA scoring criteria; 12 speakers with fluent aphasia, 12 with non-fluent aphasia, 13 with DAT, and 20 elderly participants from the healthy group were compared on the finalized MCA. RESULTS: Results of MANOVA revealed significant univariate omnibus effects of speaker group as an independent variable on each main concept index. MCA profiles differed significantly between all participant groups except dementia versus fluent aphasia. Correlations between the MCA performances and the Western Aphasia Battery and Cognitive Linguistic Quick Test were found to be statistically significant among the clinical groups. CONCLUSIONS: The MCA was appropriate to be used among native speakers of English. The results also provided further empirical evidence of discourse deficits in aphasia and dementia. Practitioners can use the MCA to evaluate discourse production systemically and objectively.

Treating visual speech perception to improve speech production in nonfluent aphasia.

BACKGROUND AND PURPOSE: Several recent studies have revealed modulation of the left frontal lobe speech areas not only during speech production but also for speech perception. Crucially, the frontal lobe areas highlighted in these studies are the same ones that are involved in nonfluent aphasia. Based on these findings, this study examined the utility of targeting visual speech perception to improve speech production in nonfluent aphasia. METHODS: Ten patients with chronic nonfluent aphasia underwent computerized language treatment utilizing picture-word matching. To examine the effect of visual speech perception on picture naming, 2 treatment phases were compared-one that included matching pictures to heard words and another in which pictures were matched to heard words accompanied by a video of the speaker's mouth presented on the computer screen. RESULTS: The results revealed significantly improved picture naming of both trained and untrained items after treatment when it included a visual speech component (ie, seeing the speaker's mouth). In contrast, the treatment phase in which pictures were only matched to heard words did not result in statistically significant improvement of picture naming. CONCLUSIONS: The findings suggest that focusing on visual speech perception can significantly improve speech production in nonfluent aphasia and may provide an alternative approach to treat a disorder in which speech production seldom improves much in the chronic phase of stroke.

Voice onset time production in speakers with Alzheimer's disease.

In the present study, voice onset time (VOT) measurements were compared between a group of individuals with moderate Alzheimer's disease (AD) and a group of healthy age- and gender-matched peers. Participants read a list of consonant-vowel-consonant (CVC) words, which included the six stop consonants. The VOT measurements were made from oscillographic displays obtained from the Brown Laboratory Interactive Speech System (BLISS) implemented on an IBM-compatible computer. VOT measures for the participants' six stop consonant productions were subjected to statistical analysis. The results indicated that VOT values in speakers with Alzheimer's disease were not statistically different from those for the normal control speakers.

An atypical case of Foreign Accent Syndrome.

A new case of Foreign Accent Syndrome is described. This American woman presented with a British- or Australian- sounding accent after stroke, which resulted in a lacunar infarct in the left internal capsule. The atypical etiology and apparent changes in lexical use are described. It is hypothesized that an abnormally tense vocal tract posture may account for phonetic changes in vowel quality and a higher average fundamental frequency.