Search

Background: Researchers have used eye-tracking technology to investigate eye movements in neurotypical adults (NAs) when reading. The technology can provide comparable information about people with aphasia (PWA). Eye fixations occurring when PWA do and do not have access to text-to-speech (TTS) technology are of interest because the support improves reading comprehension and decreases processing time for at least some PWA. Aims: This study's purpose was to examine forward, regressive, and off-track eye fixations when PWA and NAs read narratives in read-only (RO) and TTS conditions. A secondary aim was to examine the influence of eye fixations on processing time. Method and Procedure: A Tobii Dynavox Pro Spectrum eye tracker recorded eye movements of nine PWA and nine NAs while reading narratives in two conditions. Movements of interest were forward fixations; within-word, within-sentence, and previous-sentence regressive fixations; and off-track fixations. Outcomes and Results: PWA exhibited significantly more forward and regressive fixations in the RO than TTS condition, whereas NAs showed opposite behaviors. NAs had significantly more off-track fixations in the TTS than RO condition, whereas PWA exhibited no difference across conditions. PWA took significantly longer to process content in the RO condition, whereas NAs took longer in the TTS condition. Conclusions: PWA and NAs differ in important ways when processing texts with and without TTS support. Examining eye-tracking data provides a means of gaining insight into the decoding and reading comprehension challenges of PWA and helps elucidate how assistive technology can mediate these challenges.

This qualitative study explored the college life phenomenon as experienced by students with mild traumatic brain injury (MTBI). Previous research about such students has focused on topics including study strategy use, access of support services, and insights from caregivers or instructors. However, little attention has been paid to the perceptions of postsecondary students, and available data stems almost exclusively from structured survey items and quantitative research studies. The lack of direct input from students with MTBI means professionals have limited insight into perceptions about students' challenges and successes associated with college experiences. To address this research gap, we asked five college students with MTBI to discuss their college experiences, factors mediating those experiences, and perceived similarities and differences between themselves and other college students with and without disabilities. Each interview lasted approximately one hour and used a semi-structured interview protocol. Data were analyzed using established phenomenological methods. Results suggested that the students experienced cognitive, physical, and social-emotional changes that altered their academic experiences, necessitated academic accommodations, and required self-advocacy skills. In addition, family and teacher support, self-determination, and academic accommodations positively affected students' college experiences, whereas factors such as injury invisibility, coursework difficulty, and teacher misconceptions or lack of support had negative effects. The findings highlight the need for additional education and support for college students with MTBI and the educators who serve them.

Metacognition and quality of life (QoL) are both adversely affected by traumatic brain injury (TBI), but the relation between them is not fully understood. As such, the purpose of this study was to determine the degree to which metacognitive accuracy predicts QoL in individuals with TBI. Eighteen participants with moderate-to-severe TBI completed a stimulus-response task requiring the discrimination of emotions depicted in pictures of faces and then provided a retrospective confidence judgment after each response. Metacognitive accuracy was calculated using participants' response accuracy and confidence judgment accuracy. Participants also completed the Quality of Life After Brain Injury (QOLIBRI) questionnaire to assess QoL in various areas of functioning. Performance of a linear regression analysis revealed that higher metacognitive accuracy significantly predicted lower overall QoL. Additionally, higher metacognitive accuracy significantly predicted lower QoL related to cognition and physical limitations. The study results provide evidence of an inverse relation between metacognitive performance and QoL following TBI. Metacognitive changes associated with TBI and their relation to QoL have several clinical implications for TBI rehabilitation. [ABSTRACT FROM AUTHOR]

Acquired brain injury (ABI) affects social relationships; however, the ways social and support networks change and evolve as a result of brain injury is not well understood. This study explored ways in which survivors of ABI and members of their support networks perceive relationship changes as recovery extends into the long-term stage. Two survivors of ABI and members of their respective support networks participated in this case study integrating information from interviews, field notes, and artifacts. Inductive data analysis revealed themes of adjustment to impairments and compensations, connection changes with other people, feelings of protectiveness toward the survivor, emotional intensity, and the influence of personality traits on the recovery process. Application of these themes to intervention suggests health care professionals might benefit from shifting their focus from the survivor alone to the survivor functioning within a social support network.

The purpose of this research was to explore the perceptions of four college students with severe traumatic brain injury and people associated with them regarding the use of learning skills and study strategies. The researchers employed a concurrent mixed method design using descriptive quantitative data as well as qualitative multiple case study data. Qualitative data came from interviews with the students with traumatic brain injury and three to four people associated with each of them; quantitative data was from the participants with traumatic brain injury and 15 to 26 of their same-class peers using the "Learning and Study Skills Strategies Inventory" ([LASSI] Weinstein, Shulte, & Palmer, 1987). Findings revealed disparities in perception between the students with traumatic brain injury and participants associated with them as well as between the qualitative and quantitative data sets of the student participants with traumatic brain injury. These differences appeared to reflect limitations in the student participants' awareness of their deficits. Despite the apparent academic success of the student participants, questions exist about the appropriateness of various accommodation strategies in maximizing postsecondary achievement and facilitating self-awareness of challenges associated with traumatic brain injury. (Contains 2 tables and 6 figures.)

Written expression is a high-level language process susceptible to impairment given mild traumatic brain injury (mTBI); however, minimal research exists about assessing or treating this aspect of language performance. This study's purpose was to determine the effect of a multicomponent intervention on the written expression of an undergraduate student with mTBI resulting in generalized expressive language impairment. Pretreatment, intervention, and posttreatment sessions extended over 11 weeks. Intervention addressed semantic associations, semantic mapping, proofreading, organization, foundational skills, and goal setting. Data reflected performance on intervention components, writing probes, and pre-posttreatment completion of a standardized writing measure. Calculation and plotting of correct writing sequence percentages revealed substantial improvement. Linear regression analysis confirmed the trend line slope for intervention probes differed significantly from baseline probes. Comparison of pre-posttreatment test results also confirmed substantial improvement. Multicomponent instruction similar to that recommended for other students with writing challenges may be effective for people with mTBI.

Purpose: The problems that people with aphasia encounter when reading passages are poorly understood. This study's purpose was in-depth examination of eye-gaze behaviors exhibited by five people with aphasia-based alexia. Method: Five adults with aphasia-based alexia and five neurotypical adults (NAs) read paragraphs while having their eye movements recorded. Acquired data included descriptive characterization of overall eye-gaze behaviors and determination of the (a) percent of fixated words, (b) average fixation duration, (c) average initial and total summed fixation durations of processing attempts on individual words, and (d) effects of word length and frequency on fixation durations. Careful examination of these data allowed examination of consistencies and discrepancies among people with aphasia and supported speculation about underlying deficits. Results: Case participants exhibited unique fixation behaviors in comparison to one another and to neurotypical adults. Case participants' total reading time, percent of fixated words, average fixation duration, and average initial and total summed fixation durations on passage words exceeded those of neurotypical adults. Four of five exhibited positive word length and negative word frequency correlations with fixation durations. Conclusions: People with aphasia display eye-gaze behaviors unique to them and differing from those of NAs when reading texts. Better understanding of the connection between specific eye-gaze behaviors and problems decoding words, linking them with lexical-semantic information, and constructing meaning from written content is necessary to further progress in developing effective assessment tools and treatments. [ABSTRACT FROM AUTHOR]

Purpose: This mixed-methods research sought to examine the experience of people with aphasia who used text-to-speech (TTS) support to read a novel for virtual book club participation. Method: Six people with chronic aphasia used a TTS system to review portions of a novel about which they conversed during eight virtual book club meetings occurring over 5 weeks. During one-on-one interactions prior to each meeting, participants answered comprehension questions and provided feedback about reading experiences. Then, during group meetings, they reviewed and discussed relevant book content and predicted upcoming content. During a structured individual interview, participants reflected on their supported reading and book club experience. Results: Participants reported a range of reading confidence prior to study participation, mostly influenced by decreased comprehension or reading speed. After book club participation, four participants expressed increased confidence. Some reported searching for key words and skipping difficult words as strategies additional to TTS support. All reviewed at least some book sections more than once either with or without TTS support. Highly motivated participants expressed low frustration and high reading ease and enjoyment. Perceived comprehension was roughly consistent with actual comprehension across participants. Most believed TTS support promoted faster reading than otherwise possible. Participants liked adjustable features affecting speech output rate, word or sentence highlighting, and font size. Psychosocial benefits included decreased isolation and increased friendship. Conclusions: The findings extend previous evidence about perceived and actual benefits associated with TTS support. People with aphasia express positive experiences when given TTS support during book club participation. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to compare the visual attention patterns of adults with aphasia and adults without neurological conditions when viewing visual scenes with 2 types of engagement. Method: Eye-tracking technology was used to measure the visual attention patterns of 10 adults with aphasia and 10 adults without neurological conditions. Participants viewed camera-engaged (i.e., human figure facing camera) and task-engaged (i.e., human figure looking at and touching an object) visual scenes. Results: Participants with aphasia responded to engagement cues by focusing on objects of interest more for task-engaged scenes than camera-engaged scenes; however, the difference in their responses to these scenes were not as pronounced as those observed in adults without neurological conditions. In addition, people with aphasia spent more time looking at background areas of interest and less time looking at person areas of interest for camera-engaged scenes than did control participants. Conclusions: Results indicate people with aphasia visually attend to scenes differently than adults without neurological conditions. As a consequence, augmentative and alternative communication (AAC) facilitators may have different visual attention behaviors than the people with aphasia for whom they are constructing or selecting visual scenes. Further examination of the visual attention of people with aphasia may help optimize visual scene selection.

This single case study served to examine text-to-speech (TTS) effects on reading rate and comprehension in an individual with mild aphasia and cognitive impairment. Findings showed faster reading, given TTS presented at a normal speaking rate, but no significant comprehension changes. TTS may support reading in people with aphasia when time limitations exist.

The researchers performed a survey study to determine the effectiveness of collegiate programmes in dispelling common misconceptions about traumatic brain injury (TBI) while preparing undergraduate and graduate students for special education (SpEd) careers. Respondents included 136 undergraduate and 147 graduate SpEd students in their final semesters before obtaining degrees. Each completed an 18-item true/false survey about TBI and the associated recovery process. Results were compared with survey responses from 318 lay public respondents who participated in a previous study. Two major findings emerged: (a) no significant differences existed in misconception endorsement between SpEd students completing Bachelor's versus Master's degrees; and (b) graduating students in SpEd teacher preparation programmes endorsed similar misconceptions as lay public respondents; hence, these programmes do not appear effective in dispelling common TBI misconceptions. Improving academic preparation for special educators regarding TBI is imperative for effectively identifying, assessing and serving student survivors.

Purpose: The purpose of the study was to compare the visual attention patterns of adults with aphasia and adults without neurological conditions when viewing visual scenes with 2 types of engagement. Method: Eye-tracking technology was used to measure the visual attention patterns of 10 adults with aphasia and 10 adults without neurological conditions. Participants viewed camera-engaged (i.e., human figure facing camera) and task-engaged (i.e., human figure looking at and touching an object) visual scenes. Results: Participants with aphasia responded to engagement cues by focusing on objects of interest more for task-engaged scenes than camera-engaged scenes; however, the difference in their responses to these scenes were not as pronounced as those observed in adults without neurological conditions. In addition, people with aphasia spent more time looking at background areas of interest and less time looking at person areas of interest for camera-engaged scenes than did control participants. Conclusions: Results indicate people with aphasia visually attend to scenes differently than adults without neurological conditions. As a consequence, augmentative and alternative communication (AAC) facilitators may have different visual attention behaviors than the people with aphasia for whom they are constructing or selecting visual scenes. Further examination of the visual attention of people with aphasia may help optimize visual scene selection., About one in every 250 people in the United States has aphasia (National Aphasia Association, 2011). Researchers estimate that as many as 25%-60% of these individuals experience chronic language impairment [...]

Purpose: To determine the effect of personal relevance and contextualization of images on the preferences and word-picture matching accuracy of people with severe aphasia. Method: Eight adults with aphasia performed 2 experimental tasks to reveal their preferences and accuracy during word-picture matching. The researchers used 3 types of visual stimuli--personally relevant, contextualized photographs; non-personally relevant, contextualized photographs; and noncontextualized, iconic images--paired with 3 types of target words--labels of people or objects, actions, and socially relevant events--as the stimulus materials. Results: Data analysis showed that participants (a) preferred using personally relevant, contextualized photographs rather than other types of photographs/images to represent target words and (b) performed more accurate word-picture matching when presented with target words associated with personally relevant, contextualized photographs than target words associated with noncontextualized or nonpersonalized photographs/images. Conclusions: Clinically, the findings highlight the importance of using personally relevant, contextualized photographs rather than generic contextualized photographs or noncontextualized, iconic images to support the communication attempts of people with aphasia who cannot communicate effectively using natural speech alone. (Contains 3 tables and 2 figures.)

A study evaluated and compared four methods of assessing reliability on one discourse analysis procedure--a modified version of Damico's Clinical Discourse Analysis. The methods were Pearson product-moment correlations; interobserver agreement; Cohen's kappa; and generalizability coefficients. The strengths and weaknesses of the methods are described. (Author/CR)

A survey of school-based speech-language pathologists (n=485) in 10 states found that training had a positive effect on respondents' knowledge of assessment, treatment, and overall management of students with traumatic brain injuries (TBI). However, many respondents were uncertain about providing services to students with TBI and many had misconceptions about TBI. (DB)

A case study is used to demonstrate the effects of mild traumatic brain injury on educational efforts. Discussion covers factors complicating school reintegration, ways to facilitate school reintegration, identification of cognitive and behavioral consequences, minimization of educators' discomfort, reintegration program design, and family concerns. (DB)

A survey of 239 school-based speech-language pathologists revealed that respondents routinely supplement quantitative assessment procedures with language sample analyses, are sensitive to the effects of some contextual variables on sample representativeness, and use language sampling information to assist in planning intervention services. (Author/JDD)

An adult with language-learning difficulty participated in an instruction program for remediating a morphological impairment. The program focused on metalinguistic information and the contrast of sentence pairs differing in single morphological features. Results confirmed the program's effectiveness in improving the accuracy of suffix usage in written language. (Author/JDD)

People with aphasia often have reading impairments that affect participation in daily activities. Text-to-speech (TTS) devices are technology-based supports that can facilitate processing of written materials. The purpose of this study was to gather information about the reading behaviors and TTS technology perceptions of people with aphasia who had first learned about system features and options. Sixteen people with chronic aphasia participated in single, one-on-one instructional and guided practice sessions using TTS systems. They answered close-ended questions about current reading behaviors and materials and ways they believed these would change given TTS system access. Participants reported reading at home and community locations. Most read calendars, newspapers, magazines, and mail. Participants who did not read lengthy materials – such as newspapers, magazines, and novels – indicated their interest in these materials would likely increase given TTS support. Although participants did not predict substantial comprehension changes given TTS support, most expressed interest in the technology after learning about it. Thus, people with aphasia perceive TTS systems as helpful for comprehending lengthy materials. Given modest predictions about comprehension benefits, presenting TTS as one of several support strategies is an appropriate recommendation. [ABSTRACT FROM AUTHOR]

Cognitive-communication impairments associated with acquired brain injury (ABI) are often identifiable through performance of discourse analyses. Determining appropriate elicitation procedures and having sufficient time to learn procedures, transcribe samples, and [...]

Recent advances using AAC strategies and systems have increased functional communication skills of people with chronic aphasia. This single subject multiple baseline study investigated the use of one such system--a [...]

Written expression challenges following traumatic brain injury (TBI) in adults have received little clinical attention but can substantially affect quality of life and the success of reintegration efforts. Assessment tools and procedures are lacking despite the likelihood of post-TBI problems with microstructure (e.g., productivity, spelling accuracy) and macrostructure (e.g., topic adherence, organization) aspects of written language. The lack of standardized procedures forces reliance on informal methods to determine writing strengths and challenges. Method: A combination of assessment procedures allowed for evaluation of the productivity and efficiency, adherence to writing conventions (e.g., spelling, sentence structure, punctuation), and macrostructure organization (e.g., story grammar, topic adherence) of written narratives collected from five adults with TBI. Results: Use of multiple assessment methods revealed disparate writing challenges across the five case examples. The differing writing profiles underscore the necessity of evaluating multiple aspects of written narratives. Conclusions: The described analysis methods can help clinicians determine areas of strength and challenge in written work generated by adults with TBI. Examination of multiple aspects of writing is key to garnering a comprehensive appraisal of post-TBI writing. [ABSTRACT FROM AUTHOR]

Background: Stroke-like migraine attacks after radiation therapy – also known as SMART syndrome – constitute a rare condition characterised by headache, seizures, vision abnormalities, hemiparesis, and aphasia. The condition usually resolves within a few days or weeks with little to no residual impairment; however, recovery in some cases is protracted and incomplete. Aims: The purpose of this case report was to describe the one-year progression of language in a person, GB, with slow recovery from SMART syndrome. Methods & Procedures: GB was diagnosed with SMART syndrome at 39 years of age. Formal and informal assessments occurred at six, 11, 18, 29, and 52 weeks post-onset of SMART syndrome. Standardised assessment involved administration of portions of the Western Aphasia Battery – Revised, and informal assessment took the form of written and spoken language sample analyses. Outcomes & Results: Initial evaluation at two weeks post-onset revealed global aphasia. This evolved into severe Wernicke's aphasia by six weeks post-onset. Repeated evaluation over subsequent months revealed gradual improvement but continuing and substantial language impairment. At one-year post-onset, GB displayed anomic aphasia and persistent reading and writing deficits. Conclusions: Substantial language recovery from SMART syndrome can occur beyond the initial few months post-onset. Documentation of the nature and extent of language impairment provides a starting point for developing and refining efficacious treatment protocols. [ABSTRACT FROM AUTHOR]