Anomia Treatment With Parallel-Naming Task of Verb/Noun With

Anomia treatment with parallel naming task of verb / noun with same stem in Greek language: A case – study E. Efstratiadou1,4, A. Apalidou2, I. Papathanasiou1,2,4, I. Evdokimidis3, K. Potagas3,4 1Division

of Language and Communication, SHS, City University London, UK 2Department of Speech and Language Therapy, TEI of Western Greece Patras, Greece 3Department of Neurology, Medical School, University of Athens, Greece 4Thalis Aphasia Project, Department of Linguistics, School of Philosophy, University of Athens, Greece

Introduction •Numerous treatment studies have documented that verbs and nouns can be differentially affected in aphasia. • A large number of studies in the literature documented that verb retrieval problems are often associated with agrammatism in Broca’s and non-fluent aphasia. For individuals with fluent anomic aphasia with different underlying forms, three distinct patterns of verb/noun dissociation have been described in the literature: verb superiority1,2,3,4, equal retrieval difficulties for verbs and nouns5 and better noun retrieval with poorer verb retrieval6. •The explanations for dissociation of nouns and verds naming in aphasia, based on the framework of the neuropsychological model, focus on semantic-conceptual, lexicalgrammatical or lexical-morpho/phonological differences between nouns and verbs7,8. • Greek is a highly inflected and stem-based language9. Verbs and nouns have similar morphological , inflectional complexity. Stems in Greek serve as representational units rather than actual words, carrying a small semantic meaning. Word meanings and grammatical category are derived from the inflection suffix. Inflected words considered more difficult to process9.

Aim Current Study The present case – study investigates if using the parallel naming of nouns and verbs with same stem (naming pairs) and different inflection suffix, as a therapy strategy, in a subject with fluent anomic aphasia, can improve noun and verb retrieval. The aim of the present case – study : • if parallel naming task of nouns and verbs with the same steam can increase naming ability, • if noun acts as an aid in verb production or vice –versa • if there is a facilitator effect (improvement in naming words and generalisation)

Method

Results

Participant

Following therapy, KA demonstrated improved in her naming abilities of both treated items and control items indicating generalisation of naming improvement had occurred to untreated items.

KA was a 73-year-old woman, Greek native speaker, two year post onset of left CVA, with a very mild right hemiparesis. KA was a primary school educated and a retired seamstress. KA’s language presentation and results on the Greek version of BDAE9 and the Greek adaptation of Boston Naming Test (BNT) were consistent with a diagnosis of Anomic aphasia. The BNT results showed severe impaired naming skills (8/45), characterized by phonological errors and impairment at the morpho/syntactic level in the neuropsychological model.

Design The study is single-case research design. KA naming skills was assessed pre post therapy.

Noun acts as an booster in verb production, as illustrated in the second stage of therapy. Specifically, when KA was asked to name the verb, first, and then, the noun, she correctly named 33,3% the noun first, and then, the verb although the action picture was in front of her.

Material 1.For assessing verbs and nouns retrieval ability, a picture-naming task with 30 objects (nouns) and 30 actions (verbs) with unequal stem has been designed. 2.For the training material, a 45-picture set of Greek nouns and verbs (e.g. /sidero/ (iron) noun and /siderono/ (ironing) verb) with the same stem pairs has been designed.

Treatment and control items •To determine treatment items, at the baseline, KA was asked to name (in one word) the object or action depicted in the pictures. •From the 45 same stem pairs, 27 pairs were selected as training items and the remaining 18 were selected been as control item.

Treatment sessions Treatment sessions delivered on 2 hourly sessions a week in a period of 12 weeks. Each treatment session was divided into two stages: •First stage: an object / noun picture was presented and KA was asked to name the object, first, and, then, the action/verb. •Second stage: the same paired pictures were presented and KA was asked to name the action/verb first and, then, the object/noun. Phonological cue was provided based on the Phonologic Cueing Treatment (PCT) principle when KA was unable to name the picture.

Discussion • Results supported previous findings, reporting that verbs and nouns are affected differently in aphasia. • Baseline assessment outcomes of same stem noun / verb retrieval ability is contradictory to previous finding, but agreed with Kambanaros(2008)10 findings, since there was a significant noun/verb dichotomy, with verbs in Greek being significantly more difficult to retrieve than nouns. • Findings suggested that the parallel naming task of the same stem pairs of noun / verb improves verb retrieval, showing a facilitation effect of the treatment, with a significant generalization of verbs but not nouns. • Noun acts as an booster in verb production, as illustrated in the second stage of therapy. • Replication of this study is required with a larger number of treatment items, to strengthen findings. References: 1)Goodglass, H., Klein, B., Carey, P., & Jones, K. (1966). SpeciWc semantic categories in aphasia. Cortex, 2, 74–89. 2)Zingeser, L., & Berndt, R. S. (1988). Grammatical class and context eVects in a case of pure anomia: Implications for models of language production. Cognitive Neuropsychology, 5, 473–516. 3)Zingeser, L., & Berndt, R. S. (1990). Retrieval of nouns and verbs in agrammatism and anomia. Brain and Language, 39, 14–32.4) Breedin, S. D., SaVran, E. M., & Schwartz, M. F. (1998). Semantic factors in verb retrieval: An eVect of complexity. Brain and Language, 63, 1–31. 5)Luzzatti, C., Raggi, R., Zonca, G., Pistarini, C., Contardi, A., & Pinna, G. D. (2002). Verb–noun double dissociation in aphasic lexical impairments: The role of word frequency and image ability. Brain and Language, 81, 432–444. 6)Jonkers, R., & Bastiaanse, R. (1998). How selective are selective word class deWcits. Two case studies of action and object naming. Aphasiology, 12, 245–256. 7) Bates, E., Chen, S., Tzeng, O., Li, P., & Opie, M. (1991). The noun–verb problem in Chinese. Brain and Language, 41, 203–233. 8) Druks, J. (2002). Verbs and nouns—A review of the literature. Journal of Neurolinguistics, 15, 289–315.9)Kehayia,E.,& Jarema, G. (1991). On agrammatism in Greek. Grazer Linguistische Studien, 35, 47-63. 10) Kambanaros, M. (2008). The trouble with nouns and verbs in Greek fluent aphasia. Journal of Communication Disorders, 41, 1-19. 9) Papathanasiou et. al., (2008). Boston Diagnostic Aphasia Examination, Greek version .

This research has been co-financed by the European Union (European Social Fund – ESF) and Greek national funds through the Operational Program "Education and Lifelong Learning" of the National Strategic Reference Framework (NSRF) - Research Funding Program: THALIS – UOA - "Levels of impairment in Greek aphasia: Relationship with processing deficits, brain region, and therapeutic implications", Principal Investigator: Spyridoula Varlokosta.