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Use of Autobiographical Sentence Generation to Treat Anomia: Case Studies of Two Mandarin-Speaking Bilinguals with Primary Progressive Aphasia (PPA)

Li-Wun Kathleen Tan1, 2*, Sajlia Jalil3 and Susan J. Rickard Liow2
  • 1 Ng Teng Fong General Hospital, Singapore
  • 2 National University of Singapore, Singapore
  • 3 Changi General Hospital, Singapore

Background. It has been shown that naming treatments can improve confrontational naming in patients with Primary Progressive Aphasia (PPA) (Jokel, Graham, Rochon, & Leonard, 2014). However, generalisation to functional communication remains a challenge (Cadório, Lousada, Martins, & Figueiredo, 2017). Evidence for transfer of gains to an untreated language for bilinguals with PPA is also limited (Meyer, Snider, Eckmann, & Friedman, 2015). Sohn Chaird, Rickard Liow and Jalil (2016) reported promising results for generalisation to conversation in two English-speaking patients with mild PPA, following treatment involving autobiographical sentence generation (i.e., production of sentences related to one’s personal life). Aims. The aim of this study is to evaluate if autobiographical sentence generation can facilitate improvements in functional communication for bilinguals with moderate to severe PPA. Also examined was whether this treatment method can facilitate cross-language transfer of treatment gains to an untreated language. Method. Two English (L1)-Mandarin (L2) bilingual PPA patients who had moderate to severe language impairments were recruited: AB, a 51-year-old female and DC, a 54-year-old male. Both underwent 12 treatment sessions in Mandarin over six weeks, with homework provided after each session. Each session lasted about two hours for AB and 45 to 60 minutes for DC. Treatment involved picture-naming with a cueing hierarchy, followed by autobiographical sentence generation with the target word. Participants were assessed in English and Mandarin across three baselines, immediately post-treatment and three weeks post-treatment. Outcome measures included picture-naming scores as well as performance on picture description and conversation tasks. For the picture description task, Nicholas and Brookshire’s (1992) Correct Information Units (CIUs) analysis method was used to quantify participants’ performance. Performance in conversation was operationalised in terms of quantitative measures of word finding in conversation proposed by Herbert, Hickin, Howard, Osborne and Best (2008). Results. AB and DC both showed post-treatment improvements for picture-naming of Mandarin treated words and these gains were maintained three weeks post-treatment. Unexpectedly, however, generalisation to conversation was limited for both participants, although AB showed improved speaking informativeness and efficiency during picture description. Neither participant showed cross-language transfer of treatment effects. Implications. Results suggest that for participants with PPA with moderate to severe impairments, autobiographical sentence generation may have limited potential to bring about improvements in functional communication. It is proposed that various factors may mediate the extent to which treatment gains can be generalised in PPA, including disease severity, general cognitive abilities and affective factors. The study also sheds light on cross-language transfer of treatment gains in PPA. It is suggested that the degree to which treatment gains can transfer to an untreated language may be constrained by the severity of patients’ language deficits and also the degree of linguistic similarity between the treated and untreated languages.

References

Cadório, I., Lousada, M., Martins, P., & Figueiredo, D. (2017). Generalization and maintenance of treatment gains in primary progressive aphasia (PPA): a systematic review. International Journal of Language and Communication Disorders, 52(5), pp.543–560. https://doi.org/10.1111/1460-6984.12310 Herbert, R., Hickin, J., Howard, D., Osborne, F., & Best, W. (2008). Do picture-naming tests provide a valid assessment of lexical retrieval in conversation in aphasia? Aphasiology, 22(2), pp.184–203. https://doi.org/10.1080/02687030701262613 Jokel, R., Graham, N. L., Rochon, E., & Leonard, C. (2014). Word retrieval therapies in primary progressive aphasia. Aphasiology, 28(8-9), pp.1038-1068. https://doi.org/10.1080/02687038.2014.899306 Meyer, A. M., Snider, S. F., Eckmann, C. B., & Friedman, R. B. (2015). Prophylactic treatments for anomia in the logopenic variant of primary progressive aphasia: cross-language transfer. Aphasiology, 29(9), pp.1062–1081. https://doi.org/10.1080/02687038.2015.1028327 Nicholas, L. E., & Brookshire, R. H. (1992). A system for scoring main concepts in the discourse of non-brain-damaged and aphasic speakers. Clinical Aphasiology, 21, pp.87-99. Sohn Chaird, C., Rickard Liow, S. J., & Jalil, S. B. (2016). Positive Effects of using Autobiographical Discourse in Language Treatment for Primary Progressive Aphasia. (Unpublished master's thesis). National University of Singapore, Singapore.

Keywords: Primary progressive aphasia (ppa), Anomia, bilingualism, language rehabilitation, generalisation

Conference: Academy of Aphasia 57th Annual Meeting, Macau, Macao, SAR China, 27 Oct - 29 Oct, 2019.

Presentation Type: Poster presentation

Topic: Not eligible for student award

Citation: Tan L, Jalil S and Rickard Liow SJ (2019). Use of Autobiographical Sentence Generation to Treat Anomia: Case Studies of Two Mandarin-Speaking Bilinguals with Primary Progressive Aphasia (PPA). Front. Hum. Neurosci. Conference Abstract: Academy of Aphasia 57th Annual Meeting. doi: 10.3389/conf.fnhum.2019.01.00086

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Received: 01 May 2019; Published Online: 09 Oct 2019.

* Correspondence: Ms. Li-Wun Kathleen Tan, Ng Teng Fong General Hospital, Singapore, Singapore, e0145775@u.nus.edu