Effects on communication from intensive treatment with semantic feature analysis in aphasia

Background: Anomia, a persistent and frequent symptom of aphasia after stroke, obstructs the transfer of information in conversation, which can have serious consequences for participation in everyday social interaction with significant others and in society. Aims: This study aimed to replicate the findings of Coelho and his colleagues, as well as Boyle, and Wambaugh and Ferguson regarding the use of semantic feature analysis (SFA) for individuals with aphasia after stroke. Its main purpose was to explore whether intervention could (1) increase the ability to participate in conversation and (2) lead to positive changes in functional communication as perceived by the participants themselves and their significant others. Methods & Procedures: In this multiple-baseline across-subjects-design study, three participants with chronic aphasia were treated with intensive training using SFA. Treatment outcome was assessed with repeated measures of confrontation naming of actions and objects and with quantitative ratings of the quality of speech as well as communicative participation in conversation. The ratings were made by independent assessors blinded as to what phase of the study the data were obtained from. In addition, a questionnaire measuring perceived functional communication as reported by the participants and their significant others was administered before and after the training as well as at a follow-up session 10-12 weeks after the training was completed. Outcome & Results: Only minor treatment outcomes were apparent in this study. Visual inspection of the results showed a slight increase in the ability to participate in conversation for two of the three participants as well as a fall in the number of complex paraphasias for one of them and an increase in self-corrections for two. There was no improvement in the participants' confrontation-naming ability. Two of the three participants rated their own functional communication skills higher at follow-up than before training while the third participant reported no change. As regards the ratings by significant others at follow-up versus before training, there was one slight decrease, one slight increase, and one considerable increase. Conclusions: Treatment with SFA might improve communicative skills and increase participation in everyday conversation despite not having a measurable effect on confrontation-naming ability in a formal assessment situation. Further research is needed to identify the individuals with aphasia who can benefit from treatment with SFA and to determine the nature of its impact on communicative participation.