Sentence level processing therapies

Question 1

Functional Level: Argument Structure Therapy Example

Answer 1

Verb Network Strengthening Treatment (VNeST)- Edmonds et al., 2009

Question 2

Explain VNeST

Answer 2

Systematic retrieval of target verbs and related nouns to generate agent and patients, strengthening complete argument structure production around the verb and potentially thematic role mapping.

It activates a large network of autobiographical and semantic knowledge around a central concept that maximises potential for generalisation to untrained words.

1. For each verb, client generates 3 pairs of agents (who) and patients (what) related to the verb.
2. Client reads each word triad aloud

The client selects one triad, is assed where why and when to create a long detailed sentences,

Client reads aloud 12 prepared sentences using the same verb (some correct, some wrong agent, themes reversed etc.) and must say whether sentences are correct or not.

Asked again to retrieve the verb.

Question 3

Is VNeST successful at different levels?

Answer 3

Word- Significant improvement in verb and noun retrieval

Sentence- significant improvement in sentence production around treated AND untreated verbs (Ag + V + Pt)

Increase in number of complete sentences.

Question 4

Does VNeST generalise? Provide references.

Answer 4

Edmonds et al., 2009
Yes! Generalisation to untreated words.

VNeST has showed generalised verb retrieval and improved thematically complete sentence production for untreated verbs as well as treated verbs.

Structural gains in spontaneous speech, including increased number of complete sentences, increased complexity and sentneces and MLU.

Question 5

How to make VNeST more functional

Answer 5

Since Edmonds et al., 2009 had same sample size so generalisation cannot be assumed, selecting functional relevant verbs to patient’s daily life and generate personally relevant agents like family member’s names to support personal goals.

Question 6

Example of goal for VNeST

Answer 6

To retrieve relevant nouns and verbs to produce complete 2-argument spoken sentences with 80% accuracy following the 11-week therapy block.

Question 7

Reference supporting telerehabilitation use for VNeST

Answer 7

Torinsson et al., 2024

Question 8

Multilevel therapy for sentence processing/production

Answer 8

NARNIA- Whitworth et al., 2015.

A Novel Approach to Real-life communication: Narrative Intervention in Aphasia.

Combines word and sentence level in context of a narrative.
1) Client identifies main event in each picture and then the verb and nouns. They then create a complete sentence around structure.

2) Using the framework for Narrative Discourse (mind map) sentences are organised around setting the scene, the events taking place and concluding the story. Addition of connectives.

3) When demonstrated narrative ability, the frameworks for recount, procedure and exposition are introduced.

Can use rea-life incidents e.g. planning a holiday, shaving.

Client rates their performance on various scales to monitor performance.

Question 9

Outcomes and generalisation of NARNIA

Answer 9

Whitworth et al., 2015
Potential generalisation of single word retrieval to untreated words.

Generalisation seen on topics not discussed in NARNIA.

Lexical Change- Improved retrieval of nouns and verbs. Increase in the number of verbs in connected speech!

NO SIGNIFICANT CHANGE on tests of sentence production but increase in number of 2 and 3 argument structures and complex sentences in spontaneous speech and improved production of discourse structure in spontaneous speech.

Question 10

Example of target/aim for NARNIA

Answer 10

To create complete sentences, with accurate argument structure using the NARNIA structure for support, with 80% accuracy.

Question 11

How to maximise linguistic generalisation for sentence processing.

Answer 11

Combine work on Verb and Sentence production.

Therapies which work on ‘process’- argument structure, thematic role assignment.

Use multi-level therapies! Milman et al. (2014) suggest three key reasons for using multi level intervention:
- Interconnected nature of ‘linguistic networks’.
- Reality of clients having multiple difficulties
- Potential facilitation of generalisation to everyday communication.

Transfer skill to another setting e.g. clinic, home, pubs, shopping trips. To different communication partner, e.g. therapist, partner, family member.