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Repetition Priming and Anomia: an Investigation of Stimulus Dosage University of Montana ScholarWorks at University of Montana Speech, Language, Hearing, and Occupational Speech, Language, Hearing, and Occupational Sciences Faculty Publications Sciences 2008 Repetition Priming and Anomia: An Investigation of Stimulus Dosage Catherine A. Off University of Montana - Missoula, [email protected] Follow this and additional works at: https://scholarworks.umt.edu/commsci_disorders_pubs Part of the Speech and Hearing Science Commons, and the Speech Pathology and Audiology Commons Let us know how access to this document benefits ou.y Recommended Citation Off, Catherine A., "Repetition Priming and Anomia: An Investigation of Stimulus Dosage" (2008). Speech, Language, Hearing, and Occupational Sciences Faculty Publications. 2. https://scholarworks.umt.edu/commsci_disorders_pubs/2 This Dissertation is brought to you for free and open access by the Speech, Language, Hearing, and Occupational Sciences at ScholarWorks at University of Montana. It has been accepted for inclusion in Speech, Language, Hearing, and Occupational Sciences Faculty Publications by an authorized administrator of ScholarWorks at University of Montana. For more information, please contact [email protected]. ©Copyright 2008 Catherine A. Off Repetition Priming and Anomia: An Investigation of Stimulus Dosage Catherine A. Off A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy University of Washington 2008 Program Authorized to Offer Degree: Department of Speech and Hearing Sciences UMI Number: 3328511 Copyright 2008 by Off, Catherine A. All rights reserved. INFORMATION TO USERS The quality of this reproduction is dependent upon the quality of the copy submitted. Broken or indistinct print, colored or poor quality illustrations and photographs, print bleed-through, substandard margins, and improper alignment can adversely affect reproduction. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if unauthorized copyright material had to be removed, a note will indicate the deletion. ® UMI UMI Microform 3328511 Copyright 2008 by ProQuest LLC. All rights reserved. This microform edition is protected against unauthorized copying under Title 17, United States Code. ProQuest LLC 789 E. Eisenhower Parkway PO Box 1346 Ann Arbor, Ml 48106-1346 University of Washington Graduate School This is to certify that I have examined this copy of a doctoral dissertation by Catherine A. Off and have found that it is complete and satisfactory in all respects, and that any and all revisions required by the final examining committee have been made. Chair of the Supervisory Committee: Reading Committee: Kristie A< Spencer f ] Margaret A. Rogers^ ) x Sheri JfMizumori Date: 7-/0- #f In presenting this dissertation in partial fulfillment of the requirements for the doctoral degree at the University of Washington, I agree that the Library shall make its copies freely available for inspection. I further agree that extensive copying of the dissertation is allowable only for scholarly purposes, consistent "fair use" as prescribed in the U.S. Copyright Law. Requests for copying or reproduction of this dissertation may be referred to ProQuest Information and Learning, 300 North Zeeb Road, Ann Arbor, Ml 48106-1346,1-800-521-0600, to whom the author has granted "the right to reproduce and sell (a) copies of the manuscript in microform and/or (b) printed copies of the manuscript made from microform." Signature^ Date 7-/0-00 University of Washington Abstract Repetition Priming and Anomia; An Investigation of Stimulus Dosage Catherine A. Off Chair of the Supervisory Committee: Assistant Professor Kristie A. Spencer Department of Speech & Hearing Sciences In a recent review of anomia management, Maher & Raymer reported that 30% of aphasia intervention research from 1946 to 2001 focused on naming; however, "despite this proliferation of case reports and small group studies, there is still no clear agreement on how best to manage these deficits" (Maher & Raymer, 2004, p. 13). The inconsistency of acquisition, maintenance, and generalization effects observed across participants and types of treatment protocols is likely to stem from an inadequate knowledge base about how subject and treatment variables influence learning. One treatment variable that has received increasing attention over the past two or three years is treatment intensity. Principles of neurobiological learning across both animal and human research suggest that the intensity of treatment is a significant factor for learning. Additional research exploring experience-dependent neural plasticity involved in memory and learning indicates that a large number of trials per session are required to elicit behavioral and/or neural change. Despite a considerable amount of literature examining overall treatment intensity, data are not available regarding the frequency (i.e., stimulus dosage) of treatment at which individuals with aphasia will maximally benefit. A single-subject A-B design with replication across four individuals with aphasia and one healthy non-brain injured gender-matched control participant was used to assess the influence of repeated attempts at picture-naming, coupled with repeated exposure to hearing and reading target words, on the acquisition and maintenance of trained stimuli, and generalization to untrained stimuli. Individuals with chronic aphasia participated in a multi-week repetition priming protocol designed to investigate the influence of stimulus dosage on naming accuracy and latency. Results revealed positive repetition priming effects for trained items across both acquisition and maintenance phases; such positive effects were not observed for untrained stimuli or alternate exemplars. Stimulus dosage manipulations did not consistently influence naming performance for individuals with aphasia. TABLE OF CONTENTS Page List of Figures iv List Tables v Chapter I: Literature Review 1 Neuroplasticity during Recovery from Aphasia 4 Mechanisms of Learning 9 Neurobiological Principles of Rehabilitation 10 Principles of Learning to Consider for Rehabilitation 13 Repetition Priming: An Implicit Learning Paradigm 15 An Information-Processing Model of Repetition Priming 16 Behavioral Characteristics of Repetition Priming 17 Neural Substrates of Repetition Priming 22 Lexical Retrieval Deficits Following Stroke 25 Methods of Investigating Lexical Retrieval 27 Off-Line Methods 27 On-Line Methods 28 Anomia: Lexical Retrieval in Impaired Linguistic Systems 29 Behavioral Characteristics of Anomia 30 Neural Substrates of Lexical Access 34 Variables to Consider: Investigating Individuals with Aphasia 36 Subject Variables 36 Lexical Variables 38 Anomia Treatment Research 41 Anomia Treatment Dosage and Intensity 50 Treatment Intensity 50 Stimulus Dosage 52 Chapter II: Goals and Research Questions 56 Chapter III: Pilot Study 60 Research Design and Methods 60 Participants 60 Procedures 63 Stimuli 63 Protocol - Individual with Aphasia 63 Protocol - Healthy Control Participants 64 Summary of Results 64 Modifications Stemming from Pilot Data 66 Chapter IV: Methodology 68 Research Design 68 Participants 68 Recruitment 68 Demographics 69 Consent 69 Recordings 70 Individuals with Aphasia 70 Subject Selection/Enrollment 70 Exclusionary Criteria 73 i Case#1:A102 73 Case#2:A103 73 Case#3:A104 74 Case#4:A106 74 Non-Brain Injured, Healthy Control Participant 76 Subject Selection/Enrollment 76 Procedures 78 Stimuli and Instrumentation 78 Stimuli 78 Instrumentation 79 Delivery Schedule and Details 80 Baseline Probe Sessions 80 Training Sessions 81 Training Probe Sessions 82 Generalization Probe Sessions 82 Maintenance Probe Sessions 83 Data Collection and Analysis 84 Response Accuracy Data 84 Response/Reaction Time Data 85 Reliability Procedures 85 Chapter IV: Results 87 Participant Delivery Schedules and Stimulus Dosage 87 Accuracy Data 88 Trained vs. Untrained Items 88 Descriptive Statistics 88 Visual Analysis 89 1 -Trial vs. 4-Trials/Session 94 Descriptive Statistics 94 Visual Analysis 94 Effect Size for Response Accuracy 98 Stimulus Generalization 99 Descriptive Statistics 99 Visual Analysis 100 Response Time/Reaction Time Data 102 Trained vs. Untrained Items 102 Descriptive Statistics 102 Visual Analysis 103 1 -Trial vs. 4-Trials/Session 108 Descriptive Statistics 108 Visual Analysis 108 Effect Sizes for Response/Reaction Time 114 Stimulus Generalization 115 Descriptive Statistics 115 Visual Analysis 115 Lexical Variables 118 Chapter VI: Discussion and Future Studies 119 Summary of Results - Response Accuracy 119 Training Phase Relative to Baseline Phase 119 II Training Phase - Acquisition 120 Summary of Results - Response Time/Reaction Time 121 Training Phase Relative to Baseline Phase 122 Training Phase - Acquisition 122 Persistence of Repetition Priming 123 Sensitivity to the Number of Trials per Session 125 Generalization of Repetition Priming 126 Summary and Conclusions 127 Future Directions 129 Bibliography 131 Appendix A: Consent Form - Control Participants 150 Appendix B: Consent Form - Individuals with Aphasia 154 Appendix C: Audio Recording Publication Consent Form 159 Appendix D: Medical Release of Information Form 160 Appendix E: HIPPA Privacy Form 162 Appendix F: Telephone Screening Form - Individuals with Aphasia 165 Appendix G: Preliminary Screening Questionnaire 168 Appendix H: Medical Records Data Collection Form 170 Appendix I: Telephone Screening Protocol
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