What's new for semantic feature analysis? Revisiting a classic therapy technique Linda Jones, Julia Murphy and Claire Layfield (Group Co-Leaders) Lyndsey Nickels - Academic Member Presented by Claire Layfield 2012 Adult Language Group NSW Speech Pathology Evidence Based Practice Network
Semantic Feature Analysis • Aphasia is frequently associated with semantic breakdown • Semantic feature analysis is a technique that underpins the general philosophy behind many treatments for semantic impairments
Semantic word retrieval impairment Object, picture or idea Semantics purrs 4-legs pet fur barks scales Phonological Lexicon dog rabbit fish house robin cat Phonological Buffer/ Phonemes k d æ o g t Slide modified with thanks to Lyndsey Nickels
Semantic Feature Analysis GROUP ACTION PROPERTIES ASSOCIATION (Boyle, 2001; Boyle, 2004; Coelho, McHugh, & Boyle, 2004; Kiran, & Johnson,2008; Kiran, 2008; Rider, Wright, Marshall & Page, 2008)
Semantic Feature Analysis • Semantic feature analysis therapy is provided at word level BUT our treatment goals are discourse based • Clinical Question: For people with aphasia, in what circumstances does SFA improve • Naming of treated items • Naming of untreated items • Generalisation to spontaneous speech
Semantic Feature Analysis: CAPS • Initial searching by the group found 23 articles • From these 16 were CAPPED • The others were excluded because • Treatment data was not available (e.g. expert commentary) • Treatment was not applicable (e.g. neuroimaging) • The participants had speech and language impairments in addition to aphasia
The Evidence: Research Design • Research design • Single case experimental design • Case series • Low level of evidence on NHMRC evidence hierarchy. • BUT well designed single case and case series, can be more powerful in terms of clinical applicability.
The Evidence: Participants • No correlation between treatment efficacy and • Type of aphasia • Severity of aphasia • Time post onset • Aetiology • Representative of the group caseload
The Evidence : Intervention • Variability noted in • Treatment schedules • Therapy duration • Individual vs group based • Variability noted in therapy administration • Cueing hierarchies, prompts, responses to errors • Added components of discourse (put word into phrase)
The Evidence: Measurement • Measures included • confrontational naming (typically treated and untreated items) • Standardised measures • Generalisation measures typically discourse based (CIU, words and error production rates) • Participation measures: Social validity questionnaire
The Evidence: Outcomes • Treated items • increased and maintained • Untreated items • Similar trends but reduced in magnitude • Standardised assessments • Small improvements to overall scores • Generalisation • At best “modest” improvements in discourse based measurements maintained over time
Applying these results to clinical practice • Semantic feature analysis • Appears to be clinically feasible • Increases naming, reduces perseveration, and this transfers to conversation in the short term • What remains in question is • Is this technique more beneficial than other therapy techniques and • Is there a way of combining this technique with a second level of phrase/sentence level therapy which may generate and maintain functional communication improvements
Future Research • Research investigating • Semantic feature analysis vs other techniques which is controlled for therapy dosage • Semantic feature analysis in group vs individual settings • Systematic investigation of enhancing maintenance and generalisation • Outcomes from acute and chronic phases of therapy • would all be helpful to determine the extent and nature of the therapy benefits reported in the literature to date
Questions??? Target = Ruby Digs holes in new lawn Barks in the middle of the night Best Friend Jumps to get clean clothes off the line Steals shoes and chews them
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